Specialty Mental Health Services (SMHS) Outcomes for Children and Youth

In 2017, the California Department of Health Care Services (DHCS) selected two statewide outcome tools: the Child and Adolescent Needs and Strengths (CANS) tool and the Pediatric Symptom Checklist (PSC-35), to be utilized by mental health providers under the Mental Health Plan (MHP) outlined in Information Notice 17-52

Child and Adolescent Needs and Strengths (CANS)

CYF Memo # 01- 17/18 and CYF Memo # 05-17/18 outline the County of San Diego (County) Behavioral Health Services (BHS) Children, Youth and Families’ implementation plan for the CANS roll out and trainings offered for certification.

Subsequently in January 2018, the California Department of Social Services (CDSS) disseminated ACL 18-09 announcing its selection of the CANS assessment tool as the functional assessment tool to be used with the Child and Family Team (CFT) process. The selection of the CANS tool by both DHCS and CDSS exemplifies the importance of ongoing collaboration/integration between BHS and Child Welfare Services when children and youth are engaged in both systems.

The County recognizes that in utilizing CANS as a standardized assessment tool our system of care providers can effectively identify and work towards meeting the needs of children, youth and families through a strength-based, needs-driven approach.

  • CANS is a document that organizes clinical information collected during the behavioral health assessment in a consistent manner to improve communication among those providing services to the child/youth.
  • CANS is used as a decision-support tool to guide client planning and to track changing strengths and needs over time.
  • As an assessment tool, CANS is used by clinicians and CFTs to develop a client/action plan.
  • As an outcome monitoring tool, CANS may be used by the larger systems of care to track aggregate improvement by children and families on the entire tool or on a specific domain of the tool.

Pediatric Symptom Checklist (PSC-35)

PSC-35 is a psychosocial screening tool designed to facilitate the recognition of cognitive, emotional and behavioral issues so appropriate interventions can be initiated as early as possible. The PSC-35 parent/caregiver version is completed by the parents/caregivers for children and youth ages 3 to 18 and the PSC-Y (youth version) is completed by youth ages 11 to 18.

Local Implementation

  • CANS and PSC-35 utilization by Organizational Providers was initiated at the start of fiscal year (FY) 18/19 (Year 1).
  • CANS and PSC-35 utilization was expanded to the Fee-For-Services network in FY 19/20 (Year 2).
  • CANS 0 to 5 version - required by CDSS - was also locally adopted by the MHP at the start of FY19/20 (Year 2).
  • CANS clinical outcome objectives were informed by Year 1 data and implemented for Year 2.
  • PSC Youth version initiated in Year 1, but not mandated through DHCS.
  • Four additional CANS modules were selected locally effective Year 1 – Trauma Module (In sync with CDSS CANS), Juvenile Justice Module, Sexuality Module and Substance Use Module.
  • The Utilization Management (UM) session-based cycle increased from 13 to 14 sessions to allow for an additional CANS assessment session.
  • CANS and PSC data is embedded in UM requests to provide further justification for additional sessions.

Social Determinates of Health

The Child and Adolescent Needs and Strengths (CANS) assessment is leveraged to evaluated youth’s progress on the Live Well San Diego (LWSD) Areas of Influence.  See the CASRC Website - Other Reports section for the annual data.

For additional information about social determinates of health as it relates to children and youth, please see the Children, Youth and Families Framework.

Outcomes Resources

CASRC Website (outcome tools and data entry)

Training and user guides:

RIHS Website



CDSS CFT Brochures: