An optional but recommended staff response is to employ MAYSI-2 Second Screening for critical cases. Second Screening involves the staff member asking the youth three or four questions for each scale that has contributed to the youth being identified as a critical case. The MAYSI-2 Manual (or Web MAYSI-2) provides these Second Screening questions for each of the clinical scales. This allows staff to determine whether the youth’s high score is truly urgent or may be less urgent than the youth’s answers to the MAYSI-2 items suggested. 

When Second Screening is used by an agency, a critical case usually is defined according to Definition B as described above in [add anchor link]“Critical Case Decision Rules.”

The MAYSI-2 Manual and the MAYSI-2 Helpdesk provide further guidance for agencies to develop decision rules that meet their agency’s own objectives and resources for responding to youths’ behavioral health needs.