2013-10-23T14:15:54-05:00 2012-12-31 042894325 BRAVER PC 117 KENDRICK STREET SUITE 800 NEEDHAM MA 02494 990 2012-01-01 043221069 SCREENING FOR MENTAL HEALTH INC SCRE 7812390071 ONE WASHINGTON ST NO 304 WELLESLEY HILLS MA 02481 DOUGLAS JACOBS MD 7812390071 2013-10-15 1 ERIC SAUNDERS P00039212 6179693300 2012 2016-02-24 21:20:13Z DOUGLAS JACOBS MD ONE WASHINGTON ST NO 304 WELLESLEY HILLS MA 02481 3544855 0 X WWW.MENTALHEALTHSCREENING.ORG X 1994 MA SCREENING FOR MENTAL HEALTH, INC. ("THE ORGANIZATION") IS A UNIQUE NON-PROFIT ORGANIZATION WHOSE MISSION IS TO PROMOTE THE IMPROVEMENT OF MENTAL HEALTH BY PROVIDING THE PUBLIC WITH EDUCATION, SCREENING, AND TREATMENT RESOURCES. THE ORGANIZATION PROVIDES THESE SERVICES TO MORE THAN A HALF A MILLION PEOPLE EACH YEAR. TO DO THIS, THE ORGANIZATION COORDINATES ACTIVITIES OF THOUSANDS OF UNIQUE SCREENING SITES LOCATED IN EVERY STATE ACROSS THE COUNTRY AND APPROXIMATELY 30 LARGE EMPLOYERS AND HEALTH CARE COMPANIES. THE ORGANIZATION RECRUITS EACH OF THE SCREENING SITES, PROVIDES THE MODEL FOR THE EVENT AND MAKES MATERIALS AVAILABLE FOR SITES IMPLEMENTING THE PROGRAM. ADDITIONALLY, ONLINE SCREENINGS ARE AVAILABLE TO COMMUNITY-BASED ORGANIZATIONS, HOSPITALS, COLLEGES AND UNIVERSITIES, WORKPLACES, AND MILITARY INSTALLATIONS WORLDWIDE, THUS BRINGING THE PROGRAM AND SERVICES TO AN EVEN LARGER AUDIENCE. 6 5 27 0 0 0 60134 37000 3736777 3105550 18391 40094 20739 0 3836041 3182644 0 0 0 0 1509882 1388764 0 0 0 1956812 1567992 3466694 2956756 369347 225888 5627947 5828792 130173 105130 5497774 5723662 X THE MISSION OF SCREENING FOR MENTAL HEALTH IS TO PROMOTE THE IMPROVEMENT OF MENTAL HEALTH BY PROVIDING THE PUBLIC WITH EDUCATION, SCREENING, AND TREATMENT RESOURCES. 0 0 1312848 2191761 THE MILITARY PATHWAYS PROGRAM PROVIDES ANONYMOUS MENTAL HEALTH AND ALCOHOL SELF-ASSESSMENTS AND RELATED EDUCATIONAL MATERIALS FOR FAMILY MEMBERS AND SERVICE PERSONNEL IN ALL BRANCHES INCLUDING THE NATIONAL GUARD AND RESERVE. THE SELF-ASSESSMENTS ARE AVAILABLE ONLINE,24/7 AND AT FAMILY EVENTS HELD WORLDWIDE. THE PRIMARY GOALS OF THE PROGRAM ARE TO REDUCE STIGMA, RAISE AWARENESS ABOUT MENTAL HEALTH, AND CONNECT THOSE IN NEED TO AVAILABLE RESOURCES. THE SELF-ASSESSMENTS ADDRESS DEPRESSION, POSTTRAUMATIC STRESS DISORDER (PTSD), GENERALIZED ANXIETY DISORDER, ALCOHOL USE AND BIPOLAR DISORDER. THE SOS SIGNS OF SUICIDE PREVENTION PROGRAM IS ALSO OFFERED THROUGH MILITARY PATHWAYS FOR MILITARY CHILDREN IN THE U.S. AND OVERSEAS THROUGH DEPARTMENT OF DEFENSE AND MILITARY IMPACTED SCHOOLS. 115284 131884 NATIONAL DEPRESSION SCREENING DAY IS AN ANNUAL MENTAL HEALTH EDUCATION AND SCREENING EVENT CONDUCTED BY HOSPITALS, MENTAL HEALTH CENTERS, SOCIAL SERVICE AGENCIES, AND OLDER ADULT FACILITIES. EVENT KITS PROVIDE READY-TO-USE MATERIALS FOR CONDUCTING A PUBLIC, EDUCATIONAL SCREENING EVENT FOR DEPRESSION, BIPOLAR DISORDER, GENERALIZED ANXIETY DISORDER, AND POSTTRAUMATIC STRESS DISORDER. ADDITIONALLY, THE EVENT IS COMPLEMENTED BY A YEAR-ROUND ONLINE SCREENING PROGRAM, THROUGH WHICH ORGANIZATIONS CAN OFFER MEMBERS OF THEIR COMMUNITY 24/7 ACCESS TO SCREENING TOOLS, AS WELL AS CUSTOMIZED REFERRAL INFORMATION, ON THEIR WEBSITE 268876 305240 YOUTH PROGRAMS-THE PROGRAM'S PRIMARY OBJECTIVES ARE TO EDUCATE YOUTH THAT DEPRESSION IS A TREATABLE ILLNESS AND TO EQUIP THEM TO RESPOND TO A POTENTIAL SUICIDE IN A FRIEND OR FAMILY MEMBER USING THE SOS TECHNIQUE. SOS IS AN ACTION-ORIENTED APPROACH INSTRUCTING STUDENTS HOW TO ACT (ACKNOWLEDGE, CARE AND TELL) IN THE FACE OF A MENTAL HEALTH EMERGENCY. THE SOS PROGRAMS ALSO PROVIDE EDUCATION MATERIALS FOR YOUTH, PARENTS, AND SCHOOL STAFF. 279212 331765 COLLEGE PROGRAMS- OFFERS PROGRAMS TO PROMOTE PREVENTION, EARLY DETECTION AND TREATMENT OF PREVALENT, UNDER-DIAGNOSED AND TREATABLE MENTAL HEALTH DISORDERS AND ALCOHOL PROBLEMS AFFECTING COLLEGE STUDENTS. THROUGH ONLINE AND IN-PERSON SCREENING TOOLS, COLLEGERESPONSE PROVIDES CONFIDENTIAL AND EFFECTIVE PROGRAMS FOR: DEPRESSION, BIPOLAR DISORDER, ANXIETY, POST-TRAUMATIC STRESS DISORDER, EATING DISORDERS, AND ALCOHOL PROBLEMS. THIS PROGRAM SERVICES APPROXIMATELY 650 COLLEGES. 72829 SUICIDE RESEARCH PROGRAM-SCREENING FOR MENTAL HEALTH PROVIDES SUICIDE PREVENTION PROGRAMS ACROSS THE LIFECYCLE. PREVENTION PROGRAMS CAN BE IMPLEMENTED ON A STATE-WIDE, COMMUNITY-WIDE, OR INDIVIDUAL FACILITY BASIS. 153039 144900 WORKPLACE RESPONSE PROGRAM-SCREENING FOR MENTAL HEALTH OFFERS EMPLOYERS A NATIONALLY UTILIZED PROGRAM OF MENTAL HEALTH EDUCATION AND ANONYMOUS SCREENING FOR COMMON MENTAL HEALTH CONCERNS INCLUDING DEPRESSION. 505080 476665 2202088 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 27 1 0 0 0 0 0 0 0 0 0 0 X 6 5 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 MA X X THE ORGANIZATION 7812390071 ONE WASHINGTON ST NO 304 WELLESLEY HILLS MA 02481 DOUGLAS JACOBS MD 20.00 X X 0 90000 10000 JERROLD ROSENBAUM MD 1.00 X 0 0 0 JAMES HENRY SCULLY JR MD 1.00 X 0 0 0 JEFFERSON BRUCE PRINCE MD 1.00 X 0 0 0 LEONARD FREEDBERG MD 1.00 X 0 0 0 MATTHEW NOCK PHD 1.00 X 0 0 0 JOSEPH MATZKIN 1.00 X 0 0 0 CONNIE DICOCCO 40.00 X 101163 0 15480 KATHERINE CRUISE 32.00 X 109070 0 20416 210233 90000 45896 2 0 0 0 BOSTON DIGITAL PRODUCTIONS 316 STUART STREET BOSTON MA 02116 PSA, VIDEO AND DVD PRODUCTION 103333 1 37000 37000 MILITARY PROGRAM 900099 2191761 2191761 COLLEGE PROGRAMS 900099 331765 331765 YOUTH PROGRAMS 900099 305240 305240 WORKPLACE RESPONSE 900099 144900 144900 NATIONAL DEPRESSION SC 900099 131884 131884 3105550 90246 90246 312059 362211 -50152 -50152 -50152 3182644 3105550 0 40094 201163 158038 43125 929821 730487 199334 24795 19480 5315 135380 106358 29022 97605 76681 20924 8971 546 8425 40691 40691 212967 212306 661 90774 25266 65508 173380 167 173213 53256 53239 17 32217 32217 31735 31735 KIT DESIGN 460325 460317 8 COMMUNICATION TECHNOLOG 165489 113456 52033 VIDEO PRODUCTION 145537 145537 CONSULTANTS 99701 77358 22343 52949 22852 30097 2956756 2202088 754668 0 41635 2923474 3235703 590377 546370 35952 21159 219075 195592 41425 23483 1995084 2002077 5627947 5828792 96566 87255 13329 7969 20278 9906 130173 105130 X 5470774 5710464 27000 13198 5497774 5723662 5627947 5828792 225888 0 X X 0 1 X 1 0 X 3361889 3904941 3496193 3075945 2402102 16241070 841908 792158 718597 727967 690296 3770926 4203797 4697099 4214790 3803912 3092398 20011996 0 197735 75000 25000 297735 197735 75000 25000 297735 19714261 94986 71682 46947 30803 90246 334664 94986 71682 46947 30803 90246 334664 3196 8678 1017 1326 14217 4301979 4777459 4262754 3836041 3182644 20360877 0.96820 0.95010 0.01640 0.01680 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 136236 136236 0 82839 59356 23483 23483 OBLIGATION UNDER CAPITAL LEASE 9906 9906 X 3182644 0 3182644 0 3182644 2956756 0 2956756 0 2956756 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE ORGANIZATION EVALUATES ALL SIGNIFICANT TAX POSITIONS AS REQUIRED BY ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA. AS OF DECEMBER 31, 2012 AND 2011, THE ORGANIZATION DOES NOT BELIEVE THAT IT HAS TAKEN ANY TAX POSITIONS THAT WOULD REQUIRE THE RECORDING OF ANY ADDITIONAL TAX LIABILITY NOR DOES IT BELIEVE THAT THERE ARE ANY UNREALIZED TAX BENEFITS THAT WOULD EITHER INCREASE OR DECREASE WITHIN THE NEXT TWELVE MONTHS. X X 0 0 0 0 0 0 0 0 0 CONNIE DICOCCO 101163 0 0 0 0 0 0 0 15480 0 116643 0 0 0 DR DOUGLAS JACOBS BOARD MEMBER AND FOUNDER/PRESIDENT OF THE ORGANIZATION 100000 DR. DOUGLAS JACOBS IS THE SOLE OWNER OF PROFESSIONAL PSYCHIATRIC ASSOCIATES (PPA). PPA PAYS DR. JACOBS SALARY, AND DR. JACOBS DEVOTES 1/2 OF HIS SALARIED TIME TO THE ORGANIZATION. DR. JACOBS PERFORMS ADMINISTRATIVE TASKS FOR THE ORGANIZATION. PPA ALSO SUB-LEASES SPACE TO THE ORGANIZATION. THE ORGANIZATION PAYS RENT FOR THE SUB-LEASED SPACE, AND REIMBURSES PPA FOR THE AMOUNT OF DR. JACOBS' TIME DEVOTED TO THE ORGANIZATION. 0 FORM 990, PART VI, SECTION B, LINE 11 THE FINANCIAL CONSULTANT, EXECUTIVE DIRECTOR AND PRESIDENT REVIEW THE TAX RETURN DRAFT BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REVIEWS ALL OF THE INFORMATION PROVIDED IN THE ANNUAL DISCLOSURES. FORM 990, PART VI, SECTION B, LINE 15A IN AN EFFORT TO BENCHMARK THE COMPENSATION FOR THESE, THE PRESIDENT AND EXECUTIVE DIRECTOR GATHERED INFORMATION FROM COMPARABLE NON-PROFIT ORGANIZATIONS. WHEN COLLECTING THIS DATA, THEY LOOKED FIRST TO THE GUIDESTAR COMPENSATION REPORT NOTING COMPARABLE INDUSTRY SECTORS, ORGANIZATIONS BUDGETS, NUMBER OF EMPLOYEES AND LOCATIONS FOR CONSISTENCIES WITH SMH. A COMPENSATION RECOMMENDATION WAS MADE TO, AND APPROVED BY THE BOARD OF DIRECTORS. BASED ON THE DATA GATHERED, SMH'S PROPOSED COMPENSATION WAS AT OR BELOW THOSE BEING OFFERED AT SIMILAR SIZE ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 19 ALL GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST IN ADDITION TO BEING AVAILABLE ON THE MA ATTORNEY GENERAL'S WEBSITE AND VIA INFORMATIONAL WEBSITES SUCH AS GUIDESTAR. FORM 990 PART XII LINE 2(C) THERE HAVE BEEN NO CHANGES FROM THE PRIOR YEAR.