Should We Screen Middle and High School Students for Mental Health Disorders?

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90% of youth who die by suicide suffer from a treatable mental illness. 

65% experience symptoms for a full year prior to their death.

When we identify kids at risk, we can save lives.

Over 10 years ago, President George Bush accepted The New Freedom Commission on Mental Health recommendation that the federal and state governments work to implement broader access for youth mental health screenings as a matter of public health.  While we are still waiting for federal assistance, local organizations are taking up the challenge and offering free mental health screenings to middle and high school age students. One of those organizations, Mental Health America of Illinois (MHAI) has been quietly running a mental health screening program, Youth Screen, in Chicago-area schools since 2007.

Educating youth on mental health conditions

Beginning with a youth education program, Katie Mason, Program Director for MHAI, visits classrooms, speaks to students and educates them about mental health and mental health conditions. Returning the next day, the students are given the opportunity to participate in a confidential, written personal questionnaire.  Answers to the 14 questions identify students who are at risk for developing major depression, an anxiety disorder and/or a substance abuse disorder.

Trained Youth Screen volunteers review the completed questionnaires with each student individually. When a student scores “positive,” the program coordinator and trained case managers follow-up with parents of the student.  Their goal is to educate the parent on the child’s symptoms and their effect, as well as link them to the appropriate academic and social services in the school and the community.   Program staff follow-up and support the parent throughout the process of setting up and getting to that crucial initial appointment.

“The program works best when we are able to have representatives from a local behavioral health center onsite during the screening,” states Ms. Mason.   “At risk students have the opportunity to speak with a qualified mental health professional and establish an immediate relationship.”  If behavioral health center representatives are not onsite during the screening days, students and their parents are given a list of resources to contact for additional follow-up.

Involving parents

Active parental consent is required to participate in the program.  On the educational day, students are given a consent form.  Any parent who wishes to have their child opt-out of the program need only return the signed form to school.  Parents are informed of any suicide attempts or ideation, regardless of age.  Additionally, the local school crisis protocol is immediately enacted when a student is identified with current suicide ideation.

Since its conception, the program has screened over 3,000 students in Chicago-area schools.  Six hundred of those students have been referred to behavioral health experts with many successful outcomes.  Almost 140 students have been identified as having current suicide ideation or previous attempts. During the past school year a 6th grader was identified with current suicide ideation and had made a suicide attempt just seven days before being screened.  Neither the school staff nor the parents were aware of her attempt.  When asked, the student reported she had not told her parents as she thought they would resist her attending counseling.

Funding is the only thing standing in the way of more schools participating in the program.  Although Illinois Governor Quinn signed the Mental Health First Aid Training Act in August it is unclear if grants can be used to support student screening programs. Currently grant funding from a private foundation covers the program.

One grateful principal has this to say about the program: “Youth screening has made such a difference in the social/emotional health of our students.  We were made aware of issues that might have otherwise gone unknown and I truly believe that our students’ lives are better for the resources that were shared thanks to the work of Youth Screen.”

Your turn

Is there routine medical health screening in your community’s school?

Do you think there should be routine mental health screening for youth?

What methods would you use to identify kids at risk of suicide or experiencing a mental health condition?

(Source: Shaffer, et al., Psychiatric diagnosis in child and adolescent suicide (1996)

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