Mental Health Screening in Schools

Division of Child and Adolescent Psychiatry, Center for School Mental Health Analysis and Action, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Journal of School Health (Impact Factor: 1.43). 03/2007; 77(2):53-8. DOI: 10.1111/j.1746-1561.2007.00167.x
Source: PubMed


This article discusses the importance of screening students in schools for emotional/behavioral problems.
Elements relevant to planning and implementing effective mental health screening in schools are considered. Screening in schools is linked to a broader national agenda to improve the mental health of children and adolescents. Strategies for systematic planning for mental health screening in schools are presented.
Mental health screening in schools is a very important, yet sensitive, agenda that is in its very early stages. Careful planning and implementation of mental health screening in schools offers a number of benefits including enhancing outreach and help to youth in need, and mobilizing school and community efforts to promote student mental health while reducing barriers to their learning.
When implemented with appropriate family, school, and community involvement, mental health screening in schools has the potential to be a cornerstone of a transformed mental health system. Screening, as part of a coordinated and comprehensive school mental health program, complements the mission of schools, identifies youth in need, links them to effective services, and contributes to positive educational outcomes valued by families, schools, and communities.

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Available from: Mark D Weist
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    • "School-based mental health interventions are particularly appropriate given the access to young people in schools (Weist, Rubin, Moore, Adelshiem, & Wrobel, 2007). Not surprisingly, the majority of current services in mental health are delivered via schools (Burns et al., 1995; Weist et al., 2007). Although schools may be an ideal place to offer mental health interventions, less clear is the most effective or relevant approaches to providing broad-based interventions to young people who have experienced a collective trauma such as a natural disaster. "
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    ABSTRACT: This article presents the Journey of Hope, a school-based group work intervention for children and early adolescents who have experienced a collective trauma such as a natural disaster. This broad-based intervention takes an ecological approach to prevention and treatment and focuses on normalizing emotions and building coping skills after a disaster. Through the use of group work interventions such as use of rituals, group problem solving, and experiential and reflective learning, children and early adolescents work toward enhancing protective factors to help them in their recovery. Considering the short- and long-term emotional strains children may experience after a disaster, such group programs should be more widely accessible in schools.
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    • "The conceptualization of what SMH looks like in application is emerging more fully, as an equitable partnership between schools, communities, and families (Weist & Murray, 2007). Weist and Murray (2007) provide a summary of the " expanded model " : " SMH provides a full continuum of mental health promotion programs and services in schools, including enhancing environments, broadly training and promoting social and emotional learning and life skills, preventing emotional and behavioral problems, identifying and intervening in these problems early on, and providing intervention for established problems. School mental health promotion programs should be available to all students, including those in general and special education, in diverse educational settings, and should reflect a shared agenda -with families and young people, school and community partners actively involved in building, continuously improving, and expanding them " (p. "

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    • "There is a demand for fast and accurate mental health screening in a range of general population settings where time and resource restrictions preclude administration of comprehensive clinical measures . Mental health screening has application to research and to clinical settings, including virtual clinics (Cuijpers et al., 2009; Donker et al., 2009), primary care (Spitzer et al., 1999) and schools (Husky et al., 2011; Weist et al., 2007). Although there are accurate and brief self-report scales available for assessing many specific mental disorders, there is little knowledge about the most efficient methods of screening for multiple disorders (Donker et al., 2009). "
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    ABSTRACT: There is a need for brief, accurate screening when assessing multiple mental disorders. Two-stage hierarchical screening, consisting of brief pre-screening followed by a battery of disorder-specific scales for those who meet diagnostic criteria, may increase the efficiency of screening without sacrificing precision. This study tested whether more efficient screening could be gained using two-stage hierarchical screening than by administering multiple separate tests. Two Australian adult samples (N=1990) with high rates of psychopathology were recruited using Facebook advertising to examine four methods of hierarchical screening for four mental disorders: major depressive disorder, generalised anxiety disorder, panic disorder and social phobia. Using K6 scores to determine whether full screening was required did not increase screening efficiency. However, pre-screening based on two decision tree approaches or item gating led to considerable reductions in the mean number of items presented per disorder screened, with estimated item reductions of up to 54%. The sensitivity of these hierarchical methods approached 100% relative to the full screening battery. Further testing of the hierarchical screening approach based on clinical criteria and in other samples is warranted. The results demonstrate that a two-phase hierarchical approach to screening multiple mental disorders leads to considerable increases efficiency gains without reducing accuracy. Screening programs should take advantage of prescreeners based on gating items or decision trees to reduce the burden on respondents.
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