Universal Screening to Identify Students with Mental Health Challenges

School is central to young people’s lives. It’s where they spend more hours of their day than any place other than home. Teachers and other school staff are often in the best position to identify students who are struggling and help them get adequate care, support, and helpful interventions.  However, many students who experience mental health challenges may show few external symptoms, making it difficult to identify all students who need mental health services. Districts can benefit from clinically supported tools, e.g., universal mental health screenings, to help better identify students experiencing mental health challenges. The earlier we identify symptoms, the quicker we can intervene and provide treatment, which can reduce the incidence rate, duration, and severity of youth mental illness.

What is a universal mental health screening?

“School-based universal mental health screening provides important information about the emotional and behavioral health of students and school-level functioning and is recognized as an essential component of a multitiered school behavioral health (SBH) framework.” (Siceloff et al, 2017).

Things to consider prior to screening

Prior to using a mental health diagnostic test, it is essential that schools have:

  • A properly trained staff who can safely and effectively screen children and adolescents (i.e., at a minimum, staff who have been trained on how to administer a given screening tool and interpret the results).
  • A system for referral and follow-up when screening identifies a problem that requires further attention.
  • Access to school-based and community resources to adequately address the student’s mental health needs. (Source: National Center on Safe Supportive Learning Environments, Mental Health Screening Tools for Grades K–12 )

How can schools implement universal mental health screenings?

Many schools partner with qualified mental health providers, e.g., universal screening agencies with expertise and experience in universal screening, to aid them, particularly in larger schools with minimal staff. These agencies work with school districts to provide tools and a process for implementation customized to their needs. In addition to mental health conditions like depression, trauma, anxiety, substance abuse, and eating disorders, screening agencies can identify at-risk students experiencing psychosocial stressors contributing to suicidality, self-harm, and violence.

Timing: The beginning of the school year is the ideal time to conduct a universal screening which will provide a school with a baseline result. Critical milestones in the academic year are also appropriate times to administer a screening. (Source: Project Cal-Well: Universal Social, Emotional, and Behavioral Screening for Monitoring and Early Intervention)

Frequency: It is recommended that universal screenings take place two times per year. However, it may be more practical to begin with one mental health screening assessment in the first year testing is implemented. (Source: Project Cal-Well: Universal Social, Emotional, and Behavioral Screening for Monitoring and Early Intervention)

Benefits of implementing universal screenings

Most importantly there are the direct benefit to students:

  • Early identification of at-risk students can inform a more proactive approach to the implementation of services and supports.
  • School-based screening efforts can help schools proactively identify students at-risk of or currently experiencing a range of mental health concerns, including internalizing symptoms of distress.
  • Screening results allow schools to disseminate data according to context and student demographics, among other variables, so that students’ mental health can be monitored throughout the school year. (Connors et al, 2022)

However, districts also experience other benefits:

  • A prevention-focused mental health intervention model has been shown to offer substantial cost savings, with one study finding savings of approximately $30,000 each year, a 50% reduction in disciplinary referrals, and a 22% decrease in suspensions. (von der Embse et al, 2021)

Effective School Solutions’ recommendations regarding universal mental health screenings

Effective School Solutions recommends that districts incorporate regular mental health screenings of all students throughout the school year, following best practice guidelines for conducting such screenings.  To implement such a program, and in addition to funding, state and the federal government need to issue consistent guidelines and best practices for districts to conduct universal mental health screenings, with a focus on parental awareness and consent, required systems for follow up, and data and privacy considerations.

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