Mental Health Screening May Help Identify At-Risk Teens

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According to the National Institute of Mental Health, 50 percent of lifelong mental illness begins around age 14, with 11 percent of teenagers suffering from depression by the age of 18.

A recent study performed by TeenScreen National Center for Mental Health Checkups at Columbia University sought to discover whether routine screening in high schools could identify teens that may be at-risk for mental illness. Since “at-risk” means that a person is likely to have a condition but the possibility of prevention exists, the goal of the screenings would be to make early identifications among the student population in order to recommend appropriate preventive care.

The study involved 2,500 high school students from six Wisconsin public schools during the years 2005-2009. Researchers used a diagnostic predictive scales-8 questionnaire to identify conditions such as depression, generalized anxiety, social phobia, obsessions and compulsions, and suicide.

TeenScreen provided every student with a one-on-one debriefing following the screenings. Those who scored positively were encouraged to attend a second stage clinical interview. The second interview was conducted by a trained master’s level clinician to further evaluate whether the student might benefit from either school-based or community-based services. During these various interviews TeenScreen found that three of four students who were identified as at-risk for mental illness were not presently receiving treatment.

The study reports that, following the screenings, 73.6 percent of at-risk students had a minimum of one appointment with a mental health professional by 90 days and that 56.3 percent had minimal treatment. Minimal treatment was defined by three appointments or more with a mental health provider. TeenScreen’s executive director said that the value of the school-based screening had been demonstrated by the study results.

Not everyone, however, is equally convinced that regular screening for mental illness is called for in high school. Opponents wonder if screenings are a needed preventive tool or an opportunity for over-diagnosis and over-medication of adolescents. They fear that teens who are encountering the normal stresses of teen years and the high school environment may register a false positive. Both kids and parents who don’t take them to treatment may be labeled, some fear.

Legislators in Texas have proposed a bill that would prohibit federal dollars from being used to conduct mandatory mental health screenings without parental consent. Currently, federal officials recommend that physicians perform annual screenings for depression with their 12- to 18-year-old patients, but to date those screenings remain voluntary.

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