Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-02T19:07:17.819Z Has data issue: false hasContentIssue false
  • English
  • Français

From barriers to implementation: Advancing universal mental health screening in schools

Published online by Cambridge University Press:  02 September 2021

John R. Burns Open the ORCID record for John R. Burns [Opens in a new window]  and
Ronald M. Rapee
John R. Burns*
Affiliation:
Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia Shore School, Sydney, New South Wales, Australia
Ronald M. Rapee
Affiliation:
Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
*
*Correspondence author. Email: [email protected]
Get access

Abstract

In light of concerning evidence that many young people with mental disorders are not receiving appropriate mental health intervention, school-based mental health screening has been advocated as one way to improve identification of at-risk youth. Despite having much promise, universal screening in schools remains a relatively uncommon practice internationally. Various barriers that deter school psychologists and counsellors from screening have been identified, including lack of resourcing to implement screening, lack of knowledge about the mechanics of how to carry out a screening program, and concern about how to manage the anticipated increased workload generated by following up identified students. In this practice-based paper we discuss a four-stage process that guides school psychologists and counsellors in the establishment of a school-based screening program, with specific reference to overcoming perceived barriers.

Keywords

Screeningearly interventionschool mental healthprevention
Type
Practitioner Paper
Information
Journal of Psychologists and Counsellors in Schools , Volume 31 , Special Issue 2: Actioning Research within Schools: Key Processes for Planning Successful Interventions , December 2021 , pp. 172 - 183
Check for updates
Copyright
© The Author(s) 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aisbett, D. L., Boyd, C. P., Francis, K. J., Newnham, K., & Newnham, K. (2007). Understanding barriers to mental health service utilization for adolescents in rural Australia. Rural and Remote Health, 7, 624. https://doi.org/10.22605/RRH624 Google ScholarPubMed
Albers, C.A., Glover, T.A., & Kratochwill, T.R. (2007). Introduction to the special issue: How can universal screening enhance educational and mental health outcomes? Journal of School Psychology, 45, 113–116.CrossRefGoogle Scholar
Angold, A., Costello, E.J., Messer, S.C., Pickles, A., Winder, F., & Silver, D. (1995). Development of a short questionnaire for use in epidemiology studies of depression in children and adolescents. International Journal of Methods in Psychiatric Research, 5, 237–249.Google Scholar
Breslau, J., Lane, M., Sampson, N., & Kessler, R.C. (2008). Mental disorders and subsequent educational attainment in a us national sample. Journal of Psychiatric Research, 42, 708–716. doi: 10.1016/j.jpsychires.2008.01.016 CrossRefGoogle Scholar
Bruhn, A.L., Woods-Groves, S., & Huddle, S. (2014). A preliminary investigation of emotional and behavioral screening practices in K-12 schools. Education & Treatment of Children, 37, 611–634. doi: 10.1353/etc.2014.0039 CrossRefGoogle Scholar
Burns, J.R., & Rapee, R.M. (2016). Screening for mental health risk in high schools: The development of the Youth RADAR. Psychological Assessment, 28, 1220–1231. doi: 10.1037/pas0000237 CrossRefGoogle ScholarPubMed
Burns, J.R., & Rapee, R.M. (2018). School-based assessment of mental health risk in children: The preliminary development of the Child RADAR. Child and Adolescent Mental Health, 24, 1–10. doi: 10.1111/camh.12258 Google ScholarPubMed
Burns, J.R., & Rapee, R.M. (2021). Barriers to universal mental health screening in schools: The perspective of school psychologists. Journal of Applied School Psychology. doi: doi.org/10.1080/15377903.2021.1941470 CrossRefGoogle Scholar
Calear, A.L., & Christensen, H. (2010). Systematic review of school-based prevention and early intervention programs for depression. Journal of Adolescence, 33, 429–438. doi: 10.1016/j.adolescence.2009.07.004 CrossRefGoogle ScholarPubMed
Chartier, M., Stoep, A.V., McCauley, E., Herting, J.R., Tracy, M., & Lymp, J. (2008). Passive versus active parental permission: Implications for the ability of school-based depression screening to reach youth at risk. Journal of School Health, 78, 157–164. doi: 10.1111/j.1746-1561.2007.00278.x CrossRefGoogle ScholarPubMed
Chorpita, B.F., Yim, L., Moffitt, C., Umemoto, L.A., & Francis, S.E. (2000). Assessment of symptoms of DSM-IV anxiety and depression in children: A revised child anxiety and depression scale. Behavior Research and Therapy, 38, 835–855. doi: 10.1016/s0005-7967(99)00130-8 CrossRefGoogle ScholarPubMed
Corrieri, S., Heider, D., Conrad, I., Blume, A., König, H.-H., & Riedel-Heller, S.G. (2014). School-based prevention programs for depression and anxiety in adolescence: A systematic review. Health Promotion International, 29, 427–441. doi: 10.1093/heapro/dat001 CrossRefGoogle ScholarPubMed
de Girolamo, G., Dagani, J., Purcell, R., Cocchi, A., & McGorry, P.D. (2012). Age of onset of mental disorders and use of mental health services: Needs, opportunities and obstacles. Epidemiology and Psychiatric Sciences, 21, 47–57. doi: 10.1017/S2045796011000746 CrossRefGoogle ScholarPubMed
DeCou, C.R., & Schumann, M.E. (2018). On the iatrogenic risk of assessing suicidality: A meta-analysis. Suicide and Life-Threatening Behavior, 48, 531–543. doi: 10.1111/sltb.12368 CrossRefGoogle ScholarPubMed
Deighton, J., Tymms, P., Vostanis, P., Belsky, J., Fonagy, P., Brown, A., Martin, A., Patalay, P., & Wolpert, M. (2013). The development of a school-based measure of child mental health. Journal of Psychoeducational Assessment, 31, 247–257. doi: 10.1177/0734282912465570 CrossRefGoogle ScholarPubMed
Dever, B.V., Raines, T.C., & Barclay, C.M. (2012). Chasing the unicorn: Practical implementation of universal screening for behavioral and emotional risk. School Psychology Forum, 6, 108–118.Google Scholar
Dowdy, E., Furlong, M., Raines, T.C., Bovery, B., Kauffman, B., Kamphaus, R.W., Dever, B.V., Price, M., & Murdock, J. (2015). Enhancing school-based mental health services with a preventive and promotive approach to universal screening for complete mental health. Journal of Educational and Psychological Consultation, 25, 178–197. doi: 10.1080/10474412.2014.929951 CrossRefGoogle Scholar
Dowdy, E., Nylund-Gibson, K., Felix, E.D., Morovati, D., Carnazzo, K.W., & Dever, B.V. (2014). Long-term stability of screening for behavioral and emotional risk. Educational and Psychological Measurement, 74, 453–472. doi: 10.1177/0013164413513460 CrossRefGoogle Scholar
Drummond, T.B. (1994). The Student Risk Screening Scale (SRSS). Josephine County Mental Health Program.Google Scholar
Faulstich, M.E., Carey, M.P., Ruggiero, L., Enyart, P., & Gresham, F. (1986). Assessment of depression in childhood and adolescence: An evaluation of the Center for Epidemiological Studies Depression Scale for Children (CES-DC). American Journal of Psychiatry, 143, 1024–1027.Google Scholar
Fox, C., Eisenberg, M., McMorris, B., Pettingell, S., & Borowsky, I. (2013). Survey of Minnesota parent attitudes regarding school-based depression and suicide screening and education. Maternal and Child Health Journal, 17, 456–462. doi: 10.1007/s10995-012-1017-8 CrossRefGoogle ScholarPubMed
Ghanizadeh, A., & Jahedizadeh, S. (2014). Teacher burnout: A review of sources and ramifications. Journal of Education, Society and Behavioural Science, 6, 24–39. https://doi.org/10.9734/BJESBS/2015/15162 CrossRefGoogle Scholar
Gloff, N.E., LeNoue, S.R., Novins, D.K., & Myers, K. (2015). Telemental health for children and adolescents. International Review of Psychiatry, 27, 513–524. doi: 10.3109/09540261.2015.1086322 CrossRefGoogle ScholarPubMed
Glover, T.A., & Albers, C.A. (2007). Considerations for evaluating universal screening assessments. Journal of School Psychology, 45, 117–135. doi: http://dx.doi.org/10.1016/j.jsp.2006.05.005 CrossRefGoogle Scholar
Goodman, R. (1997). The Strengths and Difficulties Questionnaire: A research note. Journal of Child Psychology and Psychiatry, 38, 581–586. doi: 10.1111/j.1469-7610.1997.tb01545.x CrossRefGoogle ScholarPubMed
Goodsell, B., Lawrence, D., Ainley, J., Sawyer, M., Zubrick, S.R., & Maratos, J. (2017). Child and Adolescent Mental Health and Educational Outcomes: An analysis of educational outcomes from Young Minds Matter: the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. The University of Western Australia. https://youngmindsmatter.telethonkids.org.au/globalassets/subsite-media/subsite-documents/young-minds-matter/childandadolescentmentalhealthandeducationaloutcomesdec2017.pdf Google Scholar
Gould, M.S., Marrocco, F.A., Kleinman, M., Thomas, J.G., Mostkoff, K., Cote, J., & Davies, M. (2005). Evaluating iatrogenic risk of youth suicide screening programs: A randomized controlled trial. JAMA, 293, 1635–1643. doi: 10.1001/jama.293.13.1635 CrossRefGoogle ScholarPubMed
Gunnell, D., Kidger, J., & Elvidge, H. (2018). Adolescent mental health in crisis. BMJ, 361, k2608. doi: 10.1136/bmj.k2608 CrossRefGoogle ScholarPubMed
Haugland, B.S.M., Haaland, Å.T., Baste, V., Bjaastad, J.F., Hoffart, A., Rapee, R.M., Raknes, S., Himle, J.A., Husabø, E., & Wergeland, G.J. (2020). Effectiveness of brief and standard school-based cognitive-behavioral interventions for adolescents with anxiety: A randomized noninferiority study. Journal of the American Academy of Child and Adolescent Psychiatry, 59, 552–564.e552. doi: 10.1016/j.jaac.2019.12.003 CrossRefGoogle ScholarPubMed
Hertz, M.F., & Barrios, L.C. (2021). Adolescent mental health, COVID-19, and the value of school-community partnerships. Injury Prevention, 27, 85. doi: 10.1136/injuryprev-2020-044050 CrossRefGoogle ScholarPubMed
Humphrey, N., & Wigelsworth, M. (2016). Making the case for universal school-based mental health screening. Emotional and Behavioural Difficulties, 21, 22–42. doi: 10.1080/13632752.2015.1120051 CrossRefGoogle Scholar
Husky, M.M., Kaplan, A., McGuire, L., Flynn, L., Chrostowski, C., & Olfson, M. (2011). Identifying adolescents at risk through voluntary school-based mental health screening. Journal of Adolescence, 34, 505–511. doi: http://dx.doi.org/10.1016/j.adolescence.2010.05.018 CrossRefGoogle ScholarPubMed
Iachini, A., Pitner, R., Morgan, F., & Rhodes, K. (2016). Exploring the principal perspective: Implications for expanded school improvement and school mental health. Children & Schools, 38, 40–48. doi: 10.1093/cs/cdv038 CrossRefGoogle Scholar
Ivey-Stephenson, A.Z., Demissie, Z., Crosby, A.E., Stone, D.M., Gaylor, E., Wilkins, N., Lowry, R., & Brown, M. (2020). Suicidal Ideation and Behaviors Among High School Students — Youth Risk Behavior Survey, United States, 2019. MMWR Supplements, 69, 47–55. DOI: http://dx.doi.org/10.15585/mmwr.su6901a6external icon CrossRefGoogle ScholarPubMed
Jellinek, M.S., Murphy, J.M., Robinson, J., Feins, A., Lamb, S., & Fenton, T. (1988). Pediatric Symptom Checklist: Screening school-age children for psychosocial dysfunction. Journal of Pediatrics 112, 201–209.CrossRefGoogle ScholarPubMed
Kamphaus, R.W., & Reynolds, C.R. (2015). Behavior Assessment System for Children – third edition (BASC-3): Behavioral and Emotional Screening System (BESS). Pearson.Google Scholar
Kessler, R.C., Amminger, G.P., Aguilar-Gaxiola, S., Alonso, J., Lee, S., & Ustun, T.B. (2007). Age of onset of mental disorders: A review of recent literature. Current Opinion in Psychiatry, 20, 359–364. doi: 10.1097/YCO.0b013e32816ebc8c CrossRefGoogle ScholarPubMed
Kuhn, C., Aebi, M., Jakobsen, H., Banaschewski, T., Poustka, L., Grimmer, Y., Goodman, R., & Steinhausen, H.-C. (2017). Effective mental health screening in adolescents: Should we collect data from youth, parents or both? Child Psychiatry & Human Development, 48, 385–392. doi: 10.1007/s10578-016-0665-0 CrossRefGoogle ScholarPubMed
Kutcher, S., & Wei, Y. (2013). Challenges and solutions in the implementation of the school-based pathway to care model:The lessons from Nova Scotia and beyond. Canadian Journal of School Psychology, 28, 90–102. doi: 10.1177/0829573512468859 CrossRefGoogle Scholar
Lawrence, D., Johnson, S., Hafekost, J., Boterhoven De Haan, K., Sawyer, M.G., Ainley, J., & Zubrick, S.R. (2015). The mental health of children and adolescents. Report on the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Australian Government Department of Health. https://www.health.gov.au/resources/publications/the-mental-health-of-children-and-adolescents Google ScholarPubMed
Leach, L.S., & Butterworth, P. (2012). The effect of early onset common mental disorders on educational attainment in Australia. Psychiatry Research, 199, 51–57. doi:https://doi.org/10.1016/j.psychres.2012.03.040 CrossRefGoogle ScholarPubMed
Lovibond, P.F., & Lovibond, S.H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33, 335–343. doi:https://doi.org/10.1016/0005-7967(94)00075-U CrossRefGoogle ScholarPubMed
McGorry, P.D., & Mei, C. (2018a). Early intervention in youth mental health: Progress and future directions. Evid Based Ment Health, 21, 182–184. doi: 10.1136/ebmental-2018-300060 CrossRefGoogle ScholarPubMed
McGorry, P.D., & Mei, C. (2018b). Tackling the youth mental health crisis across adolescence and young adulthood. BMJ, 362, k3704. doi: 10.1136/bmj.k3704 CrossRefGoogle ScholarPubMed
McLoone, J., Hudson, J.L., & Rapee, R.M. (2006). Treating anxiety disorders in a school setting. Education & Treatment of Children, 29, 219.Google Scholar
Merry, S.N., Stasiak, K., Shepherd, M., Frampton, C., Fleming, T., & Lucassen, M.F.G. (2012). The effectiveness of SPARX, a computerised self help intervention for adolescents seeking help for depression: Randomised controlled non-inferiority trial. BMJ, 344. doi: 10.1136/bmj.e2598 CrossRefGoogle ScholarPubMed
Miller, L.D., Martinez, Y.J., Shumka, E., & Baker, H. (2014). Multiple informant agreement of child, parent, and teacher ratings of child anxiety within community samples. Canadian Journal of Psychiatry, 59, 34–39. doi: 10.1177/070674371405900107 CrossRefGoogle ScholarPubMed
Moor, S., Maguire, A., McQueen, H., Wells, E., Elton, R., Wrate, R., & Blair, C. (2007). Improving the recognition of depression in adolescence: Can we teach the teachers? Journal of Adolescence, 30, 81–95. doi: 10.1016/j.adolescence.2005.12.001 CrossRefGoogle ScholarPubMed
National Mental Health Commission. (2020). The economic case for investing in mental health prevention: Summary. https://www.mentalhealthcommission.gov.au/getmedia/ffbf9cc5-f815-4034-b931-dfc0c1ecb849/The-economic-case-for-investing-in-mental-health-prevention Google Scholar
Niesyn, M.E. (2009). Strategies for success: Evidence-based instructional practices for students with emotional and behavioral disorders. Preventing School Failure: Alternative Education for Children and Youth, 53, 227–234. doi: 10.3200/PSFL.53.4.227-234 CrossRefGoogle Scholar
Olfson, M., Druss, B.G., & Marcus, S.C. (2015). Trends in mental health care among children and adolescents. New England Journal of Medicine, 372, 2029–2038. doi: 10.1056/NEJMsa1413512 CrossRefGoogle ScholarPubMed
Orchard, F., Pass, L., Cocks, L., Chessell, C., & Reynolds, S. (2019). Examining parent and child agreement in the diagnosis of adolescent depression. Child and Adolescent Mental Health, 24, 338–344. doi: 10.1111/camh.12348 CrossRefGoogle Scholar
Robinson, J., Pan Yuen, H., Martin, C., Hughes, A., Baksheev, G.N., Dodd, S., Bapat, S., Schwass, W., McGorry, P., & Yung, A.R. (2011). Does screening high school students for psychological distress, deliberate self-harm, or suicidal ideation cause distress--and is it acceptable? An Australian-based study. Crisis, 32, 254–263. doi: 10.1027/0227-5910/a000087 CrossRefGoogle ScholarPubMed
Romer, D., & McIntosh, M. (2005). The roles and perspectives of school mental health professionals in promoting adolescent mental health. In Evans, D.L., Foa, E.B., Gur, R.E., Hendin, H., O’Brien, C.P., Seligman, M.E.P., & Walsh, B.T. (Eds.), Treating and preventing adolescent mental health disorders: What we know and what we don’t know (pp. 597–615). Oxford University Press.CrossRefGoogle Scholar
Sanchez, A.L., Cornacchio, D., Poznanski, B., Golik, A.M., Chou, T., & Comer, J.S. (2018). The effectiveness of school-based mental health services for elementary-aged children: A meta-analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 57, 153–165. doi:https://doi.org/10.1016/j.jaac.2017.11.022 CrossRefGoogle ScholarPubMed
Scott, M.A., Wilcox, H.C., Schonfeld, I.S., Davies, M., Hick, R.C., Turner, J.B., & Shaffer, D. (2009). School-based screening to identify at-risk students not already known to school professionals: The Columbia Suicide Screen. American Journal of Public Health, 99, 334–339. doi: 10.2105/AJPH.2007.127928 CrossRefGoogle Scholar
Shochet, I.M., & Hoge, R. (2009). Resourceful Adolescent Program: A prevention and early intervention program for teenage depression. In Essau, C.A. (Ed.), Treatments for adolescent depression: Theory and practice. (pp. 123–157). Oxford University Press.CrossRefGoogle Scholar
Soneson, E., Childs-Fegredo, J., Anderson, J.K., Stochl, J., Fazel, M., Ford, T., Humphrey, A., Jones, P.B., & Howarth, E. (2018). Acceptability of screening for mental health difficulties in primary schools: A survey of UK parents. BMC Public Health, 18, 1404. doi: 10.1186/s12889-018-6279-7 CrossRefGoogle ScholarPubMed
Spence, S.H. (1998). A measure of anxiety symptoms among children. Behaviour Research and Therapy, 36, 545–566.CrossRefGoogle ScholarPubMed
Stiffler, M.C., & Dever, B.V. (2015). Mental health screening at school: Instrumentation, implementation, and critical issues. Springer.CrossRefGoogle Scholar
Stjerneklar, S., Hougaard, E., McLellan, L.F., & Thastum, M. (2019). A randomized controlled trial examining the efficacy of an internet-based cognitive behavioral therapy program for adolescents with anxiety disorders. PLOS ONE, 14, e0222485. doi: 10.1371/journal.pone.0222485 CrossRefGoogle ScholarPubMed
Twenge, J.M., Cooper, A.B., Joiner, T.E., Duffy, M.E., & Binau, S.G. (2019). Age, period, and cohort trends in mood disorder indicators and suicide-related outcomes in a nationally representative dataset, 2005–2017. Journal of abnormal psychology, 128, 185–199. doi: 10.1037/abn0000410 CrossRefGoogle Scholar
Walker, H.M., & Severson, H.H. (2014). Systematic Screening for Behavior Disorders: SSBD (2nd edition). Pacific Northwest Publishing Co.Google Scholar
Wei, Y., Kutcher, S., & Szumilas, M. (2011). Comprehensive school mental health: An integrated ‘school-based pathway to care’ model for Canadian secondary schools. McGill Journal of Education/Revue des sciences de l'éducation de McGill, 46, 213–229. doi: 10.7202/1006436ar Google Scholar
Werner-Seidler, A., Perry, Y., Calear, A.L., Newby, J.M., & Christensen, H. (2017). School-based depression and anxiety prevention programs for young people: A systematic review and meta-analysis. Clin Psychol Rev, 51, 30–47. doi: 10.1016/j.cpr.2016.10.005 CrossRefGoogle ScholarPubMed
Wickman, E.K. (1928). Children’s behaviour and teachers’ attitudes. Commonwealth Fund.Google Scholar