School-based, mental-health screenings play an important part in identifying children with depression and helping them get treatment, according to a new study that looked at students at Pennsylvania public high schools.
Adolescents who are screened for depression in school are twice as likely to receive treatment than students who do not have in-school screenings available. Also, school screenings are better at identifying symptoms of depression among female and minority students, researchers at Penn State University said.
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A school-based, mental-health screening involves interaction between a student and a trained member of the staff, who knows the early signs and symptoms of mental health conditions, like depression, anxiety, bipolar disorder and eating disorders.
The symptoms of depression in adolescents include changes in mood, decreased interest in activities, changes in appetite and sleep patterns, difficulty focusing and behavioral issues.
The researchers said that even before the COVID-19 pandemic, concerns about student depression had been increasing. Between 2008 and 2018, the number of students reporting symptoms of depression surged from 8.3% to 14.4%. That's an increase of more than 70%.
Dr. Deepa Sekhar, a Penn State Health Children's Hospital pediatrician and an associate professor at Penn State College of Medicine, said more and more adolescents are reporting symptoms of depression. Suicide is now the second-leading cause of adolescent death.
Some mental health experts have been warning about an impending epidemic of anxiety and depression among children for more than a decade. And the psychological toll of the pandemic has exacerbated the problem.
From March until April of last year, emergency room visits for mental health issues increased 24% among children ages of 5 to 11 and by 31% for children 12 to 17, according to the U.S. Centers for Disease Control and Prevention.
Last month, the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry and Children's Hospital Association declared a national emergency, calling on leaders to address the mental health challenges children are facing.
Sekhar and her colleagues say that mental-health screenings performed in schools – just like screenings done on students for vision and hearing – are important to identify adolescents who are struggling.
She noted that relying on annual checkups for screenings wouldn't be effective because less than half of U.S. adolescents between the ages of 12 and 18 have regular doctor checkups. And even those adolescents who do see their doctor regularly are not screened for depression, despite the recommendation from the U.S. Prevention Services Task Force.
"This research shows we do have better ways to reach students," Sekhar said.
She added that the next step is to help school districts interested in offering depression screenings to break down barriers preventing them from offering this service to their students.
"Staff at our participating schools were pretty amazing; they were willing to take the leap with us," she said. "There are a lot of great educators out there who are incredibly dedicated to their students."
The study published in the JAMA Network Open included almost 13,000 students from 14 public high schools in Pennsylvania. The three-year study included students from both rural and urban school districts.
At each high school two of the four grades were randomly assigned to the screening, which was administered through a questionnaire. The students in other grades were only screened or offered support through the state-mandated Student Assistance Program if they exhibited concerning behavior.