Mental Health Screening in Schools: Identifying and Addressing Students' Needs, Study notes of Psychology

Download Mental Health Screening in Schools: Identifying and Addressing Students' Needs and more Study notes Psychology in PDF only on Docsity! Worksheet Overview Screening for Grades K–12 Mental health is an important part of overall student well-being.1 About 20% of children and youth experience a mental, emotional, or behavioral health disorder, yet only roughly half of these children receive mental health services.2 Screening tools can be useful for schools to understand how to identify and address the mental health needs of the children and adolescents they serve. Screening is termed “universal” when it is provided to an entire student population (i.e., a grade, school, district, or state) to identify students’ strengths and needs.3 In this brief, we use the term screening to refer to universal screening. With the help of properly trained staff and a plan for implementation,4 screening tools can provide schools with data to recognize students’ strengths and challenges; in turn, this information can be used to inform next steps to understand and address students’ needs.5 For example, if screening results indicate that a student is struggling with symptoms of depression, the school can develop appropriate in-school supports and can connect the student to relevant community service providers. In particular, data from mental health screening tools can inform schools’ universal and selective prevention efforts. Prevention strategies can assist schools to respond by promoting student well-being before symptoms worsen (e.g., with a referral to comprehensive assessment of an identified problem).6 Prior to using a screening tool, 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); (b) a system for referral and follow-up when screening identifies a problem that requires further attention; and (c) access to school- based and community resources to adequately address the student’s mental health needs.7 If schools lack these capacities, then the utility of screening will be questionable. Many experts consider it unethical, for example, to screen students if appropriate referral, diagnostic or treatment resources are not School Mental Health and Behavioral Health School mental health refers to specific emotional or behavioral needs that may be associated with a clinical condition and can be framed in terms of resilience to violence and trauma. Behavioral health is often used synonymously with mental health, although it can be defined more specifically as the conditions caused by problematic behaviors including substance use. In this brief, we use the term “school mental health” to encompass the full range of such conditions. Tiers of School Service Provision6 Universal services are provided to all students, regardless of risk level. Selective prevention services are provided to students who are at risk for a disorder. Indicated services are provided to students who currently have a disorder. Mental Health Screening Tools for Grades K–12 ` 2 available.8 In such cases, schools may need to cast a wide net and consider innovative service delivery systems (i.e., using mobile mental health resources, telepsychiatry) when identifying potential supports.9,10 Mental health literacy (i.e., providing teachers and other school staff with the information and training necessary to notice unmet mental health needs) is vital to promote student well-being and can support timely intervention. A focus on mental health literacy in schools can reduce the stigma often associated with mental health issues.11 In times of particular community anguish or trauma, such a focus can facilitate the rapid detection of critical mental health issues among students that indicate a need for crisis support or intervention. Important Considerations for Screening Tool Use To select and implement an appropriate school-based screening tool, the National Center for School Mental Health (NCSMH) advises that schools should consider (1) what student needs are important to assess (e.g., symptoms of depression or anxiety; social-emotional skills); (2) whether they have an adequate system in place to conduct screening and follow-up (including viability of screening methods when direct, in-person contact might be unsafe or otherwise not possible); (3) how long a tool takes to administer and how much it costs (i.e., is it feasible?); (4) whether the tool comes with access to training or support for staff; and (5) whether the tool is reliable, valid, and evidence based (i.e., it has been studied and found effective for their specific population and areas of interest).4 A complete NCSMH guide on screening (see “Additional Resources”) outlines key screening implementation steps, including consent and assent processes. The following are additional considerations for schools on the use of mental health screening: ￭ Screening can help inform how schools should interact with youth in ways that prevent retraumatization of students who report distressing experiences.12 Screening that asks students to describe distressing experiences in detail (e.g., events that were traumatizing) may also generate negative emotions or impacts. Schools should have supports in place to manage and minimize those impacts (e.g., the screening procedure maximizes student privacy, a school counselor is available for students to talk to before or after, staff are trained on how to administer tools in a sensitive way) and that students feel safe and grounded when they leave the screening.13 ￭ Research on the effectiveness of trauma screening in schools and the availability of brief and effective universal screening tools for trauma is accumulating, but is still fairly limited.3 Depending on which student needs they are seeking to assess, school leaders may want to consider whether the school is the most effective setting for screening. ￭ Screening often collects sensitive data. These data are critical to identifying student needs and should be securely stored so that only staff needing the information have access to it. Furthermore, schools should limit screening records to avoid collection of sensitive information, except as is necessary to inform next steps. ￭ Schools should ensure, before undertaking screening, that they are connected to the resources necessary to address the student needs that the screening identifies. Such connections might take the form of in-house staffing, partnerships with school- and community-based mental health providers, and virtual (e.g., tele-mental health, apps) supports that students and their families can readily access.5 ￭ Not all screening tools have been validated to accurately screen certain populations of children and adolescents (e.g., refugee children and adolescents, ethnically diverse groups). Before selecting a tool, schools should investigate whether it has been studied and found to be effective with the population they intend to screen.14,15,16 ` 5 References 1 National Association of School Psychologists. (2020). School-based mental health services: Improving student learning and well-being. https://www.nasponline.org/resources-and-publications/resources-and- podcasts/mental-health/school-psychology-and-mental-health/comprehensive-school-based-mental-and- behavioral-health-services-and-school-psychologists 2 Bradshaw, C., Williamson, S., Kendziora, K., Jones, W., & Cole, S. (2019). Multitiered approaches to school-based mental health, wellness, and trauma response. In D. Osher, M. J. Mayer, R. J. Jagers, K. Kendziora, & L. Wood (Eds.), Keeping students safe and helping them thrive: A collaborative handbook on school safety, mental health, and wellness (Vol. 1; pp. 85-109). Praeger. 3 Eklund, K., Rossen, E., Koriakin, T., Chafouleas, S. M., & Resnick, C. (2018). A systematic review of trauma screening measures for children and adolescents. School Psychology Quarterly, 33(1), 30–43. 4 Center for School Mental Health. (2018) School mental health screening playbook: Best practices and tips from the field. https://noys.org/sites/default/files/School-Mental-Health-Screening-Playbook.pdf 5 Siceloff, R., Bradley, J., & Flory, K. (2017). Universal behavioral/emotional health screening in schools: overview and feasibility. Report on Emotional and Behavioral Disorders in Youth, 17(2), 32–38. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6350819/ 6 Lever, N., Connors, E., Freeman, E., & Stephan, S. (2019). Introduction to comprehensive school mental health. National Center for Healthy Safe Children. https://healthysafechildren.org/learning-module-series/mental- health-module-series 7 Humphrey, N., & Wigelsworth, M. (2016). Making the case for universal school-based mental health screening. Emotional and Behavioural Difficulties, 21(1), 22–42. https://doi.org/10.1080/13632752.2015.1120051 8 Finkelhor, D. (2017). Screening for adverse childhood experiences (ACEs): Cautions and suggestions. Child Abuse and Neglect, 85, 174–179. doi:10.1016/j.chiabu.2017.07.016 9 Luxton, D. D., Mccann, R. A., Bush, N. E., Mishkind, M. C., Reger, G. M. (2011). MHealth for mental health: Integrating smartphone technology in behavioral healthcare. Professional Psychology: Research and Practice, 42(6), 505– 512. https://doi.org/10.1037/a0024485 10 Germain, V., Marchand, A., Bouchard, S., Drouin, M., & Guay, S. (2009). Effectiveness of cognitive behavioural therapy administered by videoconference for posttraumatic stress disorder. Cognitive Behaviour Therapy, 38, 42–53. https://doi.org/10.1080/16506070802473494 11 Smith, J. D., Whitley, J., Smith, J. D., & Vaillancourt, T. (2013). Promoting mental health literacy among educators: Critical in school-based prevention and intervention. Canadian Journal of School Psychology, 28(1), 56–70. https://doi.org/10.1177/0829573512468852 12 Overstreet, S., & Chafouleas, S. (2016). Trauma-informed schools: Introduction to the special issue. School Mental Health, 8(1), 1–6. https://link.springer.com/article/10.1007/s12310-016-9184-1#CR14 13 Substance Abuse and Mental Health Services Administration. (2014). Screening and assessment. In Trauma- informed care in behavioral health services: Treatment Improvement Protocol Series, No. 57 (ch. 4). Center for Substance Abuse Treatment. https://www.ncbi.nlm.nih.gov/books/NBK207188/ 14 Glover, T. A., & Albers, C. A. (2007). Considerations for evaluating universal screening assessments. Journal of School Psychology, 45(2), 117–135. doi:10.1016/j.jsp.2006.05.005 ` 6 15 Gadeberg, A., & Norredam, M. (2015). Urgent need for validated trauma and mental health screening tools for refugee children and youth. European Child and Adolescent Psychiatry, 25(8), 929–931. doi:10.1007/s00787-016-0837-2 16 Gadeberg, A., Montgomery, E., Frederiksen, H., & Norredam, M. (2017). Assessing trauma and mental health in refugee children and youth: A systematic review of validated screening and measurement tools. European Journal of Public Health, 27(3), 439–446. https://doi.org/10.1093/eurpub/ckx034 17 Suldo, S. M., & Shaffer, E. J. (2008). Looking beyond psychopathology: The dual-factor model of mental health in youth. School Psychology Review, 37(1), 52–68. 18 Kamphaus, R., & Reynolds, C. (2015). BASC-3 Behavioral and Emotional Screening System (BASC-3 BESS). Professional Assessments. https://www.pearsonassessments.com/store/usassessments/en/Store/Professional- Assessments/Behavior/Comprehensive/BASC-3-Behavioral-and-Emotional-Screening- System/p/100001482.html 19 Walker, H., Severson, H., & Feil, E. (2014). Systematic Screening for Behavior Disorders (SSBD): Administrators guide, universal screening for PreK–9 (2nd ed.). Pacific Northwest Publishing. https://www.ancorapublishing.com/wp-content/uploads/2018/08/SSBD_Portfolio.pdf 20 Massachusetts General Hospital Psychiatry. (2019). Pediatric Symptom Checklist (PSC). Overview. https://www.massgeneral.org/psychiatry/services/treatmentprograms.aspx?id=2088 21 Youth in Mind. (2016). Strengths and Difficulties Questionnaire (SDQ). https://www.sdqinfo.org/ 22 University of Missouri. (2014). Social, Academic, and Emotional Behavior Risk Screener (SAEBRS). http://ebi.missouri.edu/?p=1116 23 Ci3T.org. (2021). Student Risk Screening Scale—Internalizing and Externalizing (SRSS-IE). https://www.ci3t.org/screening 24 Dowdy, E., Ritchey, K., & Kamphaus, R. (2010). School-based screening: A population-based approach to inform and monitor children’s mental health needs. School Mental Health. 2(4), 166–176. doi:10.1007/s12310-010- 9036-3 25 Volpe, R., & Briesch, A. (2018). Establishing evidence-based behavioral screening practices in U.S. schools. School Psychology Review, 47(4), 396–402. https://doi.org/10.17105/SPR-2018-0047.V47-4 26 Dowdy, E., Furlong, M., Eklund, K., Saeki, E., & Ritchey, K. (2010). Screening for mental health and wellness: Current school-based practices and emerging possibilities. In B. Doll, W. Prohl, & J. Yoon (Eds.), Handbook of youth prevention science. Routledge. The contents of this National Center on Safe Supportive Learning Environments product was assembled under a contract from the U.S. Department of Education, Office of Safe and Supportive Schools to the American Institutes for Research (AIR), Contract Number ED-ESE-16-A-0002. The contents of this product do not necessarily represent the policy or views of the U.S. Department of Education, nor do they imply endorsement by the U.S. Department of Education. 1400 Crystal Drive, 10th Floor | Arlington, VA 22202-3289 | 202.403.5000 14 55 7_ 04 /2 1