Abstract

Introduction:A 2009 National Academies of Sciences report on child mental health prevention and treatment concluded that screening for mental health risk is an essential component of service delivery. To date, however, there are few practical assessments available or practices in place that measure individual child risk, or risk aggregated at the school or community level. This study examined the utility of a 30-item paper and pencil student self-report screener of behavioral and emotional risk (BER) for surveying community risk among 7 schools.Methods:In 2010, 2,222 students in 3 middle and 4 high schools in a medium-sized school district in Georgia were administered the Behavioral and Emotional Screening System Self-Report Child/Adolescent form (BESS Student). The BESS is designed to measure 4 sub-syndromal BER factors for developing mental health disorders: inattention/hyperactivity, internalizing, school problems, and personal adjustment. Analysis of Variance and Chi Square analyses were used to assess the association between adolescent self-reported BER as an indicator of school BER, grade level, child ethnic identification and gender, socioeconomic status, and special education placement status.Results:BESS scores differentiated well between schools for overall BER and special education status, as well as between grade levels, ethnicity, and gender groups. One high school, known by the school administration to have numerous incidents of student behavior problems, had the most deviant 4 BER domain scores of all 7 schools. Girls rated themselves as having a higher prevalence of BER (14%) than boys (12%); middle school students reported fewer difficulties than high school students.Conclusion:Middle and high school students were capable of identifying significant differences in their own BER across schools, suggesting that universal mental health risk screening via student self-report is potentially useful for identifying aggregated community risk in a given school that may warrant differential deployment of mental health prevention and intervention strategies. BESS results reliably identified individual mental health risk associated with special education placement, which is documented to lead to poor school outcomes such as school dropout and lack of enrollment in post-secondary education.

Highlights

  • A 2009 National Academies of Sciences report on child mental health prevention and treatment concluded that screening for mental health risk is an essential component of service delivery

  • Middle and high school students were capable of identifying significant differences in their own behavioral and emotional risk (BER) across schools, suggesting that universal mental health risk screening via student self-report is potentially useful for identifying aggregated community risk in a given school that may warrant differential deployment of mental health prevention and intervention strategies

  • Behavioral and Emotional Screening System (BESS) results reliably identified individual mental health risk associated with special education placement, which is documented to lead to poor school outcomes such as school dropout and lack of enrollment in post-secondary education. [West J Emerg Med. 2013;14(4):384–390.]

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Summary

Introduction

A 2009 National Academies of Sciences report on child mental health prevention and treatment concluded that screening for mental health risk is an essential component of service delivery. Schools provide an organizational structure that reaches more children with more continuity than primary care, or any other child and family service setting.[7] Schools, are for the most part unprepared to provide preventive mental health services due to limited staff training, a competing focus on and time commitment to educational service delivery, and a lack of assessment methods for delivering services such as universal screening, which is a necessary component of any preventive mental health service delivery program.[8, 5, 9, 3]

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