Universal Mental Health Screening Research Articles

Comparing Mental Health of US Children of Immigrants and Non-Immigrants in 4 Racial/Ethnic Groups.

To compare the mental health status of children of immigrant (COI) and non-immigrant (NI) parents and to determine whether differences in mental health status between COI and NI vary across 4 racial/ethnic groups. We conducted universal mental health screening of 2374 sixth graders in an urban public school district. To screen, we administered well-validated adolescent depression and disruptive behavior problem questionnaires. We evaluated associations between child mental health, parent immigration status, and race/ethnicity using binomial regression. Among Asian American/Pacific Islanders and Latinos, COI had significantly higher depression and disruptive behavior scores compared to NI. For Blacks/African Americans, children of NI parents had significantly higher disruptive behavior scores compared to COI. For European Americans, scores of COI and NI did not differ and were relatively low. Our study suggests that how the emotional health of COI is faring relative to children of NI depends on the child's race/ethnicity.

Effects of mischievous responding on universal mental health screening: I love rum raisin ice cream, really I do!

Student surveys are often used for school-based mental health screening; hence, it is critical to evaluate the authenticity of information obtained via the self-report format. The objective of this study was to examine the possible effects of mischievous response patterns on school-based screening results. The present study included 1,857 high school students who completed a schoolwide screening for complete mental health. Student responses were reviewed to detect possible mischievous responses and to examine their association with other survey results. Consistent with previous research, mischievous responding was evaluated by items that are legitimate to ask of all students (e.g., How much do you weigh? and How many siblings do you have?). Responses were considered "mischievous" when a student selected multiple extreme, unusual (less than 5% incidence) response options, such as weighing more than 225 pounds and having 10 or more siblings. Only 1.8% of the students responded in extreme ways to 2 or more of 7 mischievous response items. When compared with other students, the mischievous responders were less likely to declare that they answered items honestly, were more likely to finish the survey in less than 10 min, reported lower levels of life satisfaction and school connectedness, and reported higher levels of emotional and behavioral distress. When applying a dual-factor mental health screening framework to the responses, mischievous responders were less likely to be categorized as having complete mental health. Implications for school-based mental health screening are discussed. (PsycINFO Database Record

Does Depression Screening in Schools Reduce Adolescent Racial/Ethnic Disparities in Accessing Treatment?

Although placing mental health services in schools increases access to care, racial/ethnic disparities persist within the scope of school-based mental health services. Universal mental health screening is a potential strategy to increase problem detection and reduce disparities in care provision. However, no study has experimentally tested the effect of universal screening on patterns of service utilization across racial groups and the potential to reduce disparities. Using a cluster randomized design, we compared service linkage patterns among 7th- and 8th-grade Asian American and Latino students (N = 2,494; Mage = 13.65) in schools that either conducted or did not conduct universal depression screening. Multilevel analyses showed that enrollment in a universal screening school, Latino ethnicity, and low academic performance were associated with greater likelihood of referral. However, these factors were not related to caregiver consent or treatment initiation. Screening-triggered referrals were less likely to result in caregiver consent compared to routine referrals. Furthermore, universal screening did not result in a statistically significant reduction in racial/ethnic disparities in treatment referral. Implications for engaging ethnic minority families beyond the point of problem recognition and referral are discussed.

Establishing Universal Mental Health Screening in a Youth Detention Centre Context

Establishing Universal Mental Health Screening in a Youth Detention Centre Context

Making the case for universal school-based mental health screening

Mental health difficulties affect 1 in 10 children and adolescents, and up to half of adult cases begin during the school years. The individual and societal impacts of such difficulties are huge, and include poorer quality of life, lost economic productivity, destabilisation of communities, and high rates of health, education and social care service utilisation. Using early intervention and prevention in schools as a central component of a co-ordinated response to this emergent public health crisis makes good sense. Schools play a central role in the lives of children and their families, and their reach is unparalleled. It has been argued that truly comprehensive and effective mental health promotion in schools requires a universal screening component, but this is a controversial proposition. In this article we explore some of the opportunities and challenges posed by such a system. In doing so, we critically assess international literature on social validity (e.g. acceptability, feasibility and utility), definition and conceptualisation (e.g. what do we mean by ‘mental health’ and related terms?), design and implementation (e.g. planning, tool selection, linking to referral and intervention systems), psychometric considerations (e.g. are available instruments reliable and valid?), diversity (e.g. taking into account cultural variation) and costs and benefits (e.g. are the human, financial and material costs of universal screening justified by the improvements in provision and outcomes they bring?). We conclude by presenting a vision for a school-based system that takes into account these important factors.

Conducting Universal Complete Mental Health Screening via Student Self-Report

Universal screening is increasingly becoming part of prevention and early intervention best practice in schools. Although the number of schools engaging in universal screening has increased over the past decade, emotional and behavioral problems are often their primary focus. Problem-focused screening, however, does not address positive contributions to mental health and is useful for only a small percentage of students. Conversely, the information obtained when assessing for strengths is relevant for all students. The inclusion of a strength-based approach in school-based universal mental health screening serves to broaden educators’ understanding of mental health and can inform reactive and proactive interventions that address problems and enhance strengths. This article discusses the knowledge and skills needed to implement universal complete mental health screening, that is, screening that assesses for students’ strengths and problems. A detailed description of complete mental health screening is provided, followed by a step-by-step implementation guide with specific considerations for practitioners who wish to engage in complete mental health screening as part of comprehensive efforts to promote the well-being of all students. Finally, the process of complete mental health screening is illustrated with a case example.

Public views of acceptability of perinatal mental health screening and treatment preference: a population based survey.

BackgroundAt a prevalence rate of 13-25%, mental health problems are among the most common morbidities of the prenatal and postnatal periods. They have been associated with increased risk of preterm birth and low birthweight, child developmental delay, and poor child mental health. However, very few pregnant and postpartum women proactively seek help or engage in treatment and less than 15% receive needed mental healthcare. While system-related barriers limit accessibility and availability of mental health services, personal barriers, such as views of mental health and its treatment, are also cited as significant deterrents of obtaining mental healthcare. The purposes of this population-based study were to identify the public’s views regarding mental health screening and treatment in pregnant and postpartum women, and to determine factors associated with those views.MethodsA computer-assisted telephone survey was conducted by the Population Research Laboratory with a random sample of adults in Alberta, Canada. Questions were drawn from the Perinatal Depression Monitor, an Australian population-based survey on perinatal mental health; additional questions were developed and tested to reflect the Canadian context. Interviews were conducted in English and were less than 30 minutes in duration. Descriptive and multivariable regression analyses were conducted.ResultsAmong the 1207 respondents, 74.8% had post-secondary education, 16.3% were 18-34 years old, and two-thirds (66.1%) did not have children <18 years living at home. The majority of respondents strongly agreed/agreed that all women should be screened in the prenatal (63.0%) and postpartum periods (72.7%). Respondents reported that when seeking help and support their first choice would be a family doctor. Preferred treatments were talking to a doctor or midwife and counseling. Knowledge of perinatal mental health was the main factor associated with different treatment preferences.ConclusionsThe high acceptability of universal perinatal mental health screening among the public provides a strong message regarding the public value for routine screening during pregnancy and postpartum periods. Perinatal mental health literacy is the most prominent determinant of screening and treatment acceptability and preference. Efforts to enhance population literacy as part of a multifaceted perinatal mental health strategy may optimize pregnant and postpartum women’s mental health.

Universal Mental Health Screening in Pediatric Primary Care: A Systematic Review

Universal mental health screening in pediatric primary care is recommended, but studies report slow uptake and low rates of patient follow-through after referral to specialized services. This review examined possible explanations related to the process of screening, focusing on how parents and youth are engaged, and how providers evaluate and use screening results. A narrative synthesis was developed after a systematic review of 3 databases (plus follow-up of citations, expert recommendations, and checks for multiple publications about the same study). Searching identified 1,188 titles, and of these, 186 full-text articles were reviewed. Two authors extracted data from 45 articles meeting inclusion criteria. Published studies report few details about how mental health screens were administered, including how clinicians explain their purpose or confidentiality, or whether help was provided for language, literacy, or disability problems. Although they were not addressed directly in the studies reviewed, uptake and detection rates appeared to vary with means of administration. Screening framed as universal, confidential, and intended to optimize attention to patient concerns increased acceptability. Studies said little about how providers were taught to explore screen results. Screening increased referrals, but many still followed negative screens, in some cases because of parent concerns apparently not reflected by screen results but possibly stemming from screen-prompted discussions. Little research has addressed the process of engaging patients in mental health screening in pediatric primary care or how clinicians can best use screening results. The literature does offer suggestions for better clinical practice and research that may lead to improvements in uptake and outcome.

The Brief Assessment Checklists (BAC-C, BAC-A): Mental health screening measures for school-aged children and adolescents in foster, kinship, residential and adoptive care

Abstract More than half of children and young people in foster, kinship, and residential care, as well as those subsequently adopted from care, have mental health difficulties that require clinical formulation and intervention. While an increasing number of alternate care jurisdictions are instituting universal mental health screening, existing measures may not adequately screen for a range of attachment- and trauma-related mental health difficulties observed among these populations. The Brief Assessment Checklist for Children (BAC-C), and the Brief Assessment Checklist for Adolescents (BAC-A) are 20-item caregiver-report psychiatric rating scales designed to: 1. screen for and monitor clinically-meaningful mental health difficulties experienced by children and adolescents in various types of care; and 2. be safely administered and interpreted by health and social care professionals other than child and adolescent mental health clinicians. The BAC-C/A were also designed to be used as brief casework monitoring tools by foster care and adoption agencies, and for treatment monitoring in CAMHS. The BAC-C and BAC-A were derived from the Assessment Checklist for Children (ACC, 120 items) and Assessment Checklist for Adolescents (ACA, 105 items) respectively. Internal consistency of BAC-C (N = 347) and BAC-A (N = 230) scores were 0.89 and 0.87 respectively. The BAC-C/A were highly accurate in screening for clinical range ACC and ACA scores (area under the curve (AUC) ranging from 0.96 to 0.99), as well as for CBCL clinical range scores (AUCs: BAC-C = 0.89 to 0.92; BAC-A = 0.93 to 0.94). They were moderately accurate in screening for children that caregivers reported had been referred to mental health services (AUCs: BAC-C = 0.74; BAC-A = 0.79). Initial BAC-C/A psychometric properties compare favourably with that of existing screening instruments, including the Strengths and Difficulties Questionnaire and the Brief Problem Monitor (CBCL short form).

The Consequences of Juvenile Detention Reform for Mental Health and Sexually Transmitted Infection Screening Among Detained Youth

To understand how diversion of low-risk youth from juvenile detention affected screening practices for detained youth. In a 22-month cross-sectional study of 2,532 detainees (age, 13-18 years), mental health and sexually transmitted infection (STI) screening data were compared before and after the beginning of diversion efforts through implementation of a Risk Assessment Instrument (RAI). Detention diversion resulted in a 30% census reduction. In a logistic regression, younger age (odds ratio [OR] = 1.10 for a 1-year increase; confidence interval [CI]: 1.03, 1.17), Hispanic versus white race/ethnicity (OR = .53; CI: .35, .82), and less severe crime (OR = .90 per 1 point; CI: .89, .91) predicted reduced likelihood of detention. Mental health and STI screening increased significantly after implementation of the RAI. Additionally, the rate of positive STI tests increased among detained males (9% pre-RAI to 14% after implementation of the RAI, p = .01). However, implementation of the RAI did not result in a significant increase in the number of positive mental health screens. Universal mental health and STI screening are increasingly common public health practices in detention centers. The results of this study indicate that juvenile justice diversion programming affects public health screening rates among detained youth in our population. Future study of the possible unintended consequences of criminal justice initiatives on public health outcomes is recommended.

Implementing mental health screening within a youth alcohol and other drugs service

Background: While clinical studies consistently demonstrate high rates of co-occurring mental health problems among young people with substance use disorders, mental health assessments are not routinely conducted within Alcohol and Other Drug (AOD) settings. Aims: To describe the implementation of a universal mental health screening program within a youth AOD service. We report on the adoption of screening by AOD staff over the subsequent 30 months, as well as rates of identified psychological problems. Method: Examination of service data that were collected following implementation of the screening program. Results: Between August 2005 and December 2007, AOD workers completed 383 screens (87.4%) from a total of 438 eligible young people. Two hundred and sixty-eight (70.0%) scored 17 or above on the K10, with the mean score of the sample being 23.4 (SD = 9.6). Twenty-seven per cent reported moderate to severe suicide risk, with 9.9% reporting self-harm in the past month. Conclusion: With appropriate level...

School-based mental health checkups: Ready for practical action?

Fox, Halpern, and Forsyth (2008) offer a compelling case for school-based mental health checkups for children at risk for developing anxiety and depressive disorders. Although the concept of universal mental health screening has obvious merits, a number of important issues in clinical science, practice, and training need to be addressed in order to promote successful implementation. With regard to clinical science, issues pertaining to risk assessment, screening implementation, and prevention effects for anxiety and depression deserve additional attention. Many of the challenging issues involved in the dissemination and utilization of evidence-based treatments, including current training of school-based clinicians, apply to screening and prevention efforts. We highlight some of what needs to be done in order to transport the concept of mental health checkups into school-based practice.

Status Quo Will Be Theme Of 2006 Federal MH Budget

Status Quo Will Be Theme Of 2006 Federal MH Budget

Bill Barring MH Screenings Based on Wrong Assumptions

Back to table of contents Previous article Next article Government NewsFull AccessBill Barring MH Screenings Based on Wrong AssumptionsChristine LehmannChristine LehmannSearch for more papers by this authorPublished Online:18 Mar 2005https://doi.org/10.1176/pn.40.6.00400006Federal funds cannot be used for universal, mandatory, or involuntary mental health screening of children under 18 without their parents' consent if a new bill in Congress is enacted.Rep. Ron Paul (R-Tex.) re-introduced the Parental Consent Act (HR 181) in the House of Representatives in January. He had introduced an identical bill last year that dozens of his colleagues condemned and then defeated (Psychiatric News, October 15, 2004).“The bill protects the fundamental right of parents to direct and control the upbringing and education of their children,” Paul told his colleagues, according to the January 4 Congressional Record.Paul argued that the bill is necessary and presented several questionable findings as factual statements to Congress—among them, that the President's New Freedom Commission on Mental Health had proposed in its landmark report that all children undergo mandatory, universal, non-consensual mental health screening, according to the Congressional Record.To set the record straight, APA and the American Academy of Child and Adolescent Psychiatry (AACAP) sent a letter about the bill to members of the House and Senate last month and called on them to oppose the legislation, according to Nicholas Meyers, director of the APA Department of Government Relations,APA and AACAP stated that the findings included in the legislation make false allegations about mental health screening, diagnosis, and treatment.“The bill is based on a false premise,” Meyers told Psychiatric News. “The New Freedom Commission never proposed universal and mandatory screening for children without parental consent.”What the commission had stated on the subject in its final report was,“ Quality screening and early intervention should occur in readily accessible, low-stigma settings, such as primary health care facilities and schools, and in settings where a high level of risk for mental health problems exists, such as juvenile justice and child welfare.”The commission also addressed parental consent by stating, “Whenever `child' or `children' is used in the final report, it is understood that parents or guardians should be included in the process of making choices and decisions for minor children.”Paul's legislation also states that psychiatrists make diagnoses subjectively. “Therefore,” the bill reads, “it is all too easy for a psychiatrist to label a person's disagreement with the psychiatrist's political beliefs as a mental disorder.”In responding to this argument in the letter to Congress, APA and AACAP pointed out that “a patient's political beliefs are not included as a basis for psychiatric diagnostic criteria or in commonly accepted treatment guidelines for mental disorders.”The two associations emphasized that the letter addresses only a few of the false allegations in the legislation.“Taken together, there is ample evidence to oppose the bill, which is neither accurate nor needed,” the two associations wrote. “On behalf of our members and particularly our patients, including children and adolescents that we treat, we respectfully urge you to reject this unnecessary legislation.”The bill had 21 cosponsors in late February and was before subcommittees of the House committees on Ways and Means, Energy and Commerce, and Education and the Workforce.An APA Advocacy Action Alert on the bill is posted online at<http://capwiz.com/psych/mail/oneclick—compose/?alertid=6952921>. The alert provides links to the text of HR 181, the APA/AACAP letter to Congress, and Paul's introductory remarks to the House. The final report of the New Freedom Commission on Mental Health is posted online at<www.mentalhealthcommission.gov>.▪ ISSUES NewArchived