Mental Health Screening and Follow-up Care in Public High Schools

• Published in: Journal of the American Academy of Child and Adolescent Psychiatry Vol. 50; no. 9; pp. 881 - 891
• Main Authors: Husky, Mathilde M., Ph.D, Sheridan, Marian, R.N, McGuire, Leslie, M.S.W, Olfson, Mark, M.D., M.PH
• Format: Journal Article
• Language: English
• Published: Maryland Heights, MO Elsevier Inc 01-09-2011; Elsevier; Elsevier BV
• Subjects: Adolescent; Adolescents; Adult and adolescent clinical studies; At risk; At Risk Students; Biological and medical sciences; Child clinical studies; Community Mental Health Services - utilization; Community Relations; Community service; Community Services; Educational Environment; Female; Follow-Up Studies; Grade 9; Health Services; High School Students; Humans; Identification; Interview, Psychological; Male; Medical sciences; Medical screening; Mental Disorders; Mental Disorders - diagnosis; Mental Disorders - therapy; Mental Health; Mental health care; Mental Health Programs; Pediatrics; Psychiatry; Psychological assessment; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Referral; Referral and Consultation - utilization; Referrals; Retrospective Studies; Risk factors; School Health Services - utilization; screening; Secondary school students; Self Destructive Behavior; Self Report; service use; Students - psychology; Students - statistics & numerical data; Suicidal Ideation; Suicide; Suicides & suicide attempts; Therapy; suicidal ideation; screening; service use; Grammar school; Patient follow-up; Mental health; Medical screening; Suicide ideation
• ISSN: 0890-8567; 1527-5418
• DOI: 10.1016/j.jaac.2011.05.013

Objective Despite increased interest in screening adolescents for mental health problems and suicide risk, little is known regarding the extent to which youth are identified and connected with appropriate services. Method Between 2005 and 2009, a total of 4,509 ninth-grade students were offered screening. We reviewed the records of the 2,488 students who were screened. Students identified as being at risk were provided with a referral. Data were collected on screening results, mental health referrals, and completion of recommended treatment over approximately 90 days. Results Among students screened, 19.6% were identified as being at risk, 73.6% of whom were not currently receiving any treatment. Students referred for school services tended to be less severely ill than those referred for community services, with lower rates of suicidal ideation, prior suicide attempts, and self-injury. Among at-risk students not currently in treatment, 76.3% of students referred received at least one mental health visit during the follow-up period. Overall, 74.0% of students were referred to school and 57.3% to community services. A great majority of school referrals (80.2%) successfully accessed services, although a smaller proportion of community services referrals successfully accessed treatment (41.9%). Conclusions Systematic voluntary school-based mental health screening and referral offers a feasible means of identifying and connecting high-risk adolescents to school- and community-based mental health services, although linkages to community-based services may require considerable coordination.