15% of Seattle sixth-graders identified “in distress”in universal emotional health screening

iStock_000003798811XSmallDepression and other emotional problems can interfere greatly with a child’s ability to learn, but it often takes teachers and administrators far too long to identify those students most in need of help.

To detect these problems at the middle school transition, Seattle conducted a universal emotional health screening of all sixth graders enrolled in four participating middle schools. According to a report in the Journal of Emotional and Behavioral Disorders, some 15% of 861 students screened positive for emotional distress. About 9% of all students screened were referred to a variety of resources, including academic tutoring, school counselor and/or community mental health services.

Key features of the DPSP include: universal screening, accommodation of students with special needs, a questionnaire that assessed both internalized and externalized symptoms of emotional distress, clinical follow-up at the school with identified students, and referrals to academic, social and mental health supports.

Concern about high yield from screening

While schools may be concerned that a universal screening would yield so many children that it would overwhelm resources, the authors note that the yield from the Developmental Pathways Screening Program (DPSP) was “manageable”. To minimize impact on limited resources and also to help allay fears, students who screened positive for emotional distress also received on-site structured clinical evaluations with children’s mental health professionals within two weeks. Seventy-one percent of students who were evaluated were found to be experiencing significant emotional distress.

The questionnaires included six demographic items, and 30 questions each from the Mood and Feelings Questionnaire (Angold & Costello, 1987) and externalizing questions from the Youth Self Report (Achenback, 2001). The screening questionnaire was administered by three trained DPSP field staff during one classroom period. Non-participants, who included students with very limited English proficiency and severe developmental disabilities, along with students whose parents had declined to have their child participate, were given a packet containing a words puzzle and instructed to work quietly at their desks.

Students and parents had been prepared for the screening with a letter home from the school principal and presentations in classes or at assemblies. Students also received an informational flyer and colorful posters announcing the program also were visible around the schools.

According to the authors of the report, “referrals to community mental health resources were made if a student’s identified mental health issues extended beyond middle school adjustment, for example, exposure to recent trauma or stressful life events (e.g., death, divorce, domestic violence) ubs.coor long-standing, unattended conditions or situations.” Costs of implementing classroom-based screening are estimated at $9-$15 per enrolled students, with the exact cost depending on the size of the school and the number of positive screens.

The Seattle screening program found that a disproportionately high number of African American and Asian American students screened positive. It also found that “among Asian Americans, students who screened positive were most likely to actually be distressed and in need of support.” The authors stress that one of the benefits of such screening is that it can identify students in populations “that may have restricted access to early identification and intervention services.”

“Universal Emotional Health Screening at the Middle School Transition” Journal of Emotional and Behavioral Disorders Volume 13 Number 4 Winter 2005 pps. 213-223 March 2006.

Published in ERN March 2006 Volume 19 Number 3


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