Getting an A on the test you studied for all week. Your crush smiling at you while you are at your locker. Your friends saving a seat for you at the lunch table by the window. High school has plenty of highs, but it also has its fair share of lows. And while mood swings are a normal part of being a teen, periods of prolonged sadness can indicate clinical depression.
Depression is a chronic and often debilitating illness linked to suicide–60% of those who attempted suicide struggled with major depressive disorder. With major depressive disorder on the rise, the need for effective screening is essential in identifying individuals who need care and treatment for their condition. School-based screening programs can be particularly useful in finding teens with major depressive disorder and starting a conversation about the potential for additional care needs.
Dr. Deepa Sekhar and her team worked with a population of 12,900 students in Pennsylvania to compare (universal) screening for all students versus (targeted) screening for students who are referred for depressive symptoms in high schools. For the universal screening intervention, students completed a depression survey (PHQ-9). Any student who had symptoms of depression were referred to an existing student assistance program. In the targeted screening arm, school administrators, teachers, or parents referred students for mental health support based on observing concerning behavior.
Sekhar and colleagues showed that students in schools with universal screening identified nearly 6 times more students with treatable depression. Broad screening also led to higher likelihoods of students confirming follow-up needs and initiating treatment.
The study calls for implementing universal screening–done confidentially and with educational elements to mitigate stigma–paired with a robust infrastructure to support students who may seek resources for initiating mental health treatment.
Databyte via Deepa L. Sekhar, Eric W. Shaefer, James G. Waxmonsky, et al. Screening in High Schools to Identify, Evaluate, and Lower Depression Among Adolescents: A Randomized Clinical Trial. JAMA Network Open, 2021.