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The TeenScreen National Center for Mental Health Checkups is an evidence-based, national mental health and suicide risk screening program. The program helps communities in the United States establish early identification programs. Through these programs, families are offered the opportunity for their teens to participate in a screening for mental health problems, such as depression and other suicide risk factors. TeenScreen National Center for Mental Health Checkups began its first pilots in 1999, training sites in Indiana, New Hampshire, and Oklahoma. The national initiative to offer voluntary screening for depression and suicide risk to every American teenager was launched in 2003 by leaders in adolescent health and education. As of 2008, TeenScreen National Center for Mental Health Checkups has over 500 active screening sites in 43 states in the U.S., plus 3 additional countries. [1] Screening is voluntary and offered through schools, clinics, doctors' offices, juvenile justice facilities, and other youth-serving organizations and settings.[1]

Early mental health screening has been endorsed by former U.S. Surgeon General David Satcher[2][3] and the President’s New Freedom Commission on Mental Health.[4] The TeenScreen National Center for Mental Health Checkups is included as an evidence-based program in the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA)'s National Registry of Evidence-based Programs and Practices (NREPP)[5] as a scientifically tested and reviewed intervention.

Because of stigma and other factors, some individuals and organizations oppose mental health screening.

Screening processEdit

As of 2006, participation in the TeenScreen program requires the written consent of a parent or legal guardian. Only in situations where neither parent is accessible, such as in teen shelters and the juvenile justice system, passive consent (parental consent is assumed if it is not explicitly denied) may be used.

After a parent has decided he or she would like his or her teen to participate in the mental health screening through a local organization, and the youth has agreed to participate in the screening, the youth is given a short set of questions regarding different symptoms that occur in depressed or suicidal youth. This questionnaire is the first stage of the screening process. Teens that answer yes to more than a certain number of these questions advance to a short one-on-one interview with a mental health professional to follow up on the symptoms that the teen identified and to determine whether the teen is experiencing any impairment as a result of the symptoms. This second step of the program is where parents can find out whether their teen might benefit from a more in-depth assessment.

Only teens that both indicate they might have a problem on the screening questionnaire and are deemed to be at risk by a mental health professional are considered to have “screened positive.” The parents of these teens are informed of the results and are offered a referral to a local professional for a complete mental health evaluation. The TeenScreen National Center for Mental Health Checkups uses a questionnaire and interview process to see if a teen may be suffering from depression or other mental health problems. It is not a medical diagnosis. Treatment choices, if any, are left to parents.[6]

ResearchEdit

Some research on effectiveness:

Screening is an accurate predictor of mental health problems that may develop into more serious conditions. In a study examining young adults several years after they had participated in TeenScreen in high school, two-thirds of those who made a later suicide attempt or went on to experience a major depression in young adulthood had been identified as being at risk in high school.[7] Clinicians in school-based health centers (SBHCs) using screening tools to assess students who present for services correctly identify three times the number of depressed youth, five times the number of anxious youth, and four times the number of youth with multiple disorders as compared to SBHC clinicians who do not use screening tools.[8]

Some research on safety: Mental health screening and directly asking youth if they are thinking about suicide or have made a prior suicide attempt does not put the idea of committing suicide in their heads, increase suicidal ideation, or create distress.[7][2][9] One randomized controlled trial determined that:[9]

  • Teens who participated in screening did not have higher distress levels than teens who did not participate. This was true immediately after being screened and two days later.
  • Screening participants did not have higher rates of depressive symptoms than non-participants.
  • Screening participants were not more likely to report suicidal ideation after completing the screening.
  • Depressed teens and previous suicide attempters who were screened were less distressed and suicidal than depressed teens and previous suicide attempters who were not screened.

One review of mental health screening from the U.S. Preventive Services Task Force report of May 2004 concluded:[10]

  • There is no evidence that screening for suicide risk reduces suicide attempts or mortality.
  • There is limited evidence on the accuracy of screening tools to identify suicide risk.
  • There is insufficient evidence that treatment of those at high risk reduces suicide attempts or mortality.
  • No studies were found that directly address the harms of screening and treatment for suicide risk.

Other research shows that rates of self-reported suicide attempts decrease when screening is combined with education about suicide and its prevention.[11] The U.S. Surgeon General has highlighted screening as an effective method of youth suicide prevention,[2][3] and the President’s New Freedom Commission on Mental Health places a high priority on the implementation of voluntary school-based screening programs.[4]

CriticismEdit

Some organizations that have strong feelings against mental health screening programs claim that the program is funded by drug companies or is trying to encourage anti-depressant use. The TeenScreen National Center for Mental Health Checkups states that both of these assertions are untrue and that its funding comes from private foundations, individuals, and "organizations committed to the early identification of mental illness in youth and the prevention of teen suicide". Their website shows that for every dollar of support provided to the TeenScreen National Center for Mental Health Checkups, a local program attracts more than four times that amount in local donations, grants or in-kind support.[12]

Several federal programs, including the President’s New Freedom Commission on Mental Health and the Garrett Lee Smith Memorial Act, directly support local screening efforts; a number of state programs have also created unique partnerships to support screening at the community level.[13]

Some of the groups who oppose mental health screening include the Church of Scientology, the Citizens Commission on Human Rights (CCHR), the Eagle Forum, EdWatch, Liberty Coalition, the Association of American Physicians and Surgeons (AAPS), the International Center for the Study of Psychiatry and Psychology,[14] Alliance for Human Research Protection, the Rutherford Institute, and Texans for Safe Education and the Citizens for Health.

Many of these groups also spoke up in opposition of mental health screenings that were conducted without explicit parental consent. In 2005, TeenScreen became the subject of a lawsuit in Indiana by parents who objected to the passive consent procedure.[15][16] In June 2006, TeenScreen changed their consent procedures for all school-based TeenScreen sites so that active parental consent is required. In this system, a parent or legal guardian must sign and return a written consent form before his or her child is allowed to participate. In situations where neither parent is accessible, such as in teen shelters and the juvenile justice system, passive consent (parental consent is assumed if it is not explicitly denied) may be used.

NotesEdit

  1. 1.0 1.1 http://www.teenscreen.org/our-local-programs
  2. 2.0 2.1 2.2 U.S. Surgeon General (1999). Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health.
  3. 3.0 3.1 U.S. Public Health Service (2000). Report of the Surgeon General’s Conference on Children’s Mental Health: A National Action Agenda. Washington, DC: Department of Health and Human Services.
  4. 4.0 4.1 New Freedom Commission on Mental Health, Achieving the Promise: Transforming Mental Health Care in America. Final Report. DHHS Pub. No. SMA-03-3832. Rockville, MD: 2003.
  5. National Registry of Evidence-Based Programs and Practice
  6. "Columbia University TeenScreen Program: Mental Health Check-Ups for Youth - Screening Process". http://www.teenscreen.org/screening-process. Retrieved 2008-09-09.[dead link]
  7. 7.0 7.1 Shaffer D, Restifo K, Garfinkel R, Wilcox H, Ehrensaft M, Munfakh J. (1998). "Screening for young-adult suicidality and mood disorders in high school." Poster presented at the annual meeting of the American Academy of Child and Adolescent Psychiatry; Anaheim, CA.
  8. Levitt JM, WonPat-Borja A, Buffered S, Jensen P. (2004). "Implementing evidence-based assessment strategies in schools." Poster presented at the annual meeting of the American Psychological Association; Honolulu, HI.
  9. 9.0 9.1 Gould M, Marrocco F, Kleinman M, Thomas J, Mostkoff K, Cote J, Davies M. (2005). "Evaluating iatrogenic risk of youth suicide screening programs: A randomized controlled trial." Journal of the American Medical Association; 293: 1635-1643. PMID 15811983
  10. Screening for Suicide Risk: Recommendation and Rationale - U.S. Government Preventive Services Task Force
  11. Aseltine RH and DeMartino R. (2004). "An outcome evaluation of the SOS suicide prevention program." American Journal of Public Health; 94(3): 446-451. PMID 14998812
  12. http://www.teenscreen.org/national-teenscreen-support
  13. http://www.teenscreen.org/federal-partnerships-and-support-for-suicide-prevention http://www.teenscreen.org/state-partnerships-for-suicide-prevention
  14. Website of the International Center for the Study of Psychiatry and Psychology
  15. US teenager’s parents sue school over depression screening test - British Medical Journal
  16. The actual copy of the lawsuit is on the Rutherford Institute's website.case 3:05-cv-00586-JTM-CAN - Rutherford.org

External linksEdit

  • TeenScreen.org - 'Setting The Record Straight About TeenScreen' (October 17th, 2005)
  • [1] - National Registry of Evidence Based Programs and Practice
  • [2] - President's New Freedom Commission on Mental Health
  • [3] Garrett Lee Smith Memorial Act
  • Ron Paul's Congressional homepage - Speech on bill banning mandatory mental health screening of children
  • Parental Consent Act of 2007, full text - Bill to ban mandatory mental health screening of children, introduced in House of Representatives in 2007
  • AntiDepressantsFacts.com - 'Bush Administration, Columbia University & "Teen Screen Program"', Charly Groenendijk (June 25, 2004)
  • Scoop.co.nz - 'TeenScreen - The Law Suits Begin' (opinion), Evelyn Pringle (June 2005)
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