Mental health: To screen or not to screen?

3 options for uncovering new student mental health needs—conducting universal screening, acting on referrals or looking for trends
By: | September 1, 2020
GettyImages: Esther Moreno Martinez / EyeEmGettyImages: Esther Moreno Martinez / EyeEm

Feeling detached from everyone and everything beyond their family because of the pandemic may cause students who have never been on educators’ radar in the past for mental health concerns to start bubbling to the surface as the school year begins—regardless of whether they are continuing to learn remotely or back at school buildings.

“It’s important to uncover new needs that students are going to be presenting with,” says John Crocker, director of school mental health and behavioral services at Methuen (Mass.) Public Schools. “As a field, we’re pretty terrible at identifying internalizing concerns. Add to that the trauma of COVID-19, and increased anxiety and depression, and having a greater sensitivity to the needs of our kids is going to be really important.”

Weigh these options for uncovering student mental health issues:

1. Conduct universal screening.

If you have the infrastructure in place to address the needs of a potentially large number of students either in person or remotely who may convey mental health needs through a web-based screening tool, engage in a screening early in the school year, Crocker says. If you don’t have a coordinated means of remote follow-up and crisis prevention and intervention, then you may not want to start screening all students this year and may want to concentrate on those about whom you already have concerns instead. “Screening in person is hard enough, then add to that the element of remote screening and remote coordinated follow-up, and that’s just another layer that needs to be accounted for,” he says. “It’s tough to account for all the layers.”

Before conducting a remote screening, ensure you have a strong connection with the parents of students participating, Crocker says. “There needs to be a higher level of communication happening with those who are in the home and who can ultimately serve as emergency support because we’re not in the same building as we’re screening.”

The same is true regarding a screening for trauma. If you’re not sure you have the capacity to address the needs of a high number of students in a high school, for example, you may want to choose a class for a pilot screening, then reflect on the results and whether you can continue to scale up. “Address the needs of those students, then see if you can move on to a next set of students,” he says.

2. Act on referrals.

If your district or school building is not ready to conduct a large-scale mental health screening, be prepared to conduct more initial assessments based on teacher, parent, and student referrals, Crocker says. Also recognize a drop in student attendance or grades, or an increase in challenging behavior, as a red flag. “When one of those flags goes up, that’s an opportunity for us to conduct an initial assessment to rule in or rule out social-emotional concerns,” he says.

For example, if a teacher notices a student has stopped logging on for assignments in the past week, you’d want to investigate if there is underlying anxiety, depression, or trauma related to COVID-19, Crocker says. “That’s a much lighter lift in terms of starting in on the use of psychosocial data. It uses existing systems that people are familiar with and gets people used to the use of psychosocial data in a way that is a little less of a systems-level concern, and it’s something you can do right away. That to me is a nice in-between solution for districts that really want to be sensitive to their kids’ needs but can’t go down the road of universal screening.”

3. Look for trends.

You may also want to conduct needs assessments, such as those of staff, parents, students, and the community, to see how different groups are doing and determine if there are any trends. “This is not for identification; it’s anonymous,” Crocke says. “You are looking for trends to see the number of students or families who have needs related to food insecurity or social-emotional issues or even technology. If a family can’t put food on the table, I’m guessing academics are the least of their concerns.”

Cara Nissman covers autism, school psychology, and IEP team issues for Special Ed Connection, a DA sister publication.