Suicide screening and other K12 interventions have faced opposition from those who argue such approaches risk inciting self-harm among students. But new research has found just the opposite—that school-based screening is a crucial tool in preventing self-harm.
The use of the Patient Health Questionnaire-9—a depression screening tool also known as PHQ-9—increased a school’s chances of identifying students at risk for suicide and getting them into some level of treatment. A questionnaire designed specifically to assess suicide risk—such as the Ask Suicide Screening Questions [ASQ] tool—would be even more effective, according to the Journal of Pediatrics study spearheaded by medical researchers at Penn State University.
The team screened half of the approximately 13,000 students who participated in the study. The questionnaire asks students if, in the previous two weeks, they have felt little interest in regular activities, had trouble sleeping, staying awake or concentrating, been feeling like a failure, or considered suicide or self-harm. Students who were assessed were seven times more likely to be identified as at risk for suicide and four times more likely to begin receiving mental health counseling.
When the team used a previous version of the questionnaire that lacked the suicide and self-harm question, a substantial number of at-risk students were missed. The researchers acknowledged, however, the ongoing challenges school staff face when screening students, particularly as more extensive interventions are needed when students are identified as at-risk.
Movement on mental health
Legislation to improve school-based mental health care has been passed and proposed in several states in recent months, according to the National Council of State Legislators. A new law in Delaware requires the state’s education department to work on statewide K12 mental health education programs. Colorado, meanwhile, is now compiling statewide data on chronic absenteeism, in-school and out-of-school suspensions, and the number of school-related arrests.
The Council of State Legislators noted several other recent developments in K12 mental health care:
- Connecticut, New Hampshire, Oklahoma and Tennessee passed laws last year that required schools to print the 988 Suicide and Crisis Lifeline number on student identification cards.
- Kentucky school districts must update their attendance policies to excuse absences for mental health reasons.
- Louisiana has created the Student Behavior, Mental Health and Discipline Task Force to examine trauma-informed services, the feasibility of school psychologist and social worker ratios, and various aspects of student discipline.
- Pennsylvania now provides grants to districts to develop or adopt suicide awareness and prevention curricula, and train school employees and students to identify signs of anxiety, depression, suicide or self-harm.
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Researchers elsewhere are working to improve and accelerate the training of school-based behavior analysts, counselors and social workers. The University of Oklahoma has launched “Project Rural Innovation for Mental health Enhancement,” or PRIME—with a $5.6 million state grant—to improve mental health care in rural schools. Increasing the number of homegrown counselors is a key goal that the researchers hope will lead to bigger decreases in suspensions, expulsions, and other disciplinary actions.
“Oklahoma has some of the most diverse rural schools in the entire country,” said lead researcher Brittany L. Hott, an associate professor of special education and associate director of the university’s Institute for Society and Community and Society Transformation. “We are going to grow our own. We are going to recruit from the rural districts that we are serving.”
