School screening increases identification and treatment of depression

UNIVERSITY PARK, Pa .– Students who participated in the universal school-based depression screening were twice as likely to start treatment as their peers who did not receive the screening, according to a new study from Pennsylvania State College of Medicine researchers.

Dr Deepa Sekhar, associate professor of pediatrics, who was a senior researcher, said the study provides important information on how to tackle depression in young people. The next step will be to look for ways to break down barriers so that school districts interested in implementing depression screening can do so effectively.

“Our study is published at a time when more and more adolescents are reporting symptoms of depression,” said Sekhar, pediatrician at Penn State Health Children’s Hospital and executive director of Penn State PRO Wellness. “From 2008 to 2018, the numbers increased by more than 70%, from 8.3% to 14.4%. During the pandemic, concerns about increasing depression among college students became widespread. Suicides, which are often associated with mental health problems, are now the second leading cause of death among adolescents. “

Penn State PRO Wellness, which led the research effort, conducts a variety of educational programs and community-based research studies. Sekhar highlighted the high need for screening given the growing incidence of unmet mental health needs among students.

“This research shows that we have better ways to reach students,” she said.

Because most children and adolescents are enrolled in public education, screening in schools may be a more effective approach for identifying symptoms and treating depression, Sekhar added. Relying solely on doctors and other health professionals to spot depression is not enough. While the U.S. Task Force on Prevention Services recommends universal screening for depression in primary care 12-18 year olds, less than half of U.S. teens have regular check-ups and even fewer get screened. Schools currently perform visual and hearing screening to identify barriers to students’ academic success, but Sekhar notes that depression can affect academic achievement as well.

The three-year study was unique from previous studies on student depression because of its large size. More than 12,000 students in grades 9 to 12, from 14 public high schools in Pennsylvania, were involved, Sekhar said. Another distinguishing feature was that the students were overwhelmingly in the minority, from urban and rural neighborhoods, and many were from disadvantaged socio-economic backgrounds.

In each of the schools, students in two of the four high school grades were randomly assigned to be screened for depressive symptoms using an established questionnaire. Students in other classes went through the school year as usual, receiving screening and support under the Pennsylvania State-mandated Student Aid Program only if they were reported in. because of worrying behavior.

Researchers found that universal school screening for depressive symptoms increased both identification and initiation of treatment for depression in adolescents. The study also found greater identification of depressive symptoms in women and minority students, although these groups did not have a significantly greater onset of treatment. Overall, students who received universal screening were twice as likely to initiate treatment. The researchers published their results in the open JAMA network.

“Looking at the results,” Sekhar said, “next we want to focus on what school districts, nationwide, need to implement a universal screening program. We know the support from administrators will be there. essential, as well as clear policies and procedures for screening and follow-up. It is also important to emphasize to schools and families that screening simply identifies symptoms and does not diagnose depression or any other mental health problem. ”

The researchers worked with stakeholders who included parents, students, school staff, and the Student Assistance Program. Sekhar said school districts were enthusiastic and extremely helpful during the research. School participation was staggered over the 2018-2019 and 2019-2020 academic years.

“The staff at our participating schools were pretty amazing; they were ready to take the plunge with us, ”she said. “There are a lot of great educators out there who are incredibly dedicated to their students.”

James waxmonsky, Jennifer kraschnewski, Eric Schaefer, Krista Pattison and Alissa Molinari of Penn State College of Medicine; Leslie Walker-Harding of Seattle Children’s; and Perri Rosen of the Garrett Lee Smith Youth Suicide Prevention Grant also contributed to this research. Penn State researchers do not disclose any associated conflicts of interest.

The research was funded by a Patient Centered Outcomes Research Institute (PCORI) Award (AD-2017C3-8752) totaling $ 2.03 million and also by the Health Resources and Services Administration of the US Department of Health and Social Services for a prize totaling $ 900,000. (R40MC31765). The use of Research Electronic Data Capture in this project was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health through the Penn State Clinical and Translational Science Institute (grant UL1 TR002014). The opinions presented in this publication are the sole responsibility of the authors and do not necessarily represent those of the study sponsors.