Could school screening assist with adolescent depression?

A new research attempts school screening to identify depression in teenagers
  • Adolescent depression has been on the rise in the United States.
  • Because the majority of teenagers attend school, they might be a good area to look for pupils who are depressed.
  • According to a new study, uniformly screening students for depression was more efficient than teachers indicating changes in behavior that could imply depression in identifying children and getting them to start treatment.

A new study looks into the consequences of uniformly screening students in schools for depression. According to the researchers, screening is a more effective technique than depending on instructors to report behavior that may suggest depression.

The study, published in the journal JAMA Network Open, suggests a novel approach to dealing with the considerable increase in depression among teenagers in the United States since 2008.


According to the National Institute of Mental Health (NIMH), depression is a common but significant mood condition that can have profound negative impacts on quality of life.

Symptoms vary from person to person, but they might include:

  • feeling sad, anxious, emotionally empty, irritable, restless, or hopeless
  • speaking slowly
  • having low energy
  • having disrupted sleep
  • finding it difficult to concentrate
  • having suicidal thoughts

Depression is a mental illness that may afflict people of all ages, including teenagers. According to the National Institute of Mental Health, 15.7 percent of teenagers in the United States experienced at least one major depressive episode in 2019 — the most recent year for which data is available.

This figure has nearly doubled from 2008, when it was only 8.3%.\

Depressive disorder screening

The Preventive Services Task Force recommended that all adolescents be screened for depression in primary care settings in 2009. In practice, however, this has not been accomplished.

According to the authors of the report, there are huge discrepancies in who has access to basic healthcare, with more than 60% of adolescents not receiving routine preventative care. There are also regional disparities as well as racial and ethnic disparities.

Because the majority of teenagers attend school, schools might be an excellent area to spot those who are depressed.

In the United States, schools are now required to examine students for certain physical health issues. Mental health disorders such as depression, on the other hand, rely on school workers identifying behavior that might indicate depression and reporting it to the appropriate services.

Speaking with Medical News Today, Dr. Deepa Sekhar — a pediatrician at Penn State Health Children’s Hospital, Hershey, and the corresponding author of the present study — said that “the current approach depends upon adolescents exhibiting symptoms/acting out in some way, e.g., failing classes, missing classes, [or] irregular behavior.”

Dr. Sekhar and her colleagues sought to determine if uniformly screening for depression in schools would result in more kids with suspected depression being identified and treated than a targeted program.

According to Dr. Sekhar, “Our study is publishing at a time when more adolescents are reporting symptoms of depression.”

“The numbers climbed by more than 70% from 8.3 percent to 14.4 percent between 2008 and 2018.” Concerns about rising student depression were prominent during the epidemic. Suicides, which are frequently linked to mental illnesses, are now the second biggest cause of youth death, according to Dr. Sekhar.

Almost 13,000 people took part

The Screening in High Schools to Identify, Evaluate, and Lower Depression (SHIELD) research took conducted in Pennsylvania public high schools between November 6, 2018, and November 20, 2020.

A total of 12,909 students from 14 high schools took part in the competition.

The researchers assigned students in each school to either 9th and 11th grade universal screening or 10th and 12th grade universal screening.

If and when staff members identified depression-related behavior in students in other grades, they continued to report them. This traditional approach might also be used for students who were undergoing universal screening.

Students who received universal screening completed the Patient Health Questionnaire-9, a well-known depression screening questionnaire. They did this electronically during school hours.

Significant identification of depression

During the research, 1,226 students (9.5%) satisfied the criteria for major depressive illness. One thousand and twenty-six of them came from the general screening group, with the remaining 200 from the regular focused screening group.

Following an initial evaluation by student support workers, 233 students from the universal screening group needed to be followed up on, and 80 of them started therapy.

In contrast, 64 of the targeted screening group needed to be followed up on, with 35 of them starting therapy.

Students who completed universal screening were 5.9 times more likely to have their major depressive disorder symptoms diagnosed and 2.1 times more likely to begin the prescribed therapy, according to these data.

Universal screening, according to Dr. Sekhar, might be beneficial for other prevalent mental health concerns as well, but only if schools have the tools to treat students who have been recognized as having mental health difficulties.

“Screening should not be done unless you are confident that intervening for identified students is successful and that you have the capacity to act,” Dr. Sekhar stated.

“For example, we know that glasses may benefit kids who can’t see well, but it wouldn’t make sense for a school district to screen if identified students couldn’t obtain glasses.”

Research in the future

The researchers intend to continue their investigation. “Our next step,” Dr. Sekhar added, “is to think about how we can best enable schools interested in universal screening to effectively implement this approach.”

Dr. Sisi Guo of the University of California, Los Angeles’ Semel Institute for Neuroscience and Human Behavior, and Dr. Grace Bai Jhe of Boston Children’s Hospital’s Division of Adolescent/Young Adult Medicine noted the importance of the research while also identifying additional questions that need to be answered in an invited commentary on the study.

Future study, according to Drs. Guo and Jhe, should look at the extent to which universal screening can detect adolescents with subclinical symptoms. It might also look at whether students identified by universal screening techniques stick with therapy following the first session.

While universal screening may be beneficial in detecting adolescents with major depressive illness, schools must be well-funded and resourced to respond to this information, according to Dr. Guo and Dr. Jhe.

“Both old and newly discovered, more equitable financing and policies are required to guarantee that personnel are effectively educated and schools remain accessible to all adolescents,” they write.