Lessons Learned From Universal Screening of Mental Wellbeing

Posted On October 1, 2019
Categories Uncategorized

Four Years of Universal Mental Health Screening in Georgia’s Schools:
WHAT WE HAVE LEARNED

By Emily Graybill, PhD, NCSP, Brian Barger, PhD, Andrew T. Roach, PhD, Quynh Wellons, M.Ed., Ashley Salmon, MPH, Camara Gregory, MPH, & Corey Jones, MPH

 

The three school districts participating in Georgia Project AWARE have been the trailblazers for helping us understand how to implement universal mental health screening in Georgia. We at the Center for Leadership in Disability at Georgia State University (CLD-GSU) have had the honor of guiding these districts through a step-by-step, evidence-informed universal screening process. In addition to providing educators with screening data to inform decisions about student supports, we at the CLD-GSU analyzed the screening data to help answer broader questions about universal mental health screening in schools. Here are some of the research questions we have asked and answered.

 

Question: Does student-reported universal mental health screening data identify students at risk for mental health concerns who would not otherwise be identified through discipline data?

Answer: Yes. In a sample of 1,735 middle school students in Georgia, students who rated themselves high on the screener’s externalizing behavior subscale were more likely to have a high number of office discipline referrals (ODRs) by the end of the school year. Students who rated themselves high on the screener’s internalizing behavior subscale were less likely to have a high number of ODRs by the end of the school year. This means that a middle school’s ODR data are likely to help educators identify students with externalizing behaviors but the ODR data are unlikely to be useful for identifying students with internalizing concerns. Universal mental health screening is one of the few ways to systematically identify students who may be struggling silently with issues like anxiety or depression.

 

Question: Does teacher-reported universal mental health screening data identify students at risk for mental health concerns who would not otherwise be identified through discipline data?

Answer: Yes. In a sample of 1,201 elementary school students in Georgia, students rated high by their teachers on the externalizing behavior subscale were more likely to have 15a high number of ODRs by the end of the school year. Students rated high by their teachers on the internalizing behavior subscale had varied numbers of ODRs at the end of the school year. Some students who were rated high on the internalizing behavior subscale had high numbers of ODRs and some had low numbers of ODRs. This means that an elementary school’s ODR data are likely helpful in identifying students with externalizing concerns but would only indicate some, but not all, students with internalizing concerns. Universal mental health screening provides elementary school teachers with a systematic way to identify students who may be struggling silently with issues like anxiety or depression.

 

Question: Do different informants (e.g., teachers, students) and different screeners identify different students as at risk?

Answer: Yes. We examined screening results from 100 students in one high-achieving high school that conducted universal mental health screening using both a teacher-report screener and student-report screener. The results confirmed that teacher and student reporting, as well as different screening tools, will result in some different students being identified. The choice of informant and screening tools should be dependent on the needs and resources of the school.

 

Question: How do teachers feel about completing the universal mental health screener?

Answer: According to a sample of 60 elementary school teachers in Georgia schools, the universal mental health screener is easy to use and the teachers see the importance of conducting screening to identify students who may be at risk for mental health concerns. More of the teachers would like to see the screening data used in a timely manner to help connect students to services. To ensure teacher buy in, schools interested in conducting universal mental health screening should make sure that the data collected is used efficiently and effectively.

 

Question: When teachers complete the universal mental health screener, do they rate students differently based on the student’s race, gender, and grade?

Answer: Not in the dataset that we analyzed from Georgia schools. In a sample of 4,755 elementary school students in Georgia schools who were 48% female, 52% male, 47% African American, 39% White, 9% Hispanic and 6% Other or Mixed Races, 50% in K-2nd and 50% in 3rd-5th, there were minimal differences in teacher responses across the race, gender, and grade of the students. This means that teacher responses on the universal mental health screener were not significantly different based on the race, gender, or grade of the student. Mental health screeners exist that are not systematically biased regarding race, gender or grade, so schools may be confident that they are measuring the same concerns in different groups.

 

Review the CLD-GSU’s website for additional information about implementing universal mental health screening. Contact Dr. Emily Graybill at egraybill1@gsu.edu if your district is interested in implementing universal mental health screening.