A Case for Depression Screening In Schools

It is tough for students to succeed in life and in school if they suffer from depressive disorders. We test our youth for so many things, including intelligence and scoliosis, so why not depression? Three hundred and fifty million people around the world are affected by depression, and it is important for health care professionals to detect it early. According to the Maternal & Child Health Journal, 2% of young children and 8% of teens have depression at any point in time. "The number one illness worldwide that causes morbidity is major depression. It causes people to miss work, school, and not function at the level they should be able to," stated Rimal Bera, MD, a psychiatrist at UC Irvine Medical Center. Dr. Bera believes that there should be depression screening in schools because, in his view, "Depression screening is just as important as [checking] weight and blood pressure."

According to the Journal of Child and Adolescent Psychiatric Nursing, the latest studies on teen depression in the United States show that the issue has worsened, but tools to screen accurately the illness in youth have improved. Recognizing depression in teens is currently a significant mental health issue of the World Health Organization, mainly because it contributes to low grades and suicide risks. It can have a terrible impact on physical and mental well-being and academic success if it is not treated. Occasionally, students miss school because of depression, which is a financial burden to taxpayers. A student at Lincoln High School in San Diego missed 87 days of the 10th grade (approximately half of the school year), which cost her school $2,464.71. Sometimes students even drop out of high school because of depression. When this happens, there are correlations with higher unemployment and incarceration rates.

Regular screening in a school environment is a great way to detect the illness early. Dr. Bera said:

Doing a depression screening every year of school could be helpful, but certainly doing it towards the end of high school would be beneficial. It could be done at a school assembly or a science class with a lot of other screenings, such as a bullying assessment.

The Journal of Child and Adolescent Psychiatric Nursing explains that there are many factors that have to be taken into consideration when screening teens for depression. Important stakeholders must be involved before the screening takes place. These stakeholders may consist of school administrators, teachers, families, and mental health organizations. Agreement must be acquired from students getting assessed, parents/guardians, and school districts. Then, guidelines should be determined for the implementation, compilation, scoring, analysis, and follow-up of the assessment.

Dr. Bera added, "Depression screening should be simple and user friendly at first, and school counselors, nurses, and teachers could administer it." He recommends the Hamilton Rating Scale for Depression and the Beck Depression Inventory. Some other well-known evaluations are the Children's Depression Inventory and Reynolds Adolescent Depression Scale.

Technology is making significant advances everywhere, including depression screening. Dr. Bera shared:

There are some smart phone applications now to help track depression. Someone could track depression on his or her phone and the data could go straight to the doctor's office. If the doctor saw the patient was getting worse, they could call him and see if he's taking his medication.

In fact, a professor and an alumnus from my alma mater, Pepperdine University, created an app called MoodKit, which helps with depression and other mental health issues. This app works by having people link their mental states, behaviors, and thoughts. It is different from reading books since it is interactive. "This is a market that investors are getting excited about since there is so much room for growth," said Dr. Bera. Perhaps technology could assist with this issue since there is a shortage of psychiatrists

According to the Maternal and Child Health Journal, some factors that affect bringing depression screening into schools, besides proven effectiveness, are school budgets, politics, the feelings of everyone involved (which can include a stigma toward mental illness), and what parents want. Parents are very important in the big picture since they pay taxes, school board members listen to them, and they are very involved in their children's health. Studies show that education about depression and mental health reduces the stigma toward it. Dr. Bera said:

The stigma of mental illness will always be stronger than the stigma of physical illness since depression can't be found with a blood test or an X-Ray. The diagnosis will always be based on what you say, what I pick up, and what family members say. There will always be guardedness or shame, but it will get less.

He added, "The stigma associated with depression will lessen with education in places like schools and places of worship. In fact, Saddleback Church [in Lake Forest, CA] is holding a large conference on mental illness in October."

Education is key to informing people about mental health. Taking steps toward improving students' well-being, and assisting them with living their lives to the fullest without the burden of depression is essential. Depression screening in schools is fundamental to this.