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Mental health screening for teens: necessary preventive care or threat of over diagnosis?

Bummed out kids may benefit from psych evaluation.
Bummed out kids may benefit from psych evaluation.
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With increased mental health problems for youth, required screening raises debate students are gearing up to go back to school, buying school supplies and thinking about sports physicals and increasingly, counselors are trying to also steer students toward mental health screening questionnaires like the one below, produced by Teen Screen.

According to the National Institute of Mental Health, half of all cases of mental illness start by age 14 and about 11% of teens suffer from a depressive disorder by 18. Combined with the stresses of adolescence and high school, those issues, if left untreated, can lead to higher dropout rates, substance abuse and even suicide—the third-leading cause of death among teens. Federal authorities have recommended expanding such programs and have advised physicians to perform annual depression screening for patients 12-18, but the screenings remain voluntary. Opponents fear that teens who aren’t really depressed may answer questions in a way that leads to a false positive and that they’ll be subsequently labeled as problematic, or that their parents will be stigmatized if they don’t seek treatment. Rep. Ron Paul (R – Texas) has already introduced legislation that would prohibit federal funds from being used for any mandatory mental health screening without parental consent. Are these screenings a necessary preventive care measure or an invasion of teens’ privacy that leads to over diagnosis and over-prescription of psychiatric medications?

Some sample questions from a questionnaire designed to identify mental-health problems in teens:

In the past three months:

• Has there been a time when nothing was fun for you and you just weren't interested in anything? Yes/No

• Has there been a time when doing even little things made you feel really tired? Yes/No

• Did you have problems with your schoolwork or grades because of you feeling sad or depressed?

• Have you had an attack when all of a sudden you felt you very afraid or strange?

• Have you had a time when you suddenly felt that you were suffocating or you couldn't breathe?
The test screens for:

• Social phobia

• Generalized anxiety

• Panic attacks

• Obsessions and compulsions

• Depression

• Suicide ideation (past month) or attempts (past year)

• Alcohol or substance abuse/dependence

Source: TeenScreen Center for Mental Health Checkups at Columbia University


Elizabeth Pfromm, president and CEO of the Los Angeles Child Guidance Clinic, a mental health clinic specializing in early intervention

Pia Valenzuela Escudero, assistant director for School Mental Health Services; program manager for the Trauma Services Adaptation Center for Schools and Communities at the Los Angeles Unified School District