School-based screening can improve mental health of teenagers, new study finds

School-based screening for mental health problems, combined with a referral system, can be effective at improving and protecting the mental health of adolescents, according to a new study by researchers at the Royal College of Surgeons in Ireland (RCSI).

The research, published in BMC Public Health, is the first study to examine the impact of school-based interventions on preventing psychotic experiences, which are an early indicator of developing mental disorders in children and adolescents.

Of the interventions tested, one consisting of a universal screener and selective intervention was found to both reduce the rates of, and prevent psychotic experiences at 12-month follow up.

Lead author and RCSI PhD student, Lorna Staines said psychotic experiences are particularly common in the adolescent population and are associated with a fourfold increased risk for psychotic disorder, and a three-fold increased risk for any mental disorder.

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“This study has for the first time identified school-based programmes as an effective route to prevent psychotic experiences,” she said.

Professor Mary Cannon, the RCSI’s professor of psychiatric epidemiology and youth mental health, said prevention has two key objectives: to reduce the symptoms of mental health disorders, and prevent new incidence of symptoms.

“This study demonstrates that school-based interventions have the potential to be effective at both key aims of prevention, making a positive impact on public mental health,” she said.

The study comes at a time of rising concern over the scale of mental health problems among schoolchildren.

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While experts say the proportion of mental health problems among schoolchildren has been growing for many years, there is fresh evidence that it has been exacerbated by the pandemic.

The Department of Education is funding a pilot project this year to provide primary school pupils with access to specialist counsellors in schools.

It follows calls from teachers and experts for the development of in-school counselling in response to rising levels of anxiety.

A recent report from the Oireachtas education committee has recommended extending in-school counselling pilot to second level.

In addition, it has proposed the creation of an expert taskforce on professional training for school mental health supports, to ensure there is an adequate supply of qualified counsellors, and the appointment of a mental health responsible for delivering in-school supports to students in liaison with the HSE.

Responding to the Oireachtas report, Professor Paul Downes of DCU, who is director of the university’s Educational Disadvantage Centre, said the findings sent a “powerful message” to Minister for Education Norma Foley on the need to extend the national pilot of specialist emotional counsellors and therapists to include secondary schools.

“There is no rhyme or reason not to have a similar pilot at secondary school level,” he said.

A distinctive feature of the report was that the “walls between health and education are tumbling down, as part of a multidisciplinary teams vision in and around schools to support mental health and complex interrelated needs,” he said.

He called for the pilot project to be accelerated and not to wait for a wider of developing a multidisciplinary vision for schools in Ireland.

“There is a real risk that the first step will become drowned in bureaucracy and interdepartmental delays, if it is made to depend on the second complex step of establishing multidisciplinary teams in and around schools,” he said.