If We Don't Ask, We'll Never Know

...and the consequences can be dire.

Posted Dec 07, 2016

If you were born in the 1960s, 70s, or 80s, and you lived in the United States, chances are you remember a few tests administered in your school that were not designed to measure your reading, writing, or arithmetic.  One test involved wearing a set of headphones while raising your left or right hand corresponding to the sound of tones in each ear.  Another test involved reading shapes or letters on a chart from a distance.  I can even recall one day in kindergarten when class time was used to have us chew a tablet and then brush our teeth.  The blue spots in our mouth when we finished highlighted areas where we did not brush adequately and may be at risk for a cavity.  In the United States, we take considerable time from our children’s education to ensure that they are healthy, developing appropriately, and at low risk for a wide range of future difficulties. 

But interestingly, there are no universal screening programs to detect mental health problems.  Why is that? 

Some of my research is designed to ultimately prevent youth suicide, and as part of our work, we conduct universal mental health screenings in traditional public school settings.  With parental consent, we ask all children to complete just a few simple questionnaires, and the results are quite alarming to most.

Findings reveal that in a school no different than most schools in America, about one in every ten children report that they have frequently thought about hurting themselves or ending their lives.  About 1 in 20 report that within the year prior to our assessment, they have actually attempted suicide.  These results are generally consistent with findings from the CDC and a variety of other epidemiological surveys.  What may be most surprising, however, is that the children reporting suicidal thoughts and behaviors are not the kids you might expect. 

Parents are routinely shocked to learn that their child has been considering suicide.  Many recognize that their child has become a bit more oppositional as they have matured.  Some say that their son or daughter has seemed emotional.  But most chalk it up to “hormones,” or typical teenage “ups and downs.”  The majority are shocked to learn that their children’s distress is actually far more severe than they ever realized.  And like any parent, most are petrified to think that their child might one day suffer a self-inflicted death. 

Don’t judge these parents for being unaware of their children’s feelings.  Suicide is a silent killer.  Depression doesn’t offer obvious signs like a case of ADHD or Conduct Disorder.  The typical depressed teen may seem a little more irritable, a little more sleepy, or a little less interested in what usually makes them happy.  Among males and ethnic minorities, teens may even be less likely to tell their friends or parents that they are feeling sad at all.  This underscores the need for simple mental health screening in schools.  A trained mental health professional has a far better chance detecting a hidden mental health problem in just minutes.  And failure to screen for these symptoms can have consequences far more dire than a cavity.