Call to assess all children’s mental health in primary school

Call to assess all children’s mental health in primary school


Routine mental health checks should be offered to all children in primary schools to enable problems to be identified early, and perhaps also save money, suggests a visiting scholar at the Feinberg School of Medicine. In his Personal View on bmj.com today, Dr Simon Williams asks why mental health screening should be regarded as less important than the physical checks that are already carried out in schools.

 

Dr Williams argues that school is the most appropriate setting for the identification of mental health problems in children and adolescents, although it is not the right environment for their treatment. He adds that universal screening at several points during a child’s school life – rather than targeting traditionally at-risk children – could destigmatise a mental health diagnosis.

 

He writes: “The UK government’s current mental health outcomes strategy focuses on ‘prevention of mental illness and early identification and intervention’, emphasising a more ‘localised approach’. However, when it comes to prevention and early identification, a more standardised approach would be more equitable and effective. Physical health checks have been done in schools for more than a century, so why not mental health checks?”

 

Dr Williams writes that three-quarters of problems in adults are extensions of juvenile disorders, about half of which could have been diagnosed before the age of 15 – and that, left untreated, they can lead to more serious problems including those related to crime, unemployment and suicide in adolescence and adulthood.

 

He cites research evidence that early identification and intervention could be cost-effective “even for some of the most costly mental health disorders such as conduct disorder and depression”. He points out that mental health problems are estimated to cost the UK about £105bn a year – including £21.3bn on health and social care, more than double the cost of cancer diagnosis and treatment. He proposes: “Introducing mental health screening in schools could enable early diagnosis and treatment of childhood mental health problems and therefore reduce many of the costs associated with adolescent and adult mental health problems.”

 

From a practical perspective, he suggests that counsellors or trained specialists could administer a diagnostic tool such as the Beck Youth Inventories in a group setting, to identify signs of depression, anxiety, anger problems, and disruptive behaviour, and the children’s responses then scored individually.

 

Dr Williams concludes: “One of the problems with localised healthcare, including mental healthcare, is that it can perpetuate existing inequalities or create new disparities. Offering routine mental health checks in schools is one way to ensure that all children get equal access to resources for the prevention or early diagnosis of mental health problems.”

 



By Louise Prime

 

Wednesday, 25 September 2013




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