School-based screening can successfully identify students with symptoms of major depressive disorder (MDD) and help them to begin treatment, according to a randomized clinical trial published in JAMA Network Open.¹

Researchers from the Penn State College of Medicine and Penn State PRO Wellness conducted a study to examine the impact of school-based screening on diagnosis of depression. The three-year study enrolled 12 909 students from 9th to 12th grades attending 14 public high schools in Pennsylvania. Many of the students in the study were from lower socioeconomic status. A questionnaire was used to screen students for symptoms of depression. Either 9th and 11th grades or 10th and 12th graders underwent universal screening, while the other grades were assigned to targeted screening.

Compared to usual targeted student referral based on observed behaviors of concern, students who were assigned to universal screening were nearly six times more likely to have symptoms of a major depressive disorder (MDD) and twice more likely to start treatment for MDD. The prevalence of symptoms of depression was higher in girl students and minority students, although not many of them started treatment for their symptoms. 

This study has public health implications. Mental health problems often begin from a very early age. There is now evidence to show that even children suffer from depression, which affects their academic progress. Quite often, only targeted screening of children, mostly at the doctor’s clinic, is done. However, this randomized-controlled trial has shown that universal screening of school children for symptoms of depression was able to successfully pick up cases of adolescent depression, who would otherwise fall through the cracks and increased the chances of initiating treatment of MDD. Screening for vision and hearing is routinely done for school children. Similarly, they should also be screened for symptoms of depression. Instead of relying only on physician diagnosis, a school-based screening program can be a more effective approach.

Reference

1. Sekhar DL, et al. Screening in high schools to identify, evaluate, and lower depression among adolescents: a randomized clinical trial. JAMA Netw Open. 2021 Nov 1;4(11):e2131836. doi: 10.1001/jamanetworkopen.2021.31836.