Call for mental health screening for all students


Children and adolescents should be screened in school for signs of mental health problems, a leading academic has claimed.

Children and adolescents should be screened in school for signs of mental health problems, a leading academic has claimed.

Dr Simon Nicholas Williams, from Cambridge University’s Institute of Public Health, said most mental health problems in adults started in childhood and were costing health and social services billions of pounds a year.

If emotional and mental disorders were caught earlier, interventions could be put in place resulting in fewer incidents of serious economic or social problems, such as crime, unemployment and suicide, later in life, he said.

Writing in the British Medical Journal, Dr Williams said there was no reason why mental health screening should not be carried out, since pupils already receive physical health checks. Screening should be carried out at intervals during the child’s education, he suggested.

He said: “By using a validated tool, by administering it at multiple points during a child’s school years, and by carefully following up or referring children with potential mental health problems for further monitoring, we can reduce the potential risks of false positives, which are characteristic of a number of other routine screening programs.”

Headteachers remained cautious about the proposals. Brian Lightman, general secretary of the Association of School and College Leaders, said: “Teachers and other school staff are more aware of the signs of mental health issues in students than they were a decade ago, but at the end of the day they are not trained to support students with serious issues including eating disorders, self-harming, abnormal friendship problems and depression, which are very much on the increase.

“More schools are hiring their own education psychologists and other professionals, especially as local authorities’ capacity to provide these services has decreased. 

“However, schools’ budgets are squeezed as well and access to trained mental health professionals remains a concern.” 

Russell Hobby, of the National Association of Head Teachers, said that while the idea was “interesting”, health professionals would have to carry out the checks, rather than teachers, who were not qualified to do so.

“We would have to be quite careful about any labels and stigma attached to this,” he added. “It would have to be done in a sensitive fashion.”

Dr Williams said screening would cost about £27 per child, and that all children should be checked to remove any risk of stigma – and not just those deemed to be at risk. 

Although some mental health issues were more common in children from disadvantaged backgrounds, he said, others such as anxiety were sometimes more common in young people from more affluent groups.

Barbara McIntosh, head of children and young people’s programmes at the Mental Health Foundation and the Foundation for People with Learning Disabilities, said Mr Williams’ comments were welcome.

“We are increasingly concerned about the emotional wellbeing of many children and this can escalate when they reach adolescence, causing a great deal of anguish both for them and their families.

“Early interventions do make a difference in treating these problems and are kinder on the public purse. However, schools generally feel they lack the skills and expertise to deal with these issues so we need better training of teachers to be able to identify problems.”

She said that a generic test could be developed to screen all children, with more specific checks for children who were presenting emotional problems or were at risk of developing them because of family background or other social and economic consequences.

“Children and adolescent mental health services are now stretched in some areas because of cut backs, but they still exist and voluntary sector organisations also offer provision,” Ms McIntosh added. “We know anecdotally, from speaking to schools, that increasing numbers of children and young people are experiencing anxiety and other mental health issues, but we really need more data to be collected on the extent of the problem.”

Lucie Russell, from the charity Young Minds, said existing provision was “patchy”. 

“Screening as part of early intervention is theoretically a positive step forward, but it must be backed up with comprehensive support and treatment for identified children and their families.”

Headteachers in some schools are using Pupil Premium funding to support young people with mental health problems – for example, by buying in the services of child psychologists for individuals or groups of pupils.

However, some organisations expressed concern at the proposals. Chris McGovern, chairman of the Campaign for Real Education, said the idea was an “extension of the nanny state”.

“Good schools with high aspirations, inspirational teachers and a broad curriculum will do far more to support children who may be vulnerable to mental health issues than a screening programme that will, inevitably, focus on introspection and the looking for problems where none exist,” he said.


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