User:WWB Too/TeenScreen

The TeenScreen program was developed by a team of researchers at Columbia University, led by the director of the university's Division of Child and Adolescent Psychiatry, David Shaffer, MD.{{cite news |title=Battling a National Killer: TeenScreen Aims To Prevent Teen Suicide |first=Arline |last=Kaplan |url= |newspaper=Psychiatric Times |date=1 March 2006 |page=1}} The goal was to make researched and validated screening questionnaires available for voluntary identification of possible mental disorders and suicide risk in middle and high school students.{{cite news |title=County studying two new mental health initiatives |first=Linda |last=Vanderwerf |url= |newspaper=West Central Tribune |date=7 July 2011}} These questionnaires include the Columbia Suicide Screen that was researched and developed at Columbia University. Schools and communities using the TeenScreen program began screening adolescents in 1999. In 2003, the New Freedom Commission on Mental Health, created under the administration of George W. Bush, identified the TeenScreen program as a "model" program and recommended that adolescent mental health screening become common practice in the early identification and assessment of mental health disorders in youth.New Freedom Commission on Mental Health, Achieving the Promise: Transforming Mental Health Care in America. Final Report. DHHS Pub. No. SMA-03-3832. Rockville, MD: 2003.

The organization launched a national initiative to offer voluntary mental health screening to all U.S. teens in 2003. The following year, TeenScreen was approved for inclusion in the national Suicide Prevention Resource Center's (SPRC) list of evidence-based suicide prevention programs.{{cite web |url=http://www.teenscreen.org/images/stories/PDF/2004%20Annual%20Overview.pdf |title=Columbia University TeenScreen Program: Science into Policy, Prevention and Action 2004 Overview |date=2004 |work=TeenScreen.org |publisher=Columbia University |accessdate=16 August 2011}} In 2007, it was included as an evidence-based program in the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA)'s National Registry of Evidence-based Programs and Practices as a scientifically tested and reviewed intervention.{{cite web |url=http://www.nrepp.samhsa.gov/ViewIntervention.aspx?id=150 |title=TeenScreen |last1= |first1= |last2= |first2= |date=February 2007 |work=National Registry of Evidence-Based Programs and Practice |publisher= |accessdate=10 August 2011}} In 2009, the organization launched TeenScreen Primary Care to increase mental health screening by pediatricians and other primary care providers. The launch of the initiative coincided with increasing support for adolescent mental health screening from health and medical organizations. In the same year the U.S. Preventive Services Task Force recommended that annual adolescent mental health screening be incorporated into routine primary care and the Institute of Medicine recommended expansion of prevention and early identification programs.{{cite news |title=Will students take a mental health test? |first=Laura |last=Landro |url=http://online.wsj.com/article/SB10001424053111904199404576538292146976766.html |newspaper=The Wall Street Journal |date=30 August 2011 |accessdate=6 September 2011}}

{{As of |2011}}, the program is led by executive director Laurie Flynn, deputy executive director Leslie McGuire and scientific advisor Mark Olfson, M.D., alongside a National Advisory Council of healthcare professionals, educators and advocates.{{cite web |url=http://www.teenscreen.org/about/our-leadership/|title=Our Leadership |work=TeenScreen.org |accessdate=16 August 2011}}

The mission of the TeenScreen National Center is to expand and improve the early identification of mental health problems in youth.{{cite web |url=http://www.nrepp.samhsa.gov/ViewIntervention.aspx?id=150 |title=TeenScreen |last1= |first1= |last2= |first2= |date=February 2007 |work=National Registry of Evidence-Based Programs and Practice |publisher= |accessdate=10 August 2011}} In particular, TeenScreen aims to find young people at risk of suicide or developing mental health disorders so that they can be referred for a comprehensive mental health evaluation by a health professional. The program focuses on providing screening to young people in the 11-18 age range.{{cite web |url=http://www.teenscreen.org/images/stories/PDF/NatCenterBrochure3.11.11.pdf |title=TeenScreen National Center Brochure |date=11 March 2011 |work=TeenScreen.org |publisher=TeenScreen National Center |format=PDF |accessdate=6 September 2011}} Since 2003, the program has been offered nationally in schools, clinics, doctors' offices and in youth service environments such as shelters and juvenile justice settings. {{As of |2011|08}}, more than 2,000 primary care providers, schools and community-based sites in 46 states offer adolescent mental health screening through the TeenScreen National Center. In addition, the screening was also being provided in other countries including Australia, Brazil, India, New Zealand and Scotland.{{cite web |url=http://www.teenscreen.org/programs/local-programs/ |title=Local Programs |work=TeenScreen.org |publisher= |accessdate=16 August 2011}}

TeenScreen provides materials, training and technical help through its TeenScreen Primary Care and Schools and Communities programs for primary care providers, schools and youth-serving organizations that want to offer mental health screening to adolescents. A toolkit is provided, including researched and validated questionnaires, instructions for administering, scoring and interpreting the screening responses. Primary care program materials include information on primary care referrals for clinical evaluation. In the school and community setting, the screening process is voluntary and requires active parental consent and participant assent prior to the screening session.

The validated questionnaires include items about depression, thoughts of suicide and attempts, anxiety, and substance use. The screening questionnaires typically take up to 10 minutes for an adolescent to complete. Once the responses to the questionnaire have been reviewed, any adolescent identified as being at possible risk for suicide or other mental health concerns is then assessed by a health or mental health professional. The result of this assessment determines whether the adolescent should be referred for mental health services. If this is the case, parents are involved and provided with help locating the appropriate mental health services.

Mental health screening has been endorsed by the former U.S. Surgeon General David Satcher, who launched a "Call to Action" in 1999 encouraging the development and implementation of safe, effective school-based programs offering intervention, help and support to young people with mental health issues.{{cite web |url=http://www.surgeongeneral.gov/library/calltoaction/recommendations.htm |title=The Surgeon General's Call To Action To Prevent Suicide, 1999 |date=1999 |work=U.S. Surgeon General |accessdate=12 August 2011}} TeenScreen is included as an evidence-based program in the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA)'s National Registry of Evidence-based Programs and Practices as a scientifically tested and reviewed intervention.{{cite web |url=http://www.nrepp.samhsa.gov/ViewIntervention.aspx?id=150 |title=TeenScreen |last1= |first1= |last2= |first2= |date=February 2007 |work=National Registry of Evidence-Based Programs and Practice |publisher= |accessdate=10 August 2011}} In addition, the U.S. Preventive Services Task Force recommended in 2009 that mental health screening for teenagers be integrated into routine primary care appointments.{{cite journal |last1=Allen |first1=Patricia L. |last2=McGuire |first2=Leslie |year=2011 |title=Incorporating mental health checkups into adolescent primary care visits |journal=Pediatric Nursing |volume=37 |issue=3 |pages=137-41}}

Studies have been conducted on the effectiveness and impact of mental health screening for young people. In a 2004 systematic evidence review, the U.S. Preventive Services Task Force found that there were no studies that addressed whether screening as part of primary care reduced morbidity and mortality, nor any information of the potential risks of screening.{{cite web |url=http://www.ahrq.gov/downloads/pub/prevent/pdfser/suicidser.pdf |title=Screening for Suicide Risk: A Systematic Evidence Review for the U.S. Preventive Services Task Force |date=May 2004 |work=AHRQ.gov |publisher= |accessdate=10 August 2011}} In a later review, published in 2009, the task force found that there was evidence supporting the efficacy of screening tools in identifying teenagers at risk of suicide or mental health disorders.{{cite journal |pmid=20722167 |title=Screening for Child and Adolescent Depression In Primary Care Settings: A Systematic Evidence Review for the U.S. Preventive Services Task Force |last1=Williams |first1=SB |last2=O'Connor |first2=E |last3=Elder |first3=M |last4=Whitlock |first4=E |date=April 2009 |publisher= |accessdate=10 August 2011}}

A team of researchers from Columbia University and the New York State Psychiatric Institute completed a randomized controlled clinical trial on the impact of suicide screening on high school students in New York State from 2002-2004.Gould M, Marrocco F, Kleinman M, Thomas J, Mostkoff K, Cote J, Davies M. (2005). "Evaluating iatrogenic risk of youth suicide screening programs: A randomized controlled trial." Journal of the American Medical Association; 293: 1635-1643. {{PMID|15811983}} The study found that students who were given a questionnaire about suicide were no more likely to report suicidal thoughts after the survey than students in the control group who had not been questioned. Neither was there any greater risk for "high risk" students. A subsequent study by the researchers, in 2009, found that screening appeared to increase the likelihood that adolescents would receive treatment if they were at risk for mental health disorders or suicide.{{cite journal |last1=Gould |first1=MS |last2=Marrocco |first2=FA |last3=Hoagwood |first3=K |last4=Kleinman |first4=M |last5=Amakawa |first5=L |last6=Altshuler |first6=E |year=December 2009 |title=Service use by at-risk youths after school-based suicide screening. |journal=Journal of American Academy of Child and Adolescent Psychiatry |volume=48 |issue=12 |pages=1193-201 |publisher= |doi= |pmid=19858758 |accessdate=12 August 2011}}

A study published in 2011, involving 2,500 high school students, examined the value of routine mental health screening in school to identify adolescents at-risk for mental illness, and to connect those adolescents with recommended follow-up care. The research, conducted between 2005 and 2009 at six public high schools in suburban Wisconsin, found that nearly three out of four high school students identified as being at-risk for having a mental health problem were not in treatment at the time of screening. Of those students identified as at-risk, a significant majority (76.3 percent) completed at least one visit with a mental health provider within 90 days of screening. More than half (56.3 percent) received minimally adequate treatment, defined as having three or more visits with a provider, or any number of visits if termination was agreed to by the provider.{{cite journal |last1=Husky |first1=Mathilde M. |last2=Sheridan |first2=Marian |last3=McGuire |first3=Leslie |last4=Olfson |first4=Mark |year=September 2011 |title=Mental Health Screening and Follow-up Care in Public High Schools |journal=Journal of American Academy of Child and Adolescent Psychiatry |volume=50 |issue=9 |pages=881-891 |publisher= |doi= |url=http://www.jaacap.com/issues?issue_key=S0890-8567%2811%29X0008-4 |accessdate=29 September 2011}}

A separate study published in 2011, found that mental health screening was effective at connecting African-American middle school students from a predominantly low-income area with school-based mental health services.{{cite journal |last1=Husky |first1=Mathilde M. |last2=Kanter |first2=DA|last3=McGuire |first3=Leslie |last4=Olfson |first4=Mark |year=May 2011 |title=Mental Health Screening of African American Adolescents and Facilitated Access to Care |journal= Community Mental Health Journal |volume= |issue= |pages= |publisher= |doi= |pmid=21559920 |accessdate=29 September 2011}} Researchers have also found evidence to support the addition of mental health screenings for adolescents while undergoing routine physical examinations.{{cite journal |last1=Husky |first1=MM |last2=Miller |first2=K |last3=McGuire |first3=L |last4=Flynn |first4=L |last5=Olfson |first5=M |year=2011 |title=Mental health screening of adolescents in pediatric practice. |journal=Journal of Behavioural Health Services and Research |volume=38 |issue=2 |pages=159-69 |publisher= |doi= |pmid=20127189 |accessdate=11 August 2011 }}

Recommendations endorsing adolescent mental health screening have been issued by the Institute of Medicine (IOM) and the U.S. Preventative Services Task Force (USPSTF). The American Academy of Pediatrics recommends assessment of mental health at primary care visits and suggests the use of validating screening instruments. These add to statements and recommendations to screen adolescents for mental illness from the American Medical Association (AMA), the Society for Adolescent Health and Medicine, the American Academy of Family Physicians and the National Association of Pediatric Nurse Practitioners. TeenScreen has been endorsed by a number of organizations, including the National Alliance for the Mentally Ill, and federal and state commissions such as the New Freedom Commission.{{cite news |title=Screenings prompt fears of false labels |first=Matthew |last=Franck |url= |newspaper=St. Louis Post-Dispatch |date=13 December 2005 |page=A1}}

There is opposition to mental health screening programs in general and TeenScreen in particular, from civil liberties, parental rights, and politically conservative groups.{{cite news |title=Can test save lives? |first=Joe |last=Dejka |url= |newspaper=Omaha World-Herald |date=16 September 2008 |page=1A}} Rep. Ron Paul has opposed screening programs such as TeenScreen on the grounds that they negate parental rights, are not supported by evidence that suicide attempts are reduced and also may lead to overmedication of young people. The TeenScreen National Center has also been opposed by groups who claim that the organization is funded by the pharmaceutical industry.{{cite news |title=Screenings prompt fears of false labels |first=Matthew |last=Franck |url= |newspaper=St. Louis Post-Dispatch |date=13 December 2005 |page=A1}} In 2011, Senator Charles E. Grassley launched an inquiry into the funding of health advocacy groups by pharmaceutical, medical-device, and insurance companies. The TeenScreen National Center was questioned in the first stage of the inquiry but was not included in the second round as it had demonstrated to Senator Grassley's satisfaction that it does not receive funding from the pharmaceutical industry.{{cite news |title=Senator Prods Medical Non-profits to Disclose More About Industry Contributions |first=Suzanne |last=Perry |url=http://philanthropy.com/blogs/government-and-politics/senator-prods-medical-nonprofits-to-disclose-more-about-industry-contributions/28477 |newspaper=The Chronicle of Philanthropy |date=11 May 2011 |accessdate=13 September 2011}}

In 2005, TeenScreen was criticized following media coverage of a suit filed a local screening program in Indiana by the parents of a teenager who had taken part in screening. The suit alleged that the screening had taken place without parents' permissions.{{cite news |title=US teenager’s parents sue school over depression screening test |first=Jeanne |last=Lenzer |url=http://www.bmj.com/content/331/7519/714.2/suppl/DC1 |newspaper=British Medical Journal |date=2005 |accessdate=2 August 2011}} The complaint led to a change in how parental consent was handled by TeenScreen sites. In 2006, the program's policy was amended so that active rather than passive consent was required from parents before screening adolescents in a school setting.

{{Reflist|colwidth=25em}}

• [http://www.teenscreen.org/ TeenScreen official website]
• [http://www.nrepp.samhsa.gov/ViewIntervention.aspx?id=150 National Registry of Evidence Based Programs and Practice]

:Category:Mental health organizations in the United States

:Category:Clinical psychology

:Category:Medical informatics

:Category:Child and adolescent psychiatry

:Category:Suicide