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A Mental Health Screening Saved Students’ Lives in This District

If you or anyone you know is struggling with thoughts of self-harm or suicide, help is available. Call or text 988 to reach the confidential National Suicide Prevention Lifeline or check out these resources from the American Foundation for Suicide Prevention.

School district leaders in Skaneateles, N.Y., credit their universal mental health screening with saving five students’ lives in one year.

When the 1,200-student district first administered the universal screening to 660 middle and high school students in mid-January 2022, it identified five students as being at significant risk for attempting or dying by suicide, or self-harm.

The district intervened immediately, and referred the students to emergency services, including transport to a local emergency room, according to Superintendent Eric Knuth.

In each case, the district intervened in, and disrupted, the student’s suicide plan, he said.

“My attitude was, if this whole thing is a colossal waste of time, could you think of a better scenario than to have done all of this work and nothing come out of it because all of our kids are fine?” Knuth said. “That wasn’t the case, and five students are alive today because of that work.”

Universal mental health screening in schools is a concept that has received increasing attention in recent years, as young people struggle with record-high rates of anxiety and depression. The pandemic exacerbated a trend of worsening youth mental health that had been underway for about a decade already.

While many districts have hired additional mental health professionals, fewer have gone the route of universal screening, despite its endorsement by the National Association of School Psychologists, the National Center for School Mental Health, and psychologists and mental health researchers.

The Skaneateles district, located southwest of Syracuse, is in the minority, having invested in the screening tool more than two years ago. Its experience shows both the screening’s potential and its limitations, and how it can shape a district’s broader mental health strategy.

“This is work that is controversial, and it’s difficult because it really flies in the face of what’s easiest and most comfortable for adults, and really focuses on the safety of kids and what’s best for them,” Knuth said. “We had some bumps and bruises along the way, but at this point, it’s becoming a part of our culture.”

Along with identifying students in imminent danger of self-harm, the screener administered in January 2022 also flagged students at “high” and “some” risk for such behaviors, as well as “negative affect,” which could include conditions like depression and anxiety.

In addition to triaging and providing immediate assistance to students in crisis, the district has used the results to implement other mental health supports. It’s developed safety plans for higher-risk students and, more broadly, advocated for funding to hire additional school-based mental health professionals.

When the district administered the screener again in January 2023, two students were identified as being at high risk for self-harm. The percentage of students identified as being at high risk for “negative affect” dropped from 11 percent to 6 percent, according to district data.

The percentage of students identified as being at “some” risk for mental health conditions dropped from 25 percent to 16 percent.

“It’s paid off in spades,” Knuth said.

For Knuth, the work is also personal. Over his career that has spanned seven districts, six students have died by suicide. Each time, he attended funerals, helped set up memorials, and talked with grieving parents. Each time, he felt like the district wasn’t doing enough, “because afterward we sort of just crossed our fingers and hoped it didn’t happen again,” he said.

So, when a discussion about universal mental health screening came up in Skaneateles, he was on board immediately.

Students, staff, and parents were generally supportive of the screening from the outset, he said, but there was some concern among teachers that they would get into trouble “if they missed something,” like a warning sign that a student was in distress.

There is a common misconception, he said, that talking about suicide can “put the idea into someone’s head,” which can discourage teachers from broaching the topic of mental health with their students. (Researchers and several mental health organizations, including the Mayo Clinic, National Institutes of Health, and American Foundation for Suicide Prevention, have debunked that idea.)

“We just had to reassure them that none of this has anything to do with you or your performance,” Knuth said. “This is about the kids, and it’s imperfect, but if even one of those kids puts you on alert and lets you surround them with supportive resources, it’s all worth it.”

Administrators in Skaneateles are acutely aware that screening students for mental health challenges isn’t foolproof.

Jennifer Whipple, the director of the district’s special education department and a former school psychologist and social worker, can attest to that.

Her daughters both participated in the screening, and neither was flagged as needing assistance based on the answers they submitted, she said.

But one attempted suicide within the past year.

It’s possible her daughter wasn’t feeling suicidal at the time of the screening, Whipple said. (While mental illness usually comes before it, the act of suicide can often be impulsive, and the risk can subside within minutes.) Or maybe she didn’t tell the truth when filling it out.

Regardless, it’s a clear example that the screening tool is a point-in-time analysis of students’ well-being, and won’t solve 100 percent of a district’s mental health problems, Whipple said.

“We are not here to say this is the answer to everything,” she said. “But it’s creating a culture within our district that mental health is something we should talk about and not be ashamed of, and being willing to confront head-on, together.”

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