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Experts Recommend Mental Health Screenings for Students. Most Schools Aren’t Doing Them

School psychologists and counselors say screening students for signs of poor mental health is one of the best strategies schools can use to support students, but most districts aren’t doing it, according to a new survey from the EdWeek Research Center.

Youth mental health has become a top policy priority for school, district, state, and federal leaders over the past few years as young people struggle with record-high rates of depression and anxiety following the COVID-19 pandemic, which exacerbated a trend of worsening adolescent mental health that had been underway for about a decade beforehand.

Many districts have responded by hiring more school psychologists and counselors where they can and partnering with outside mental health providers to increase access to care.

But districts have been slower to adopt screenings, despite it being a strategy recommended by the National Association of School Psychologists, the National Center for School Mental Health, and psychologists and mental health researchers.

In the EdWeek Research Center survey, conducted Nov. 30 through Dec. 6, 2023, 68 percent of principals and district leaders said their district does not use universal mental health screenings. Twenty-two percent said their district conducted the screenings in certain grade levels, and 10 percent used screeners in every grade level.

The survey included responses from a nationally representative sample of 266 district leaders and 160 school leaders.

Colorado, Illinois, and New Jersey are the only states with laws that provide funding and resources for schools to implement mental health screenings, despite significant interest in supporting youth mental health among politicians across the political spectrum.

Concerns about parent consent and resources often stand in the way of bills aiming to provide support for mental health screenings. Last spring, lawmakers in Colorado passed a law that creates a mental health screening program for students in 6th through 12th grades despite opposition from parents’ rights advocates, who argued the screenings allow schools to overstep their bounds.

In Montana, a similar bill failed in the state legislature in February 2023 after lawmakers argued other screening tools—such as the U.S. Centers for Disease Control’s biennial Youth Risk Behavioral Health Survey, which gives an anonymous snapshot of student needs—are sufficient. The mental health screeners that districts use provide information specific to individual students, so educators can alert parents and mental health professionals if a student needs more care.

District and school leaders who use the screenings say they’ve been helpful both in identifying specific students who need extra support and determining which mental health services schools should offer.

How districts use screenings

The screeners, which ask students a series of questions about their emotions and feelings, identify signs of depression, anxiety, and other mental health challenges among students. They’re not meant to be a diagnostic tool, but the first step in providing extra support or care to students who need it.

In the survey, 73 percent of district leaders and principals who said their districts use mental health screeners said the tools help them identify students who need assistance so a mental health professional can speak to them.

And 66 percent said they use the screeners to inform parents when their child might need help and refer them to a mental health professional.

Nearly half of the district and school leaders, 46 percent, said the screenings help their schools determine which mental health services they should offer on campus, and 43 percent said they help school leaders make choices about programs and curriculum, such as social-emotional learning.

Parental consent is sometimes a concern

Opponents of universal mental health screenings often argue that schools don’t adequately obtain parental permission before administering them.

In Colorado, parental consent was the crux of the debate over the state law creating the statewide screening program, which Democratic Gov. Jared Polis signed in June. The law requires that participating schools use a passive parental consent model, through which schools inform parents of the screening before it happens so they can opt out of having their child screened. Opponents said that wasn’t sufficient for ensuring schools had parents’ consent.

In the EdWeek Research Center survey, 71 percent of leaders in districts that conduct screenings use a passive, opt-out model for consent. Fifteen percent said their districts use an opt-in model, through which the districts inform parents about the screenings and require them to actively provide permission before their children can participate.

Mental health experts have told Education Week that the opt-out model often allows for more students to be screened. Many parents may not see the notice about the screening or meet the deadline to provide consent, meaning their students would not have the chance to participate.

Eleven percent of the leaders in districts that screen students said they don’t inform parents before administering the screenings.

Questions about gender identity and sexuality

Schools have also heard from parents with concerns about questions in mental health screeners that ask students about their gender identity and sexuality. Such questions are used to help schools determine whether LGBTQ+ students might be more likely to have mental health challenges and need more resources to address them.

In 2021, the CDC’s Youth Risk Behavior Survey showed that LGBTQ+ students are more likely than their peers to experience persistent feelings of sadness or hopelessness and seriously consider suicide. LGBTQ+ students also struggle to access mental health care, according to the Trevor Project, a nonprofit focused on suicide prevention for LGBTQ+ youth.

Despite these factors, 70 percent of leaders in districts that use mental health screeners said they have never asked about students’ gender identity and sexuality, while 19 percent said they ask about students’ gender identity and sexuality at certain grade levels, according to the EdWeek Research Center survey. Twelve percent of leaders from districts that conduct mental health screenings said they used to ask about gender identity and sexuality but don’t any longer.

None of the district and school leaders whose districts conduct mental health screenings said the screeners they use ask students of all age levels, from the youngest students to the oldest, about their gender identity and sexuality.

The top concern with asking about students’ gender identity and sexuality was their privacy. Fifty percent of district and school leaders whose districts use mental health screenings labeled that as a reason why they don’t ask those questions in the screening tool.

However, adult reactions to the questions are another common motivating factor. District and school leaders identified concerns—or potential concerns—from parents, community members, school employees, or elected officials as a reason they don’t ask about gender identity and sexuality, with 19 percent of leaders specifically identifying parent concerns.

Some school and district leaders also said that the questions wouldn’t be developmentally appropriate and that they would have no way to use or respond to information about students’ gender identity and sexuality.

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