Pediatricians, primary care physicians and other health care providers are indispensable adjuncts to school-based assessment in identifying signs of mental health problems because they routinely see young people and their families and because confidentiality is assured.
Law and Justice Foundation - Mental health care system-related legal issues
Even if specialized mental health treatment is not readily available, the support of a primary care physician and staff can go a long way in providing support and getting people on a path towards recovery. Research has provided reliable, culturally and linguistically competent early identification and diagnostic tools.
Although schools are required to identify all mental and other health impediments to learning under the federal Rehabilitation Act and Individuals with Disabilities Education Improvement Act, including mental health issues, screening for emotional or behavioral difficulties in schools has sometimes been controversial and politicized. The concerns regarding school-based screening include the potential conflict between the Family Educational Rights and Privacy Act,  which governs most school records, and the Health Insurance Portability and Accountability Act of HIPAA ,  which governs all medical and mental health records.
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There are concerns about how to protect confidentiality of mental health and substance use evaluations in an educational setting, and there are concerns about how best to follow up with parents or guardians by school personnel to ensure linkage to follow up care. In addition, issues of possible cultural and racial bias are a significant concern among people of color. The development of reliable and culturally and linguistically appropriate screening tools remains an urgent priority. MHA acknowledges these challenges of school-based mental health screening.
However, with appropriate safeguards, MHA supports well-designed pre-school-based and school-based screening programs. While teachers and other school administrators are not and should not become diagnosticians, their candid communication with the family is vital in promoting students' well-being, including their mental health. Where any health problems are noted, their concerns should be shared with the parents or guardian in a timely manner, and parents and guardians should be counseled to see their primary care physician or a mental health professional concerning their child's need for mental or other health care.
Mental health and substance use problems should be treated no differently than other health-related concerns. School personnel should be trained to recognize the early warning signs of mental health and substance use conditions and to know the appropriate actions to take in notifying parents or guardians and in protecting the rights and privacy of young people.
In so doing, it is important to maintain strict confidentiality in accordance with HIPAA, communicating in a clear and culturally competent manner, and involving the parents or guardians in respectful shared decision-making. Several states have sought to ban mental health screening in schools. MHA opposes such legislation because it compromises the responsibilities of the schools under federal law to provide an education to all young people, regardless of disability, compromises the schools' obligation to identify and address significant impediments to learning of all kinds, discriminates against young people with emotional or behavioral difficulties, and risks constraining free communication by teachers and counselors to parents and guardians, which is essential to early identification and effective treatment of mental health and substance use conditions.
Promoting community education has been identified as a goal in the U. The initiative is significant in recognizing that education programs play a key role in preventing disease, improving health, and enhancing quality of life and includes educating communities on mental illness, behavioral health, substance use, tobacco use, and injury prevention. With long-term investment among stakeholders at various levels in communities, programs related to mental health education have been shown to reduce rates of suicide  , increase student knowledge of depression  , and increase in help seeking behaviors.
In order to prioritize community education, additional funding is needed. Despite the research on the benefits of community education for early identification of mental health problems, no current funding is available for comprehensive community-based education on the early warning signs of mental illness, early brief intervention, and linkage and referrals to treatment. New research has provided a starting point for promising programs in community-based education in mental health, and more research and research funding is needed to identify specific curricula and outreach activities that can promote early identification and effective linkage to appropriate treatment and supports.
For early identification to have any value, public and private resources must be available to assure effective treatment. In January, , the U. Department of Education with and the U.
It will remain in effect for a period of five 5 years and is reviewed as required by the Mental Health America Public Policy Committee. Suicide: Facts at a Glance.
JAMA Pediatrics 6 Advocates are citing these broad treatment requirements to obtain coverage for a range of services that children need to live at home and in the community, including screening, rehabilitative services, case management, home health care, and personal care services. Paul, MN Rev. Paul, MN Children's Issues. Policy Early identification, accurate diagnosis and effective treatment of mental health and substance use conditions  can alleviate enormous suffering for young people and their families dealing with behavioral health challenges.
Background Mental health problems affect one in five young people at any given time, and about two-thirds of all young people with mental health problems are not getting the help they need. Key recent findings include: Millions of American young people live with depression, anxiety, psychosis, attention problems, autism spectrum disorders, and a host of other mental and behavioral health issues.
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