School-Based Mental Health Screening Practices

Across the globe, schools have become pivotal settings for the early identification of mental health difficulties in children and young people. School-based screening practices encompass a spectrum of approaches, from universal self-report questionnaires administered to entire cohorts, to selective assessments directed at individuals deemed at elevated risk. Such programmes seek to detect internalising problems, including anxiety and depression, as well as externalising issues such as conduct disorder and attention-deficit/hyperactivity. Advances in digital platforms enable adaptive assessments that reduce burden on pupils and staff, while allied methods—daily health observation schemes, teacher-rated risk scales and structured clinical interviews—enhance sensitivity and specificity. Implementation strategies vary, frequently integrating staff training, stakeholder engagement and clear referral pathways to mental health support. Despite demonstrated benefits in terms of early intervention and reduced long-term burden, barriers persist: concerns about consent, data privacy, the potential for stigmatisation, resource constraints and the need for culturally appropriate instruments. Current research emphasises the importance of rigorous validation, feasibility studies within diverse educational settings and the development of protocols that balance accuracy with acceptability. As policy makers and school leaders strive for equitable access, the interconnection between screening practice and systems of care remains at the forefront of efforts to safeguard pupils’ mental health.

Research from Nature Portfolio

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School-Based Mental Health Screening Practices publication trend

The graph below shows the total number of articles in school-based mental health screening practices across all publications each year (not limited to Nature Index journals).

Technical terms

Universal screening: The administration of brief assessments to all pupils in a defined population, regardless of risk level, to detect potential mental health difficulties early.

Selective screening: Targeted assessments directed at subgroups of pupils identified as having elevated risk factors for mental health issues.

Computerised adaptive testing (CAT): A digital assessment technique that dynamically selects items based on previous responses to maximise efficiency and precision.

Group-based trajectory modelling: A statistical method that identifies clusters of individuals following similar progressions in repeated measures over time.

Red-flag system: An automated mechanism within screening tools that highlights responses indicative of high risk, triggering further evaluation or referral.

Internalising and externalising symptoms: Categories of mental health presentation where internalising refers to inward-directed issues (e.g. anxiety, depression) and externalising to outward-directed behaviours (e.g. aggression, hyperactivity).

References

1. Early detection of students’ mental health issues from a traditional daily health observation scheme in Japanese schools and its digitalization. Frontiers in Public Health (2024).
2. The impact of the newly developed school-based ‘Digital Health Contact’—Evaluating a health and wellbeing screening tool for adolescents in England. PLOS ONE (2024).
3. New evidence of predictive validity of SRSS-IE scores with middle and high school students. Frontiers in Education (2024).