Mental Health Screening in High School A community partnership

Clearwater Secondary School This is our story…..

2013 The school had concerns……. 😩 We noticed that grade 9 girls were struggling with peer relationships and anxiety 😩 ….and Grade 10 boys were becoming disengaged with school

A local doctor had concerns….. The local GP was involved in improving mental health care in his practice He was not seeing youth until they were in crisis

A conversation started….. 😔 How do we even know if there is an issue? 😔 How can our community better support youth? 😔 Are we clear on how our interagency referral process works?

A Partnership was born….. GP, CYMH, Public Health, and School All parties contribute time and resources

Collaboration…. 😔 We asked the GP, Mental Health Clinicians, school counsellor and PHN, “how do we screen for anxiety, depression, and ADHD in Grade 9 and 10 boys and girls? ” 😔 Bigger issues: Purpose Ethics Screening tools What will we do if we have positive screens?

Purpose….. Identify prevalence of clinical anxiety/depression/ADHD at CSS To ensure all youth who are asking for help get referred Create a system for early intervention for mental health for our youth

Process of implementing mental health Screening…. 😓 Decided to screen grade 10 girls and boys 😓 Ethics Obtained permission from the school district and CYMH. Informed parents, students are given the choice to “opt out” 😓 Confidentiality PHN gave youth codes and held the cross reference list. an information letter and permission form went out to all parents of Grade 10 students.An evening session for parents with local GP/PHN to discuss the purpose and process.

Tools used….. We used the MASC2 self report (anxiety) And CDI 2 (depression) Multidimensional Anxiety Scale for Children Children’s Depression Inventory We collected Data and then discovered we did not have consent to SHARE data….😩😩😩. Asked each individual student that screened positive to share data with other providers to find out if they were already being seen or referred.

Follow up with students who screened positive…. -numbers were matched with names, by the Public Health Nurse -names and results were given to the school counsellor -results were discussed with each individual -students were encouraged to speak to their parents/guardians, visit their doctor, and a referral to CYMH was offered -difficult to follow up or establish counselling so late in the school year.

Evaluation of the results and process….. Scoring was arduous and expensive Discussion to change screening tools and score them using CYMH clinicians. Get permission to share information with mental health providers when getting informed consent We were seeing similar trends as the province BUT at a 10% higher rate

Changes to the screening process in 2015….. -Mental health clinicians delivered a preamble and answered any questions -separated into groups of 5 at individual sitting areas. -used SCARED (anxiety) and PHQ9 (depression) screening tools -scored by Mental Health clinicians the day of the screening Screen for Child Anxiety Related Emotional Disorders Patient Health Questionnaire

Summary of results…. 😲 Year to year, 32%-37% of youth are screening positive for depression or anxiety 😲 59% of the youth that scored positive had no prior referrals 😲 Noted a significantly higher rate of girls scoring positive for anxiety and depression 😲 80% of girls who screened positive on one measure, screened positive on both

Where do we go from here…... 😊 Continue collaborating with Public Health, CYMH, doctors and schools 😊 Partner with CYMHSU Local Action Team 😊 Introduce coping strategies for self-regulation 😊 Teach emotional literacy as outlined in new provincial curriculum 😊 Continue Screening!!!!

Student perspective….

Questions….