2 - (SYM 117) The Kids Aren't Alright: High Level of Need for Mental Health Services Identified During a School-based Depression Prevention Trial

Background: There is currently a global youth mental health crisis. Research indicates growing levels of psychological distress among adolescents, partially attributable to the circumstances surrounding COVID-19 and its aftermath. Elevated psychopathology symptoms during adolescence are linked to a host of negative psychosocial outcomes. Adolescents spend most of their waking hours at school. As such, schools have been identified as a promising setting in which to address student mental health needs. The present study reports on levels of student psychological distress identified by depression screening and a diagnostic interview conducted as part of a school-based depression prevention trial. We compare current levels of mental health difficulties among this sample to those identified in previous school-based prevention trials that used identical measures. 

Methods: 536 adolescents (14-17 years) completed a depression screener (Center for Epidemiologic Studies Depression Scale) at school during the 2021 through 2023 academic years. Students with elevated depression symptoms (n = 275) who agreed to participate in the larger prevention study completed a diagnostic evaluation (Schedule for Affective Disorders and Schizophrenia for School Aged Children) to confirm eligibility. School counselors and administrators (n = 28) completed qualitative interviews about student mental health and school-based prevention. 

Results: 69% of students screened (n = 370) endorsed elevated depression symptoms (CES-D > 16) and 12% (n = 63) reported high symptom levels (CES-D > 40), warranting a clinical interview to assess for safety. Nine percent of students who completed a diagnostic evaluation reported active suicidal ideation and/or a recent suicide attempt, and 25% of students enrolled in the trial met criteria for a depression diagnosis. These rates are considerably higher than those reported in our previous school-based prevention trials. Qualitative data converged with these quantitative findings such that school personnel expressed growing concerns about students' mental health and the challenges schools are facing. 

Conclusions: The rate of elevated depression symptoms identified in this study is double or triple what has been reported in our prior school-based prevention trials. Youth symptom reports and the perceptions of school staff underscore the high levels of symptoms students are experiencing and the importance of schools as a critical setting for addressing youth mental health needs.