Objectives: To collate evidence on the effectiveness, cost-effectiveness, feasibility, and acceptability of screening for mental health difficulties (MHD) in schools. 

Background: Under-identification of MHD is a key barrier in connecting children and young people with care and support. School-wide screening programmes have been proposed as a way to improve identification rates.

Methods: As part of the DEAL study, we completed two systematic reviews on the effectiveness/cost-effectiveness and feasibility of school-based MHD identification, a survey of parental attitudes toward screening, and interviews with parents and school staff about identification. An ongoing Delphi study informed by these studies aims to reach consensus on the important and feasible components of school-based MHD identification.  

Results: Fifty-six reports were included in the systematic reviews. There was considerable variation in terms of the accuracy of screening: rates of false positive results ranged from 9-90%. Uptake of referrals to specialist mental health and school-based services was high, ranging from 50-80%. Screening was not particularly feasible; whilst it generally aligned with stakeholder priorities, time, cost, and resource requirements were barriers to implementation and sustainability. In the survey, nearly all of the 260 parents who responded thought early identification was important (N=254; 98%). Most viewed school-wide MHD screening as helpful (N=213; 82%), but some thought it might be harmful (N=34; 13%). In the interviews, parents noted several key barriers surrounding use of a school-wide screening approach.

Conclusions: At present, there is not enough evidence for the effectiveness, feasibility, or acceptability of school-wide MHD screening to recommend its widespread implementation. Further research is needed.

08 - ARE WE READY TO SCALE UP SCHOOL-WIDE MENTAL HEALTH SCREENING?