Mental health checks on all school pupils from age of 7?

[NoseWiperExtraordinaire]

Not sure if this has been done elsewhere on MN, but wondering if there are any thoughts to be gleaned on this.

Apparently, a study published in the British Medical Journal recommends that pupils should be asked to complete regular tests throughout their schooling to assess their emotional and psychological health.

I have to say I was surprised to see Rethink CEO express reservations, but think Paul Jenkins is right to highlight teens as a very important time to look at mental health, and other thoughts around ensuring adequate services would be in place (rather than patchy as is now).

I don't think 7 is too young to learn about good mental and emotional health, perhaps screening in isolation wouldn't be all that helpful? How about activities to raise awareness, or do these already exist? Are they good enough?

Prevention, Intervention and Postvention are equally important IMO.

I think the big barrier to doing this properly is going to be cost, as many have said above. In a sense it would actually help to take away the stigma of mental illness if screening for it were to be conducted in the same way it is conducted for physical health problems, but changing culture is hugely difficult.

And good screening + good followup costs money, especially if the aim is (rightly IMO) to work preventively and prevent recourse to medication wherever possible. Unfortunately I don't see it happening.

If I understood a parent correctly (?????) a dad told e they do this i Belgium before the children start school.

Can anyone confirm that?

Don't know about Belgium, but just googled and apparently the at that time socialist government in Australia introduced a voluntary programme that would include

"THREE-YEAR-OLDS will be screened for early signs of mental illness in a new federal government program that will consider behaviour such as sleeping with the light on, temper tantrums or extreme shyness as signs of possible psychological problems."

The Healthy Kids Check - starting on July 1 - will be predominantly conducted by GPs, who will refer children with troubling behaviour to psychologists or paediatricians.

The program is expected to identify more than 27,000 children who the government believes will benefit from additional support, but who some doctors say will be wrongly labelled as having a mental illness."

www.smh.com.au/national/health/preschool-mental-health-checks-20120609-202qd.html#ixzz2k8z2Im6z

"One of the most influential psychiatrists in the United States says the Federal Government's program to screen three-year-olds for mental health problems is "ridiculous" and potentially dangerous.

Australian preschoolers are set to be screened for early signs of mental illness as part of the Government-funded Healthy Kids Check, which would be voluntary for families."

www.abc.net.au/news/2012-06-11/expert-warns-against-child-mental-health-checks/4064474

Does anyone remember New Labour's Blunkett?

"Nurseries must try to identify the criminals of the future among toddlers as young as three, David Blunkett said yesterday.

The Home Secretary claimed it was never too early to start targeting children put at risk by their family background."

www.dailymail.co.uk/news/article-110461/Identify-future-criminals-age--Blunkett.html

www.telegraph.co.uk/news/uknews/1413244/Catch-yobs-at-nursery-age-says-Blunkett.html

The fact that similar style policies are increasingly being mooted in different countries almost makes you wonder if these are worldwide policies, predominantly progressive in origin but not exclusively. I wonder whether they are based on WHO, UN, UNESCO, World Bank etc initiatives and then implemented and reported on by national governments.

Can't find anything on this latest report in the Daily Mail, but found something from a year ago

"All school children should be screened for risk of mental illnesses such as depression, say leading mental health experts.

Scientists at Cambridge University said they had devised a computer test that could reliably identify those at high risk as early as 11-years-old."

www.dailymail.co.uk/health/article-2240279/All-school-children-Britain-tested-mental-health-illnesses-say-experts.html#ixzz2k91RQj4A

Needless to say, comments of the Daily Mail readers in the Comment Section are not in favour.

These type of policies are even being advocated in the United States

Two Democratic senators have proposed a bill in Connecticut that apparently would make mandatory mental health checks necessary for even homeschooled children, not just those in state schools.

"Advocacy organizations and many Connecticut residents are united in opposing a bill mandating the psychiatric screening of children and teenagers in Connecticut.

S.B. 374, An Act Requiring Behavioral Health Assessments for Children, would require schools to administer a “confidential behavioral health assessment” students in grades 6, 8, 10 and 12 and home schooled children aged 12, 14 and 17, the results of which will only be shared with parents or guardians, according to the bill.

The bill was introduced by two New Haven Democratic legislators, Sen. Toni Harp and Rep. Toni Walker and was discussed at a public health committee hearing on March 8."

www.raisinghale.com/2013/04/02/opposition-school-mental-health-checks/#sthash.iC8ldDYp.dpuf

claig I absolutely share your concerns about overdiagnosis here... On the other hand I would like to see young people with real problems helped much earlier, and many of those who could be helped come from families least able to offer that help themselves. I work in mental health, and it is a problem the medics and the research establishment struggle with - the ethics of it all, the risk weighed against the potential benefit, all of it. There isn't an easy answer.

I do know that doing nothing isn't an answer at all, though.

Yes, something should be done to help children suffering from mental illness, but I don't think blanket screening of the entire school population is the answer. I think it could be misused and lead to overmedication and unnecessary medication. I think it may be dangerous and I wonder where the initiative is really coming from and whether it is a global initiative.

I have googled a bit and found that there were concerns about the release of DSM-5.

www.psychologytoday.com/blog/turning-straw-gold/201301/your-physical-illness-may-now-be-labeled-mental-disorder

"Children have tantrums, people get forgetful as they age. We all feel depressed or anxious from time to time. Most people understand these issues, and would feel alarmed to hear that healthcare insurers would pay out for absent-mindedness, or that a healthcare regulatory agency had approved a drug to treat childhood temper tantrums.

But if you are dealing with a child diagnosed with “disruptive mood dysregulation disorder”, or a middle-aged man diagnosed with “mild neurocognitive disorder”, then you’re in business. Psychiatrists can bill health insurers for treating the condition, and pharmaceutical companies have an opportunity for profit. Indeed, if it turns out that an existing drug coming to the end of its licence is effective in ‘treating’ the ‘condition’, that’s a new market for an old drug.

These two ‘disorders’, proposed for inclusion in the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, due to be launched in May 2013, highlight how a bad system is threatening to become even worse—continuing the pathologising of normality, lowering a swathe of diagnostic thresholds and inflating the apparent prevalence of mental health problems, especially in vulnerable populations such as children and older people."

Professor Peter Kinderman states Ditch the language of disorder

www.psychologytoday.com/blog/side-effects/201302/dsm-5-has-gone-press-containing-major-scientific-gaffe

"I am deeply concerned with the process by which the Task Force is attempting to create a Brave New World in DSM-V, and the manner in which that group is proceeding."

www.psychiatrictimes.com/articles/dsm-v-mind-made

A nanny state and a Brave New World may be progressive, but they should not be mandatory.

Big Brother and Big Pharma may be progressive, but they should not override parental choice and decision making and I can understand the parents in Connecticut opposed to the proposed Democratic representatives' bill

"Advocacy organizations and many Connecticut residents are united in opposing a bill mandating the psychiatric screening of children and teenagers in Connecticut."

I don't think it will get through here yet. The progressives have been voted out of power and even though there are many progressives in the Conservative Party, I'm not sure they will be able to get it past the Daily Mail.

' the medics and the research establishment struggle with - the ethics of it all, the risk weighed against the potential benefit, all of it'

That's good that they a thinking about that because it is about ethics. It is disproportionate and is the socialist Nanny State on steroids, just as when the progressives claimed it was "for our own good" that everybody in this country should be on a DNA database and have a biometric ID card at the cost of their civil liberties.

I agree that DSM-V is a load of bilge, and the majority of MH experts I work with agree. DSM-V is all about medicalising normal human distress and it is 100% bad.

But I don't think the idea of doing something to pick up young people at risk of mental illness earlier than they are now is socialist nanny state on steroids at all. I know a lot of people who had very difficult lives who are now suffering fro psychosis, depression and anxiety - if they had been picked up much earlier, how much better could their lives have been?

Daily Mail conspiracy theories aren't a solution to this, we need to be compassionate, ethical and pragmatic about this, not complain about 'the nanny state'. I've seen the fallout from too many cases where the parents most definitely did not know best - very often through no fault of their own, but because there was no help for them.

Our current government demonises these people when it should be helping them - not by throwing free money at them, but by investing in real support. Unfortunately that's expensive, and whingeing about 'scroungers' plays better with the voters.

If that makes me a progressive, so be it - I prefer to think of myself as compassionate and pragmatic instead.

Oh, and I am 100% in agreement with you on the previous government's plan for ID cards. That was Stalinist and no two ways about it. There's many flavours of left wing, you know. Some of us are very in favour of individual civil liberties.

'But I don't think the idea of doing something to pick up young people at risk of mental illness earlier than they are now is socialist nanny state on steroids at all'

But this is sceening all the 7 year olds in the country and that is disproportionate and carries risks of misdiagnosis etc. That is the socialist Nanny State on steroids, just as I think that Blunkett's talk of spotting future criminals at the age of 3 in nursery schools was too.

'not complain about 'the nanny state'

The Nanny State is real, it's not a Daily Mail conspiracy theory, it's not a joke, it is part of the credo of the progressives.

'If that makes me a progressive, so be it - I prefer to think of myself as compassionate and pragmatic instead.'

But that's what the progressives on steroids thought when they wanted every citizen in the country to be on a DNA database and to have a biometric ID card. But the public and the Daily Mail didn't think they were "compassionate and pragmatic".

And when I say "progressives", I don't mean ordinary lifelong Labour voters like Mrs Duffy, I mean the progressives in Parliament who come up with these Big Brother, Brave New World policies.

I very much doubt that the idiots in the Labour party who thought up the ID card programme considered themselves compassionate and pragmatic - not unless they were deluded enough to need major treatment. Some people are just wicked control freaks.

We have them in the Tory party too - Michael Gove, Iain Duncan Smith, Jeremy Hunt, Chris Grayling - the list is endless. I think on the whole you can simply substitute the word 'progressives' as you use it for 'politicians', because if you want to run the country, you are probably the wrong person to do it.

But that's just me being cynical

Goodnight.

Not all politicians are progressives, fortunately. On the whole, i think the Tories have been much better than Blair, Blunkett and co.

It is an honourable thing to want to run the country provided the motives for doing it are honourable i.e. to serve and listen to the people and to maintain their freedoms and civil liberties.

I'm cynical about progressives, but not the others.

Goodnight.

This reminded me of

Mental health services are woefully under resourced, all I can see from such a programme is the labelling and medicating of children.

As far as I can see it's bloomin obvious if there is something not right with a child. For example in my 6 year olds class there is one boy who has since reception has been violent and disruptive, the child needs some sort of help, you dont need a screening programme to tell you that!!

A good teacher should be able to identify and help children with problems.

The problem is that 'good teachers' are not trained as mental health therapists. They are trained as teachers.

Teachers and TAs are being expected to take on many of the roles of outside professionals (often after 10 minutes training in the cloakroom) - speech therapy, OT, physio, social training.

Of course, it is a teacher's responsibility to 'help with' complex mental problems (attachment disorders, ODD, etc), but experts must guide this 'help' by suggesting appropriate strategies to use int he classroom. These experts should also be involved personally in the child's development and visit regularly to support teaching staff and the child.

We are seeing more and more looked after and adopted children in schools with serious attachment disorders. Even though statemented, an adopted child in my class receives NO help from anyone outside school, which is shocking. He has great difficulties in relating to other children and adults; he wanders; he can't concentrate; and, furthermore, he witnessed dreadful things and suffered neglect in the first 4 years of his life. Why isn't he eligible for therapy? (I have asked and the powers that be say he's not eligible for any.)

Surely all children who have apparent mental health issues at a young age should be seen by psychiatrists or psychotherapists REGULARLY for appropriate therapy? How else are they going to mature into functioning adults?

We will reap the results of all this negligence in future years.

Very good points ipadquietly.

All of that would cost money, whereas a simple blanket screening programme would not be as expensive of itself. But will there be real follow-up which costs money and time or will there be prescription of medicines to profit Big Pharma?

If it is done well and resources are put in place to follow up then I'm all for it. However my experience of NHS Camhs for ds (9) has been less than impressive. They've acknowledged that he needs to be seen urgently but cannot provide us with an appointment. He has an outside chance of an appointment just before Christmas, which would be 3 months from his urgent referral. Thankfully we have cover to go privately for the more severe issue affecting ds. I have no idea what we would do if we didn't have the cover or I couldn't afford to pay.

I agree with both ipad and claig .

We don't need a generation of children stuffed with antidepressants/anxiolytics/ADHD drugs they don't need, we need funding for really high quality behavioural and social interventions which are about people who know what they're doing helping people who need help. The kind of targeted interventions that would help a whole family would cost a fortune in the short term. It's just a shame that governments of all political colours can't see that they would save an even bigger fortune in the long term.

You're right pointyfangs. The cost of helping people early with good one-to-on human interventon and contact is nothing compared to future costs to society if people are left to try and cope alone and if they struggle in the future.