In a pair of articles published in The Lancet Psychiatry, child psychiatry experts say that schools are essential for identifying and helping the 1 in 10 children that have mental health problems.
Children spend more time in school than in any other formal institution, say the authors, and as such, school plays a huge role in all areas of children’s development.
Peer relationships, social interactions, academic attainment, cognitive process, emotional control, behavioral expectations, physical development and moral development are all mediated through school, and all of these areas are affected by mental health.
Mental health problems such as behavioral disorders and anxiety are common in children, and depression also becomes common in the later years of high school.
Experts warn that if such problems are not treated, they can affect many different aspects of a young person’s development, potentially leading to school failure and non-attendance, as well as affecting later relationships and career choices.
In the new articles, the authors say that 75% of people who access mental health services had a diagnosable disorder before they reached 18. Also, in high-income countries, estimates show that only 25% of children who require a mental health intervention are identified or treated.
About 10-20% of children and young people worldwide would benefit from some form of mental health intervention, according to the authors.
However, some people are concerned that mental health screening in schools may contribute to young people being labeled and stigmatized.
“If 10% of children had diabetes,” responds lead author Dr. Mina Fazel, a child psychiatrist at the University of Oxford in the UK, “we wouldn’t be saying that screening was a bad thing. Schools provide a platform to access large proportions of young people, and the vast majority of children picked up by screening would not need complex interventions.”
Dr. Fazel says that the gap between research and practice must close in order for mental health services to be successfully delivered to young people.
“We know what works,” she says, “but where we fall down is implementing this on a large scale in schools. We also need national policies to help education and mental health services work more closely together.”
She adds:
“The evidence shows that children prefer to be seen in school rather than outside school. But right now, health and education are very different systems.
The reality is that we are not maximizing on the opportunities to work in these environments. We need to have an approach that is child focused and to do this, health and education must become more closely aligned.”
In addressing mental health problems in countries with low resources and a scarcity of mental health professionals, the authors point to India’s SHAPE program as an effective initiative.
SHAPE trains lay school health counselors to promote both physical and mental health, as well as how to screen for visual and weight problems and bullying. Both whole-school interventions and one-on-one counseling are used in this program.
Commenting on the articles, the editor of The Lancet Psychiatry, Dr. Niall Boyce, says:
“The promotion of good mental health needs to come out of the clinic and into the wider world. We hope that The Lancet Psychiatry papers by Mina Fazel and colleagues will be a valuable resource for teaching and mental health professionals around the world as they strive to improve the education and well-being of young people.”