Making the case for universal school-based mental health screening
Making the case for universal school-based mental health screening
复制标题
DOI：
10.1080/13632752.2015.1120051
复制
发表时间：
2016-01-01
影响因子：
1
通讯作者：
Wigelsworth, Michael
中科院分区：
文献类型：
--
作者：
Humphrey, Neil;Wigelsworth, Michael
每10名儿童和青少年中就有1人患有精神健康问题，多达一半的成人病例开始于上学期间。这些困难对个人和社会的影响是巨大的，包括生活质量下降，经济生产力损失，社区不稳定，以及卫生，教育和社会护理服务利用率高。将学校的早期干预和预防作为协调应对这一紧急公共卫生危机的核心组成部分是有道理的。学校在儿童及其家庭的生活中发挥着核心作用，其影响范围是无与伦比的。有人认为，真正全面和有效的学校心理健康促进需要一个普遍的筛查组成部分，但这是一个有争议的命题。在这篇文章中，我们探讨了这样一个系统所带来的一些机遇和挑战。在此过程中，我们批判性地评估了关于社会有效性（例如可接受性，可行性和实用性），定义和概念化（例如“心理健康”和相关术语的含义是什么？）的国际文献，设计和实施（例如规划、工具选择、与转诊和干预系统的联系）、心理测量考虑（例如现有工具是否可靠和有效？）多样性（例如，考虑到文化差异）以及成本和效益（例如，普遍筛查的人力、财力和物力成本是否因其在提供和结果方面的改进而合理？最后，我们提出了一个以学校为基础的系统，考虑到这些重要因素的愿景。
Mental health difficulties affect 1 in 10 children and adolescents, and up to half of adult cases begin during the school years. The individual and societal impacts of such difficulties are huge, and include poorer quality of life, lost economic productivity, destabilisation of communities, and high rates of health, education and social care service utilisation. Using early intervention and prevention in schools as a central component of a co-ordinated response to this emergent public health crisis makes good sense. Schools play a central role in the lives of children and their families, and their reach is unparalleled. It has been argued that truly comprehensive and effective mental health promotion in schools requires a universal screening component, but this is a controversial proposition. In this article we explore some of the opportunities and challenges posed by such a system. In doing so, we critically assess international literature on social validity (e.g. acceptability, feasibility and utility), definition and conceptualisation (e.g. what do we mean by 'mental health' and related terms?), design and implementation (e.g. planning, tool selection, linking to referral and intervention systems), psychometric considerations (e.g. are available instruments reliable and valid?), diversity (e.g. taking into account cultural variation) and costs and benefits (e.g. are the human, financial and material costs of universal screening justified by the improvements in provision and outcomes they bring?). We conclude by presenting a vision for a school-based system that takes into account these important factors.