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School district leaders in Skaneateles, N.Y., credit their universal mental health screening with saving five students鈥� lives in one year.
When the 1,200-student district first administered the universal screening to 660 middle and high school students in mid-January 2022, it identified five students as being at significant risk for attempting or dying by suicide, or self-harm.
The district intervened immediately, and referred the students to emergency services, including transport to a local emergency room, according to Superintendent Eric Knuth.
In each case, the district intervened in, and disrupted, the student鈥檚 suicide plan, he said.
鈥淢y attitude was, if this whole thing is a colossal waste of time, could you think of a better scenario than to have done all of this work and nothing come out of it because all of our kids are fine?鈥� Knuth said. 鈥淭hat wasn鈥檛 the case, and five students are alive today because of that work.鈥�
Universal mental health screening in schools is a concept that has received increasing attention in recent years, as young people struggle with record-high rates of anxiety and depression. The pandemic exacerbated a trend of worsening youth mental health that had been underway for about a decade already.
While many districts have hired additional mental health professionals, fewer have gone the route of universal screening, despite its endorsement by the National Association of School Psychologists, the National Center for School Mental Health, and psychologists and mental health researchers.
The Skaneateles district, located southwest of Syracuse, is in the minority, having invested in the screening tool more than two years ago. Its experience shows both the screening鈥檚 potential and its limitations, and how it can shape a district鈥檚 broader mental health strategy.
鈥淭his is work that is controversial, and it鈥檚 difficult because it really flies in the face of what鈥檚 easiest and most comfortable for adults, and really focuses on the safety of kids and what鈥檚 best for them,鈥� Knuth said. 鈥淲e had some bumps and bruises along the way, but at this point, it鈥檚 becoming a part of our culture.鈥�
Along with identifying students in imminent danger of self-harm, the screener administered in January 2022 also flagged students at 鈥渉igh鈥� and 鈥渟ome鈥� risk for such behaviors, as well as 鈥渘egative affect,鈥� which could include conditions like depression and anxiety.
In addition to triaging and providing immediate assistance to students in crisis, the district has used the results to implement other mental health supports. It鈥檚 developed safety plans for higher-risk students and, more broadly, advocated for funding to hire additional school-based mental health professionals.
When the district administered the screener again in January 2023, two students were identified as being at high risk for self-harm. The percentage of students identified as being at high risk for 鈥渘egative affect鈥� dropped from 11 percent to 6 percent, according to district data.
The percentage of students identified as being at 鈥渟ome鈥� risk for mental health conditions dropped from 25 percent to 16 percent.
鈥淚t鈥檚 paid off in spades,鈥� Knuth said.
For Knuth, the work is also personal. Over his career that has spanned seven districts, six students have died by suicide. Each time, he attended funerals, helped set up memorials, and talked with grieving parents. Each time, he felt like the district wasn鈥檛 doing enough, 鈥渂ecause afterward we sort of just crossed our fingers and hoped it didn鈥檛 happen again,鈥� he said.
So, when a discussion about universal mental health screening came up in Skaneateles, he was on board immediately.
Students, staff, and parents were generally supportive of the screening from the outset, he said, but there was some concern among teachers that they would get into trouble 鈥渋f they missed something,鈥� like a warning sign that a student was in distress.
There is a common misconception, he said, that talking about suicide can 鈥減ut the idea into someone鈥檚 head,鈥� which can discourage teachers from broaching the topic of mental health with their students. (Researchers and several mental health organizations, including the Mayo Clinic, National Institutes of Health, and American Foundation for Suicide Prevention, have debunked that idea.)
鈥淲e just had to reassure them that none of this has anything to do with you or your performance,鈥� Knuth said. 鈥淭his is about the kids, and it鈥檚 imperfect, but if even one of those kids puts you on alert and lets you surround them with supportive resources, it鈥檚 all worth it.鈥�
Administrators in Skaneateles are acutely aware that screening students for mental health challenges isn鈥檛 foolproof.
Jennifer Whipple, the director of the district鈥檚 special education department and a former school psychologist and social worker, can attest to that.
Her daughters both participated in the screening, and neither was flagged as needing assistance based on the answers they submitted, she said.
But one attempted suicide within the past year.
It鈥檚 possible her daughter wasn鈥檛 feeling suicidal at the time of the screening, Whipple said. (While , the act of suicide can , and the risk .) Or maybe she didn鈥檛 tell the truth when filling it out.
Regardless, it鈥檚 a clear example that the screening tool is a point-in-time analysis of students鈥� well-being, and won鈥檛 solve 100 percent of a district鈥檚 mental health problems, Whipple said.
鈥淲e are not here to say this is the answer to everything,鈥� she said. 鈥淏ut it鈥檚 creating a culture within our district that mental health is something we should talk about and not be ashamed of, and being willing to confront head-on, together.鈥�
