Views & Reviews Personal View

Bring in universal mental health checks in schools

BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f5478 (Published 24 September 2013) Cite this as: BMJ 2013;347:f5478
  1. Simon Nicholas Williams, academic clinical fellow in public health, Institute of Public Health, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB2 0SR, UK; , visiting scholar, Feinberg School of Medicine, Northwestern University, Chicago, USA
  1. simonwilliams{at}northwestern.edu

A national screening programme might be an equitable way to enable early identification of mental health problems and it could save money, says Simon Nicholas Williams

A recent BMJ study suggested that school based cognitive behavioural therapy programmes may not be effective in reducing depressive symptoms.1 I agree with the authors that further research and evaluation of such programmes are necessary. However, although school might not be the most appropriate setting for the treatment of childhood and adolescent mental health problems, it is the most appropriate setting for the identification of mental health problems in this population.

There are great benefits to be had from the provision of routine mental health checks for all schoolchildren, not only those who have traditionally been deemed most at risk. The UK government’s current mental health outcomes strategy focuses on “prevention of mental illness and early identification and intervention,” emphasising a more “localised approach.”2 However, when it comes to prevention and early identification, a more standardised approach would be more equitable and effective. Physical health checks have been done in schools for more than a century, so why not mental health checks?

Mental health problems cost the UK an estimated £105bn (€125bn; $166bn) annually. Of this, £21.3 billion is spent on health and social care,3 more than double the total annual cost of cancer diagnosis and treatment in the UK (£9.4 billion).4 About three quarters of adult mental disorders are extensions of juvenile disorders (50% …

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