Significant Items for the House, Senate and Conference
Appropriations Committee Reports
House Report No. 108-636
[Assessment of study identifying teenagers at risk] – The Committee is deeply concerned that 5% to 9% of all children suffer from a mental, behavioral or emotional disorder, which, if undiagnosed and untreated, can substantially interfere with academic achievement, or lead to student dropout, substance abuse, violent behavior, or suicide. In its July 2003 report, the President’s New Freedom Commission on Mental Health concluded that greater reliance on early detection, assessment and links with adequate treatment and support systems can help avoid or ameliorate these outcomes.
The report concluded that schools are in a unique position to identify mental health problems in their early stages and can provide a link to appropriate services. The report also cited examples of evidence-based screening techniques and tools already being utilized by some schools. The Committee is aware that SAMHSA is overseeing a very promising pilot study utilizing evidence-based screening techniques and tools to screen and identify teenagers who are at risk. The Committee urges SAMHSA to evaluate the effectiveness of that pilot study and, if proven successful, expand to additional sites. The Committee expects SAMSHA to work in collaboration with the Office of Safe and Drug-free Schools, and to report on concrete steps being taken to promote early screening and detection programs available in schools prior to the fiscal year 2006 appropriations hearings. (Page 118)
Action taken or to be taken
SAMHSA is currently overseeing two promising pilot projects utilizing evidence-based school screening programs aimed at suicide prevention. These two pilot programs utilize Screening for Mental Health, Inc.'s Signs of Suicide Program, which in a recent, published study was shown to reduce self-reported suicide attempts, and the Columbia University’s TeenScreen program, identified as a model program by the President's New Freedom Commission on Mental Health. Both pilot projects focus on examining how successful these screening programs are in being able to refer to treatment youth identified as being at risk for suicide. The first pilot project utilizes the Signs of Suicide program and is examining school based referral systems at 20 school sites in five different states to obtain preliminary data regarding the
accessibility of treatment for youth identified through screening as being at risk. This pilot project is also obtaining preliminary data regarding parental response to the identification of youths at risk through this screening process. Complete data are not yet available.
The second pilot project is collaboration between the Teen Screen program and the University of South Florida. This pilot project is examining the same issues as the pilot with Signs of Suicide, and is currently identifying methods to strengthen its evaluation of adherence to follow up recommendations for treatment of at risk youth identified in the screening. In addition, in FY 2005 SAMHSA will issue a Request for Applications for $1,984,000 in competitive grants to further test the use of screening mechanisms and identify evidence-based practices to facilitate treatment for adolescents at risk for mental disorders and suicide. The models tested will include Signs of Suicide and TeenScreen. These grants will also evaluate whether the models tested are effective in varying settings and/or for different populations.
These grants should provide information necessary to determine whether such programs should be promoted as national models in suicide prevention.
Since 1999, HHS/SAMHSA has worked in collaboration with the Departments of Education
(Office of Safe and Drug-free Schools) and Justice on the Safe Schools/Healthy Students program. By the end of the 2003-2004 school year, 190 Safe Schools/Healthy Students sites provided services to 182 school districts and approximately 5.6 million students. Through this program, grantees must address within their comprehensive plans, school-based screening and assessment to detect depression and other mental health disorders, appropriate school-based mental health prevention and early intervention services, and referral and follow-up with local public mental health agencies when treatment is indicated. This element of the Safe Schools/Healthy Students comprehensive plan is to provide mental health preventive services early to reduce risk of onset or delay the onset of emotionally and behavioral problems for some children, and to identify those children who already have serious emotional disturbance and to ensure that they receive appropriate referral, treatment and follow-up services.
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