Health Update

Schools Could Do More On Youth Depression, Survey Says

Although studies show that teenagers are at significant risk for developing depression and other mental-health conditions, few U.S. high schools have clearly defined procedures for identifying students with such problems and referring them for treatment, according to a recent survey.

When asked what percentage of their students who might need counseling or treatment actually receive those services, only 7 percent of high school “mental-health professionals” surveyed said all such students do, and 31 percent reported that most do. The Annenberg Public Policy Center at the University of Pennsylvania, in Philadelphia, released the findings last month.

A press release with the survey results is available from the Annenberg Public Policy Center.

The findings are based on a national survey of 725 high school and 515 middle school professionals described as “knowledgeable about the mental-health services in their schools.” Fully 89 percent of respondents were school counselors, psychologists, social workers, or nurses.

The margin of error for the high school component of the poll is 3.7 percentage points; for the middle school findings, it is 4.4 percentage points.

Only 34 percent of the high school staff members responding agreed that their schools had a “clearly defined and coordinated process for identifying students who may have a mental-health condition.” A clear majority, 61 percent, said that half or fewer than half of the students in their schools receive the services they need for their conditions.

Of the middle school staff members surveyed, 42 percent agreed that their schools had a good process for identifying students with mental-health problems, and 58 percent said that half or fewer than half of students receive needed treatment and services.

Libby K. Nealis, the director of public policy for the Bethesda, Md.-based National Association of School Psychologists, said the findings should aid her group’s efforts to convince schools of the need for comprehensive mental-health services.

“We have too many school mental-health professionals doing triage rather than a more proactive approach,” Ms. Nealis said.

“These services are being provided in schools with a focus on violence prevention and early identification, from the leadership on down,” she said. “But in places where the caseloads are high and there isn’t that focus, mental-health services fall through the cracks or they’re offered piecemeal.”

Mentally Ill Children

“Incarceration of Youth Who Are Waiting for Community Mental Health Services in the United States,” is available from the House of Representatives Committee on Government Reform. (Requires Adobe’s Acrobat Reader.)

Failing to link mentally ill children with the services and treatments they need can carry heavy consequences, a congressional report suggests.

In a six-month survey of 524 juvenile-detention centers across the country, nearly 15,000 incarcerated youngsters—roughly 7 percent of all the children in the centers that responded to the investigation—were being held only because they were waiting for mental-health services.

The report, released last month, was prepared for Rep. Henry A. Waxman, a California Democrat, and Sen. Susan Collins, a Republican from Maine, by the House Committee on Government Reform’s special-investigations division. The survey followed Senate hearings held last year to examine the challenges faced by families of mentally ill children.

Two-thirds of the nation’s juvenile-detention centers hold children and adolescents who are awaiting community mental-health treatment, the study found. In 33 states, it found, such youngsters are incarcerated without any criminal charges, and those waiting for treatment are as young as 7.

Together, the centers spend an estimated $100 million annually to house youths waiting for mental-health services.

“According to experts in mental health and juvenile detention, the survey results likely underestimate the full scope of the problem,” the report warns. “Major improvements in community mental-health services are urgently needed to prevent the unnecessary and inappropriate incarceration of children and youth in the United States.”

Vaccination Rates

The nation’s immunization rates for children have reached record highs, the U.S. Department of Health and Human Services announced late last month. Vaccination Rates: The nation’s immunization rates for children have reached record highs, the U.S. Department of Health and Human Services announced late last month.

The immunization level for chickenpox vaccine increased from nearly 81 percent among children 19 to 35 months of age in 2002 to 85 percent in 2003. At the same time, coverage for three or more doses of the vaccine for pneumococcal disease increased from roughly 41 percent in 2002 to 68 percent last year.

In 2003, the percentage of U.S. children receiving the recommended four doses of the Diphtheria, Tetanus and Pertussis, or DtaP, vaccine; three doses of polio vaccine; one dose of measles vaccine; three doses of the Hib vaccine, for the bacterial infection Haemophilus influenzae type b; and three doses of hepatitis B vaccine, increased to 79.4 percent, compared with 74.8 percent in 2002.

Still, as in previous years, urban areas suffered lower immunization rates in 2003 than did whole states. But the rates for some states, such as Colorado, with its 67.5 percent vaccination rate for the series of shots just listed, are cause for concern, health officials say. (“Vexing Vaccines,” July 28, 2004.)

—Darcia Harris Bowman