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Behavioral Health Screenings in Local Middle Schools through SBIRT

Lidia Harding
Agency news Blog Q&A School-based
Mental Health Screening

This fall, YES, Lake Washington, and other Eastside schools will introduce a universal screening for mental health and substance use risk factors for local middle school students.

The research-based program is called Screening Brief Intervention and Referral to Services, or SBIRT.

The initial launch of the screening will be conducted with seventh graders in thirteen local middle schools. For about 10 minutes, they will interact with a research-based, teen-friendly online survey. The survey helps YES and school staff identify students who might be at risk for, or currently experiencing, a behavioral health concern.

YES’ Chief Operating Officer, David Downing, believes “this screening will help us identify the kids who might not otherwise receive help, especially the kids who otherwise ‘look’ fine.”

Students will be identified as tier 1 (no intervention), tier 2 (low-grade intervention (e.g. matched to a YES SUCCESS Mentor), or tier 3 (immediately referred to counseling services). YES, will have an SBIRT team member on hand to ensure that students and their families can have a positive experience accessing care.

You can learn more about the SBIRT program by reading the recent articles in local media:

You can also read our question and answer with YES COO David Downing below.

If you have any questions, please contact your local school district for more information.

What is SBIRT?

SBIRT is a King County-wide effort funded by the Best Starts for Kids Initiative that will empower us as a community to more effectively identify and address the needs of middle school students through the use of a universal screening tool, the SBIRT Check Yourself Tool This will be accompanied by brief structured sessions for students who present with “red flags,” and may include referral to assessment and/or other community-based support.

Why talk about this now?

While it is true that the SBIRT project is in an implementation process with a high level of forethought and pre-work to ensure it is done at a high standard of effectiveness, it is definitely the right time to be talking about it. We are at the beginning of the school year, and both YES and our school partners are already seeing mental health and substance use issues among our youth.

History tells us that the number of youth recognized as needing help will quickly grow as the fall continues. This is an opportunity to engage parents and the community in an important focus and discussion on mental health at the front, end and understand the importance of early screening and prevention work. Overall as a community, we want to intervene early to get the best long-term outcomes with young people. It is also notable that September is Suicide Prevention Awareness month.

How will parents be involved?

As a parent myself, I do understand parents having questions and wanting to understand this fully. We actually see this engagement by parents and the community as a huge plus. We all possess mental health (or social-emotional well-being), and depending on what is going on in our lives it can be expressed in a positive way, or it can come with great challenge and pain. Sadly, we often see families who don’t understand their connection to mental health until it becomes a significant challenge, or even a crisis, and they need immediate help from YES. Using this project as a way to engage the community, and having a wider recognition and conversation about youth mental health is a really healthy thing for us to be doing in East King County.

The SBIRT project will be implemented with transparency by the districts. Parents will be informed in a way similar to how they are now about the Healthy Youth surveys. It will be administered with an opt-out option. We want parents to understand the survey, and be able to have conversations with their youth before and after.

You mentioned that it is a healthy thing for us to be talking about this in East King County. Is there something unique about East King County?

Child and youth mental health concerns, like the rise of anxiety, depression, and suicidal feelings, is a national trend. Nationally there has been an approximate 10% increase in the number of children and youth we hospitalize. We are definitely experiencing this unfortunate upward trend in our own community. This is why efforts such as SBIRT that empower us to intervene earlier and support young people before matters become more severe is a worthy effort.

East King County is a unique community. Contrary to wide misperception, we have extensive ethnic and income diversity, but we see that mental health issues are impacting kids of all backgrounds. For example, Healthy Youth Survey data indicates that about 13% of Eastside eighth graders have reported suicide in the past year. The SBIRT project is a universal approach to reverse this trend.

How will the SBIRT program be implemented?

Planning for the SBIRT project includes carefully pacing the process. We know we will start smart, which means smaller, so we have the capacity to support, and connect young people and their families to helpful resources. That has been and continues to be a number one priority for us in all the planning.

Has the Check Yourself Tool been specifically designed for this program?

The Check Yourself Tool itself is not new and comes from work done by Seattle Children’s Hospital and The University of Washington. It has been used with youth in primary care settings, school-based health clinics, and the Emergency Department at Seattle Children’s Hospital. It questions youth about risk and protective factors in their lives, and is dynamic in the sense that, depending on their answers, the survey adapts to ask questions more relevant to them. It also has an interactive educational component adapted to meet the needs of the youth based on their responses. Students will have an option at the end where they are asked if they would like to talk to a counselor about anything from the survey. If there are any serious red flags that come up, families will, of course, be notified.

Learn more about the response of mental health issues that concern our youth.

Recently, The Seattle Times reported how King County is responding to concerns over the intensity of the mental health needs of our local youth.

A few months ago, NPR reported how the American Academy of Pediatrics issued updated guidelines that call for universal screening for depression in youth. YES wants to lead the way in providing this critical service to our youth.

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