Washington youth are experiencing a mental health crisis. COVID-19 has exacerbated underlying issues felt by young people, including anxiety, depression and suicidal ideation. Over the past two months, national experts and senior officials have sounded the alarm. The Centers for Disease Control and Prevention (CDC) ‘issued a warning on teen mental health.’ The United States Preventive Task Force called for the regular screening of children ages eight to 18 for anxiety.
In King County, we saw an increase among 10 to 13-year-olds for emergency room visits for suspected suicide attempts. Before the pandemic, the American Academy of Pediatrics issued a report noting that “mental health disorders have surpassed physical conditions.” Pediatric offices are swamped with youth in distress. We are in a nationwide emergency. Our children and youth need us to act.
One powerful way King County is taking action for youth mental health is by partnering with local school districts on our School-Based Screening, Brief Intervention, and Referral to services or treatment (SB SBIRT) program. SBIRT began before the pandemic and over the past three years has proven its effectiveness in detecting youth mental health challenges before they become a crisis. SBIRT is currently in 12 school districts and provides a structured approach to promoting social and emotional health and preventing substance use for students. Once a student fills out a brief survey ranging from their goals and identity to substance use, they are offered opportunities to connect to individualized resources and speak with a caring adult who has been trained in the model. As current contracts with school districts come to an end, 11 school districts that currently use SBIRT recently reapplied to continue funding for the program.
Since the program began in 2019, over 22,000 students have participated in the program, resulting in nearly 4,000 referrals to services. The program has implemented broad mental health screenings across 47 middle schools, identifying students in need of mental health support and connecting them to mental health resources. Key successes of this program include detecting and providing support for students who internalize distress, and building stronger connections with adults so they feel safe asking for help.
Given the program’s initial results and the need in the community, King County recently awarded 11 school districts funding to continue the program for another three years. The awarded schools recognize the importance of this crisis and are focused on improvements to suicide prevention, intervention, overdose prevention strategies, and expanding the number of students served. Students in the program most commonly report suicidal ideation, depressive and anxiety symptoms, bullying and self-harm.
School-based SBIRT is the product of extensive work with local school districts and community partners, developing a tool built on current research and evidence and tailored to community input. King County also works with schools and partners to ensure data security of sensitive information is consistent with district policies, and parents and students are fully informed of their option to participate or not. The results of the program are being evaluated, using accepted methods, practices and oversight to ensure validity and integrity of the findings.
King County has invested $16.4 million to support SB SBIRT since 2019, including new funding for the next three years. The program is jointly funded through Best Starts for Kids and the MIDD levy within the Department of Community and Human Services (DCHS).
The School-Based SBIRT model was adapted by Reclaiming Futures (Portland State University) in collaboration with cross-divisional support by King County, including Best Starts for Kids and the Behavioral Health and Recovery Division in DCHS, and informed by community partners, leaders in education, mental health professionals—all committed to health promotion, preventing youth suicide and building resources to support the young people of King County.
|Frequently Asked Questions |
How does school-based SBIRT work?
Screening: SBIRT begins with an interactive, youth friendly survey. The Check Yourself survey is a secure, web-based application developed by Seattle Children’s Hospital. The survey asks questions about students’ strengths, substance use, social and emotional health, and safety.
Brief intervention: If students’ answers indicate they may be struggling, or if students indicate on the survey that they would like to talk further, students meet with a staff member trained in the model. These conversations put a student’s answers on the survey into context, and helps students consider their goals and explore what motivates them.
Referral to services: Staff trained in the model connect students who would benefit from further support to individualized resources, which might include academic support, mentoring, social activities, or behavioral health services.
Is school-based SBIRT evidence based?
· The Check Yourself screen has validated screening tools embedded within the program and is an important innovation to fill a gap in strengths based, youth health promotion and substance use prevention interventions that is tailored to King County communities.
Are parents or caregivers notified?
· Yes, parents and caregivers are provided notice and parental consent is required.
· Parents and caregivers have the option to opt their student out of the program.
Is student information confidential?
· Yes, a secure Data Dashboard (Tickit Health) captures survey data and de-identifies the data, displays summary reports of student responses and is the administrative hub for a variety of features, including safety alerts and downloading Excel files of aggregated data.
· Check Yourself is HIPAA and Family Educational Rights and Privacy Act (FERPA) compliant with password protection and meets personal health information privacy and security standards.