Risk-behaviour screening for identifying adolescents with mental health problems in Europe
- 1k Downloads
Indicated prevention of mental illness is an important public health concern among youth. The aim of this study was to establish a European school-based professional screening among adolescents, which included variables on both a broad range of risk-behaviours and psychopathology; and to investigate the indicative value of adolescent risk-behaviour and self-reported psychopathology on help-seeking and psychological problems that required subsequent mental healthcare. A two-stage professional screening approach was developed and performed within the multi-centre study “Saving and Empowering Young Lives in Europe” (SEYLE). The first stage of screening comprised a self-report questionnaire on a representative sample of 3,070 adolescents from 11 European countries. In the second stage, students deemed at-risk for mental health problems were evaluated using a semi-structured clinical interview performed by healthcare professionals. 61 % of participants (n = 1,865) were identified as being at-risk in stage one. In stage two, 384 participants (12.5 % of the original sample) were found to require subsequent mental healthcare during semi-structured, clinical assessment. Among those, 18.5 % of pupils were identified due to screening for psychopathology alone; 29.4 % due to screening for risk-behaviours alone; and 52.1 % by a combination of both. Young age and peer victimization increased help-seeking, while very low body mass index, depression, suicidal behaviour and substance abuse were the best predictors of referral to mental healthcare. Screening of risk-behaviours significantly increased the number of detected students requiring subsequent mental healthcare. Screening of risk-behaviours added significant value in identifying the significant amount of European pupils with mental health problems. Therefore, attention to adolescent risk-behaviours in addition to psychopathology is critical in facilitating prevention and early intervention. Identifying factors that increase compliance to clinical interviews are crucial in improving screening procedures.
KeywordsSEYLE Adolescence Psychopathology Risk-behaviour Mental health Self-injury Depression Substance abuse Peer victimization Screening Help-seeking Health-care
The SEYLE project is supported by the European Union through the Seventh Framework Program (FP7), Grant agreement number HEALTH-F2-2009-223091. SEYLE Project Leader and Principal Investigator is Professor in Psychiatry and Suicidology Danuta Wasserman, National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP) at Karolinska Institutet (KI), Stockholm, Sweden. The Executive Committee comprises Professor Danuta Wasserman and Senior Lecturer Vladimir Carli, both from NASP, KI, Sweden; Professor Marco Sarchiapone from the University of Molise, Italy; Professor Christina W. Hoven, and Anthropologist Camilla Wasserman, both from the Department of Child and Adolescent Psychiatry, Columbia University and New York State Psychiatric Institute, New York, US; the SEYLE Consortium comprises sites in twelve European countries. Site leaders are Danuta Wasserman (NASP, Coordinating Centre), Christian Haring (Austria), Airi Varnik (Estonia), Jean-Pierre Kahn (France), Romuald Brunner (Germany), Judit Balazs (Hungary), Paul Corcoran (Ireland), Alan Apter (Israel), Marco Sarchiapone (Italy), Doina Cosman (Romania), Vita Postuvan (Slovenia) and Julio Bobes (Spain). Special thanks regarding this manuscript go to Katja Klug, Gloria Fischer and Lisa Göbelbecker from the University of Heidelberg, Germany, for their extensive help in the development and evaluation of the professional screening procedure during the SEYLE study.
Conflict of interest
The authors declare that they have no conflict of interest.
The study has been approved by the appropriate ethics committee of each study centre and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
- 4.Brunner R, Kaess M, Parzer P, Fischer G, Carli V, Hoven CW, Wasserman C, Sarchiapone M, Resch F, Apter A, Balazs J, Barzilay S, Bobes J, Corcoran P, Cosman D, Haring C, Iosue M, Kahn JP, Keeley H, Meszaros G, Nemes B, Podlogar T, Postuvan V, Saiz PA, Sisask M, Tubiana A, Varnik A, Wasserman D (2013) Life-time prevalence and psychosocial correlates of adolescent direct self-injurious behaviour: a comparative study of findings in 11 European countries. J Child Psychol Psychiatr. doi: 10.1111/jcpp.12166
- 5.Carli V, Wasserman C, Wasserman D, Sarchiapone M, Apter A, Balazs J, Bobes J, Brunner R, Corcoran P, Cosman D, Guillemin F, Haring C, Kaess M, Kahn JP, Keeley H, Keresztény A, Iosue M, Mars U, Musa G, Nemes B, Postuvan V, Reiter-Theil S, Saiz P, Varnik P, Varnik A, Hoven C (2013) The Saving and Empowering Young Lives in Europe (SEYLE) randomized controlled trial (RCT): methodological issues and participant characteristics. BMC Public Health 13:479PubMedCentralPubMedCrossRefGoogle Scholar
- 18.Jessor R (2007) Problem behaviour theory: a brief overview. http://www.colorado.edu/ibs/jessor/pb_theory.html/
- 20.Kaufman J, Birhamer B, Brend D, Rao U, Flynn C, Moreci P, Williamson D, Ryan N (1997) The schedule for affective disorders and schizophrenia for school-age-children—present and lifetime version (K-SADS): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 36:980–988PubMedCrossRefGoogle Scholar
- 23.Mann JJ, Apter A, Bertolote J, Beautrais A, Currier D, Haas A, Hegerl U, Lonnqvist J, Malone K, Marusic A, Mehlum L, Patton G, Phillips M, Rutz W, Rihmer Z, Schmidtke A, Shaffer D, Silverman M, Takahashi Y, Varnik A, Wasserman D, Yip P, Hendin H (2005) Suicide prevention strategies: a systematic review. JAMA 294:2064–2074PubMedCrossRefGoogle Scholar
- 27.Paykel, ES, Myers JK, Lindenthal JJ, Tanner J (1972) Suicidal feelings in the general population: a prevalence study. Br J Psychiatry, pp 380–406Google Scholar
- 28.Reynolds WM (1991) A school-based procedure for the identification of adolescents at risk for suicidal behaviours. Family Community Health 14:64–75Google Scholar
- 35.Wasserman D, Carli V, Wasserman C, Apter A, Balazs J, Bobes J, Bracale R, Brunner R, Bursztein-Lipsicas C, Corcoran P, Cosman D, Durkee T, Feldman D, Gadoros J, Guillemin F, Haring C, Kahn JP, Kaess M, Keeley H, Marusic D, Nemes B, Postuvan V, Reiter-Theil S, Resch F, Saiz P, Sarchiapone M, Sisask M, Varnik A, Hoven CW (2010) Saving and empowering young lives in Europe (SEYLE): a randomized controlled trial. BMC Public Health 10:192PubMedCentralPubMedCrossRefGoogle Scholar
- 36.WHO (2009) Global School-Based Student Health Survey. World Health Organisation, GenevaGoogle Scholar