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Risk-behaviour screening for identifying adolescents with mental health problems in Europe

European Child & Adolescent Psychiatry volume 23, pages 611–620 (2014)Cite this article

Abstract

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.

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Acknowledgments

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.

Ethical standards

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.

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Authors and Affiliations

  1. Clinic of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Blumenstrasse 8, 69115, Heidelberg, Germany

    Michael Kaess, Romuald Brunner, Peter Parzer & Franz Resch

  2. National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden

    Vladimir Carli, Tony Durkee & Danuta Wasserman

  3. Feinberg Child Study Centre, Schneider Children’s Medical Centre, Tel Aviv University, Tel Aviv, Israel

    Alan Apter & Dana Feldman

  4. Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary

    Judit A. Balazs & Luca Farkas

  5. Institute of Psychology, Eotvos Lorand University, Budapest, Hungary

    Judit A. Balazs

  6. Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain

    Julio Bobes & Pilar A. Sáiz

  7. Clinical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania

    Horia G. Coman & Doina Cosman

  8. National Suicide Research Foundation, Cork, Ireland

    Padraig Cotter & Helen Keeley

  9. Research Division for Mental Health, University for Medical Information Technology (UMIT), Hall in Tirol, Austria

    Christian Haring

  10. Department of Health Sciences, University of Molise, Campobasso, Italy

    Miriam Iosue

  11. Department of Psychiatry and Clinical Psychology, Centre Hospitalo-Universitaire (CHU) de NANCY, Université H. Poincaré, Nancy, France

    Jean-Pierre Kahn, Alexandra Tubiana & Marco Sarchiapone

  12. Mental Health Department, PINT, University of Primorska, Primorska, Slovenia

    Tina Podlogar & Vita Postuvan

  13. Estonian-Swedish Mental Health and Suicidology Institute, Est Ctr Behav & Hlth Sci, Tallinn University, Tallinn, Estonia

    Merike Sisask & Peeter Värnik

  14. Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, USA

    Christina W. Hoven

  15. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA

    Christina W. Hoven

Authors
  1. Michael Kaess
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  2. Romuald Brunner
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  3. Peter Parzer
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  4. Vladimir Carli
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  6. Judit A. Balazs
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  9. Doina Cosman
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  10. Padraig Cotter
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  11. Tony Durkee
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  13. Dana Feldman
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  14. Christian Haring
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  15. Miriam Iosue
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  16. Jean-Pierre Kahn
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  17. Helen Keeley
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  18. Tina Podlogar
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  19. Vita Postuvan
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  20. Franz Resch
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  21. Pilar A. Sáiz
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  22. Merike Sisask
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  23. Alexandra Tubiana
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  24. Peeter Värnik
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  25. Marco Sarchiapone
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  26. Christina W. Hoven
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  27. Danuta Wasserman
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Corresponding author

Correspondence to Michael Kaess.

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Kaess, M., Brunner, R., Parzer, P. et al. Risk-behaviour screening for identifying adolescents with mental health problems in Europe. Eur Child Adolesc Psychiatry 23, 611–620 (2014). https://doi.org/10.1007/s00787-013-0490-y

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