TFJH Student Handbook

Thompson Falls Schools and RBHI Mental Wellness Screening

Individuals with good mental well-being have energy, happiness, pride, healthy relationships, and resilience. These are traits that our school tries to foster in students. Persons with lower mental well-being may experience anxiety, fear, depression, sadness, or shame. Some may feel a burden to others. Some may feel life itself is difficult or impossible. This may place them at higher risk of suicide. Our school wants to help these students have a better life experience. First, we must identify which students need extra support.

WHY SCREEN FOR MENTAL WELL-BEING?
Schools often use validated screeners to measure a student’s skills and knowledge. Academic and health screenings help students, families, and providers learn how well school and health care programs are working. They also identify students who might need extra help. Without routine screening, teachers often would not know that a particular student or group of students needs extra help with a particular aspect of learning. For example, dividing fractions or hearing the sound breaks in words are more difficult for some students. Likewise, screening for height, weight, vision, hearing, and dental screenings help determine if students are physically healthy.

Screening for mental health issues measures a critical aspect of children’s overall health. It can help measure of the effectiveness of the school’s approach to mental health. It also provides an effective way to find out if a student is in need of help. This is important because not all students experiencing mental health issues have outward signs. Many do not tell anyone they are struggling. Such issues negatively impact
happiness, relationships, behavior, health, safety, and academic performance.

Many of our students experience social, mental, and emotional well-being. However, here, and nationwide, at least 1 in 5 students experience a significant mental health issue during their school years. In Montana, rates of youth suicide have regularly been among the highest in the country. We need to do more to help our children live their fullest lives. The good news is that mental health issues are like any other health issue,
such as learning healthy eating habits or taking insulin to treat diabetes. They are usually very treatable, especially if detected early. Additionally, students experiencing mental health issues can be taught skills that will help prevent or lessen the severity of future mental health issues.

Our school carefully examined whether screening poses any risk to students. For example, we looked into whether asking about students’ mental health could cause a student to become suicidal, make thoughts of suicide worse, or increase the risk of suicide attempt. This is called “iatrogenic risk.” All 17 studies looking at iatrogenic risk among those with suicidal thoughts or behaviors have shown that there is no risk associated with mental health screening. Just as math screenings do not cause math learning difficulties, mental health screening does not cause mental health issues.

HOW DOES SCREENING WORK?
Our school is working with a local nonprofit, Rural Behavioral Health Institute (RBHI), which specializes in digital school-based mental health screening. RBHI works closely with MERET Solutions, a leader in mental health screening for the medical industry. RBHI and MERET Solutions received a grant that will provide free computerized mental health screening to all 6th -12th grade students in our school in the 2024-2025 school year.

Our school will also provide opportunities for students and their families to give feedback about their experience. Please see the consent form attached to this letter. The form requests your permission for your child to participate in the screening. The consent forms will be collected by the school secretaries. School and healthcare officials hope that all families will want to be a part of the screening. It will help identify and offer help to any students who may need extra support. It will also help the school determine how well programs are working. Each student will be assigned a unique code. This will keep results strictly confidential. The day of screening, students will logon with a computer or smartphone and enter their
codes to access the screener. The screener takes about 5 to 15 minutes. Any student who wishes to stop during the process of screening will be told they can before screening starts.

Only the school counselors will have access to the codes associated with the students’ names. They will only access an individual student’s results if the results indicate the student could benefit from additional support. Parents and guardians may request their child’s results. The parent or guardian may also grant permission for the school to share their child’s result with their doctor or therapist. In the unlikely event that a student is in danger of self-harming and the parent or guardian is unreachable, the school counselor will alert the Crisis Response Team. The team will begin working with the student to further assess risk and maximize the student’s safety.

FREQUENTLY ASKED QUESTIONS

IS THE CONSENT FORM GOOD FOR THE WHOLE YEAR?
Yes, the consent form is for the 2024-2025 school year. Parents and guardians or the student may decide at any time not to participate. If time allows and in coming school years, we may ask students to take the screener twice during the year. This will probably be once a semester. The reason we want students to take the screener more than once is that it will give us a better idea of how students are feeling over time. Sometimes a student has a bad day, goes through a breakup, or has a fight with a friend. A student may indicate they have symptoms of anxiety or depression or thoughts of suicide when under stress. Later, the student may feel much better. Screening will help us find the students who aren’t feeling better to make sure they receive the support they need.

IS SCREENING SAFE?
Yes. There has been a lot of research on screening for mental health in children and adolescents. All the research shows that asking whether someone is experiencing thoughts about depression, anxiety, or suicide does NOT cause suicide or make a youth feel worse. To the contrary, students often report they feel better knowing support is available if they need it. 

WHAT IS IN THE SCREENER?
There are 4 assessments, all validated for youth 6th grade on up.

• Suicide risk – eC-SSRS (electronic Columbia – Suicide Severity Risk Scale)
  • Recommended by the FDA as gold standard suicide risk survey
  • Varied number of questions (number depends on answers) about suicidal thoughts, suicidal plans, and suicide attempts
• Depression symptoms – Patient Health Questionnaire (Adolescent Version)
  • 9 questions about common symptoms of depression and how frequently in the past 2 weeks a student had them, if ever
  • Depression is a major risk factor for suicide. 
  • 11% of adolescents will have had depression by the time they are 18.
• Anxiety symptoms – General Anxiety Disorder Scale
  • 7 questions about common symptoms of anxiety and how frequently in the past 2 weeks a student had them, if ever 
  • Anxiety is a major risk factor for suicide.
  • 32% of youth have had anxiety by age 18.

• It is possible your child might feel uncomfortable or tired answering some of the questions in the screener. Your child may refuse to answer any of the questions, take a break, or stop taking the screener at any time.
• Any time information is collected there is a small potential risk of unplanned sharing of an individual’s personal information. Every effort will be made to keep your child’s information confidential. Your child will be given a code to use instead of her/his name. All data will be anonymous unless there is immediate risk of self-harm. If this occurs, your child’s screening will be shared with the crisis response team. There will be no way for anyone outside the designated person(s) at the school to link your child’s name to the data your child provides in the questionnaire.
  • The school, RBHI, and MERET Solutions will make every effort to protect your child’s privacy using one-way encrypted data. This is like the system used by healthcare providers for patient records.
  • RBHI and MERET Solutions will never have access to the identities associated with the data.
  • Your child’s data will never be sold. 

WHO DO I CONTACT ABOUT THIS INTERVENTION IF I HAVE QUESTIONS?
Please contact Rob Christensen at rchristensen@tfalls.org or 406-827-3561.

DOES YOUR CHILD HAVE TO TAKE PART IN SCREENING?
No. This screening is considered part of the school’s health program. While we view this as one of several helpful health screenings and encourage all students to participate, if you do not want your child to participate in screening, they do not have to.

WHAT ABOUT FUTURE USE OF DATA AND RE-CONTACT?
The screener data will not be kept in the student’s cumulative file or on the student information system. However, there will be a flag placed in Infinite Campus that alerts the school and parents that a record of the data exists on the MERET server.

Our school district may do different analyses using grouped data. No individual students will ever be identified except to provide them care. For example, we may want to know how many students show signs of depression. We may want to determine if depression symptoms improve after an intervention is done in the school. We may share grouped data with other school districts in Montana to compare how our students are doing and how our programming compares. RBHI may share summarized data from schools with funders or in public talks about the program but will NEVER use our school’s name or the name of any student.

If you change your mind and do not want us to keep your child’s screening information, please call or email the school office. You and your child will not be identified in any report about the intervention. Your child’s data can be deleted permanently at any time.