This week, The Washington Post published an opinion piece suggesting that school-based mental health screening “endangers kids” and that therapy doesn’t help students at risk. After 25+ years working in behavioral health and health care policy, I can say with confidence: the evidence tells a very different story.
Screening Saves Lives
- More kids get help when schools screen. A 2021 study in JAMA Network Open of nearly 13,000 high school students found that universal depression screening made students almost six times more likely to be identified and twice as likely to start treatment compared with teacher referral alone.
- Asking about suicide doesn’t plant ideas. Randomized studies show that asking about suicidal thoughts does not increase distress or suicidal ideation—it gives kids a safe way to talk about what they are already carrying.
- According to a 2023 study in Preventive Medicine Reports, parents, school staff, and students in a qualitative study of universal screening via the SHIELD program reported that screening increased awareness of mental health needs and made seeking help more acceptable.
- Prevention programs work. The Signs of Suicide program has been shown in multiple school-based trials to reduce suicide attempts by 40–60 percent.
Therapy and Early Intervention Help At-Risk Youth
- Dialectical Behavior Therapy for Adolescents (DBT-A) has repeatedly been shown to reduce suicide attempts and self-harm. A randomized clinical trial published in JAMA Psychiatry found that adolescents receiving DBT-A had significantly fewer suicide attempts and self-injurious behaviors than those receiving supportive therapy. A more recent systematic review and meta-analysis in Psychological Medicine confirmed that DBT-A produces small-to-moderate but meaningful reductions in both self-harm and suicidal ideation across multiple studies.
- Cognitive Behavioral Therapy (CBT) consistently reduces depression and anxiety in adolescents, including when it’s delivered in schools. A randomized trial published in the Journal of the American Academy of Child & Adolescent Psychiatry tested both brief and standard formats of school-based CBT for teens with anxiety. Both versions significantly reduced anxiety, depression, and functional impairment, with durable effects at one-year follow-up—proving that school settings can be effective platforms for evidence-based therapy.
Meta-analyses of school-based programs confirm these benefits more broadly. Reviews of CBT and DBT-A in schools highlight that outcomes are strongest when trained clinicians deliver programs and actively involve parents and families in treatment planning. A recent overview in Frontiers in Psychology found consistent positive effects on youth depression and anxiety across dozens of school-based trials.
Addressing Substance Use Early
Mental health screening also creates opportunities to identify and address substance use—a major risk factor for later mental health disorders and suicide. Programs like SBIRT (Screening, Brief Intervention, and Referral to Treatment)have been shown to reduce adolescent alcohol and drug misuse in school and clinical settings. More recently, experts emphasized that early screening for adolescent substance use helps prevent escalation into serious disorders and promotes health equity.
Safer Schools Through Early Intervention
The need for these programs feels particularly urgent given the tragic shooting this week at Evergreen High School in Colorado, where a 16-year-old student shot two classmates before dying by suicide. Authorities reported that locked doors and rapid staff action prevented even greater harm.
Research by the U.S. Secret Service and Department of Education shows that most school shooters exhibit warning signs—mental health struggles, suicidal thoughts, substance use—before violence occurs. School-based screening and threat assessment programs are proven tools to identify those red flags and connect students to help.
But early identification only works if it’s paired with reasonable gun safety policies for children and families. For example, a recent RAND analysis found that states with strong child access prevention and safe storage laws have lower rates of unintentional firearm injuries, suicides, and deaths among children. Preventing school shootings requires a comprehensive approach: addressing both mental health and access to firearms.
Schools as Partners, Not Substitutes
Schools don’t replace parents or doctors—they extend the safety net. With the right training and safeguards, they can:
- Spot risks early through screening
- Connect kids to care through referral pathways
- Partner with families and providers in follow-up
Colorado’s I Matter program is a strong example: providing free therapy sessions for youth through schools and community outreach so cost and access aren’t barriers—and early indicators show it’s having real positive effect. Since launching in late 2021, over 13,000 youth across 62 counties have received care via I Matter, with more than 50,000 therapy sessions delivered, and 80 percent of participants being referred into additional behavioral health services.
The Bigger Picture
From my decades in this field, I know that parental support, stable home environments, and good nutrition are essential for children’s well-being. But they do not replace preventive screening, early intervention, or substance use prevention—they complement them.
When we delay asking questions, fail to screen, or leave signs unheeded, the consequences can be devastating. The Evergreen tragedy should be a call to action—not a reason to retreat.
That’s why the claim that school screening “endangers kids” is misleading and dangerous. The evidence is clear: thoughtful screening, early intervention, and access to therapy save lives. Dismissing these tools ignores decades of research—and puts students at greater risk.