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Health and Mental Health, Should We Screen Children?

Allan Schwartz, LCSW, Ph.D. Updated: Apr 16th 2012

Health and Mental Health, Should We Screen Children?"Which came first, the chicken or the egg?" Which came first, the heart attack or the episode of major depression six months ago? Is the depression irrelevant to the heart attack?

For a very long time, mental issues were thought to be separate from physical health. We now know that mind and body are closely connected and that mental and physical health are closely intertwined. As proof of this is a report issued by SAMHSA, Substance Abuse and Mental Health Administration. The report states that anyone who had a mental illness in the past year is likely to develop a serious physical illness. Among the mental illnesses discussed are major depressive episode, or any other behavioral illness that interferes with the ability to work and function on a daily basis. The physical serious physical illnesses that can result are diabetes, high blood pressure, cardiovascular disease, asthma or stroke. Statistics show that those who experienced an episode of one of the mental illnesses is at a significantly higher risk of physical illnesses than those who did not. Does this mean that a mental illness is the direct cause of a physical illness? The anwer is probably not but that there is a connection.

How does this affect our children?

Many years ago when I was a school teacher, there was a youngster in my class who was extremely introverted. In fact, introversion is not an adequate description of what she was like. It would be more accurate to say that she was mute. She did not talk to other students in class and did not respond to me, as her teacher. When I reported this to the psychology and guidance department of the school nothing was done because it was thought that she was just a quiet girl. In a few months she dropped out of school and never returned. As it turned out, she had a serious mental illness. Should she have been screened for a possible mental illness?

The question of screening school children for psychological problems is being discussed and debated. Statistics show that, in cases where children were screened for depression when they were in elementary school were very likely to be diagnosed and given anti depressant medication as adults. In light of the connection between emotional and physical health, it seems to make sense that psychological checkups for children make sense.

There are a number of problems with the idea of sending kids for a psychological checkup. First, who is going to do the psychological assessment. Most school psychologists are already over whelmed with their responsibilities without adding more. Second, are will all children be examined or only those who are showing signs of having problems? If children are assessed and identified, will they be stigmatized by the other kids? If children are identified, what happens next? Schools cannot afford to pay for psychotherapy, anti depressant medication is contra indicated for kids because of the danger of suicide and most parents cannot afford private psychotherapy, if they even agreed it's necessary. Lastly, would you want your children to be evaluated by a school system for psychological problems?

On the other hand, if we could identily kids at risk for developing a mental illness, could we prevent them from becoming more ill later on? Considering the connection between physical and emotional health, could we prevent serious physical illnesses from occurring later on?

What is your opinion? Would you be willing to have your child evaluated for mental health and, if the findings were positive, would you be willing or able to send your child for treatment? Should a school system even be involved with this type of thing?

Your responses are encouraged.

Allan N. Schwartz, PhD

Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at for details.

Reader Comments
Discuss this issue below or in our forums.

Selective Mutism? - Beth - Apr 17th 2012

The girl you described may have suffered from Selective Mutism. My daughter has this and she is very socially anxious and can't speak in certain social situations. She completely shuts down in public even though she is very talkative at home. It has been difficult to find any help for her. Many doctors and teachers don't have an understanding of this. Educating the public about mental illness would be helpful. Screening might also be a good idea. Something to think about.

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