Comparing Universal versus Focused Screening for Depression among Teens in High School -- The SHIELD Trial

What was the research about? The rate of major depressive disorder, or MDD, among teens has gone up over the last decade. Having MDD increases the risk for suicide, the second leading cause of death among teens. School-based screening can help identify teens with MDD and get them treatment. In Pennsylvania, all schools have the Student Assistance Program, or SAP, that helps students with issues affecting success in school. Trained SAP staff can confirm if MDD symptoms require follow-up and refer students to school or community services if needed. In this study, the research team compared two types of MDD screening for high school students: Universal, or broad screening. All students completed a nine-question screener for MDD on an iPad. Students with MDD symptoms received a referral to their school's SAP. Any student with suicidal thoughts received immediate services. Targeted, or focused screening. Teachers, staff, and parents referred any students with concerning behavior to their school's SAP. Schools in Pennsylvania currently use this approach for screening. The research team wanted to learn which type of screening identified more students with MDD and helped get them treatment, especially those often missed in focused screening.