Exploring Self-Referral as a Low-Burden, Universally Administered Strategy to Connect Adolescents to Mental Health Supports Following Anonymous School-Based Screening
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| Title: | Exploring Self-Referral as a Low-Burden, Universally Administered Strategy to Connect Adolescents to Mental Health Supports Following Anonymous School-Based Screening |
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| Language: | English |
| Authors: | Meghan A. Costello (ORCID |
| Source: | School Psychology. 2026 41(4):434-445. |
| Availability: | American Psychological Association. Journals Department, 750 First Street NE, Washington, DC 20002. Tel: 800-374-2721; Tel: 202-336-5510; Fax: 202-336-5502; e-mail: order@apa.org; Web site: http://www.apa.org |
| Peer Reviewed: | Y |
| Page Count: | 12 |
| Publication Date: | 2026 |
| Sponsoring Agency: | Substance Abuse and Mental Health Services Administration (SAMHSA) (DHHS/PHS) National Institute on Drug Abuse (NIDA) (DHHS/PHS) |
| Contract Number: | INTF2400H78500224455 5K12DA04349007 |
| Document Type: | Journal Articles Reports - Research |
| Education Level: | Junior High Schools Middle Schools Secondary Education High Schools |
| Descriptors: | Mental Health, Referral, Middle School Students, High School Students, Depression (Psychology), Anxiety, Mental Disorders, Emotional Response, Attention Deficit Hyperactivity Disorder, Suicide, Psychological Patterns, Self Disclosure (Individuals), LGBTQ People, At Risk Persons, School Health Services, Screening Tests, Gender Differences, Racial Differences, Ethnicity, Substance Abuse |
| Geographic Terms: | Massachusetts |
| DOI: | 10.1037/spq0000719 |
| ISSN: | 2578-4218 2578-4226 |
| Abstract: | Integrating widespread, low-burden approaches to facilitate connection to school-based care may be helpful in expanding mental health reach in schools. The present study describes students' use of a single-item self-referral process following a school-wide anonymous screener of mental health and substance use. The Substance Use and Risk Factor Survey included a school-based referral request item in 47 Massachusetts public middle and high schools in fall 2023 (N = 16,236; 47% girls; 4% gender diverse; 41% racially or ethnically marginalized or minoritized). Students who self-referred, in comparison to those who did not self-refer, endorsed more symptoms of depression and anxiety (M[subscript self-referral] = 3.7 [SD = 3.8], M[subscript noReferral] = 3.0 [SD = 3.3], p = 0.0001), psychoticlike experiences (M[subscript self-referral] = 1.1 [SD = 1.6], M[subscript noReferral] = 0.9 [SD = 1.4], p = 0.0004), emotional reactivity (M[subscript self-referral] = 24.4 [SD = 23.7], M[subscript noReferral] = 20.8 [SD = 20.8], p = 0.001), and inattention and hyperactivity (M[subscript self-referral] = 0.8 [SD = 0.8], M[subscript noReferral] = 0.7 [SD = 0.7], p = 0.001). Students who self-referred were more likely to endorse a past-year suicide attempt (6.6% among self-referral group, 3.1% among the no-referral group; OR = 1.7, p = 0.02) and not talking to anyone (formal or informal mental health supports) about their mental health in the past year (31.4% self-referrals, 21.9% no referral; OR = 1.7, p < 0.001). Students who self-referred were also more likely to hold a minoritized gender identity (6.9% self-referrals, 3.9% no self-referrals; OR = 1.8, p = 0.012). School staff (N = 15) noted that the self-referral process was helpful (M = 3.87/5, SD = 1.27), and approximately half of the students requesting support (53.7%) were not already engaged in school-based mental health support. Self-referral requests following school-wide screeners may be a useful strategy to identify students experiencing mental health distress without supports in place. |
| Abstractor: | As Provided |
| Entry Date: | 2026 |
| Accession Number: | EJ1507971 |
| Database: | ERIC |
| Abstract: | Integrating widespread, low-burden approaches to facilitate connection to school-based care may be helpful in expanding mental health reach in schools. The present study describes students' use of a single-item self-referral process following a school-wide anonymous screener of mental health and substance use. The Substance Use and Risk Factor Survey included a school-based referral request item in 47 Massachusetts public middle and high schools in fall 2023 (N = 16,236; 47% girls; 4% gender diverse; 41% racially or ethnically marginalized or minoritized). Students who self-referred, in comparison to those who did not self-refer, endorsed more symptoms of depression and anxiety (M[subscript self-referral] = 3.7 [SD = 3.8], M[subscript noReferral] = 3.0 [SD = 3.3], p = 0.0001), psychoticlike experiences (M[subscript self-referral] = 1.1 [SD = 1.6], M[subscript noReferral] = 0.9 [SD = 1.4], p = 0.0004), emotional reactivity (M[subscript self-referral] = 24.4 [SD = 23.7], M[subscript noReferral] = 20.8 [SD = 20.8], p = 0.001), and inattention and hyperactivity (M[subscript self-referral] = 0.8 [SD = 0.8], M[subscript noReferral] = 0.7 [SD = 0.7], p = 0.001). Students who self-referred were more likely to endorse a past-year suicide attempt (6.6% among self-referral group, 3.1% among the no-referral group; OR = 1.7, p = 0.02) and not talking to anyone (formal or informal mental health supports) about their mental health in the past year (31.4% self-referrals, 21.9% no referral; OR = 1.7, p < 0.001). Students who self-referred were also more likely to hold a minoritized gender identity (6.9% self-referrals, 3.9% no self-referrals; OR = 1.8, p = 0.012). School staff (N = 15) noted that the self-referral process was helpful (M = 3.87/5, SD = 1.27), and approximately half of the students requesting support (53.7%) were not already engaged in school-based mental health support. Self-referral requests following school-wide screeners may be a useful strategy to identify students experiencing mental health distress without supports in place. |
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| ISSN: | 2578-4218 2578-4226 |
| DOI: | 10.1037/spq0000719 |
