| Title: |
Exploring Self-Referral as a Low-Burden, Universally Administered Strategy to Connect Adolescents to Mental Health Supports Following Anonymous School-Based Screening |
| Language: |
English |
| Authors: |
Meghan A. Costello (ORCID 0000-0002-9520-4676); John Crocker; Jasmeen Kaur; Rosie Du; Elizabeth Oxendine; Lauren Greenspan; Rebecca Butler; Randi M. Schuster |
| 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 |