Universal school mental health screenings don’t mean kids will get help, psychologist says

Starting next school year, students in Illinois will undergo annual mental health screenings. A bill signed into law earlier this year makes Illinois the first state in the country to require the screenings, although parents are able to opt their kids out.

There is a lot of concern about the state of mental health among children in this country. The State of Mental Health in America 2025 report finds, among other things, that while the percentage of young Americans who’d experienced a major depressive episode in the past year decreased from 2023 to 2024, more than 11% of those between the ages of 12-17 did experience one.

To learn more about that — and whether the idea of mandatory mental health screenings in schools could bring those numbers down — The Show spoke to Marilyn Cabay, a clinical psychologist in private practice and former school psychologist.

Full conversation

MARK BRODIE: Marilyn, what do you make of this idea being tried in Illinois?

MARILYN CABAY: It’s a complicated issue, and schools are doing a lot already. To go in and additionally require schools to add another screening, which in a sense is another way of evaluating somebody, I think poses some concerns. Are these screening tools actually going to be accurate, valid? I know there’s a lot of research that goes into developing assessments, but we have unique communities in each of the schools.

What do we do with that information? There’s certainly going to be a cost involved to adding that. And I might backtrack and say that schools are already required to do a screening of academic and behavioral health to identify children who might potentially have or be eligible for being evaluated to have a disability that could affect their education.

So I don’t know at this point if adding an additional screening would tax an already stressed system as far as resources go.

BRODIE: Let me ask you about what you were saying about what happens with the data. And I wonder, even if the screenings do a good job and identify students who maybe have behavioral health or mental health needs, are there the services available for those students and their families? Or is it just a matter of saying, “OK, this is a student who needs some help. You should go find it?"

CABAY: That’s a real concern because we have a shortage of mental health providers nationwide. With what we have here in Arizona, for instance, the ratio of how many psychologists to students that is recommended is one psychologist to 500 students in schools, and right now we have about one psychologist to between 1,300 and 1,500 students.

The number of counselors, the ratio compared to what’s recommended is even much poorer. So there’s not a lot available within schools to provide those services. And then if you’re referring outside of schools, there’s also a shortage of providers. The providers that are taking insurance are even more limited, and then providers working with minors are more limited.

BRODIE: How accurate do you think these screenings can be? Like, is there a danger of having false positives or false negatives in this sort of thing?

CABAY: Certainly there’s a danger. And it’s one thing to have a full evaluation and look at reports from parents and teachers and observe behavior of children and listen to their own self reports and do assessments, but that is time consuming and costly. Now, I understand there is a hope that in screening children, maybe they would be able to provide some sort of intervention that could benefit them prior to problems developing, but I don’t know if that’s actually been shown as being effective.

BRODIE: Well, what are the dangers to the students if, for example, there’s a screening given and a student is found to have “name your condition,” but they don’t actually? What is the danger for that student in that?

CABAY: Well, one way of describing it would be it could lead to a self-fulfilling prophecy. And then there’s also the problem with how parents or teachers might interact with students who are identified, especially if they’re not necessarily clearly needing services. If they need support — and I don’t want to disregard that schools are doing wonderful things to help children who do need and would benefit from some extra support. I’m just concerned that perhaps identifying kids with a screener might lead to overidentification.

BRODIE: Well, and I also would imagine that the manner in which the screening is done would matter, right? Like if it’s a self-evaluation, a student answers a bunch of questions. Or a trained professional observing a student in class — and you kind of alluded to this — or even a trained professional sort of asking the questions and gauging the answers that the student gives. I would imagine that could influence the answers and the results as well.

CABAY: Yeah, definitely it would. And I don’t know that at this point they would even try to do something as far as a professional interacting with students. Back to what the resources are and what I’ve read about school screenings, it would probably be more like a checklist sort of screening.

And as you know, probably physicians have been doing mental health screenings for children and adults. And that might be a good environment to do it. That might be the good place to do it because it’s more private, it’s more individual, There’s a potential to talk about it.

BRODIE: Well, so I don’t think I have to tell you about all of the research and the writing and sort of the worry about the mental health of kids in this country right now. So is there a better way to try to get help to kids who need it, who maybe otherwise wouldn’t be getting it?

CABAY: I think all kids would benefit from learning and growing in their understanding of mental health and the importance of mental health. And I think that the country is actually moving in that direction.

But I think as much as we can help students in schools understand that emotions are important, understanding and supporting each other is important, the serious impact of bullying or ostracizing, the benefits of inclusion from learning from each other, those things would all be very helpful.

BRODIE: Well, what you’re describing kind of sounds like sort of a universal education system almost to help students identify, for example, how to not be unkind to each other, or maybe even something as basic as put your phone away and stop scrolling social media, things like that, as opposed to a screening of their mental health.

Am I hearing you correctly?

CABAY: Yeah, yeah. I mean, we’re aware of some of the things that promote health. Like, we don’t want to have students coming to school with food insecurity, with housing insecurity, things like that. Those are things that would be helpful to address within school, promoting social interaction, perhaps peer buddies. I think teachers would like to do that.

But I also think that there’s a lot of pressure on schools right now.

BRODIE: Well, do you anticipate that this idea of sort of universal mental health screening in schools, do you expect this to gain in popularity, or do you think it’s going to continue to be sort of a one-off here and there?

CABAY: I don’t know. I. What I’ve seen is like in Illinois, it’s been planned for the '26-'27 school year. There’s a lot of research going on in Wisconsin and in the New England states. Here in Arizona, do I expect it to take off? I would probably say not right away.

BRODIE: Because of resources?

CABAY: Maybe because of resources.