Introduction: A 2009 National Academies of Sciences report on child mental health prevention
and treatment concluded that screening for mental health risk is an essential component of service
delivery. To date, however, there are few practical assessments available or practices in place
that measure individual child risk, or risk aggregated at the school or community level. This study
examined the utility of a 30-item paper and pencil student self-report screener of behavioral and
emotional risk (BER) for surveying community risk among 7 schools.
Methods: In 2010, 2,222 students in 3 middle and 4 high schools in a medium-sized school district
in Georgia were administered the Behavioral and Emotional Screening System Self-Report Child/
Adolescent form (BESS Student). The BESS is designed to measure 4 sub-syndromal BER factors
for developing mental health disorders: inattention/hyperactivity, internalizing, school problems,
and personal adjustment. Analysis of Variance and Chi Square analyses were used to assess the
association between adolescent self-reported BER as an indicator of school BER, grade level, child
ethnic identification and gender, socioeconomic status, and special education placement status.
Results: BESS scores differentiated well between schools for overall BER and special education
status, as well as between grade levels, ethnicity, and gender groups. One high school, known by
the school administration to have numerous incidents of student behavior problems, had the most
deviant 4 BER domain scores of all 7 schools. Girls rated themselves as having a higher prevalence
of BER (14%) than boys (12%); middle school students reported fewer difficulties than high school
students.
Conclusion: Middle and high school students were capable of identifying significant differences in
their own BER across schools, suggesting that universal mental health risk screening via
student self-report is potentially useful for identifying aggregated community risk in a given school
that may warrant differential deployment of mental health prevention and intervention strategies.
BESS results reliably identified individual mental health risk associated with special education
placement, which is documented to lead to poor school outcomes such as school dropout and lack
of enrollment in post-secondary education.