case study 
How do we know who needs additional support?
The identification process.

As a means of assisting young people to cope, schools can provide prevention and early intervention programs, which can be delivered in a universal mode for all students, or as selected or indicated for students who have high mental health support needs. However, one of the difficulties when providing selected or indicated programs is the identification of students. The processes of identification and referral of students who have additional support needs can vary from very informal processes and systems to very formal ones (Campbell, 2003).

Multi-modal identification process
Often the identification of students with high mental health support needs in the areas of behaviour and learning is easier than identifying students with emotional and mental health needs. As students with high mental health support needs often experience internalizing problems of depression and anxiety, they tend to be under-identified and under-referred (Abidin & Robinson, 2002; Gardiner, 1994; Green, Clopton, & Pope, 1996; Pearcy, Clopton & Pope, 1993). Effective diagnosis relies on multi-informants and uses multi-methods (Kazdin & Weisz, 1998; Kraemer et al., 2003). Ideally students are identified

   • in multiple settings (such as home, classroom and playground)
   • by multiple informants (such as parents, teachers, peers and self-report)
   • using a variety of methods (such as teacher nomination, rating scales, observation, self-reports) (Gresham, MacMillan, & Bocian, 1997).

Two of the demonstration schools in the MindMatters Plus initiative instigated an identification process using a multi-disciplinary approach which collated data from teachers, specialists, and students. It was adapted from an approach being used in some primary schools (Campbell, 2003) to the high school situation for the identification of students with high mental health support needs. The three part process involved

1. Teacher observations: Teachers are crucial to the success of interventions in schools and have a good knowledge of students. In this first phase, teachers raise any concerns they have had with students with a chaired panel of multi-disciplinary specialists.

2. School support team contribute and then collate all information: Without compromising confidentiality, welfare personnel such as the school counsellor, nurse and youth worker nominate students not yet identified and with whom they have worked and who are in need. In this second phase further students can be added.

3. The student self-report: As adolescents have been found to be able to accurately report both their depression and anxiety (Brooks & Kutcher, 2003), the self-report instruments are an important procedure.

These need to be carefully considered with advice from a psychologist. Schools will need instruments that are low cost and easily accessible while still providing adequate psychometric properties of reliability and validity. In addition, the measures need to be relatively short for students to complete in one sitting and have a low reading age so all students are able to understand them. In this third phase, students complete a battery of self-report assessment measures.

This Guide has been developed to assist welfare staff in secondary schools in the early identification of students requiring support in the area of mental health. The identification process informs which appropriate interventions to implement in order to assist these young people.