UNCG Research

Mental health and schoolchildren

Assessments for early intervention

Posted on Wednesday, October 19th, 2016 by Olivia Wood.
Photo credit: CDC/Amanda MillsPhoto credit: CDC/Amanda Mills

Over the 2011-2012 and 2012-2013 school years, 874 children in North Carolina attempted suicide, according to the North Carolina Department for Health and Human Services. Of these attempts, 56 resulted in death. Elementary school students accounted for 66 of the attempts overall, and two of the deaths. 

Researchers at UNCG and their collaborators hope that early detection of risk factors and preventative interventions can reduce these incidents in the future.

UNCG Assistant Professor of Social Work Dr. Danielle Swick and Dr. Stephanie Daniel of the Wake Forest School of Medicine are analyzing data from over 4,000 students in three different counties to determine which mental health risk factors are the most common, and thus, what problems should be targeted first for intervention. They want to reach the greatest number of at-risk kids as early as possible.


Dr. Danielle Swick is an assistant professor in the UNCG Department of Social Work.

Dr. Danielle Swick is an assistant professor in the UNCG Department of Social Work.

The data were collected by administering a risk assessment tool to students that came to school-based health centers in the three counties between 2011 and 2015. The counties represent the different types of communities across North Carolina: one rural, one suburban, and one semi-rural.

School-based health centers are convenient, trusted, affordable, and widely-utilized, meaning that the data captured a large proportion of the school system’s total student population. In the suburban and semi-rural counties studied, 90% of students utilized health services provided by their school. In the rural county, 50% used them.

“School-based health centers provide an invaluable service to children and their families, particularly around prevention and risk identification,” explains Swick. “Really getting in there early to help children, ultimately, saves so much down the road. And it saves money.”

School-based health centers also mean that students can easily access services–such as mental health counseling– in a familiar environment without drawing the attention of their peers, helping to circumvent issues related to the stigma around mental illness.

Students took the RAAPS Risk Assessment, which assesses potential risk factors for poor academic achievement and health. Examples include not wearing a helmet, suspension from school, and sexual activity.

Obviously, not every factor measured directly causes negative consequences, but past studies have shown a correlation between each factor and one or more negative outcomes. For example, “Do you have a boyfriend or girlfriend?” is a question on the assessment because those relationships, while often positive, come with potential issues around physical and mental health.


Swick found that the single most common risk factor across all three counties was having an in-school or out-of-school suspension. The number of students with suspensions was even greater than the number of students with boyfriends/girlfriends. She also found that far more students were sexually active in the rural county than in the suburban and semi-rural counties.

Additional analyses will determine if there are any notable differences across race, age, or gender. Understanding which students are facing what risks forms the basis of deciding which interventions school-based health centers should implement and how.

Interventions can, for example, focus on teaching students coping skills or how to form healthy relationships with others, all of which are protective factors against developing a mental illness.

Future directions for the project include analyzing data from other assessments the students took and looking into the causes behind the different risk factors — not just how many students experience them.

By treating students who are already suffering as early as possible and stepping in to solve potential problems before they even develop, the school systems will help students succeed not just academically, but in every respect.

“If a child can’t sit still in their chair in the classroom, because they’re experiencing behavioral challenges, they’re not going to be able to learn,” says Swick. “How can you expect a child to learn if they’re experiencing either mental health challenges or physical health challenges? It’s really important that the school-based health center is an integrated model and addresses the needs of the whole child.”


According to the National Institute of Mental Health, one in five school-aged children in the U.S. meet the diagnostic criteria for a mental health disorder with impaired functioning, and half of all adults diagnosed with a mental illness exhibited symptoms before age 14. However, due to the stigma that still surrounds mental illness, not everyone seeks treatment, and those who do may wait until their symptoms begin to have a serious impact on their daily lives, which can lead to a more severe case of their mental illness or co-occurrence of multiple disorders.

If you believe you or someone you know may be suffering from a mental illness, do not hesitate to contact a healthcare provider. For UNCG students, faculty, and staff, the UNCG Counseling Center can be reached at 336-334-5874. Counseling sessions are free of charge up to 10 sessions per year. If you are in crisis, dial 911 or the UNCG Police at 336-334-4444.


Olivia1_SmallArticle author Olivia Wood is a media and communication intern with the Office of Research and Economic Development. Olivia is a senior at UNCG double majoring in English and cultural anthropology with a minor in classical studies. She has a deep love for Virginia Woolf and a passion for research toward social justice. She likes this job because she gets to learn about all the fascinating research happening at UNCG.