Around midnight on April 13, Governor Abigail Spanberger signed into law HB355, which directs a state advisory committee and the Department of Education to study and make recommendations for a universal mental-health screening program for public school students in grades six through 12.
The new law doesn’t mandate a program yet, but that’s clearly the goal. As originally drafted, the legislation sought to do so by next school year, and the study of “evidence-based,” recommended “best practices” that the law requires will create a framework for future implementation.
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The mental-health industry peddles universal screening—brief questionnaires given to all students—as “preventive,” “evidence-based,” or necessary to improve academic outcomes. That’s all false. High-quality research over several decades has failed to find mental-health or academic benefits from universal screening programs.
Widespread screening does, however, produce alarmingly high rates of false positives, leading to harmful misdiagnoses. One study published by Cambridge University showed a false-positive rate as high as 90 percent. That’s why Virginians (and all Americans) should push back against efforts to introduce universal mental-health screenings in schools.
In recent years, school districts across the country have begun requiring students to answer personal questions about emotions, behaviors, and suicidal thoughts. The practice has become widespread, with at least one-third of schools reporting that they administer mental-health screenings. Last year Illinois became the first state to mandate that all schools administer universal screenings to students in third through twelfth grade.
Most students that such screenings flag as “at risk” are merely feeling the normal stresses of life, so the scrutiny often leads to unwarranted labeling and intervention. By design, screening interprets emotions through a medical lens, construing any sign of anxiousness, inattention, or distress as a potential clinical disorder. But there’s simply no foolproof way to confirm mental-health disorders—no biomarkers, blood tests, or brain scans. Ordinary worry can easily be misconstrued as anxiety disorder, sadness as clinical depression.
Serious mental illnesses causing functional impairment affect only about 5 percent of Americans, and these conditions typically don’t develop until the late teens and early twenties. If America’s nearly 50 million public school kids were screened annually for rare conditions, the majority flagged would be false positives, leading potentially to millions of children being wrongly shuffled into the mental-health system.
Misidentification has consequences. Even a provisional diagnosis can change a child’s self-understanding or how adults interpret that child’s behavior. Youth mental-health treatments are also limited: few are truly evidence-based or effective, and both therapy and medication can be harmful for those who don’t need it.
The downsides of universal screening outweigh any potential benefits. This is why it’s not recommended by Canada or the U.K. in primary-care settings (and is recommended only provisionally in the U.S.—without supportive evidence). Yet schools, which lack the safeguards or expertise of the health-care system, have adopted screening at scale.
At doctor’s offices, parents are significantly less comfortable when practitioners directly administer mental-health assessments to children (as opposed to questionnaires being completed by parents), when results aren’t discussed with a physician or psychologist, and when topics cover certain mental-health conditions, thoughts of suicide, and gender identity. All these undesirable aspects are typical of universal school screenings. Fewer than half of parents support depression screening that starts in sixth grade, as Virginia nearly mandated with HB355.
Parents also overwhelmingly want to be informed when screenings happen, but schools often administer these programs with minimal parental awareness or consent. Virginia’s new law already specifies that mandatory screening, when implemented, must be provided on an opt-out, not opt-in, basis. That puts the burden on parents to discover whether a screening is planned, to refuse participation, and to do so quickly, because the school will deem their lack of a timely “no” as consent. Further, in most cases, including Virginia’s, the law does not require schools to track parental consent systematically. This explains how one survey of school counselors showed that 75 percent admitted to administering surveys without explicit permission.
Struggling students shouldn’t be ignored, but universal screening, ironically, does just that. The screening process doesn’t identify the students most in need of support. They’re already known to teachers and staff, who are trained to notice distress, academic decline, and signs of instability at home; or they have been evaluated in other assessments already, such as those for special education or accommodations.
The problem isn’t identification—it’s that students with identified needs routinely go without adequate support. If schools can’t help the struggling students they already know about, how will anyone benefit from flagging even more kids?
It’s time to say no to universal mental-health screening.