(USA TODAY) -- Children can't enroll in school without a doctor's verification of good health, and many districts also require visits to dentists and eye doctors. The Newtown school massacre has focused attention on dealing with mental health. A key step should be adding mental health screenings to the list of required checkups.
Such screening is rarely done and represents a huge unmet need: Best estimates suggest that fewer than 2% of schools have a systematic mental health screening program.
Most perpetrators in a mass shooting suffered from mental illness that could have been identified at a young age. But spree killings are not the only reason to make such a change. Young people with undiagnosed mental illness are at higher risk of suicide, more likely to use drugs and alcohol, and twice as likely to drop out. Moreover, since the Columbine High School killings, two reports from the office of the U.S. Surgeon General have supported making mental health screenings of children routine.
Early social and emotional development is a robust predictor of future mental health and stability. Today, we have not only the skills but also reliable tools to help identify children - at very early ages - who might be at risk for mental health problems long before they erupt into debilitating illness and, though rarely, a dangerous crisis.
Then why don't we at least require a mental health checkup for all students nationwide, from preschool through college? Arguments against such a long overdue step are predictable:
Is it because mental health is a private matter? Mental health records are protected by patient privacy laws that are just as or more restrictive than laws covering medical records. These records remain private in all but the rarest, most at-risk cases, in which mental health professionals are convinced that someone is a danger to himself or others.
Is it because examining the mental health of children would interfere with families? Parents with serious reservations could withhold permission for their child's mental health checkup, just as sometimes occurs when parents refuse to get their children vaccinated.
Is it because children will be misdiagnosed and overmedicated? This could pose a slight risk, but the benefits outweigh the risks. Do we refrain from seeing a doctor for fear she might diagnose a non-existent illness? Maybe some people do, but most of us want a professional assessment of our health, no matter what we decide to do next.
Is it because children will be labeled and ostracized at school? Mental health records are private, so there is no access to any descriptions that could "label" a child. And school psychologists work hard to keep individual students and the student body as a whole functioning in the healthiest possible way - without labels.
Gun control isn't enough
In the wake of the Newtown massacre, we can and should debate gun control. But we need to do more.
We must rethink what's required to attend school. A child must be physically, mentally and behaviorally able to participate. If a mental health assessment suggests otherwise, we must have a system in place that offers help - long before a problem becomes a crisis.
RahilBriggs, assistant professor of pediatrics at Albert Einstein College of Medicine in New York, is director of the Healthy Steps Program at Children's Hospital at Montefiore.