Project to Learn About Youth – Mental Health – South Carolina

Update, July 2014: In Spring 2014, pilot-testing of the two-stage process was completed, using three classrooms from the participating school district. The pilot work facilitated a refinement of the screening and diagnostic evaluation procedures in preparation for the district-wide study, which will take place during the 2014-2015 academic year. In September 2014, teachers will complete online screening measures. Invitations for the Stage 2 evaluations are expected to be sent in October 2014, with evaluations beginning shortly thereafter. District and school personnel have been excellent and enthusiastic partners in this project.


Kate Flory, PhD, Principal Investigator, University of South Carolina. Internalizing, externalizing, and tic disorders among children and adolescents increase the risk for many negative outcomes. Reports estimate that many youth with mental health problems are not being identified or receiving appropriate treatment. Thus, the objectives of the proposed project are threefold: 1) to describe the prevalence and co-occurrence of internalizing, externalizing, and tic disorders among children and adolescents (grades K-12) within a defined population, 2) to describe rates of current and previous mental health treatment among members of the defined population previously diagnosed with a mental disorder, and 3) to explore diversion and misuse of psychoactive medications prescribed to treat a mental disorder.

Adapting the methodology used in the CDC-funded PLAY-ADHD project, a two-stage, stratified design will be utilized for estimating the prevalence of mental health diagnoses and treatment among children and adolescents in grades K-12 in a mostly rural school district in the Sandhills region of South Carolina (approximately 10,000 total students). In Stage 1, for each child in the population, teachers will complete an online screening measure, which includes the Strengths and Difficulties Questionnaire (SDQ) and the BASC-2 BESS. In Stage 2, some high-screen youth (i.e., those at-risk for internalizing, externalizing, or tic disorders) will be invited to complete a thorough diagnostic evaluation, primarily utilizing the NIMH DISC interview. Additionally, a randomly-selected sample will be recruited consisting of negative-screen youth (i.e., low-risk for disorders) using a frequency-matched approach, with matching by age, sex, and race, to complete a diagnostic evaluation. Approximately 600 families will participate in Stage 2. Analyses will be conducted using SAS and SUDAAN and will include weights to adjust for the sampling design. Findings will be disseminated to school district personnel and the SC Department of Education, along with the scientific community through peer-reviewed journal articles and presentations at national and international scientific meetings.