Conducting a depression screening for kids aged 12 to 18 — don’t rely on school mental health assessments as a diagnosis

The U.S. Preventive Services Task Force recommends screening adolescents aged 12 to 18 for major depressive disorder, noting that the overall benefits are moderate and justify the effort. There is insufficient evidence to support screening for kids under 11. Suicide is the second leading cause of death among people aged 10 to 19. School mental health assessments conducted each academic year are population-wide screenings, not diagnostic tools. If a child reports feeling distressed, or shows sudden changes in eating, sleeping, interests, or academic performance, they should be referred to a psychiatrist or clinical psychologist right away.

Costs range from zero to just a few dozen yuan; this covers filling out a screening questionnaire at a community clinic or hospital outpatient department. Calling the 12355 and 12356 hotlines is completely free.

In 2022, the U.S. Preventive Services Task Force issued a recommendation statement advising that adolescents aged 12 to 18 be screened for major depressive disorder; this recommendation falls under Category B, meaning the evidence supporting it is moderate and the benefits are also moderate, making it worthwhile. For children under 11, there is insufficient evidence to support depression screening (an I statement, which indicates a lack of evidence and no formal recommendation). Likewise, evidence regarding both the benefits and risks of screening children and adolescents specifically for suicide risk is also limited (another I statement). The document emphasizes that suicide is the second leading cause of death among 10- to 19-year-olds, and that major depression in youth is closely linked to numerous later issues, including recurrent depressive episodes and other mental disorders, as well as a heightened risk of suicidal thoughts, suicide attempts, and death. China’s “Ten Measures to Further Improve Mental Health Care for Primary and Secondary School Students” calls for establishing a three-tier support system: homeroom teachers, full- and part-time school counselors, and psychiatrists. Each student should undergo a mental health assessment no more than once per academic year. The measures also stress the need to improve referral pathways to mental health specialists and reintegration processes after recovery. Additionally, they highlight the importance of leveraging the 12355 Youth Service Hotline and the 12356 Psychological Assistance Hotline (issued nationwide in October 2025).

This B rating reflects the original recommendation strength grading used by the task force, rather than a quantifiable measure of actual effectiveness. It represents a U.S.-based recommendation; no equivalent official screening guidelines currently exist in China. A positive screening result merely indicates the need for a follow-up evaluation — it does not constitute a formal diagnosis. Guidance on handling suicidal thoughts can be found in Section 1, Item 25, while family coping strategies are outlined in Section 29.

US Preventive Services Task Force (2022). Screening for Depression and Suicide Risk in Children and Adolescents: US Preventive Services Task Force Recommendation Statement. JAMA. https://doi.org/10.1001/jama.2022.16946；教育部办公厅 (2025). 进一步加强中小学生心理健康工作十条措施（教基厅〔2025〕2 号）. https://www.gov.cn/zhengce/zhengceku/202510/content_7045528.htm