Potential mental health-related harms associated with the universal screening of anxiety and depressive symptoms in Australian secondary schools

Braund, Taylor A.; Baker, Simon T. E.; Subotic-Kerry, Mirjana; Tillman, Gabriel; Evans, Nathan J.; Mackinnon, Andrew; Christensen, Helen; O’Dea, Bridianne

doi:10.1186/s13034-024-00734-y

Child and Adolescent Psychiatry and Mental Health

Table 4 Risk measures for each outcome classification

From: Potential mental health-related harms associated with the universal screening of anxiety and depressive symptoms in Australian secondary schools

	\({n/n}_{{\text{C}}}\)	\({n/n}_{{\text{E}}}\)	CER	EER	RR	95% CI	P	ICC	P	RRR	95% CI	RRI	95% CI	P	ARR	95% CI	ARI	95% CI	P	NNTB	95% CI
Case classification
Depression (CES-DC)	362/877	131/398	0.413	0.329	0.80	[0.58, 1.10]	0.167	0.064	< 0.001	0.20	[− 0.05, 0.46]	− 0.20	[0.05, − 0.46]	0.121	0.08	[− 0.06, 0.15]	− 0.08	[0.06, − 0.15]	0.170	11	[NNTH 4 to ∞ to NNTB 27]
New case^a	34/834	13/378	0.039	0.033	0.81	[0.43, 1.52]	0.511	0.034	0.391	0.19	[− 0.32, 0.70]	− 0.19	[0.32, − 0.70]	0.464	0.01	[− 0.02, 0.03]	− 0.01	[0.02, − 0.03]	0514	130	[NNTH 261 to ∞ to NNTB 521]
Anxiety (GAD-7)	199/878	53/400	0.227	0.133	0.61	[0.35, 1.08]	0.092	0.124	< .001	0.39	[0.03, 0.74]	− 0.39	[− 0.03, − 0.74]	0.030	0.10	[− 0.01, 0.21]	− 0.10	[0.01, − 0.21]	0.078	10	[NNTH 1 to ∞ to NNTB 21]
New case^a	37/823	13/373	0.043	0.034	0.78	[0.53, 1.15]	0.210	0.000	1	0.22	[− 0.08, 0.52]	− 0.22	[0.08, − 0.52]	0.156	0.01	[− 0.01, 0.02]	− 0.01	[0.01, − 0.02]	0.213	107	[NNTH 61 to ∞ to NNTB 275]
Psychological distress (DQ-5)	256/878	79/398	0.292	0.198	0.66	[0.42, 1.06]	0.084	0.112	< .001	0.34	[0.03, 0.65]	− 0.34	[− 0.03, − 0.65]	.032	0.11	[− 0.01, 0.23]	− 0.10	[0.01, − 0.23]	0.071	9	[NNTH 1 to ∞ to NNTB 18]
New case^a	40/817	10/370	0.047	0.026	0.50	[0.19, 1.32]	0.160	0.045	0.278	0.50	[0.02, 0.99]	− 0.50	[− 0.02, − 0.99]	0.042	0.02	[− 0.01, 0.05]	− 0.02	[0.01, − 0.05]	0.110	41	[NNTH 9 to ∞ to NNTB 90]
Reliable change classification
Help-seeking intentions (GHSQ)	34/877	8/397	0.039	0.020	0.50	[0.18, 1.42]	0.193	0.094	0.009	0.50	[− 0.02, 1.02]	− 0.50	[0.02, − 1.02]	0.060	0.02	[− 0.01, 0.05]	− 0.02	[0.01, − 0.05]	0.178	50	[NNTH 23 to ∞ to NNTB 122]
Mental health stigma (MHLS)	26/869	7/393	0.030	0.018	0.61	[0.24, 1.53]	0.286	0.023	0.679	0.39	[− 0.17, 0.95]	− 0.39	[0.17, − 0.95]	0.170	0.01	[− 0.01, 0.03]	− 0.01	[0.01, − 0.03]	0.248	85	[NNTH 60 to ∞ to NNTB 231]
Other classification
Inhibited help-seeker (AHSQ)	141/876	32/395	0.161	0.081	0.50	[0.31, 0.80]	0.004	0.068	< .001	0.50	[0.27, 0.74]	− 0.50	[− 0.27, − 0.74]	< 0.001	0.09	[0.03, 0.15]	− 0.09	[− 0.03, − 0.15]	< 0.005	11	[3, 19]
Impaired daily functioning	121/878	39/401	0.138	0.097	0.73	[0.43, 1.23]	0.223	0.088	< .001	0.27	[− 0.11, 0.65]	− 0.27	[0.11, − 0.65]	0.160	0.04	[− 0.03, 0.11]	− 0.04	[0.03, − 0.11]	0.244	24	[NNTH 16 to ∞ to NNTB 65]

Note: Denominators (\({n}_{{\text{C}}}\) and \({n}_{{\text{E}}}\)) vary due to missing data and loss to follow-up. Models account for cluster (school) in log Poisson generalised linear mixed models.
\({n}_{{\text{C}}}\) Total number of students in the control condition with data available for the specified measure, \({n}_{{\text{E}}}\) Total number of students in the intervention (experimental) condition with data available for the specified measure, CER Control Event Rate, EER Experimental Event Rate, RR Relative Risk, RRR Relative Risk Reduction, RRI Relative Risk Increase, ARR Absolute Risk Reduction, ARI Absolute Risk Increase, NNT Number Needed to Treat.
^a New case refers to students who were not classified as a case at either of the previous time points (i.e., baseline or 6 weeks post-baseline). ICC values was calculated using non-robust standard errors due to limitations in ICC calculations with robust standard errors

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ISSN: 1753-2000

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