Accuracy of Teachers in Identifying Elementary School Students Who Report At-Risk Levels of Anxiety and Depression

Internalizing disorders, specifically depression and anxiety, affect up to 14 and 32 % of youth, respectively (Merikangas et al. in J Am Acad Child Adolesc Psychiatry 49:980-989, 2010). In part to overcome barriers to receiving community services, schools have become a major provider of mental health services to children. Schools need effective mechanisms in place to accurately identify students who may need such services. The current study examined the accuracy of one such method, teacher nominations, in identifying elementary school children who self-report elevated levels of depression and/or anxiety. Participants were 238 fourth and fifth-grade students within a large, urban school district in a southeastern state and their 26 classroom teachers. Regarding sensitivity, teachers identified 50 and 40.7 % of students who repeatedly reported at-risk levels of depression and anxiety, respectively. Teachers falsely identified as symptomatic 16.2 and 17.5 % of students with typical levels of depression and anxiety, respectively. These findings suggest teachers can identify approximately half of children who experience at-risk levels of depression and anxiety, but substantial miss rates call into question this method for use as either an alternative to universal screenings or as an initial step (gatekeeper role) in a multi-modal identification process.