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Table 4 Perceived harms of MHD screening

From: Acceptability of screening for mental health difficulties in primary schools: a survey of UK parents

Theme Number of comments
Theme 3. Harms of screening to the child
 Sub-theme 13. Screening may be uncomfortable for children
Ex. “It could be harmful as an outsider could come in to discuss with the children and they could then worry as it’s an unfamiliar face and might not feel comfortable to talk.”
 Sub-theme 14. Children may feel singled out/ may be stigmatised
Ex. “Could make the child feel singled out if they were treated differently...”
 Sub-theme 15. Children may not understand the screening process or the questions
Ex. “Children wouldn’t know why they where taking part”
 Sub-theme 16. Once identified, there might not be resources to support children
Ex. “Obviously these checks would need to be done, recorded, and dealt with very sensitively and then are there resources to follow up any cases with concern? ...”
Theme 4. Harms associated with screening accuracy
 Sub-theme 17. It is difficult to detect emotional difficulties in children
Ex. “How often screening? Kids are up one week, down the next, in fact emotions change daily!”
 Sub-theme 18. Schools may misunderstand or misinterpret children’s answers to screening questions
Ex. “But I do feel that it may not seem clear to school, why these problems could be present, which could cause problems, so understanding is needed, especially with special needs.”
 Sub-theme 19. Teachers or staff might ask leading questions
Ex. “The health checks should not be giving children any ideas about how they ‘should’ feel and so long as they are giving an unbiased assessment, should not be harmful.”
 Sub-theme 20. Children may try to say the ‘right’ thing to adults/ tell them what they want to hear
Ex. “Children are often keen to please adults and may feel the need to answer what they think people want to hear.”
 Sub-theme 21. Screening could result in false positive or false negative results
Ex. “Dependent on the reliability and validity of the screening tool. A little wary of over-reliance on a tool.”
Theme 5. Harms associated with screening at school
 Sub-theme 22. Mental health begins at home/ is the responsibility of parents
Ex. “I do not believe its [sic] the schools responsibility to identify emotional health difficulties. It should be a parental responsibility between them and health professionals.”
 Sub-theme 23. Identification of MHD should be done by mental health professionals
Ex. “This worries me because I think this is an area that should be dealt with by mental health specialists...”
 Sub-theme 24. Screening could be harmful when conducted without proper training
Ex. “Staff conducting the checks would require suitable training/support. Poorly trained staff may mis-read emotions and information given by children.”
 Sub-theme 25. Schools are already overwhelmed/screening would overwhelm schools
Ex. “Within a strong framework. Good schools could probably cope but struggling schools may be overwhelmed by any additional requirements.”
 Sub-theme 26. Screening is unnecessary because teachers should be able to recognize MHD
Ex. “Deemed to be part of teachers training to spot signs.”
Theme 6. No harms
 Sub-theme 27. Screening is not harmful (explicitly stated)
Ex. “Never harmful to develop a child’s emotional development.”