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As they prepared to return from battle in Iraq, many soldiers took a test.
They sat at computers and completed a post-deployment health assessment, a test of their well-being. Their names were attached to the assessments. Their results would determine health care options that would be made available to them upon returning home. For those who indicated that they struggled with mental health problems, the idea was to get them help sooner rather than later.
Researchers wanted to see what might be different if the assessments were anonymous. What happened was that soldiers were more honest.
When their names weren't associated with the assessments, according to a Reuters article reporting on the research recently published in the Archives of General Psychiatry, soldiers were four times as likely to say they had thoughts of suicide. While four percent of soldiers met criteria for depression or PTSD in the assessments with names attached, 12 percent met the criteria when the assessments were anonymous.
This study raised questions worth considering, given the high suicide risk among our nation's troops, and the popularity of screening as a suicide prevention tool.
What's the incentive for military personnel who know that being honest about suicidal thoughts might affect their military careers, which might in turn affect their families and their futures?
For those who know that there aren't good mental health resources available in their home communities, why would they want to say that they need help?
The same questions could be reframed for thinking about screening young people in schools. What opportunities might a young person fear losing if she screens "positive?" What if there's one mental health professional for the whole school?
This study teaches us that the solution isn't as simple as screening, or that screening will lead to better mental health care utilization outcomes. The context of the setting in which the screening is done and the culture of the community in place to provide support are just as important - if not more so - as the act of screening.
