The study aims to compare the effectiveness of universal school-based screening for adolescent major depressive disorder (MDD0 vs the existing process of targeted screening based on observable behavior. Screening in High Schools to Identify, Evaluate, and Lower Depression (SHIELD) is a randomized clinical trial that will take place in at least 8 Pennsylvania public high schools among at least 9650 students enrolled in 9th through 12th grade. Students will be randomized by grade to either targeted screening (current process) or universal screening (intervention).


  1. Avenevoli  S, Swendsen  J, He  JP, Burstein  M, Merikangas  KR.  Major depression in the national comorbidity survey-adolescent supplement: prevalence, correlates, and treatment.  J Am Acad Child Adolesc Psychiatry. 2015;54(1):37-44.e2.

  2. Mojtabai  R, Olfson  M, Han  B.  National trends in the prevalence and treatment of depression in adolescents and young adults.  Pediatrics. 2016;138(6):e20161878

  3. Forman-Hoffman  V, McClure  E, McKeeman  J,  et al.  Screening for major depressive disorder in children and adolescents: a systematic review for the US Preventive Services Task Force.  Ann Intern Med. 2016;164(5):342-349.


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