In an effort to curb substance abuse and flag student mental health issues, in 2018, Washington state’s King County started giving students an unusual electronic survey.
为了遏制药物滥用并警告学生心理健康问题，华盛顿州的金县于2018年开始为学生提供一项不寻常的电子调查。
The Check Yourself screener, which is conducted in classrooms on school-issued iPads or laptops, first displays a short disclaimer indicating that the collected information is confidential but not anonymous to the school. Students who click “I accept” are then asked a series of questions about their gender identity and who they are most likely to have a crush on, as well as their age and race. The assessment also asks about drug and alcohol use, how much sleep students get, and levels of anxiety.
在学校教室中使用的 iPad或笔记本电脑上进行的“检查您自己”筛选器，首先会显示一个简短的免责声明，表明所收集的信息是机密的，但对学校不是匿名的。 然后，单击“我接受”的学生会被问到一系列有关其性别认同，最有可能迷恋谁以及年龄和种族的问题。 该评估还询问了药物和酒精的使用，学生的睡眠时间以及焦虑程度。
When students submit the survey, their name is stripped from their responses and replaced with a unique proxy identification code in an attempt to abide by federal privacy regulations. Then the data leaves the school system.
当学生提交调查问卷时，他们的名字会从回答中删除，并用唯一的代理身份识别码代替，以遵守联邦隐私法规。 然后数据离开学校系统。
“There are no guardrails.”
“没有护栏。”
King County student data is sent to the servers of Tickit Health, a Canadian health tech startup, which built the digital screening tool. There, it can be accessed and downloaded by King County employees. Student data is analyzed by the county to gauge the students’ mental health and used to direct help to those who might be at risk for self-harm. According to plan obtained by OneZero via a public records request, the data is also used for a program evaluation by PhD researchers at Seattle Children’s Hospital, which created the screener, to test if the screening process actually works. While the process evaluation didn’t meet the regulatory definition of research, student data is still being used to validate the screener.
金县的学生数据被发送到加拿大卫生技术初创公司Tickit Health的服务器，该公司构建了数字筛选工具。 在那里，金县员工可以访问和下载它。 该县会分析学生的数据，以评估学生的心理健康状况，并将其用于帮助可能面临自我伤害风险的人。 根据OneZero通过公开记录请求获得的计划，该数据还用于创建筛选器的西雅图儿童医院的博士研究人员的程序评估，以测试筛选过程是否真正有效。 尽管过程评估不符合研究的法规定义，但仍使用学生数据来验证筛选器。
Observers say the mental health data collected by these schools raises serious concerns. At a minimum, these systems create a government-owned dossier of students’ most personal information—data that is much more sensitive than exam grades and vaccination records.
观察人士说，这些学校收集的心理健康数据引起了人们的严重关注。 这些系统至少可以为学生提供最私人信息的政府档案，这些档案比考试成绩和疫苗接种记录更为敏感。
Gathering and digitizing detailed data on a student’s sexuality and demographic information in the classroom also makes that data vulnerable to hacks or leaks. Researchers and experts who have worked closely with the type of program undergirding the Check Yourself assessment have also voiced concerns about how it has been adapted for King County.
在教室中收集有关学生的性行为和人口统计信息的详细数据并将其数字化也使该数据容易受到黑客攻击或泄漏。 与“自我检查”评估的计划类型密切合作的研究人员和专家也对计划如何适应金县表示了担忧。
While King County is one of the first to pursue this level of data collection in schools, the growing demand for mental health and digital tools in education means it’s unlikely to be the last. In recent years, vendors, including startup WellScreen, have begun to market digital screening tools to schools, and universities like UC San Francisco and Baylor School of Health have developed apps for clinical use.
虽然金县是首批在学校中追求这种级别的数据收集的国家之一，但对心理健康和教育中的数字工具的需求不断增长，这意味着它不可能是最后一个。 近年来，供应商，包括启动钻井筛管 ，已经开始市场数字放映工具来学校， 大学像加州大学旧金山分校和健康的贝勒学校已经制定了临床使用的应用程序。
Schools have already adapted digital systems for many classroom tasks. Online portals for parent-teacher communication have become the norm in school districts across the country, and ed tech is a field now worthy of venture capital investment. Even essay grading and checking for plagiarism are being automated.
学校已经将数字系统用于许多课堂任务。 家长与老师交流的在线门户已成为全国学区的常态，而教育技术已成为如今值得风险投资投资的领域。 甚至论文的评分和抄袭检查都是自动化的。
Now, data collection is coming for social services, such as counseling. The United States is grappling with an ongoing mental health crisis in teens and young adults. The rate of teen suicide increased 56% from 2007 to 2017, with 6.8 out of every 100,000 teens dying by suicide in that time period. In Washington, detecting mental health issues in young people is especially crucial. The state department of health reports that 87 school-age children died by suicide in 2017 alone, the latest data available.
现在，数据收集正在用于社会服务，例如咨询。 美国正努力应对青少年和年轻人持续存在的心理健康危机 。 从2007年到2017年，青少年自杀率上升了56％ ，在此期间，每10万名青少年中有6.8人死于自杀。 在华盛顿，发现年轻人的心理健康问题尤为重要。 国家卫生部报告，仅2017年就有87名学龄儿童死于自杀。
King County is one of the first counties in the nation to adopt digital tools to conduct mental health screening in its schools. It was originally estimated that 35,000 children would take the county’s in-school screener, though not every school signed on to be a part of the initiative. These screenings are not anonymized within the school district, and address sensitive issues beyond drug and alcohol consumption to include questions about gender, sexuality, and whether parents drink at home. Eleven of King County’s 19 school districts now use the Check Yourself program, meaning thousands of students will take the screener this school year.
金县是美国首批采用数字工具在其学校进行精神健康筛查的县之一。 最初估计，将有35,000名儿童参加该县的校内筛查，尽管并非每所学校都签署该倡议。 这些检查并未在学区中匿名化，并且解决了毒品和酒精消费以外的敏感问题，包括有关性别，性行为以及父母是否在家喝酒的问题。 金县19个学区中的11个现在正在使用“检查自己”计划，这意味着成千上万的学生将在本学年参加筛查。
“One of the questions was even about sexuality and sexual identity and issues at home, and I thought, that’s not what this [screener] is about.”
“问题之一甚至是关于性，性身份和家庭问题的，我想，这不是这个[筛查者]所要解决的问题。”
King County’s in-school screening might be a harbinger for how digital and mental health is managed in schools across the county. In California, schools use the Healthy Kids Survey, which differs from Check Yourself in its anonymity and paper submission. California also asks detailed sexuality and gender questions but publicly discloses that no psychological or social harm has been reported in 14 years of conducting the survey.
金县的校内筛查可能预示着该县各地学校如何管理数字和心理健康。 在加利福尼亚州，学校使用“健康儿童调查”，该调查的匿名性和论文提交方式与“检查自己”不同。 加利福尼亚州还询问了有关性和性别的详细问题，但公开披露在进行调查的14年内没有报告过心理或社会伤害。
The Check Yourself software is a new variant on a model called Screening, Brief Intervention, and Referral to Treatment (SBIRT), designed to screen young people for mental illness by their health care provider to catch early signs of depression, anxiety, or self-harm. The screener was developed by PhD researchers from Seattle Children’s Hospital and the University of Washington, and the software was developed by Tickit Health. Each school district in the county has a data-sharing agreement allowing King County and Tickit Health to receive the student data.
Check Yourself软件是称为筛查，简短干预和转介治疗(SBIRT)的模型的新变体，旨在通过其医疗保健提供者筛查年轻人的精神疾病，以发现抑郁，焦虑或自我支配的早期迹象。危害。 该筛选器由西雅图儿童医院和华盛顿大学的博士研究人员开发，该软件由Tickit Health开发。 该县的每个学区都有一份数据共享协议，允许金县和Tickit Health接收学生数据。
Data breaches have become alarmingly commonplace, with more than 120 data leaks reported at U.S. schools in 2018 alone. That could pose a risk for the Check Yourself program. Check Yourself survey data remains on school servers for an indeterminate amount of time. Tickit Health retains the data throughout the summer of the previous school year. That’s a liability for students if these servers are ever breached.
数据泄露已经变得非常普遍，仅在2018年美国学校就报告了120多个数据泄露事件。 这可能会对“检查自己”程序造成风险。 Check Yourself调查数据在不确定的时间内保留在学校服务器上。 Tickit Health会保留整个上学年夏季的数据。 如果这些服务器曾遭到破坏，这是学生的责任。
And Washington state has had plenty of data leaking incidents: Tukwila School District, which uses the Check Yourself screener, fell victim to a phishing scam in December 2019 and leaked an undisclosed amount of data. King County says that no Check Yourself data was lost. Northshore School District, which also uses the Check Yourself screener, had its network attacked in September 2019, though there’s no evidence of data being stolen. In 2016, 9,000 Northshore students had their email accounts breached. The University of Washington Medicine department, which helped create the BSK screener, leaked data on 974,000 patients when its system was breached in early 2019.
华盛顿州有很多数据泄漏事件：使用Check Yourself筛选器的Tukwila学区在2019年12月成为网络钓鱼骗局的受害者，并泄漏了未披露的数据量。 金县说，“检查自己”的数据没有丢失。 北海岸学区(Northshore School District)也使用Check Yourself筛选器，其网络于2019年9月遭到攻击，尽管没有证据表明数据被盗。 2016年，有9,000名北岸学生的电子邮件帐户遭到入侵 。 华盛顿大学医学系帮助创建了BSK筛选器，该系统于2019年初遭到破坏时泄露了974,000名患者的数据。
Disclosures about Check Yourself data collection can also be inconsistent. While parents were notified about the Check Yourself screening, school districts within the county differed in how they notified parents about the program. Northshore School District followed an opt-in policy while Kent and Tahoma school districts adopted an opt-out system. None of the information or disclaimers online accurately communicate the detail of questions inquiring about a student’s gender or sexuality.
有关“检查自己”数据收集的披露也可能不一致。 在通知家长有关“检查自己”检查的同时，县内的学区在通知家长有关计划方面的方式有所不同。 北岸学区遵循选择加入政策，而肯特和塔霍玛学区则采用选择退出系统。 在线的任何信息或免责声明都无法准确传达有关学生性别或性问题的详细信息。
Asking sensitive questions in a school setting comes with risks, experts warn. King County’s Check Yourself screener asks detailed demographic information, unlike nearly all similar screeners. And although King County documentation stresses that no identifying information is attached to students’ answers, survey responses could still be used to identify students. For instance, the screener includes text boxes where students can type in their own response. Since these are not standardized, even after a name is removed, responses could be used to identify students.
专家警告说，在学校环境中问敏感问题会带来风险。 与几乎所有类似的筛查仪不同，金县的“检查自己”筛查仪询问详细的人口统计信息。 尽管金郡县的文件强调学生的答案没有任何识别信息，但调查答复仍可用于识别学生。 例如，筛选器包括文本框，学生可以在其中输入自己的回复。 由于这些不是标准化的，因此即使删除了姓名，也可以使用响应来识别学生。
Screening researchers and experts who have implemented the SBIRT system elsewhere also say that assessment isn’t meant to be extended beyond screening for drug and alcohol use and that the inclusion of screening for gender, sexuality, or mental health concerns could endanger students.
筛选在其他地方实施了SBIRT系统的研究人员和专家也表示，评估不应该扩展到对药物和酒精使用情况的筛选之外，并且对性别，性或精神健康问题的筛选可能会危害学生。
Mary Ann Gapinski, the former director of School Health Services for the Massachusetts Department of Public Health, led that state’s universal adoption of the SBIRT system in schools. Massachusetts now operates the country’s largest implementation of school-based SBIRT. Gapinski says that she questions the way King County is adopting the screening tool.
马萨诸塞州公共卫生部学校卫生服务前局长玛丽·安·加平斯基(Mary Ann Gapinski)领导该州在学校中普遍采用SBIRT系统。 马萨诸塞州现在运营着该国最大的以学校为基础的SBIRT实施方案。 加平斯基说，她质疑金县采用筛查工具的方式。
“When I heard the way they were implementing it [in King County], so many red flags went up for me because I know this isn’t safe for the kids,” she said. “One of the questions was even about sexuality and sexual identity and issues at home, and I thought, that’s not what this [screener] is about.”
她说：“当我听到他们在[金县]实施该计划的方式时，对我来说有很多危险信号，因为我知道这对孩子们来说并不安全，” “问题之一甚至是关于性，性身份和家庭问题的，我想，这不是这个[筛查者]所要解决的问题。”
Charol Shakeshaft, a professor at Virginia Commonwealth University who studies sexual abuse at schools, told OneZero of the King County data collection, “there hasn’t been any real conceptual and safety overview thinking about all the ramifications for how you would use this data. There are no guardrails.”
弗吉尼亚联邦大学的教授Charol Shakeshaft在学校研究性虐待，他对金县数据收集的OneZero表示：“没有真正的概念和安全概述来考虑如何使用这些数据。 没有护栏。”
“Electronic risk screening may be an effective and sustainable solution to increase screening rates, but little is known about the effectiveness of electronic screening tools in capturing data or decreasing risk,” the site says.
该网站说：“电子风险筛查可能是提高筛查率的有效且可持续的解决方案，但对于电子筛查工具在捕获数据或降低风险方面的有效性知之甚少。”
Meanwhile, federal health officials argue that in-school screenings and data collection efforts like SBIRT are the future. The Substance Abuse and Mental Health Services Administration released a 75-page report in January 2019 that argued universal mental health screening should be the norm in schools and detailed steps on how to set up screening.
同时，联邦卫生官员认为，像SBIRT这样的校内筛查和数据收集工作将是未来。 药物滥用和心理健康服务管理局于2019年1月发布了一份长达75页的报告 ，认为普遍的精神健康筛查应成为学校的规范，并详细说明如何进行筛查。
“Emotional or behavioral health issues are generally detected after they have already emerged. It is time for that to change,” the report’s opening page reads.
“情绪或行为健康问题通常在出现后才被发现。 该改变了，该报告的开始页上写道。
King County provided OneZero with seven preliminary testimonies from schools that had started to implement the Check Yourself tool. Each of them testified to the program’s success: School districts reported the program potentially stopped two suicides and led to the referral of one student for help through child protective services.
金县向OneZero提供了来自学校的七个初步证词，这些学校已经开始实施“检查自己”工具。 他们每个人都证明了该计划的成功：学区报告该计划可能停止了两次自杀，并通过儿童保护服务将其推荐给一名学生以寻求帮助。
Margaret Soukup, the program manager now in charge of SBIRT in King County, is the main driver for bringing the Check Yourself screener to King County. A 10-year veteran of the juvenile justice field, Soukup first saw the SBIRT intervention model in use by a group called Reclaiming Futures, funded by the Conrad. N. Hilton Foundation. She thought that the program could be even more helpful if students were screened before they had to meet with truancy officers or got wrapped into the juvenile justice system. In addition, the King County Juvenile Court leadership requested that the program be implemented in schools.
现在负责金县SBIRT的项目经理Margaret Soukup是将“检查自己”筛查器带到金县的主要动力。 Soukup在少年司法领域有10年的经验，他首先看到了由康拉德(Conrad)资助的名为Reclaiming Futures的组织使用的SBIRT干预模型。 N.希尔顿基金会。 她认为，如果在必须与逃学人员见面或被卷入少年司法系统之前对学生进行筛查，该计划可能会更加有用。 此外，金县少年法院领导要求在学校实施该计划。
Soukup says that the first round of data from real students is just now coming back to the county, and the initial results suggest the program is working to find teens who might be prone to self-harm. She also says that the county is still adapting to what they find as they continue to implement the program.
Soukup说，来自真实学生的第一轮数据现在才回到县城，初步结果表明该计划正在努力寻找可能容易自残的青少年。 她还说，该县在继续实施该计划时仍在适应他们的发现。
“We’re definitely learning as we go along,” she says. “It’s a way to start a conversation and identify young people who need connections, what we’re hearing anecdotally is that I feel like I’m seen, and now they know who to talk to when their friends aren’t feeling great.”
她说：“我们一直在学习，”。 “这是开始对话并确定需要联系的年轻人的一种方式，我们听到的轶闻是，我觉得自己很像我，现在他们知道当朋友感觉不好时该与谁交谈。”
Update: This piece was updated to clarify that the study conducted at the Seattle Children’s Hospital is managed by PhD researchers, and not medical doctors. This piece was also updated to clarify that the Seattle Children’s Hospital evaluation didn’t meet the regulatory definition of research, to clarify that the King County Juvenile Court also supported the SBIRT pilot program, and to clarify that Ticket Health does market its product for educational settings.
更新：本文已更新，以澄清在西雅图儿童医院进行的研究是由博士研究者而非医生负责的。 该文章也进行了更新，以阐明西雅图儿童医院的评估不符合研究的监管定义，以阐明金县少年法院也支持SBIRT试点计划，并阐明Ticket Health确实将其产品推向教育市场。设置。
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