Does school-based recruitment for anxiety interventions reach youth not otherwise identified? A comparison between a school-based sample and a clinical sample

The purpose of this paper is to determine how youth with anxiety recruited for a school-based randomized controlled trial (RCT) compare demographically and clinically to clinically referred youth with anxiety who participated in an RCT conducted in community mental health clinics. Youth (N = 99) with anxiety aged 12–15 years were: (a) 37 youth (M age = 13.70, SD =.89; 97.3% Norwegian; 19.0% male) from a school-based RCT and (b) 62 youth (M age = 13.8, SD = 1.0; 88.7% Caucasian; 29.5% male) from an RCT conducted in community mental health clinics. The youth were assessed for anxiety diagnoses, functional impairment, internalizing symptoms, and externalizing symptoms. Compared to the clinically referred youth who received care in community mental health clinics, the youth in the school sample met criteria for fewer anxiety diagnoses, lower severity of diagnoses, and less functional impairment caused by mental health problems. However, the school sample had significantly higher levels of youth-rated anxiety symptoms, t(95) = − 2.33, p =.02, parent-rated depression, t(94) = 4.45, p <.001, and externalizing symptoms, t(96) = 2.86, p =.005. Finally, only 12.1% of the youth who met diagnostic criteria reported receiving services at a community mental health clinic in the last year. Although many of the youth in the school sample met diagnostic criteria for one or more anxiety disorders, few had received services in community mental health clinics. This suggests that recruiting in schools may help identify youth with anxiety that may not otherwise seek mental health services.