Emoji Based Mental Health Assessments

Coming to a School District Near You!

Will smiley face scales do for children’s antidepressant prescribing what they did for opioids?

Read This! Your Action is Needed!

On February 26th, the Dallas Morning News reported that Lewisville ISD in North Texas is using an emoji based mental health assessment app on students. According to the report, Lewisville launched “a “campuswide pilot, using an app called Rhithm — which officials  described as a “digital mood meter” — that prompts students on their electronic devices to answer simple questions about their mental health, such as “How are you feeling today?””

“We’ve logged 5,000 alerts that we would not have known about otherwise if students didn’t have access to this,” said Monya Crow, a licensed professional counselor and Lewisville ISD’s executive director of counseling services.”

Really? A smiley faced scale for children’s emotional and physical state? You can see the scale here:

Will these smiley face scales do for antidepressant prescribing in children what smiley face scales did for opioid prescribing in adults? Antidepressants carry an FDA black box warning for suicide in children.

The assessment doesn’t stop at smiley faces. It also has space for students to write in extra information. You can see this in a promotional video here:

Don’t live in Lewisville ISD? Don’t worry, according to the website, it’s in 300 + schools in 10+ states. The list includes schools in Ft. Worth ISD, Denton ISD, Wichita Falls ISD, Coppell ISD, Allen ISD, Keller ISD, Clyde ISD, Flour Bluff ISD and elsewhere. You can see that here: 

Apparently, the app is designed to be able to be used every day, not every now and then.

While we assume there is parental consent, what are parents consenting to? How many screening tools have been rigorously studied for adverse events? What are the effects of frequently asking asymptomatic students how they are feeling? Much more needs to be known.

There is a lot that needs to be known about parental consent in ALL schools and programs, especially how much information are parents being given about these programs before being asked to make a decision.

Some other school districts are employing different types of screenings and apparently not all are gaining parental consent before doing so. Another alert will discuss that as we get more data. Below is one example:

Austin ISD, in September, announced its intention to do a “one-minute” interview with each of the district’s 80,000 students to “check on their mental health.” You can see the story here:

We asked AISD for the questions and the informed consent process. Although the sample questions clearly asked about mental health, as well as how things were going at home, AISD stated they didn’t need parental consent. AISD considers this to be part of a general counseling program. They stated, “As per ASCA [American School Counselor Association] and TEA guidelines, General Counseling is a Tier 1 service made available for all students without additional consent required.”

You can see their sample questions here:

Austin’s explanation was that such questioning was to inform a Comprehensive School Counseling Program. Such programs have existed for several years but were codified into law last session as part of House Bill 18- one of the school mental health bills you were worried about.

AISD did not use Rhithm. They came up with their own questions. They even had them “vetted by a High School student focus group.” Now that sounds scientific. This means AISD is asking these questions with no idea of whether they are going to cause adverse effects.

If you believe that parents, not school districts, are supposed to be the ones in control of their children’s medical, psychological and other care, you need to ask yourself who is in the driver’s seat with these types of programs.

What happens if your child mouths off or discusses “family business” in the course of an assessment?

There are no blood tests, X-rays, lab tests or brain scans for confirming any of the commonly diagnosed mental disorders, just subjective opinions about behavior and feelings.

What You Can Do

1.       If your child is in one of the school districts using Rhithm, let us know whether you had to fill out a consent form.

2.       Ask your school district for a copy of the consent form.

3.       Ask your school how often your child is filling out the Rhithm assessment.

4.       Ask for a copy of all dashboards, data, notes, all information expressed by your child through this app, as well as anything that would show any alerts that were generated concerning your child. Let us know what you find.

5.       Ask your District how many students have been sent to psychiatric hospitals so far this school year, compared to last year. Ask how many families were referred to Child Protective Services while you’re at it.

6.       Share this alert with any of your friends who have kids in these districts.

7.       Write to your legislator about this or any other assessment program being used in your school. Don’t know who represents you? You can find them here: Who Represents Me?

8.       Contact Lee Spiller at 800-572-2905. Let’s find out how we can work together to put parents back in control of medical, psychological and other decisions concerning their children. 

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