Every child in Michigan is expected to receive an annual physical exam. We check their vision, hearing, height, weight, blood pressure and immunizations because we understand a simple truth: Early detection saves lives, improves outcomes and reduces long-term costs.

Dr. Kanzoni Asabigi headshot
Dr. Kanzoni Asabigi is vice president of the Detroit Recovery Project and a former public health official with the City of Detroit’s Department of Public Health.

Yet when it comes to behavioral health — depression, anxiety, trauma, ADHD, substance use disorders, suicidal ideation and other mental health conditions — we too often wait until a child is already in crisis.

Michigan should establish annual behavioral health assessments for every K-12 student, just as we require annual physical health evaluations. The goal is not to label children. It is to identify concerns early, connect families to support and prevent manageable conditions from becoming lifelong crises.

The data is overwhelming. The CDC reports that in 2023, 40% of US high school students experienced persistent sadness or hopelessness and nearly 1 in 3 said their mental health was poor most or all of the time. Nationally, about 1 in 5 youth has a diagnosable mental health disorder, yet many never receive treatment. In Michigan, more than one-third of youth experiencing mental illness receive no care.

We would never tell parents to ignore chest pain in a child until that child collapses in the emergency room. But that is effectively what society does with behavioral health.

Instead of prevention, we rely on expensive intervention after damage has occurred: psychiatric hospitalizations, emergency room visits, school expulsions, juvenile detention, foster care placements, homelessness, addiction treatment and incarceration.

Untreated childhood mental health disorders are linked to lower graduation rates, unemployment, substance abuse, chronic health conditions and incarceration. The costs fall on taxpayers through Medicaid spending, law enforcement, corrections and lost productivity. Early intervention can reduce special education costs, improve attendance, lower disciplinary incidents and increase lifetime earnings.

Prevention is dramatically cheaper than crisis management.

Children with undiagnosed behavioral health needs often struggle academically and socially, disconnect from school, self-medicate with substances or enter the juvenile justice system. Over time, jails and prisons become the default “treatment system,” reflecting decades of policy failure.

Annual behavioral health assessments would normalize mental wellness the same way annual physicals normalize physical wellness. Parents would gain earlier insight into emerging concerns. Schools could intervene before behaviors escalate into suspensions or violence. Health care providers could coordinate support before a child reaches suicidal crisis, juvenile detention or psychiatric hospitalization.

Importantly, these assessments would not mean every child is diagnosed with a disorder similar to physical health screenings. Most screenings simply identify whether further evaluation may be needed. Early screening is about awareness, detection, prevention and timely support.

Some states are already moving in this direction. Illinois became the first state to require universal annual mental health screenings in public schools for grades 3–12, treating mental health screening like the hearing and vision checks schools already conduct.

Michigan can build on existing school counselors, social workers, psychologists and school-based health services, but capacity is still far too low. Michigan has roughly one school psychologist for every 1,400 students — about three times worse than recommended — an argument for investment, not inaction.

Critics will raise concerns about privacy, parental rights and cost. Those concerns require safeguards: parents must be informed and engaged; tools should be evidence-based, age-appropriate, confidential and culturally competent; and data protections must be rigorous.

The status quo ensures more children fall through the cracks until they arrive in emergency rooms, juvenile detention, or worse. Families pay the price through suicide, addiction, violence and untreated trauma—and taxpayers pay billions in avoidable public costs.

We do not question whether annual physical exams are worth the investment because we understand prevention works.

Michigan can lead by recognizing that mental health is health. Annual behavioral health assessments for K–12 students would not solve every challenge, but they would create an early warning system that catches suffering before it becomes a catastrophe.

The true cost is ignoring children until crisis is the only thing left to treat. During this Mental Health Awareness Month, Michigan should pursue legislation similar to Illinois.

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