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MGH researcher presents Wayland High pilot of I DECIDE and SBIRT, finds gaps in connection to care
Summary
At the Dec. 18 Wayland School Committee meeting, Dr. Randy Shuster of MGH summarized a school-based randomized trial and survey showing 25% of surveyed 10th–11th graders screen at risk for anxiety/depression, about 10% reported past-year suicidal thoughts, and schools paired with a youth wellness coach saw roughly double disclosure during screening.
Dr. Randy Shuster, a clinical psychologist and associate professor affiliated with Massachusetts General Hospital, told the Wayland School Committee on Dec. 18 that a portfolio of school-based programs aims to shift responses to student substance use from exclusionary discipline to early, restorative supports. Shuster described the I DECIDE and I CARE programs and a statewide SBIRT trial testing expert screening and a nonclinical "youth wellness coach" model.
Shuster said the SBIRT effort is funded through a multi-year grant portfolio (PCORI and the Massachusetts Department of Public Health) and described the randomized clinical trial as a large, multi-school project. "We have relegated ourselves to a 0 tolerance and punitive only approach to substance use in schools," Shuster said, arguing the district should consider alternatives that treat substance use on a mental-health continuum. He said Wayland was randomized to receive a youth wellness coach (named Rio Madison) as part of the trial.
Why this matters: Shuster presented survey and early-trial data the district can use to shape responses and supports. He emphasized measurement and cautioned that screening needs to link to accessible help rather than become a bureaucratic requirement.
Key findings and details: Shuster described the district's Substance Use and Related Factors survey (SERF) for 10th and 11th graders this year (administered in advisory) and said Wayland's participation represented about 85% of targeted students in those grades. He highlighted three headline figures: roughly 25% of respondents screened at or above the clinical cutoff for anxiety/depression, about 1 in 10 reported thinking about suicide in the past year, and only about 38% of students reported a close connection with a teacher or adult at school. He also reported that schools paired with a wellness coach were seeing about twice the rate of substance-use disclosure during expert screening compared with schools not paired with a coach; Shuster framed the higher disclosure as improved identification rather than increased use.
Shuster also noted subgroup differences in risk: rates were substantially higher for female and gender-diverse students and for students described as racially/ethnically diverse. He cautioned that the SERF sample in 2024 covered 10th and 11th grades (10th grade only in the first year) and that absentee or out-of-district students (for example, those in inpatient programs) are not represented in the school-day administration.
Committee questions and clarifications: Committee members asked who administered the SERF and whether the youth wellness coach ran the screening; Shuster said the surveys were administered in advisory and the coach did not facilitate administration. He explained SBIRT screening is confidential and reported only in aggregate, and that the coach sits with students in private rooms for one-on-one screening when SBIRT is implemented.
Next steps: Shuster said MGH would finalize and circulate the report in early January and offered to return for follow-up. The committee thanked the presenters and discussed ways to expand connection and tier-2 supports in the district.
