Depression hurts. That’s more than just a slogan. Depression is a stone that makes a disproportionate number of ripples.

According to Julianne Washington, advocacy director for the southwestern Pennsylvania chapter of the National Association on Mental Illness (NAMI), suicide is the second leading cause of death for children over 12, surpassed only by unintentional injury. Perhaps unsurprisingly, 90 percent of the suicide victims had some underlying mental health condition.

According to data compiled by NAMI, 20 percent of children 13 to 18 live with a brain health condition that can drastically affect their emotional, psychological, and social well-being. Half of all lifetime cases of mental illness begin by age 14.

State Rep. Dan Miller, D-Mt. Lebanon, has introduced legislation that would require a mental health check-up that would at minimum include a depression screening for each student in Pennsylvania by age 14.

“We know that many people who develop a mental health issue go untreated, and this lack of treatment can have lifelong repercussions,” says Miller.

“I’m tired of the loss,” he says. “So many people who self-medicate with drugs or alcohol, people who are in jail, people whose family members say ‘He’s just not there any more.’”

Miller got the idea for the bill after reading A Mother’s Reckoning, written by Susan Klebold, mother of Dylan, one of the shooters at Columbine High School, a shooting that killed 13 and wounded more than 20 in 1999.

“Here was a kid who was outwardly fine,” Miller says, “who had just gone to the prom, who was looking at colleges, and his parents had no idea what was going on inside his head.

“We need to recognize that mental health is arguably even more important than physical health and we need to improve our early diagnosis capabilities to get those who need treatment the help they need to improve their quality of life.”

The proposed legislation would add a mental health screening for each student no later than age 14 to the list of medical requirements students already partake in, such as vision tests, hearing exams, scoliosis screenings and immunizations. Because of changes made by the Affordable Care Act, Miller says, all insurance policies must cover such screenings.

“Even if parents opt out, at the bare minimum, it means they would at least have a conversation about mental health.”