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Fox DJ, Hanes D. Prevalence and Correlates of Unmet Mental Health Services Need in Adolescents With Major Depressive Episode in 2019: An Analysis of National Survey on Drug Use and Health Data. J Adolesc Health 2023; 72:182-188. [PMID: 36424335 DOI: 10.1016/j.jadohealth.2022.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 09/04/2022] [Accepted: 10/03/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE Mental health (MH) crises in adolescence can derail development, possibly leading to poorer health outcomes in young adulthood. According to recent estimates, approximately half of US children have unmet MH need, with increased odds when uninsured or Hispanic. The aims of this study were to update estimates of MH services need and use in the US adolescent (12- 17 years) and to reassess previously identified associations between insurance status, demographic characteristics, MH need and use, and unmet need, using data from the National Survey of Drug Use and Health (NSDUH; 2019). METHODS Adolescents aged 12-17 years were included from the NSDUH. Logistic regressions were performed to assess associations of race and insurance with outcomes of past-year major depressive episode (MDE) and unmet MH need. Adjustments were made for age, sex, and income. RESULTS Individuals of multiple races, females, and users of alcohol, marijuana, and illicit drugs had increased odds of MDE, while Black adolescents and the privately insured had decreased odds. Hispanic adolescents, people of multiple races, and users of alcohol and illicit drug had increased odds for unmet need. DISCUSSION We estimate that 15.8% of all US adolescents had an MDE and that 45.8% of these adolescents with MDE went without MH care in 2019. We found very limited support for associations of race and insurance status with past-year MDE or unmet MH need, although this may be due to the small number of uninsured adolescents sampled in 2019. Longitudinal data are needed to assess severity of MH needs and appropriateness of care.
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Affiliation(s)
- Devon J Fox
- Helfgott Research Institute, National University of Natural Medicine, Portland, Oregon.
| | - Douglas Hanes
- Helfgott Research Institute, National University of Natural Medicine, Portland, Oregon
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2
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Splett JW, Perales K, Miller E, Hartley SN, Wandersman A, Halliday CA, Weist MD. Using readiness to understand implementation challenges in school mental health research. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:3101-3121. [PMID: 35180319 DOI: 10.1002/jcop.22818] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 06/14/2023]
Abstract
Schools and research partners are increasingly implementing complex, multicomponent interventions and school-wide frameworks to better meet students' social, emotional, behavioral, and academic needs; however, in the research and real-world contexts, implementation is often fraught with many challenges and barriers to success. This study explores implementation barriers encountered during a randomized controlled trial testing effects of one complex intervention strategy-the Interconnected Systems Framework-from the lens of a practical model for conceptualizing organizational readiness-the Interactive Systems Framework for Dissemination and Implementation. Implementation of the Interconnected Systems Framework was explored via focus group and key informant interviews with school and mental health professionals, and research team members responsible for implementing the intervention in randomly assigned study schools. Results from inductive thematic analysis of verbatim transcripts identified three primary implementation challenges: staff turnover, inadequate leadership buy-in, and insufficient time for training/planning. Each challenge is explored from interview participants' perspectives and the extant literature, then connected to recommendations from implementation science to help others avoid similar challenges in their well-intentioned efforts to address the mounting concern for students' wellbeing.
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Affiliation(s)
- Joni W Splett
- School of Special Education, School Psychology & Early Childhood Studies, College of Education, University of Florida, Gainesville, Florida, USA
| | | | - Elaine Miller
- Division of K-16 Educational Initiatives, College of Education, University of South Florida, St. Petersburg, Florida, USA
| | - Samantha N Hartley
- University of Maryland School of Medicine, National Center for School Mental Health, Baltimore, Maryland, USA
| | - Abraham Wandersman
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
- Wandersman Center, Columbia, South Carolina, USA
| | - Colleen A Halliday
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Mark D Weist
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
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Abstract
This review examines the history and contemporary landscape of school mental health, describing evidence that schools are an essential component of the system of child and adolescent care and providing recommendations to advance this vital care delivery system. This literature review of scientific data and shifts to policy and practice in school mental health documents the evolution of collaboration between the education and mental health systems to support student mental health. This review describes best practices and provides examples for achieving the standards of the comprehensive school mental health systems model in states and local communities. Data demonstrate that multitiered systems of mental health support and services in schools, including mental health promotion, prevention, early intervention, and treatment, improve academic and psychosocial functioning and reduce risk of poor outcomes, including mental illness and school failure. Policy and practice shifts in the field reflect a movement toward integrating mental health systems into the education sector, including preparing the education workforce to promote mental health and to support early identification of and intervention to address mental illness. To create a full continuum of mental health supports for students, states and districts can draw on national best practices and state exemplars as they install multitiered systems of mental health supports in all schools, conduct universal student mental health monitoring, and coordinate school and community mental health systems.
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Affiliation(s)
- Sharon Hoover
- Division of Child and Adolescent Psychiatry, National Center for School Mental Health, University of Maryland School of Medicine, Baltimore (Hoover); Division of Child and Adolescent Psychiatry, Medstar Georgetown University Hospital, Washington, D.C. (Bostic)
| | - Jeff Bostic
- Division of Child and Adolescent Psychiatry, National Center for School Mental Health, University of Maryland School of Medicine, Baltimore (Hoover); Division of Child and Adolescent Psychiatry, Medstar Georgetown University Hospital, Washington, D.C. (Bostic)
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Ryan E, Jenkins M. The Bridge in Schools: a psychodynamic impact model for child mental health in disadvantaged areas. JOURNAL OF CHILD PSYCHOTHERAPY 2020. [DOI: 10.1080/0075417x.2020.1734057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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5
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Cappella E, Jackson DR, Bilal C, Hamre BK, Soulé C. Bridging Mental Health and Education in Urban Elementary Schools: Participatory Research to Inform Intervention Development. SCHOOL PSYCHOLOGY REVIEW 2019. [DOI: 10.1080/02796015.2011.12087526] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Taylor LK, Goldberg MG, Tran MHD. Promoting Student Success: How Do We Best Support Child and Youth Survivors of Catastrophic Events? Curr Psychiatry Rep 2019; 21:82. [PMID: 31410584 DOI: 10.1007/s11920-019-1067-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW School mental health services have achieved recognition for increased access to care and intervention completion rates. While best practice recommendations include connection of school mental health programming to multi-tiered systems of support that promote early identification and intervention, many schools struggle to operationalize student screening for trauma exposure, trauma symptoms, and service identification. Relatedly, progress monitoring for trauma symptoms, and the effect of trauma on school functioning in the context of catastrophic events, can also be difficult to systematically collect. RECENT FINDINGS Research regarding the effects of catastrophic events, such as exposure to natural disasters, terrorist attacks, war, or the journey to refugee status on children and youths school functioning, indicates salient age and gender differences among student responses. In addition, school professionals have been identified as sources of social support for students and as potential brokers to school linked intervention resources for children, youth, and their families. Based on our review, we outline recommendations for school professionals, including potential changes to school policies and procedures, and delineate future research questions.
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Affiliation(s)
- Leslie K Taylor
- Department of Psychiatry & Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center, 1941 East Rd, Houston, TX, 77054, USA.
| | - Melissa G Goldberg
- Department of Psychiatry & Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center, 1941 East Rd, Houston, TX, 77054, USA
| | - Minh-Hao D Tran
- Department of Psychiatry & Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center, 1941 East Rd, Houston, TX, 77054, USA
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Kase C, Hoover S, Boyd G, West KD, Dubenitz J, Trivedi PA, Peterson HJ, Stein BD. Educational Outcomes Associated With School Behavioral Health Interventions: A Review of the Literature. THE JOURNAL OF SCHOOL HEALTH 2017; 87:554-562. [PMID: 28580676 DOI: 10.1111/josh.12524] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 10/24/2016] [Accepted: 01/19/2017] [Indexed: 05/27/2023]
Abstract
BACKGROUND There is an unmet need for behavioral health support and services among children and adolescents, which school behavioral health has the potential to address. Existing reviews and meta-analyses document the behavioral health benefits of school behavioral health programs and frameworks, but few summaries of the academic benefits of such programs exist. We provide exemplars of the academic benefits of school behavioral health programs and frameworks. METHODS A literature review identified school behavioral health-related articles and reports. Articles for inclusion were restricted to those that were school-based programs and frameworks in the United States that included an empirical evaluation of intervention academic-related outcomes. RESULTS Findings from 36 primary research, review, and meta-analysis articles from the past 17 years show the benefits of school behavioral health clinical interventions and targeted interventions on a range of academic outcomes for adolescents. CONCLUSION Our findings are consistent with reports documenting health benefits of school behavioral health frameworks and programs and can facilitate further efforts to support school behavioral health for a range of stakeholders interested in the benefits of school behavioral health programs and frameworks on academic outcomes.
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Affiliation(s)
- Courtney Kase
- Behavioral and Policy Sciences, RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213
| | - Sharon Hoover
- University of Maryland School of Medicine
- National Center for School Mental Health, 737 West, Lombard Street 400, Baltimore, MD 21201
| | - Gina Boyd
- Behavioral and Policy Sciences, RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213
| | - Kristina D West
- Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services, 200 Independence Avenue, SW, Washington, DC 20201
| | - Joel Dubenitz
- Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services, 200 Independence Avenue, SW, Washington, DC 20201
| | - Pamala A Trivedi
- Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services, 200 Independence Avenue, SW, Washington, DC 20201
| | - Hilary J Peterson
- Behavioral and Policy Sciences, RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213
| | - Bradley D Stein
- Behavioral and Policy Sciences, RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213
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Walrath CM, Bruns EJ, Anderson KL, Glass-Siegal M, Weist MD. Understanding Expanded School Mental Health Services in Baltimore City. Behav Modif 2016; 28:472-90. [PMID: 15186511 DOI: 10.1177/0145445503259501] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article explores the nature of expanded school mental health (ESMH) services in Baltimore City, which at the time of the study were incorporated into 40% of the city’s public schools. A provider survey was distributed to ESMH clinicians to gather information on the characteristics of service providers and recipients, types of services being provided, and their proposed outcomes. Provider reports indicated an impressive service capacity, augmentation of traditional school-based services, and the continual need for increased mental health service hours in their buildings. In addition, the most frequently voiced benefits of the ESMH programs were increased mental health awareness and improved school climate. Implications of the findings for future programming development and research are discussed.
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Mellin EA, Taylor L, Weist MD, Lockhart NC. The Expanded School Mental Health Collaboration Instrument [Community Version]: Development and Initial Psychometrics. SCHOOL MENTAL HEALTH 2015. [DOI: 10.1007/s12310-015-9164-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Belur V, Dennis ML, Ives ML, Vincent R, Muck R. Feasibility and impact of implementing motivational enhancement therapy–cognitive behavioral therapy as a substance use treatment intervention in school-based settings. ACTA ACUST UNITED AC 2014; 7:88-104. [DOI: 10.1080/1754730x.2014.888223] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ballard KL, Sander MA, Klimes-Dougan B. School-related and social-emotional outcomes of providing mental health services in schools. Community Ment Health J 2014; 50:145-9. [PMID: 24337471 DOI: 10.1007/s10597-013-9670-y] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 11/30/2013] [Indexed: 11/29/2022]
Abstract
This study evaluated student outcomes of an expanded school mental health (ESMH) model that placed community mental health clinicians on-site in schools to identify and treat children with mental health needs. The first aim of this study was to consider school-related outcomes (suspension rates and attendance rates) for those students who received ESMH treatment (n = 159) were compared to a matched high-risk sample that did not receive such services (n = 148). Results demonstrated differences between groups over time on measures of suspensions and attendance but not academic achievement. The second aim of this study was to evaluate change in social-emotional functioning (Strengths and Difficulties Questionnaire Scores) over time for the treatment group. Results indicated significant improvements on several parent and teacher ratings. Despite limitations of the ESMH framework examined in this study, the overall results suggest some promising advantages for students who received ESMH services.
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School-Based Treatment for Anxiety in Children and Adolescents: New Developments in Transportability and Dissemination. ISSUES IN CLINICAL CHILD PSYCHOLOGY 2014. [DOI: 10.1007/978-1-4614-7624-5_26] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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14
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Mellin EA, Taylor L, Weist MD. The Expanded School Mental Health Collaboration Instrument [School Version]: Development and Initial Psychometrics. SCHOOL MENTAL HEALTH 2013. [DOI: 10.1007/s12310-013-9112-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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15
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Associations between psychosocial problems and personality disorders among Egyptian adolescents. THE SPANISH JOURNAL OF PSYCHOLOGY 2013; 16:E78. [PMID: 24230941 DOI: 10.1017/sjp.2013.29] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The study investigated the relationship between psychosocial problems and personality disorders among a sample of 817 Egyptian adolescents (408 males and 409 females). Using 15 subscales from the Adolescent Psychopathology Scale (APS-long form) we assessed prevalence rates of a number of internalizing and externalizing psychosocial disorders. Additionally, we investigated whether there are gender differences in psychopathology among Egyptian adolescents and to what extent can psychosocial problems predict specific personality disorders. Stepwise multiple regression analyses showed that the participants experienced higher levels of PD, AV, and BD. Gender differences were found in certain personality disorders as well as in externalizing and internalizing psychosocial problems. A number of externalizing and internalizing psychosocial problems were highly predictive of specific personality disorders.
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Al-Obaidi AK, Nelson BD, Al Badawi G, Hicks MHR, Guarino AJ. Child mental health and service needs in Iraq: beliefs and attitudes of primary school teachers. Child Adolesc Ment Health 2013; 18:171-179. [PMID: 32847249 DOI: 10.1111/j.1475-3588.2012.00670.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/14/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To survey Iraqi primary school teachers' beliefs and attitudes about mental health and behavioural problems of children. METHODS From 10 primary schools in Baghdad, 148 teachers were surveyed using a closed-response questionnaire to assess beliefs and attitudes regarding students' mental health and behavioural problems, needs, resources and limitations to teaching. RESULTS Disruptive behaviours were rated as main problems by the largest proportions of teachers. In-service training on 'identifying students with social, emotional, or behavioural problems' and 'effective behaviour management' was rated very important by 70% of teachers. Most teachers received no training on mental health during their teaching career. There was low reported availability of a wide range of school-based mental health resources. CONCLUSIONS Teachers in Iraq report substantial mental health and behavioural problems in primary school children and identify high unmet need for school-based mental health programmes and training.
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Affiliation(s)
- Abdul Kareem Al-Obaidi
- Institute of International Education (IIE), 5 W, 37th St. # 12, New York, NY 10018, USA.,Psychiatry, Al Mustansyria Medical College, Baghdad, Iraq
| | - Brett D Nelson
- Division of Global Health, Department of Pediatrics, Massachusetts General Hospital, Harvard Humanitarian Initiative: Director, Children in Conflict and Crisis, MA, USA
| | | | - Madelyn Hsiao-Rei Hicks
- Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, UK
| | - Anthony J Guarino
- Centre for Interprofessional Studies and Innovation MGH, Institute of Health Professions, Boston, MA, USA
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Lindsey MA, Chambers K, Pohle C, Beall P, Lucksted A. Understanding the Behavioral Determinants of Mental Health Service Use by Urban, Under-Resourced Black Youth: Adolescent and Caregiver Perspectives. JOURNAL OF CHILD AND FAMILY STUDIES 2013; 22:107-121. [PMID: 23355768 PMCID: PMC3551580 DOI: 10.1007/s10826-012-9668-z] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Black adolescents with mental health problems are less likely than non-Black adolescents with mental health problems to receive treatment, primarily for non-financial reasons including negative perceptions of services and providers, and self-stigma associated with experiencing mental health problems. To better understand these obstacles, 16 adolescents and 11 caregivers, recruited from two K-8th grade elementary-middle schools, participated in four focus groups guided by the unified theory of behavior to explore mental health help-seeking behaviors and perceptions of mental health services. In the focus groups, caregivers acknowledged more positive attitudes about seeking mental health services than adolescents, but both expected the experience of actually doing so to be negative. Adolescents and caregivers also acknowledged social norms that inhibit their mental health help-seeking. Therefore, we conclude that interventions targeting expectancies and social norms might increase the connection of urban, under-resourced Black adolescents and their families to mental health services, and be particularly important given the long-term consequences of untreated mental health problems for this group.
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Affiliation(s)
- Michael A. Lindsey
- School of Social Work, University of Maryland, 525 W. Redwood Street, Baltimore, MD 21201, USA
| | - Kerri Chambers
- School of Medicine, Department of Psychiatry, University of Maryland, Baltimore, MD 21201, USA
| | - Cara Pohle
- School of Social Work, University of Southern California, Los Angeles, CA 90089-0411, USA
| | - Peggy Beall
- School of Social Work, University of Maryland, 525 W. Redwood Street, Baltimore, MD 21201, USA
| | - Alicia Lucksted
- School of Medicine, Department of Psychiatry, University of Maryland, Baltimore, MD 21201, USA
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Girio-Herrera E, Owens JS, Langberg JM. Perceived barriers to help-seeking among parents of at-risk kindergarteners in rural communities. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2012; 42:68-77. [PMID: 22963042 DOI: 10.1080/15374416.2012.715365] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study examined help-seeking and perceived barriers to children's mental health service utilization in a large sample of parents living in rural communities who are at various stages in the help-seeking process. The goals were to (a) obtain a demographic profile of at-risk kindergarteners and their parents, (b) examine parent-reported help-seeking behaviors, and (c) assess barriers to mental health service use. Parent and teacher report of the Behavior Assessment System for Children, Second Edition, were used to screen children (N = 597) at kindergarten entry and to identify their risk status. Parents also completed the Barriers to Participation Scale and reported the frequency of help-seeking behaviors related to their child's problems. Using a cutoff score of 1.5 standard deviations above the mean, nearly half (51%) of children were identified as at-risk (76% low risk, 24% high risk) for emotional, behavioral, social, and adaptive problems. Barriers and help-seeking did not differ across parents of low and high risk children. Among parents of at-risk children, only 33% believed their child had a problem. Parents sought informal help more often than professional help; however, medical doctors and school staff were sought most among professionals. The majority of parents (61%) endorsed at least one barrier that would interfere with mental health service use. Results highlight the importance of early school mental health screening and the need for interventions to increase parent problem recognition and engagement in mental health service utilization.
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Cappella E, Hamre BK, Kim HY, Henry DB, Frazier SL, Atkins MS, Schoenwald SK. Teacher consultation and coaching within mental health practice: classroom and child effects in urban elementary schools. J Consult Clin Psychol 2012; 80:597-610. [PMID: 22428941 PMCID: PMC3399967 DOI: 10.1037/a0027725] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To examine effects of a teacher consultation and coaching program delivered by school and community mental health professionals on change in observed classroom interactions and child functioning across one school year. METHOD Thirty-six classrooms within 5 urban elementary schools (87% Latino, 11% Black) were randomly assigned to intervention (training + consultation/coaching) and control (training only) conditions. Classroom and child outcomes (n = 364; 43% girls) were assessed in the fall and spring. RESULTS Random effects regression models showed main effects of intervention on teacher-student relationship closeness, academic self-concept, and peer victimization. Results of multiple regression models showed levels of observed teacher emotional support in the fall moderated intervention impact on emotional support at the end of the school year. CONCLUSIONS Results suggest teacher consultation and coaching can be integrated within existing mental health activities in urban schools and impact classroom effectiveness and child adaptation across multiple domains.
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Affiliation(s)
- Elise Cappella
- Department of Applied Psychology, New York University, New York, NY 10003, USA.
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Herzig-Anderson K, Colognori D, Fox JK, Stewart CE, Warner CM. School-based anxiety treatments for children and adolescents. Child Adolesc Psychiatr Clin N Am 2012; 21:655-68. [PMID: 22801000 PMCID: PMC3399129 DOI: 10.1016/j.chc.2012.05.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Anxiety disorders are the most common class of psychopathology among youth, yet many of these youngsters do not receive treatment. This is particularly concerning given the chronic course of anxiety disorders, which often lead to mood disorders, substance abuse, and serious impairment. Schools are an optimal venue for identifying anxious students and delivering mental health treatment given access to youth and ability to overcome various barriers to treatment. This article reviews four school-based treatments for anxiety disorders that have been evaluated in controlled trials. Discussion centers on feasibility, challenges to school-based implementation, and future research directions for this critical area.
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Affiliation(s)
- Kathleen Herzig-Anderson
- Anita Saltz Institute for Anxiety and Mood Disorders, NYU Child Study Center, Department of Child and Adolescent Psychiatry, NYU Langone Medical Center, One Park Avenue, 8th Floor, New York, NY 10016, USA
| | - Daniela Colognori
- Anita Saltz Institute for Anxiety and Mood Disorders, NYU Child Study Center, Department of Child and Adolescent Psychiatry, NYU Langone Medical Center, One Park Avenue, 8th Floor, New York, NY 10016, USA
| | | | - Catherine E. Stewart
- Anita Saltz Institute for Anxiety and Mood Disorders, NYU Child Study Center, Department of Child and Adolescent Psychiatry, NYU Langone Medical Center, One Park Avenue, 8th Floor, New York, NY 10016, USA
| | - Carrie Masia Warner
- Anita Saltz Institute for Anxiety and Mood Disorders, NYU Child Study Center, Department of Child and Adolescent Psychiatry, NYU Langone Medical Center, One Park Avenue, 8th Floor, New York, NY 10016, USA
- Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY 10962, USA
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Stephan S, Westin A, Lever N, Medoff D, Youngstrom E, Weist M. Do School-Based Clinicians’ Knowledge and Use of Common Elements Correlate with Better Treatment Quality? SCHOOL MENTAL HEALTH 2012. [DOI: 10.1007/s12310-012-9079-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Grant R, Greene D. The health care home model: primary health care meeting public health goals. Am J Public Health 2012; 102:1096-103. [PMID: 22515874 PMCID: PMC3483945 DOI: 10.2105/ajph.2011.300397] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2011] [Indexed: 11/04/2022]
Abstract
In November 2010, the American Public Health Association endorsed the health care home model as an important way that primary care may contribute to meeting the public health goals of increasing access to care, reducing health disparities, and better integrating health care with public health systems. Here we summarize the elements of the health care home (also called the medical home) model, evidence for its clinical and public health efficacy, and its place within the context of health care reform legislation. The model also has limitations, especially with regard to its degree of involvement with the communities in which care is delivered. Several actions could be undertaken to further develop, implement, and sustain the health care home.
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Affiliation(s)
- Roy Grant
- Children's Health Fund, New York, NY 10027, USA.
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Abstract
School-based health centers (SBHCs) have become an important method of health care delivery for the youth of our nation. Although they only represent 1 aspect of a coordinated school health program approach, SBHCs have provided access to health care services for youth confronted with age, financial, cultural, and geographic barriers. A fundamental principle of SBHCs is to create an environment of service coordination and collaboration that addresses the health needs and well-being of youth with health disparities or poor access to health care services. Some pediatricians have concerns that these centers are in conflict with the primary care provider's medical home. This policy provides an overview of SBHCs and some of their documented benefits, addresses the issue of potential conflict with the medical home, and provides recommendations that support the integration and coordination of SBHCs and the pediatric medical home practice.
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Weist MD, Lindsey M, Moore E, Slade E. Building Capacity in School Mental Health. INTERNATIONAL JOURNAL OF MENTAL HEALTH PROMOTION 2012. [DOI: 10.1080/14623730.2006.9721743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Stephan S, Hurwitz L, Paternite C, Weist M. Critical Factors and Strategies for Advancing Statewide School Mental Health Policy and Practice. ACTA ACUST UNITED AC 2011. [DOI: 10.1080/1754730x.2010.9715686] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Neal JW, Neal ZP, Atkins MS, Henry DB, Frazier SL. Channels of change: contrasting network mechanisms in the use of interventions. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2011; 47:277-86. [PMID: 21181552 PMCID: PMC3053410 DOI: 10.1007/s10464-010-9403-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
This study informs community science, and seeks to narrow the research-to-practice gap, by examining how the interpersonal networks within a setting influence individuals' use of interventions. More specifically, it explores the role of two network mechanisms-cohesion and structural similarity-in urban elementary school teachers' use of interventions designed to improve academic and behavioral outcomes for students. Lagged regression models examine how position in advice giving networks influenced weekly use of the daily report card and peer assisted learning by kindergarten through fourth grade teachers in three schools. Results indicate that intervention use spreads among teachers with similar patterns of advice-giving relationships (i.e., via structural similarity), rather than from teachers who are sources of advice (i.e., via cohesion). These results are consistent with findings in other settings, and suggest that researchers wishing to increase the use of an intervention should select change agents based on their patterns of their relationships, rather than on their direct connections.
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Mellin EA, Weist MD. Exploring School Mental Health Collaboration in an Urban Community: A Social Capital Perspective. SCHOOL MENTAL HEALTH 2011. [DOI: 10.1007/s12310-011-9049-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lindsey MA, Barksdale CL, Lambert SF, Ialongo NS. Social network influences on service use among urban, African American youth with mental health problems. J Adolesc Health 2010; 47:367-73. [PMID: 20864006 PMCID: PMC2945602 DOI: 10.1016/j.jadohealth.2010.01.025] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2009] [Revised: 01/27/2010] [Accepted: 01/28/2010] [Indexed: 10/19/2022]
Abstract
PURPOSE To examine the associations between the size and quality of African-American adolescents' social networks and their mental health service use, and to examine whether these social network characteristics moderate the association between need for services because of emotional or behavioral difficulties and use of services. METHOD Participants were a community sample of African-American adolescents (N = 465; 46.2% female; mean age, 14.78) initially recruited in 1st grade for participation in an evaluation of two preventive intervention trials. Social network influences and adolescents' mental health service use in schools and community were accessed. RESULTS A significant positive association between adolescents' perception that their social network was helpful and their use of school mental health services was identified. The significant associations between need for services for anxiety, depression, or behavior problems, and school and outpatient service use were moderated by size of the social network. Specifically, among youth in need of services for anxiety or depression, school-based service use was higher for those with larger social networks. CONCLUSIONS Implications for enhancing access to formal mental health services include further examination of key social network influences that potentially serve as facilitators or barriers to formal help-seeking. The findings also suggest that it might be important to integrate social network members into interventions to address the mental health needs of adolescents.
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Affiliation(s)
- Michael A. Lindsey
- Schools of Social Work and Medicine at the University of Maryland in Baltimore, MD
| | | | | | - Nicholas S. Ialongo
- Department of Mental Health in the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Pilot Investigation of Service Use by Children Referred to A School-Mental Health Program in Alberta, Canada. SCHOOL MENTAL HEALTH 2010. [DOI: 10.1007/s12310-010-9040-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Weist MD, Stiegler K, Stephan S, Cox J, Vaughan C. School mental health and prevention science in the Baltimore City schools. PSYCHOLOGY IN THE SCHOOLS 2009. [DOI: 10.1002/pits.20453] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Fox JK, Halpern LF, Forsyth JP. Mental health checkups for children and adolescents: A means to identify, prevent, and minimize suffering associated with anxiety and mood disorders. ACTA ACUST UNITED AC 2008. [DOI: 10.1111/j.1468-2850.2008.00129.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cappella E, Frazier SL, Atkins MS, Schoenwald SK, Glisson C. Enhancing schools' capacity to support children in poverty: an ecological model of school-based mental health services. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2008; 35:395-409. [PMID: 18581225 DOI: 10.1007/s10488-008-0182-y] [Citation(s) in RCA: 144] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2008] [Accepted: 06/09/2008] [Indexed: 01/01/2023]
Abstract
School based mental health services for children in poverty can capitalize on schools' inherent capacity to support development and bridge home and neighborhood ecologies. We propose an ecological model informed by public health and organizational theories to refocus school based services in poor communities on the core function of schools to promote learning. We describe how coalescing mental health resources around school goals includes a focus on universal programming, mobilizing indigenous school and community resources, and supporting core teaching technologies. We suggest an iterative research-practice approach to program adaptation and implementation as a means toward advancing science and developing healthy children.
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Affiliation(s)
- Elise Cappella
- Department of Applied Psychology, New York University, 239 Greene Street, 5th Floor, New York, NY 10003, USA.
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Huddart P. “Joined on rather than joined up?” Primary mental health work in Scottish schools. HEALTH EDUCATION 2007. [DOI: 10.1108/09654280710778565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposePrimary mental health workers have been based in West Lothian schools since 2003 to act as links between the community and hospital‐based services. The research programme this paper describes aimed to examine how this model worked and its impact for children and their families.Design/methodology/approachThis paper reports on interviews with secondary school staff, the link workers and comparative post‐holders. The research study was qualitative and the research question was “What is the perceived impact of Mental Health Link Workers in West Lothian schools?”.FindingsThe paper finds that Primary mental health workers felt that their main contribution was building capacity in the community to support children with mental health problems, and identified four strands to this: space, relationships, skills and containment. Two described direct access for children and their families as the main gain. Secondary school staff considered that the greatest impact was for children at the onset of mental illness, and their own knowledge and skills.Practical implicationsPrimary mental health work in the community is fairly new in Scotland. This study suggested that it speeded up and improved access to services for children in need of mental health assessments and services. It was based on temporary contracts and short‐term funding. Sustainability within schools may only take place when the work becomes well resourced.Originality/valueThe paper is a detailed look at the views of Primary Mental Health Workers based in schools and school staff.
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Weist MD, Rubin M, Moore E, Adelsheim S, Wrobel G. Mental health screening in schools. THE JOURNAL OF SCHOOL HEALTH 2007; 77:53-8. [PMID: 17222155 DOI: 10.1111/j.1746-1561.2007.00167.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND This article discusses the importance of screening students in schools for emotional/behavioral problems. METHODS Elements relevant to planning and implementing effective mental health screening in schools are considered. Screening in schools is linked to a broader national agenda to improve the mental health of children and adolescents. Strategies for systematic planning for mental health screening in schools are presented. RESULTS Mental health screening in schools is a very important, yet sensitive, agenda that is in its very early stages. Careful planning and implementation of mental health screening in schools offers a number of benefits including enhancing outreach and help to youth in need, and mobilizing school and community efforts to promote student mental health while reducing barriers to their learning. CONCLUSIONS When implemented with appropriate family, school, and community involvement, mental health screening in schools has the potential to be a cornerstone of a transformed mental health system. Screening, as part of a coordinated and comprehensive school mental health program, complements the mission of schools, identifies youth in need, links them to effective services, and contributes to positive educational outcomes valued by families, schools, and communities.
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Affiliation(s)
- Mark D Weist
- Division of Child and Adolescent Psychiatry, Center for School Mental Health Analysis and Action, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
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Paternite CE. School-based mental health programs and services: overview and introduction to the special issue. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2006; 33:657-63. [PMID: 16328742 DOI: 10.1007/s10802-005-7645-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2005] [Accepted: 06/20/2005] [Indexed: 10/25/2022]
Abstract
School-based mental health (SBMH) programs and services have grown progressively in the United States in the past two decades, related in part to increased recognition of their advantages and heightened federal support. However, SBMH is an emerging field, with many issues needing attention. This introductory article provides a context for the special issue by highlighting the importance of increased conceptual clarity about SBMH, enhanced mental health-education systems integration, and advancement of the SBMH research base. Key elements for success of SBMH programs and services are discussed, as underscored recently by the report of the New Freedom Commission on Mental Health (2003) and other important initiatives. These elements include (a) school-family-community agency partnerships, (b) commitment to a full continuum of mental health education, mental health promotion, assessment, problem prevention, early intervention, and treatment, and (c) services for all youth, including those in general and special education. A synopsis of the articles in the special issue is provided, emphasizing their conceptual and empirical contributions to delivery and sustainability of effective mental health practices in schools.
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Affiliation(s)
- Carl E Paternite
- Department of Psychology, Center for School-Based Mental Health Programs, Miami University, Oxford, OH 45056, USA.
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Evans SW, Weist MD. Implementing empirically supported treatments in the schools: what are we asking? Clin Child Fam Psychol Rev 2005; 7:263-7. [PMID: 15648280 DOI: 10.1007/s10567-004-6090-0] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The research reported in this special issue addresses important areas for the continued development of empirically supported school-based treatments. Although advances in the development and evaluation of treatment services have occurred, there is little public demand for the widespread dissemination of these treatments. In this commentary, the authors draw data from historical examples, related research, and personal experience to demonstrate the need to create a societal mandate for change. They present specific implications for future areas of research and the type of public education and marketing campaign that will be needed to create a demand for empirically supported school-based treatments.
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Affiliation(s)
- Steven W Evans
- Alvin V. Baird Attention and Learning Disabilities Center and Department of Psychology, James Madison University, Harrisonburg, Virginia, USA.
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Evans SW, Mullett E, Weist MD, Franz K. Feasibility of the MindMatters School Mental Health Promotion Program in American Schools. J Youth Adolesc 2005. [DOI: 10.1007/s10964-005-1336-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Weist MD, Albus KE. Expanded school mental health: exploring program details and developing the research base. Behav Modif 2004; 28:463-71. [PMID: 15186510 DOI: 10.1177/0145445503259498] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Expanded school mental health (ESMH) programs, the focus of this special issue, provide comprehensive mental health care to youth in general and special education through partnerships between schools and community mental health agencies and programs. As these programs progressively develop in the United States, there is a critical need to build the research and evidence base for them. This article presents background to the national movement toward ESMH and provides an overview of articles contained in this special issue, which provide in-depth details and early research findings on diverse aspects of mental health programs in schools. Advantages of greater involvement of behavioral professionals in ESMH are discussed.
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Affiliation(s)
- Mark D Weist
- Department of Psychiatry, University of Maryland School of Medicine, USA
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Weist MD, Goldstein J, Evans SW, Lever NA, Axelrod J, Schreters R, Pruitt D. Funding a full continuum of mental health promotion and intervention programs in the schools. J Adolesc Health 2003; 32:70-8. [PMID: 12782445 DOI: 10.1016/s1054-139x(03)00067-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To assess the availability of public and private financing sources to support comprehensive school mental health programs. The paper focuses on "expanded school mental health" (ESMH) programs, which provide a full array of mental health promotion and intervention services to youth in general and special education through school-community partnerships. METHODS A range of strategies to fund ESMH services are reviewed, including fee-for-service funding, as well as grants, contracts, and other mechanisms from federal, state, local, and private sources. RESULTS An objective national study of the characteristics and financing of ESMH programs has yet to be conducted. Existing evidence suggests that funding for these programs is patchy and tenuous. Many programs are being funded through fee-for-service programs, which generally only support the provision of more intensive services (e.g., assessment, therapy) and are associated with significant bureaucracy and other concerns (e.g., the need to diagnose students). As programs move to enhance funding for preventive and mental health-promoting activities and services, there is an increasing need for grants, contracts, and other sources of support. CONCLUSION Progress in the national movement toward ESMH will be promoted through an interconnected agenda of quality improvement, evaluation of program effectiveness, and the advancement of advocacy. These developments will facilitate policy improvements and increased funding for the full continuum of mental health promotion and intervention in the schools.
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Affiliation(s)
- Mark D Weist
- Center for School Mental Health Assistance, Department of Psychiatry, University of Maryland School of Medicine, 680 West Lexington Street, 10th Floor, Baltimore, MD 21201, USA.
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Weist MD, Sander MA, Lowie JA, Christodulu KV. The Expanded School Mental Health Framework. ACTA ACUST UNITED AC 2002. [DOI: 10.1080/00094056.2002.10522739] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Prodente CA, Sander MA, Weist MD. Furthering Support for Expanded School Mental Health Programs. ACTA ACUST UNITED AC 2002. [DOI: 10.1207/s15326918cs0503_3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Mansour ME, Kotagal UP, DeWitt TG, Rose B, Sherman SN. Urban elementary school personnel's perceptions of student health and student health needs. AMBULATORY PEDIATRICS : THE OFFICIAL JOURNAL OF THE AMBULATORY PEDIATRIC ASSOCIATION 2002; 2:127-31. [PMID: 11926844 DOI: 10.1367/1539-4409(2002)002<0127:uespsp>2.0.co;2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To determine the perceptions of school personnel with regard to urban students' health and health needs as part of a planning process for development and implementation of school-linked health services. METHODS A self-administered, close-ended questionnaire was given to 294 schoolteachers and school staff to assess school personnel perceptions of 1) health needs of students, 2) priority of need for health services or programs delivered on-site or off-site, and 3) selected factors suspected to affect implementation of new school health services. RESULTS A total of 72% of teachers and 77% of staff completed the survey. The most highly ranked need by school personnel was mental health, followed by violence and anger management and physical abuse and domestic violence. The most commonly requested services on-site and off-site were for physical abuse or domestic violence, mental health, and drug or other substance abuse. Only 40% of teachers and staff rated current health services as excellent or good. A total of 72% of teachers and staff had some level of discomfort with their current responsibilities regarding the health of students. Parental involvement was reported to be quite low, with only 9% of teachers and staff rating it as excellent or good. CONCLUSIONS he greatest health care need identified by these elementary school personnel was not for management of chronic or acute physical health conditions, but for mental health services and programs to meet the emotional and psychosocial needs of students. When implementing school-linked or school-based mental health services, focus needs to be placed on 3 areas: 1) education of school health and educational personnel regarding common mental health issues, 2) development of systems that improve knowledge of and connection with mental health resources inside and outside the school, and 3) development of systems that improve communication within the school and between the school and parents regarding health services.
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Affiliation(s)
- Mona E Mansour
- Department of General and Community Pediatrics, Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA.
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Pastore DR, Murray PJ, Juszczak L. School-based health center: position paper of the Society for Adolescent Medicine. J Adolesc Health 2001; 29:448-50. [PMID: 11728894 DOI: 10.1016/s1054-139x(01)00314-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Baruch G. Mental health services in schools: the challenge of locating a psychotherapy service for troubled adolescent pupils in mainstream and special schools. J Adolesc 2001; 24:549-70. [PMID: 11549332 DOI: 10.1006/jado.2001.0389] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In Part 1, the case is presented for school-based mental health services in terms of the low utilization of community-based clinics and the high dropout rate among young adolescents attending clinics in the community. The advantages and potential pitfalls of school-based services are also assessed. In Part 2, the paper discusses the lessons learned from delivering psychotherapy services in mainstream and special schools to tackle the mental health problems presented by troubled pupils. The author describes the schools and discusses the expectations among teachers of the psychotherapist and psychologist. The role of the psychotherapist and psychologist in the schools is outlined. The types of treatment approach, the setting for treatment, method of referral, parental consent, and links with the wider network of adolescent mental health services and evaluation of outcome are considered. Finally, the author discusses the tensions that can arise between the psychotherapist and psychologist and school staff and ways of overcoming them.
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Affiliation(s)
- G Baruch
- Brandon Centre for Counselling and Psychotherapy for Young People, London
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Weist MD. Toward a public mental health promotion and intervention system for youth. THE JOURNAL OF SCHOOL HEALTH 2001; 71:101-104. [PMID: 11314273 DOI: 10.1111/j.1746-1561.2001.tb07301.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Substantial limitations exist at all levels of mental health care for youth in most communities in the United States. Particular gaps exist in the areas of prevention, mental health promotion, and early intervention programs. The national movement toward enhancing mental health programs for youth in schools offers an important opportunity to fill gaps in the prevention-services continuum toward the development of a Public Mental Health Promotion and Intervention System for Youth. A strategy--the Child and Adolescent Program Planning Schema (CAPPS)--is presented to analyze gaps in a community's system of mental health programs for youth, and to facilitate planning toward development of a full continuum of programs from broad, population-based prevention, and mental health promotion strategies to treatment of youth with more established problems.
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Affiliation(s)
- M D Weist
- Dept. of Psychiatry, University of Maryland, 680 West Lexington St., 10th Floor, Baltimore, MD 21201, USA.
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Weist MD, Christodulu KV. Expanded school mental health programs: advancing reform and closing the gap between research and practice. THE JOURNAL OF SCHOOL HEALTH 2000; 70:195-200. [PMID: 10900597 DOI: 10.1111/j.1746-1561.2000.tb06472.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Expanded school mental health (ESMH) programs provide a range of mental health services to youth in special and regular education including prevention, assessment, treatment, and case management. Despite the rapid growth of ESMH programs in the United States and elsewhere, many communities still do not have ESMH programs and those that do exist often fail to implement empirically validated intervention and treatment strategies. Systematic prevention efforts remain a lauded, yet illusive goal. For ESMH programs to fulfill their promise of improved access, increased productivity and improved behavioral outcomes, researchers, school-based mental health service providers, and educators must work together to move child mental health programs beyond limiting constructs and approaches. These issues are reviewed and an example of an "ideal" approach to implement best practices in schools and close the gap between research and practice is offered.
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Affiliation(s)
- M D Weist
- Dept. of Psychiatry, University of Maryland, Baltimore, MD 21201, USA.
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