Applying the extension for community healthcare outcomes (ECHO) model to promote collaborative and effective school mental health services

School staff increasingly seek to implement evidence-based school mental health services to promote student mental health. However, barriers to accessing programming and support mean that implementing these programs is difficult. Popular strategies to address these challenges, like one time professional development, often fail to be effective or sustainable. This study used mixed methods to evaluate how a set of training activities-sequential online learning modules combined with interprofessional telementoring, following the extension for community healthcare outcomes (ECHO) model-influenced provision of school mental health services. School counselors, nurses, psychologists, and social workers (n = 46) participated in training activities, which included nine, cohort-based ECHO sessions and 12 modules. We used a concurrent mixed methods design in which quantitative (implementation data and pre-post surveys) and qualitative (posttraining focus groups with a subset of participants, n = 11) data were used to evaluate training. Quantitative results indicated statistically significant pre-post improvements in participants' clinical self-efficacy (d = .83) and knowledge of evidence-based practices (d = .37). Qualitative data corroborated quantitative results. Post training, focus groups described positive reactions, learning, and behavior change, particularly with respect to equitable service provision and interprofessional teaming. ECHO appeared to facilitate the application of evidence-based strategies to real-life practice and improved participants' understanding of effective coordination of services. Taken together, findings suggest that group-based telementoring may be a high-impact strategy for supporting the implementation of effective, culturally specific, and collaborative school mental health services. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Roles and Functions of School Mental Health Professionals Within Comprehensive School Mental Health Systems

Mental health concerns are on the rise among youth, contributing to a growing need for school-based mental health services. However, challenges to service provision arise due, in part, to workforce shortages, service fragmentation, and inefficient allocation of staff time. The current study describes the professional competencies and time allocation of four school-based mental health professions (i.e., school counselors, school psychologists, school social workers, and school nurses) in order to demonstrate how schools can leverage the skills of their existing staff to coordinate a comprehensive approach to support student mental health. First, we identified the core clinical competencies needed to implement the key features of comprehensive school mental health systems. Then, we crosswalked these clinical competencies with the training standards of the four professions. Finally, we conducted a systematic review of the literature to understand how these professionals' time is allocated, as well as their responsibilities related to the provision of mental health services. Results demonstrated that, although all four professions receive training in most of the core competencies needed to implement comprehensive school mental health services, their skillsets are often underutilized in day-to-day practice. Thus, we concluded that there are at least two untapped opportunities for school leaders to support student mental health-first, maximize the use of school mental health professionals through task-shifting (i.e., reassigning tasks less central to mental health service delivery to other staff), and second, implement an integrated model of school mental health services to efficiently leverage the mental health training of professionals.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12310-022-09535-0.

Can a school climate survey accurately and equitably measure school quality? Examining the multilevel structure and invariance of the Georgia School Climate Scale

School climate measures are increasingly utilized as one indicator of school quality within educational accountability systems. However, concerns have been raised about the accuracy of these indicators given that school climate surveys are often not validated using multilevel methods. Further, cross-school comparisons in climate may not be trustworthy because the school-level invariance of climate surveys has not been investigated. There is a need to examine the validity of school-level climate constructs and to determine if surveys measure climate equitably for schools that serve underrepresented populations. The aim of the current study was to examine the multilevel factor structure of a statewide school climate survey to determine whether it measured climate equitably for students of different races/ethnicities and across schools with varying racial/ethnic and socioeconomic compositions. Participants included 259,778 students from 427 middle schools throughout a southeastern U.S. state. Cross-level invariance analyses revealed that the climate constructs were measured differently across levels of analysis, and school-level climate could not be interpreted as merely the aggregate of individual-level climate. Student- and school-level factorial invariance was tested using multilevel modeling procedures. Results revealed item bias with respect to student and school characteristics, and the relationships between school climate and student and school demographics changed after accounting for identified bias. As more educational agencies consider including school climate surveys in their accountability systems, these findings suggest that multilevel validation procedures and school-level invariance analyses are necessary to ensure accurate and equitable measurement.

Growing but Not Grown: Adolescent Black Girls’ Reasoning About a Hypothetical and Challenging Social Situation

In this study, we take a situationally specific approach to understanding how Black girls perceive, process, and respond to a hypothetical social situation. Through this, we aim to contribute to developmental inquiry that resists deficit thinking by foregrounding the voices of Black girls. The current study took place within the participatory culture-specific intervention model and included 22 early adolescent Black girls (fifth–seventh grade). We conducted semi-structured interviews, asking them to respond to a potentially risky hypothetical situation with a male peer they have just met. Thematic analysis revealed three organizing themes: the overall goal of preserving safety and dignity, a growing ability to handle high-stakes interpersonal interactions, and the expectation of empathy and protection from the community around them. These findings challenge stereotypical portrayals of Black girls as hypersexual and aggressive and add to our understanding of the psychology of Black girls by illustrating their adaptive social decision-making.

Facilitating a School-Based Prevention of Commercial Sexual Exploitation of Children

The challenges of developing and researching a school-based prevention program using the participatory culture–specific intervention model are described here. We outline the problem of commercial sexual exploitation of children that motivated our project and the characteristics of students most at risk (African American girls in middle school). We provide an analysis of the factors that can facilitate creation and implementation of similar prevention programs in schools. These factors include establishing partnerships with community resources, including school insiders, and establishing trust, especially with students placed at risk.