Commentary: School Psychology, Context, and Population-Based Practice

Abstract

Ringeisen, Henderson, and Hoagwood 2003) have provided an important discussion of the significance of school context to children's mental health, particularly in relation to empirically supported interventions. They have outlined the influence of context on treatment integrity, and have emphasized appropriately the significant gap between research-supported interventions and practice. Finally, they have proposed a useful heuristic for conceptualizing context and practice from the individual to the organizational to the policy level. Their conclusion is that school context is a critical mediator in both research and practice, one that must be addressed to ensure successful children's mental health services. Although Ringeisen et al. (2003) deal with children's mental health and the school context thoroughly, they address the relationship between children's mental health and school psychology practice in somewhat less detail. In this commentary, I will examine some implications for school psychology practice of moving to a contextual perspective in children's mental health services, as outlined by Ringesein et al. School psychology is the specialty in American professional psychology that is most closely aligned with current, population-based thinking about children's mental health. However, to respond effectively to recent children's mental health policy, school psychology may need to expand the way services are conceptualized, planned, and delivered. Children's mental health is important to schools. As Ringeisen et al. (2003) note, relatively little systematic attention has been given to the effect of children's social and emotional problems on immediate educational outcomes, such as academic achievement. However, broader and longer term implications of children's mental health problems seem clear: Children with social and emotional problems are at much greater risk for dropping out of school and of subsequent problems in adulthood. Children with such problems often have difficulties with peer relationships, may present discipline problems, and often are disengaged from schooling and academic pursuits. They exhibit a higher incidence of family difficulties, which has a further impact on school functioning, and often have fewer resources available to them in the community. Even in the absence of data on the effects of social and emotional problems on short term educational outcomes, the cost to schools and society of failing to deal with these children is obviously--and distressingly--high (Short & Shapiro, 1993). Historically, American schools, as a context for addressing children's mental health problems, have maintained a reactive, often negative stance. Students in the United States are expected to conform to school roles and expectations; failing that, they typically either have been excluded from school or referred for clinical educational or mental health services. Exclusion from school merely relocates the child while depriving him or her of educational supports and services. On the other hand, clinical services are expensive, require substantial additional expertise and resources, and typically define problems as residing within the child, and therefore may fail to address critical contextual contributors to child problems. And, as Ringeisen et al. (2003) accurately point out, add-on program and resource requirements may have caused schools to be less willing to deal with children with social and emotional problems. The recent report of the Surgeon General's Conference on Children's Mental Health (U.S. Public Health Service, 2000) has provided an important framework that schools and school psychologists may use to build context-sensitive mental health services. Important components of this framework include: (a) All children develop socially and emotionally, as well as cognitively, and therefore have social and emotional needs that are as important as educational needs; (b) beyond the social and emotional developmental needs of all children, a smaller group of children have serious social and emotional problems; (c) addressing the social and emotional development and needs of all children likely lowers the incidence of children with expensive and difficult-to-treat social and emotional problems; and (d) schools are crucial both in addressing the social and emotional needs of all children and in providing services to that smaller group of children with social and emotional problems. …