Mental Health in Schools

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The United States federal government has a vested interest in the mental health of children and adolescents. It considers the current state of mental health care for children a public crisis (U.S. Public Health Service, 2000). Approximately 21% of children and adolescents between the ages of 9 and 17 have a diagnosable mental or addictive disorder that causes at least minimal functional impairment; almost half of these youth, or 11% of all youth, have significantly impaired functioning, and about one-quarter of youth with mental disorders, or 5% of all youth, experience extreme functional impairment (Shaffer et aL, 1996; U.S. DePartment of Health and Human Services, 1999a). Although only limited population and community-based data are currently available, decade-old findings indicate that only one of five school-aged children and adolescents with a mental disorder actually receives specialty mental health services, and only two of five receive mental health services from any source, including the mental health, general health, education, human services, and juvenile justice sectors (Burns et aL, 1995). It has been concluded that the unmet need for mental health services for young people did not change in the 10 years between 1980 and 1990 (Burns et aL, 1995). Because education is an entitlement for all children, schools represent the single location through which virtually every child and the large majority of adolescents can be reached. Schools have the potential to contribute to the solution of this problemThe federal government supports an array of programs that promote the mental health of children and adolescents in school settings. This chapter describes consensus report recommendations issued by the U.S. DePartment of Health and Human Services. This chapter focuses on school-based programs for school-aged children and adolescents that have a comprehensive purview of mental health issues and also describes surveillance efforts that monitor school-based mental health educational and service programs