Abstract
Provision of health care in schools is a logical component of an advanced industrial society; however, health care providers have struggled to make universal school health and mental health a reality. Despite the President_s New Freedom Commission Report that stressed the need for school-based mental health in the context of a wider public health agenda, school mental health services and supports continue to be fragmented. Instead of riding a wave of new resources, knowledge, and a quality focus, the school-based mental health movement struggles to answer basic questions about identity. Is school mental health the provision of services similar to those found in a community mental health center? Is it psychosocial services? Or is it a cluster of prevention strategies that engage the entire school? These questions remain largely unanswered. Federal and state health policy is not only a necessary component of any strategy to advance mental health for children and youth but also requires consideration of issues central to the identity of school-based programs: what is at stake, how services are integrated, and who pays.
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