School Mental Health Programs Research Articles

Demographic Differences in District-Level Policies Related to School Mental Health and Social Services-United States, 2012.

Mental health conditions among youth are a major concern. Schools can play an important role in supporting students affected by these conditions. This study examined district-level school health policies related to mental health and social services to determine if they varied by district demographic characteristics. The School Health Policies and Practices Study (SHPPS) 2012 collected cross-sectional data on school health policies and practices from a nationally representative sample of public school districts (N = 684). We used logistic regression to examine the association between district-level demographic characteristics and school mental health policies. Southern and low-affluence districts had higher odds of requiring schools to have a specified counselor-to-student ratio as compared with Northeastern and average affluence districts, respectively. Northeastern and urban districts had higher odds of requiring educational and credentialing requirements for school mental health or social services staff, compared to other regions and rural districts, respectively. Results describe the extent to which school mental health and social services programs in the United States are meeting various guidelines. More work is necessary to ensure that all schools have the resources needed to support their students' mental health and meet national guidelines, especially in districts with certain characteristics.

Rationale for the cultural construction of school mental health programming

The implementation of evidence-based psychological programming to meet the needs of a global population has been impeded by the translation of theories and research findings across populations and settings without due consideration of cultural factors. The purpose of this article is to discuss the rationale for use of partnership-based methods in the development of culturally constructed school mental health programming. We describe the application of such approaches to two diverse populations. We conclude with a discussion of future research examining the application of partnership-based approaches to the development of culturally informed psychological programming across global settings.

School mental health programme in Maharashtra - Today and way ahead

Positive mental health is, and should continue to be the basis of all the mental health policies of any country. The scarcity of well-documented school mental health (SMH) activities and the data for the region of Maharashtra is the main rationale behind this review article. After reviewing some important studies related to SMH in India, the SMH data at Child Guidance Centre of Yashwantrao Chavan Memorial Hospital in Maharashtra, will be used to discuss and propose a guideline for further SMH activities in Maharashtra. SMH program is the best way to cater to the current and future demand of mental health services and to improve overall child and adolescent mental health.

UNARV: A district model for adolescent school mental health programme in Kerala, India

Background: About a half of life time cases of mental disorders start by 14 years of age. First sign of mental illness or emotional distress can emerge in school environment. So schools are to be viewed as the potential place for recognition of mental health problems, but an unexplored area. This study describes the working of a new model for district adolescent school mental health programme, UNARV in Kerala. Methods: A descriptive study of adolescents referred from schools, seen at UNARV clinic over a period of 5 years (2007–2012). Study sample consisted of students with behavioral and scholastic problems who were referred by trained teachers from Government and Government aided High School (8th to 10th class) and Higher Secondary School (11th and 12th class) under aegis of District Panchayath, Thiruvananthapuram, Kerala. They were evaluated and given psychosocial and pharmacological interventions by child mental health expert. Results: Total 2432 students attended UNARV clinic during the period. Most common problems observed were involvement in physical fights (38.3%), viewing and showing pornography to others (21.8%), poor scholastic performance (20.7%), skipping classes (19.1%), alcohol abuse (19%), smoking (14.2%), and engaging in love affair (8.5%). Common mental disorder diagnosed was conduct disorder (36.4%). UNARV helped in reintegration of such students back in to schools and stalled the trend of such students from being dismissed or suspended from class. Conclusion: UNARV forms a sustainable alternative district model in a resource poor environment. School teachers were trained as primary counselors and expert intervention was ensured.

Experiences of school teachers on participation in a brief school mental health program: a qualitative inquiry

AbstractBackground: School mental health programs (SMHPs) aim to strengthen school teachers’ understanding about issues related to child and adolescent mental health and their management. Many studies have looked at outcomes of such programs quantitatively. However, there is a lack of studies on the qualitative effects of SMHPs. With this in mind, the aim was to explore and evaluate the experiences of school teachers in a corporate social responsibility (CSR) project who participated in a brief SMHP in the suburbs of Bangalore City in India. Materials and methods: Twenty-two school teachers of a CSR project participated in this brief one-day SMHP. The program aimed to orient the teachers about common child and adolescent psychiatric disorders. Data were collected through a semi-structured open-ended questionnaire and by narrative inquiry. The data analysis adopted a general inductive approach. Results: From the qualitative data analysis, five overarching themes have emerged: (i) positive experience of bei...

Alcohol, Substance Use and Psychosocial Competence of Adolescents in Selected Secondary Schools in Uganda: A Cross Sectional Survey.

Aims1) To determine the nature and extent of alcohol and substance use and 2) To describe the relationship between alcohol use and psychosocial competence among secondary school youths in Northern and Central Uganda.Study DesignThis was a cross-sectional study.Place and Duration of studyDepartments of Mental Health, Gulu University (Northern Uganda) and Department of Psychiatry, Makerere University College of Health Sciences (Central Uganda) between September 2011 and April 2012.MethodologyFour (4) and eight (8) secondary schools located in the rural and urban areas of Gulu and Kampala districts respectively were randomly selected to participate in the survey. A total of 3,200 students aged 12 to 24 years were recruited by proportionate multistage sampling. Data was collected using a socio-demographic questionnaire that included questions about nature and frequency of alcohol and substance use. A pre-tested self-administered survey questionnaire with scales to measure components of psychosocial competence (PSC) was administered. Data was entered in Epidata, and exported to SPSS version 16.0 for analysis. Psychosocial competence was classified as high or low depending on the responses in the sub-scales of decision making, self efficacy, empathy, emotional awareness, coping with stress and emotions, and accurate self-assessment and self-confidence.ResultsA total of 2,902 questionnaires comprising of 2,502, (86.2%) from Kampala district and 400 (13.8%)) from Gulu district were analyzed. Male to female ratio was 1:1 with an age range of 12 to 24 years and a mean of 16.5. About 70.1% had ever used alcohol and substances. Only 39.1% used substances regularly. The commonest substance used was alcohol (23.3%), followed by kuber (10.8%), khat (10.5%), aviation fuel (10.1%), cannabis (9.2%) and cigarettes (5.9%). Respondents from the Gulu district were twice more likely to use all substances. Users and regular users from the North Northern Uganda had lower psychosocial competence. Factors significantly associated with non-use of alcohol were high levels of self-confidence, non-use of cannabis and kuber and age. In the alcohol user groups, a high level of coping was associated with discontinued and experimental use of drugs of abuse.ConclusionMore than two-thirds (70.1%) of young people in this study had ever used substances of abuse only once and slightly over a third had used it regularly. From the perspectives of service provision, mental health promotion and prevention of illicit substance use, school mental health programmes that target both non-users and users are recommended.

Intentional, explicit, systematic: Implementation and scale-up of effective practices for supporting student mental well-being in Ontario schools.

Increasingly, the potential for school mental health programming to enhance the well-being of children and youth is being recognized and realized. When evidence-based practices in mental health promotion and prevention are adopted in a whole school manner, students show positive social emotional and academic benefits. These findings have stimulated a proliferation of mental well-being programming for Canadian schools, with variability across offerings in terms of supporting evidence, costs and ease of implementation. In the absence of coordination and guidance, there has been uneven uptake of high-quality programming, resulting in a patchwork of sometimes competing efforts across our country. In order to build cohesive and sustainable evidence-based programming, intentional, explicit and systematic effort must be afforded to matters of implementation and scale-up. In Canada, School Mental Health ASSIST has been developed to provide leadership, implementation support and embeddable resources to the province of Ontario’s 72 school districts, and 5000 schools, with a view to ensuring long-term sustainability of best-in-class school mental health practices. Key elements for uptake and scale-up are described, with an implementation science lens and an emphasis on aspects that are generalizable across jurisdictions.

Fostering SMART partnerships to develop an effective continuum of behavioral health services and supports in schools.

The education sector offers compelling opportunities to address the shortcomings of traditional mental health delivery systems and to prevent and treat youth mental, emotional, and behavioral (MEB) problems. Recognizing that social and emotional wellness is intrinsically related to academic success, schools are moving to adopt multi-tier frameworks based on the public health model that provide a continuum of services to all children, including services to address both academic and MEB problems. In this article, we review the potential value of multi-tier frameworks in facilitating access to, and increasing the effectiveness of, mental health services in schools, and review the empirical support for school-based mental health interventions by tier. We go on to describe a community-academic partnership between the Seattle Public Schools and the University of Washington School Mental Health Assessment, Research, and Training (SMART) Center that exemplifies how multi-tier educational frameworks, research and evidence, and purposeful collaboration can combine to improve development and implementation of a range of school-based strategies focused on MEB needs of students. Finally, we present a set of 10 recommendations that may help guide other research and practice improvement efforts to address MEB problems in youth through effective school mental health programming. (PsycINFO Database Record

School Mental Health Programme for Teachers Recruited Through Corporate Social Responsibility : A Quasi Experimental Study

School Mental Health Programme for Teachers Recruited Through Corporate Social Responsibility : A Quasi Experimental Study

Counseling Self-Efficacy, Quality of Services and Knowledge of Evidence-Based Practices in School Mental Health

Counseling self-efficacy (CSE), defined as one's beliefs about his or her ability to effectively counsel a client, is an important precursor of effective clinical practice. While research has explored the association of CSE with variables such as counselor training, aptitude and level of experience, little attention has been paid to CSE among school mental health (SMH) practitioners. This study examined the influence of quality training (involving quality assessment and improvement, modular evidence-based practices, and family engagement/empowerment) versus peer support and supervision on CSE in SMH practitioners, and the relationship between CSE and practice-related variables. ANCOVA indicated similar mean CSE changes for counselors receiving the quality training versus peer support. Regression analyses indicated that regardless of condition, postintervention CSE scores significantly predicted quality of practice, knowledge of evidence-based practices (EBP) and use of EBP specific to treating depression. Results emphasize the importance of CSE in effective practice and the need to consider mechanisms to enhance CSE among SMH clinicians.Keywords: self-efficacy, school mental health, evidence-based practices, counselor training, depressionThere are major gaps between the mental health needs of children and adolescents and the availability of effective services to meet such needs (Bums et al., 1995; Kataoka, Zhang, & Wells, 2002). This recognition is fueling efforts to improve mental health services for youth in schools (Mellin, 2009; Stephan, Weist, Kataoka, Adelsheim, & Mills, 2007). At least 20% of all youth have significant mental health needs, with roughly 5% experiencing substantial functional impairment (Leaf, Schultz, Kiser, & Pruitt, 2003). Further, less than one third of children with such mental health needs receive any services at all.The President's New Freedom Commission on Mental Health (2003) documented the position of schools as a point of contact and universal natural setting for youth and families, recognizing schools as a key factor in the transformation of child and adolescent mental health services (Stephan et al, 2007). In the past 2 decades, there has been a significant push for full-service schools that expand beyond a sole focus on education, and employ community mental health practitioners to respond to the emotional and behavioral needs of students (Conwill, 2003; Dryfoos, 1993; Kronick, 2000). The education sector is the most common provider of mental health services for children and adolescents (Farmer, Bums, Phillips, Angold, & Costello, 2003), with 70%-80% of youth who receive any mental health services obtaining them at school (Bums et ah, 1995; Rones & Hoagwood, 2000). Therefore, attention must be paid to the quantity, quality and effectiveness of school mental health (SMH) services.School Mental HealthIn recent years, SMH programs, supported by both school staff (e.g., school psychologists, social workers, counselors) and school-based community mental health clinicians, have emerged as a promising approach to the provision of mental health services for students and families (Weist, Evans, & Lever, 2003). The growth of these programs has facilitated investigation of what constitutes high-quality SMH service provision (Nabors, Reynolds, & Weist, 2000; Weist et al., 2005). This work has been supported and furthered by the Center for School Mental Health, a federally funded technical assistance and training program to advance SMH programs within the United States. In collaboration with other SMH centers (e.g., UCLA Center for Mental Health in Schools) and interdisciplinary networks focused on school health, consensus was reached to develop a guiding framework defining best practices in SMH (Weist et al, 2005). These principles call for appropriate service provision for children and families, implementation of interventions to meet school and student needs, and coordination of mental health programs in the school with related community resources, among other things. …

Emotional Distress Dispositions and Crisis Intervention for Children Treated for Mental Illness

We studied 1,397 youth undergoing treatment in a multi-program, multiservice agency serving vulnerable youth in both community and residential settings, testing for associations between four indicators of youth’s emotional distress dispositions and the frequency of crisis events demanding a crisis response within the first 6 months of youth’s participation in a treatment program. We addressed individual and program-level research aims employing a two-level hierarchical model considering both individual and program levels of influence. Results indicated the presence of strong associations for youth’s anger control and frustration management issues, a weaker association for anxiety/anxious disposition, and no significant association for irritability/poor self-control problems. Aggregate emotional distress differences for youth in school, probation, wraparound, residential, or community mental health programming contributed little beyond emotional distress differences among individual youth. Consistent with psychological theory, clinically measured emotional distress dispositions prompt significant behavioral disruption for youth in residential placements as well as in community settings, and they can be detected early in treatment for guiding remedial efforts.

Understanding Teachers' Perceptions of Student Support Systems in Relation to Teachers' Stress

Expanded school mental health (ESMH) programs are critical for addressing children's social and emotional development in schools. As broad, multisystem approaches, ESMH programs rely on teachers for effective and sustainable primary, secondary, and tertiary school mental health service delivery. In light of the increasing mental health needs among children, an improved understanding of specific ways in which teachers are affected by school mental health approaches can lead to improved implementation of such services. This is especially important considering existing evidence that teachers' ability to implement student support strategies is influenced by several other factors, including teacher stress. In light of this, this study investigated teachers' perceptions of student mental health needs, student support systems, and teacher stress. Results revealed that different aspects of student mental health needs and perceptions of student support systems predicted teachers' perceptions of stress. The article concludes with a discussion of the findings' implications for the development, dissemination, and implementation of strategies designed to address student mental health needs.

Top of mind at APA meeting: Adherence, opioids, PTSD

The largest meeting for experts in psychiatric disorders, this month's 167th annual meeting of the American Psychiatric Association (APA) delivered information on several key issues related to managing patients with psychiatric disorders. Many important topics on the agenda are reviewed in this article: medication adherence (including how pharmacists can help), new antidepressants, opioid therapy, medical and recreational use of marijuana, management of posttraumatic stress disorder, and use of antipsychotics in vulnerable children.

Trauma-Focused Cognitive Behavioral Therapy Applied to Childhood Traumatic Grief in the Aftermath of a Motor-Vehicle Accident

Symptoms of posttraumatic stress, depression, and unresolved grief can appear in children and adolescents following the witnessing or experiencing of a traumatic event and respond with intense fear, helplessness, or horror. Those who lose a loved one in a traumatic manner can develop childhood traumatic grief (CTG), where typical grieving is hindered by trauma symptoms, causing significant impairment in daily functioning, relationships, and academic pursuits. The following is a case study describing a trauma-focused cognitive behavioral approach to treat posttraumatic stress disorder and CTG in a 16-year-old driver of a motor vehicle accident in which his peer was killed. A graduate student clinician provided treatment under supervision within the context of a school mental health program. The results of the intervention were associated with significant reductions in symptoms and impairments in daily living. The implications of these data and recommendations for clinicians treating CTG are provided.

Three-year longitudinal study of school behavior and academic outcomes: results from a comprehensive expanded school mental health program

While there has been encouraging growth in the number of expanded school mental health programs (ESMH) across the country, few programs rigorously evaluate long-term academic outcomes associated with receipt of these services. This study examined the effects of services from an ESMH program on school behavior (number of out-of-school suspensions and attendance rates), and academic outcomes (standardized test scores in reading and math). Participants were 89 students from Kindergarten to 8th grade who received ESMH services and 89 students from a matched comparison group. Results revealed that ESMH services (i.e., treatment) did not have a statistically significant association with any of the school behavior or academic outcome variables. Findings are discussed in the context of theoretical and methodological challenges associated with program evaluations of ESMH. Implications for practitioners and researchers regarding program evaluation and response to stakeholders are addressed.

Improving the impact of school-based mental health and other supportive programs on students' academic outcomes: how do we get there from here?

This is the second issue in a two-part special series on evaluating the educational and academic impact of school-based programs that provide non-academic types of support, including mental health, mentoring, and family support. The papers in this series detail challenges and provide insights and practical applications based on theory and empirical research to make strong contributions toward developing, evaluating, and improving academic outcomes. Papers include a comprehensive literature review of randomized controlled studies of mental health treatments that included academic outcomes; a matched comparison group evaluation of an expanded school mental health program; a description of a qualitative process of developing a brief, modularized school-based mental health intervention partially designed to focus on academic outcomes; and a randomized study comparing academic outcomes between students who received one session of motivational interviewing to students who received two sessions paired with weekl...

Does cognitive behavioural therapy in the context of a rural school mental health programme have an impact on academic outcomes?

Given the prevalence of mental health difficulties among children and adolescents, schools have become a suitable context for providing psychological services to those who may otherwise go untreated. The co-occurrence of mental health impairments and academic problems has been widely cited, and many school mental health (SMH) programmes have begun to assess academic variables in treatment outcome. The current study evaluated a rural SMH programme's success at treating symptoms of psychological distress among high school participants and the potential association with participants' attendance, grade point averages (GPAs) and discipline referrals. Participants were 58 high school students between 14 and 18 years old. Results indicate that non-manualized cognitive behavioural therapy administered for an average of 14.88 sessions was successful at treating mental health concerns, as measured by a self-report questionnaire collected several times throughout treatment. In addition, a large proportion of student...

Policy and programmes for mental health in Kerala

A meta-analysis of 13 epidemiological studies shows a prevalence of 5.8% for mental illnesses. Psychiatric morbidity is associated with urban residence, female gender, 35-44 years age group, low socio economic status and nuclear family type. Mental health care facilities are lacking along with a huge gap in professional manpower availability. The available manpower is top heavy and concentrated in the private sector. The National mental health programme aims to assure minimum mental health care for all by application of mental health knowledge in general health care, community participation, and equitable and balanced distribution of resources and integration of mental health with general health services. The programme has failed so far to achieve its objectives due to the absence of a national mental health policy and a lack of mechanism to incorporate political leadership. There is a definite trend towards shifting from public to private health care across all income groups. A draft mental health policy for Kerala has been submitted with sections on helping family, health care delivery systems, health care services (public sector), health care services(private sector), voluntary sector and administrative aspects. The special features with regard to Kerala in mental health included higher suicide rates, alcohol use, breakdown of marriage and family, problems of ageing, strain due to unmatched parental aspirations and children’s achievements in studies, high rates of migration and single parent families. The seekers of alternate systems are not negligible but the percentage drops in subsequent episodes. Major faith healing centres and initiatives have started hospitals with psychiatric facility in the due course. Majority seek care for non-psychotic syndromes. Stigma is less intense, but people reject health workers (other than doctors) as healers. There is also poor follow up and lack of continuity in care from hospital to community. Special programmes included the district-based suicide prevention programme in Thrissur and the Ponnani initiative which included a school mental health programme, old age care, suicide prevention and palliative care. Decentralisation of administration, political will of the local leadership and availability of a committed young psychiatrist in the community were the success formula behind the Ponnani initiative. There is an urgent need to include various aspects of mental health in medical education and to promote research in the area.

An evaluation of an interdisciplinary rural school mental health programme in Appalachia

School mental health (SMH) programmes serve as a necessary niche within rural communities and aim to bring accessible care to youth who may otherwise go without mental health services. The following study evaluated the impact of mental health treatment provided by the Assessment, Support, and Counseling (ASC) Center, an SMH health initiative located within a high school in rural western North Carolina during the 2011–2012 school year. Participants were high school students between 14 and 18 years of age, predominately Caucasian (91.3%) and female (65.5%). Treatment was evaluated based on score change on the Youth Outcome Questionnaire using the reliable change index (RCI; Jacobson & Truax, 1991) to track changes in symptomatology. Following ASC Center treatment, 63% of the clinical sample was deemed to have improved or recovered based on the RCI. While the study did not use an experimental design (with associated cautions regarding interpretation of findings), the results suggest that a moderate dosage of...

Pakistan: health is an opportunity to be seized

Pakistan: health is an opportunity to be seized