Mental Health in the Schools

Progress is being made in the area of delivering mental health services in the schools through collaborative programs that involve combinations of schools, communities, and research-based programs. The goal of extending collaborative efforts to initiatives that prevent emotional and behavioral problems from developing or escalating is a cross-cutting theme of the National Agenda for Achieving Better Results for Children and Youth with Serious Emotional Disturbance. I discuss examples of collaborative efforts to prevent emotional behavioral problems in school children and ways by which this effort can be enhanced in schools and communities.     

Building Trust in Business Schools Through Ethical Governance

This paper presents conceptual arguments to suggest that trust within organizations and trustworthiness of organizations are built through ethical governance mechanisms. We ground our analysis of trust, trustworthiness, and stewardship in the business literature and provide the context of business school governance as the focus of our paper. We present a framework that highlights the importance of knowledge, resources, performance focus, transparency, authentic caring, social capital and citizenship expectations in creating a basis for the ethical governance of organizations. A version of this paper was presented at the European Academy of Management, 2005.     

The Interprofessional Collaborative Practice: Clergypersons and Mental Health Professionals

The purpose of this study is to examine the relationships among variables identified in research literature as obstacles and benefits to interprofessional collaboration-- academic education, interprofessional education, teamwork and communication skills, and trust---as it relates to the participation of clergypersons in interprofessional collaborative practice. The sample consisted of ordained Christian clergypersons in Florida who voluntarily completed a survey questionnaire. Standard and stepwise multiple regression was applied to analyze the data. The model accounts for 25% of the variation of interprofessional collaborative practice. Results also revealed that the education variables explained significantly 20% of the variance of interprofessional collaborative practice.     

Mental Health Research in K–12 Schools: Translating a Systems Approach to University–School Partnerships

The authors discuss the challenges that researchers from university and community systems face in gaining access to and partnering with K–12 school systems to conduct research. Borrowing from Szapocznik, Hervis, and Schwartz's (2003) brief strategic family theory and therapy and Bronfenbrenner's (1979, 1986) ecological systems theory, the authors outline a model for diverse research communities in the United States that can be used by counselors and other mental health services researchers who plan to conduct research in K–12 schools.     

Mental Health Collaboration: A Survey of Practicing School Psychologists

Schools have become the primary setting for mental health service among youth. However, school-based providers are sometimes limited by lack of time, training, and other resources. Furthermore, problem-solving models emphasize the importance of developing partnerships with other professionals and agencies. Thus, it is critical to engage in collaborative practice with non–school-based, community mental health providers (CMHPs). The purpose of this study was to survey practicing school psychologists about their experiences in communicating and collaborating with CMHPs. Participants (n = 194) indicated their frequency of communication and collaboration with CMHPs; although communication (i.e., release and receipt of information) was typical, fewer school psychologists reported engaging in ongoing collaboration. Benefits and barriers to collaboration were identified, and implications for practice are discussed.     

The Role of Interdisciplinary Teams in the Promotion of Physical and Mental Health

This article delineates important issues to be considered using special services professionals to develop and implement health promotion programs by means of a school-based interdisciplinary team approach. The current status of interdisciplinary teams is discussed and an expanded role for such teams in health promotion activities is advocated. Specific issues pertaining to interdisciplinary team organization and integration into school systems are reviewed in the context of health promotion program development.     

Taking Cognitive-Behavior Therapy to School: A School-Based Mental Health Approach

This paper offers an overview using cognitive-behavior therapy (CBT) within a school system. In addition to providing services to individual students, this article provides an overview of implementing CBT into a system of school-wide mental health services. Interventions are discussed at three levels—universal school-wide interventions, target interventions with at-risk students, and intensive interventions with students in need. Examples of specific programs or intervention are given for each level.     

Child and Adolescent Mental Health: Building a System of Care

According to recent studies, large numbers of children and adolescents with serious emotional or behavioral disorders receive either no mental health treatment or treatment inappropriate to their needs. In this article the authors examine the problem of unnecessary hospitalization and the inadequacy of community-based systems. They discuss the barriers that impede improved mental health service systems for children and their families and present the Child and Adolescent Service System Program (CASSP) “system of care” model as an alternative. Last, counseling and development's role in promoting and fostering positive changes in the mental health system serving children and adolescents is discussed.     

Reflective Capacity: An Antidote to Structural Racism Cultivated Through Mental Health Consultation

Effecting a paradigm shift from “reproductive health” to “reproductive justice” within the perinatal field requires changes simultaneously at the levels of the individual healthcare provider and the system of care. The Infant-Parent Program at the University of California, San Francisco (UCSF) has extended its pioneering infant and early childhood mental health consultation to perinatal service systems applying an infant mental health approach to programs caring for expecting and new parents. In partnership with two nursing programs, UCSF consultants direct their efforts at supporting reflective practice capacities and use-of-self in patient–provider relationships. Both nursing programs serve vulnerable groups of expectant and new parents who grapple with challenges to health and well-being stemming from structural racism. As reflective capacities are supported within the consultation case conferences, providers spontaneously identify the need for tools to effectively address issues of race, class, and culture and to combat structural racism throughout the healthcare system. Policies and procedures that uphold structural racism cease to be tolerable to providers who bring their full selves to the work that they are trained to do. Using these nurse consultation partnerships as organizational case studies, this article describes a range of challenges that arise for providers and delineates steps to effective engagement toward reproductive justice.     

Building a Bridge of Trust: Collaborative Assessment With a Person With Serious Mental Illness

Collaborative assessment utilizes psychological testing to help people make positive changes in their lives. Limited research has evaluated the utility of collaborative assessment for persons with serious mental illness. This case example uses the Personality Assessment Inventory to illustrate the usefulness of collaborative assessment with a person with serious mental illness. This approach informed not only diagnostic considerations but also revealed the client's current level of distress, contributed to enhanced therapeutic alliance, and directly pointed to psychiatric rehabilitation strategies.     

Inequalities in Mental Health: the Inner City Mental Health Project

This paper draws on the evidence of a 3-year evaluation study of an inner city mental health project. Innovative service developments aimed at Afro-Caribbean and Asian communities are described, as are the reactions of providers of mainstream mental health services to these initiatives. The structural position of special projects aimed at Black communities is explored in relation to mainstream mental health services, as are the difficulties which may be encountered by service users and project staff when the project is integrated into mainstream mental health services.     

The Role of Schools in Outcomes for Youth: Implications for Children's Mental Health Services Research

We explore the role of schools in children's mental health services research. Recent literature has suggested that schools play an important role in delivering services to children and adolescents with emotional and behavioral problems. Research in services research, though, has taken a fairly narrow view of which dimensions of school environments are relevant for inclusion in studies. We suggest that a broader view of school environments is appropriate and potentially beneficial to the field. Using Bronfenbrenner's ecological model as a guide, we conceptualize schools as microsystems. Such an approach suggests that all aspects of school environments (treatment as well as non-treatment) are likely to influence many of the outcomes that children's mental health services research frequently targets (e.g., behavioral problems, problematic peer relationships, academic achievement, school attendance). We review literature from a variety of disciplines to suggest relevant features of schools, with particular attention to the role of peer dynamics within schools. We conclude with implications of this expanded conceptualization of schools for children's mental health services research.     

Immigration Enforcement Policies and the Mental Health of US Citizens: Findings from a Comparative Analysis

We examined the differential impact of having a family member, friend, or co-worker/community member detained or deported on the mental health of US citizens. In 2019, a sample of 3446 adult participants of White, Black, and Latinx racial/ethnic descent were recruited to complete an online questionnaire. Participants completed the Patient Health Questionnaire-4 to screen for anxiety, depression, and psychological distress. Analyses were restricted to US citizens (n = 3282). Multivariable logistic and linear regressions were conducted to examine the mental health of US citizens who reported personally knowing a migrant who has been detained or deported and by their relationship to the migrant, overall and among Latinxs only. Among US citizens, 32% reported personally knowing someone who has been detained or deported. In multivariable analyses, US citizens who personally knew a detained or deported migrant were more likely to report anxiety, depression, and greater psychological distress. Associations were more pronounced among those who reported having a family member detained or deported. US-citizen Latinxs with social ties to migrants who have been detained or deported were especially more likely to report poor mental health than White and Latinx participants who did not personally know a migrant who has been detained or deported. It is critical that policy makers consider the potential mental health harms on migrants and its own citizens when designing policies targeting migrant communities.     

Health Promotion in the Schools:

Many children and adolescents develop a variety of behavioral health risk factors that may lead to a decrease in the quality of their lives. A number of these risk factors are preventable of controllable, especially when healthy lifestyles are established early in life. Special services providers have the opportunity and the challenge of assisting in development and facilitation of health promotion activities in the schools.     

Collaboration Between Clergy and Mental Health Professionals: A Review of Professional Health Care Journals From 1980 Through 1999

Given the frontline role of community clergy in mental health care, this study examined how collaboration with clergy was viewed by mental health and other health professionals outside of the religious community. Searches of health care journals on Medline and PsycINFO yielded 44 articles from non‐religious journals from 1980 through 1999 that specifically addressed collaboration between clergy and mental health professionals. Seven themes were identified through content analysis, including the benefits of collaboration to each profession, the need to increase the clergy's knowledge about mental heath, and the importance of referrals. Discussion about interdisciplinary referrals significantly increased over time, r_ø (1, N = 44) = .31, p < .05).     

Education and Training of Children's Mental Health Professionals: The Existing and Potential Role of Schools of Public Health

Since the early 1980s, increasing attention has been devoted in the literature to the conceptualization, development, and implementation of integrated and comprehensive mental health systems of care for children and adolescents. In establishing this new children's mental health paradigm of community-based systems of care, there are presently very few well-trained professionals and leaders focused on collaborative (including interagency) initiatives in the delivery of children's mental health services. Nevertheless, the field of public health offers an interdisciplinary setting for the education and training of individuals in children's mental health services. This national survey of all 27 accredited schools of public health in the United States and Puerto Rico examined the existing capacity for and potential to expand educational and training opportunities in the organization, financing, and delivery of children's mental health services.