JANUARY2002

What are some of the opportunities and challenges of school based mental health services?

For most children, but especially poor and minority youth, schools are the most readily available and easily accessible sites for the provision of a continuum of community-based mental health services (Tuma, 1989). Schools can foster the development of comprehensive services and integrated care. They can also provide a mechanism through which preventive treatment interventions can be developed and implemented through the collaborative input and effort of multidisciplinary teams, which include parents and children (Atkins. et al., 1998).

Schools are important partners with other social service institutions in helping youth to develop positive coping skills and keeping them and their communities safe. Many different mental health professionals exist in schools. Some are employed by the school system (e.g. school counselors, social workers, school psychologists). Others work on a contract basis in the school but are employed by agencies. Contracted services that take place within the school building are referred to as school-based mental health services.

Collaboration between school-employed and school-based mental health providers increases the opportunity to augment and expand the quality and quantity of service desperately needed by many students. The school-employed and school-based professionals are particularly effective when they work as a team to identify the mental health needs of students, provide a continuum-of-care, integrate services, and create a global school environment conducive to safety.

School-based mental health professionals bridge the discontinuity in mental health services between schools and community agencies. They offer a visible link to the outside world of community resources and serve as a liaison between the outside agency or hospital sponsoring them and the wider community. Without the presence of theses school-based professionals, many mental health services they bring would be inaccessible to students. These practitioners can provide onsite services to students with mental illnesses or those at risk of developing mental illnesses. Their mission is somewhat revolutionary in the sense that they bring to the school, mental health services that once appeared inaccessible and unappealing to students. In creating valuable linkages, they also connect students with even more specialized mental health services, which may be offered in the school, community, or the student's home, such as psychiatric consultation, family therapy, substance abuse counseling, or case management.

Despite the many benefits of having a school-based clinician, there are potential problems. Having different primary goals can make it more difficult for school-employed and school-based mental health clinicians to resolve "turf issues", differences in clinical approaches, or differences in interpretation of school procedures or regulations. There is also the increased opportunity for students, parents and school personnel to engage in "splitting" (pitting one professional against the other). However, all of these problems can be avoided or minimized by practices to encourage effective communication and mutually respectful, open, flexible attitudes. These practices can include regular weekly or monthly multidiciplinary team meetings; cross-cultural training; interdisciplinary training and supervision; and mutually agreed upon standardized procedures.

References

Atldns, M. S.. McKay. M.. Arvanitis. P., London. L., Madison. S.. Costigan. C. Haney, P., Zevenbergen, A.. Hess, L.. Bennett. D.. & Webster, D. (1998) An ecological model for school-based mental health services for urban low-income aggressive children. Journal of Behavioral Health Services Research, 5, 64-75.

Tuma J. M. (1989). Mental health services for children: The state of threat. American Psychologist, 44, 188-198.