Mental Health Issues in the Schools

School mental health programs and services in the United States have grown rapidly, facilitated by the recommendations of important initiatives such as the U.S. Public Health Service, 2000; the President's New Freedom Commission on Mental Health, 2003; and the American Academy of Pediatrics Committee [Page 289]on School Health, 2004. Schools offer access as a point of engagement with youth to address their academic and mental health needs; school mental health programs and services offer potential for reduced stigma for help seeking, increased generalization and maintenance of treatment gains, enhanced capacity for prevention and mental health promotion efforts, and ecologically grounded roles for clinicians.

School mental health is an emerging field with challenges confronted at many levels. Figure 1, an adaptation of a template proposed by Weist, Paternite, and Adelsheim and first published by Flaspohler, Anderson-Butcher, Paternite, Weist, and Wandersman, presents interrelated actions to support policies, infrastructures, resources, and practices to strengthen effective school mental health. Desired outcomes include student emotional and behavioral well-being and school success as well as enhanced family, school, and community systematic functioning. To achieve these outcomes, effective mental health promotion, primary and secondary prevention, assessment and early intervention, and intensive treatment programs and services are needed.

Undertaking a critical quality assessment and improvement agenda, in which delivery of culturally competent evidence-based practices are reflective of strong family and community engagement, helps to ensure effective school mental health practices. Service delivery infrastructures that reflect effective communication, strong collaboration, and meaningful training underpin the successful development and implementation of such programs and services. Policies that are based on a clear understanding of the current status and needs of the field promote effective school mental health practices and inform strategic planning. Judiciously allocated resources support well-coordinated, nonduplicative school mental health programs and services that reflect a common agenda for families and other stakeholders in child-serving systems (education, mental health, health, child welfare, and juvenile justice).

This entry presents several key themes for the advancement of school mental health. These include the importance of and challenges associated with achieving conceptual clarity about school mental health, the need to prioritize preventive services and mental health promotion, the move toward mental health and education systems integration, the need to strengthen the research base of the field, and future directions of school mental health.