Mental health services in schools: utilization, effectiveness, and consent.
ABSTRACT The integration of education and behavioral health services in schools continues to evolve at a rapid pace. Proponents argue that school-based behavioral health programs have many benefits, including greater access to care and improved effectiveness as compared to clinic- or hospital-based services. While preliminary research is encouraging, in general the claims of school behavioral health are not supported by data. Some critics focus on negative aspects of school behavioral health. They claim that behavioral health is being forced upon students and can cite many examples of counseling and treatment administered to children without parental consent. Utilization, effectiveness, and consent are three topics that deserve a great deal of attention in this emerging field, and are the focus of this review.
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ABSTRACT: Research for effective psychological interventions for refugee and asylum-seeking children has intensified. The need for interventions in environments more easily accessed by children and families is especially relevant for newly arrived populations. This paper reviews the literature on school and community-based interventions aimed at reducing psychological disorders in refugee and asylum-seeking children. Comprehensive searches were conducted in seven databases and further information was obtained through searching reference lists, grey literature, and contacting experts in the field. Studies were included if they reported on the efficacy of a school or community-based mental health intervention for refugee or asylum-seeking children. Two independent reviewers made the final study selection, extracted data, and reached consensus on study quality. Results were summarized descriptively. The marked heterogeneity of studies excluded conducting a meta-analysis but study effect-sizes were calculated where possible. Twenty one studies met inclusion criteria for the review reporting on interventions for approximately 1800 refugee children. Fourteen studies were carried out in high-income countries in either a school (n = 11) or community (n = 3) setting and seven studies were carried out in refugee camps. Interventions were either primarily focused on the verbal processing of past experiences (n = 9), or on an array of creative art techniques (n = 7) and others used a combination of these interventions (n = 5). While both intervention types reported significant changes in symptomatology, effect sizes ranged from 0.31 to 0.93 and could mainly be calculated for interventions focusing on the verbal processing of past experiences. Only a small number of studies fulfilled inclusion criteria and the majority of these were in the school setting. The findings suggest that interventions delivered within the school setting can be successful in helping children overcome difficulties associated with forced migration.PLoS ONE 02/2014; 9(2):e89359. · 3.53 Impact Factor
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ABSTRACT: This study examined racial/ethnic and socioeconomic differences in service utilization across sectors (specialty mental health, school, primary care) for youth at risk of depression. Our sample included 362 adolescents who were enrolled in a larger project examining the effects of an indicated school-based depression prevention program. Service use across sectors mirrored national trends and previous research findings in which the education sector was most frequently utilized for mental health services. Race/ethnicity was significantly associated with parent-reported specialty mental health service utilization, even when controlling for other predictors of use. The study also suggests that racial disparities in service access generally appear to be reduced through the availability of education sector mental health services. Socioeconomic status was not associated with service use in any sector when controlling for other predictors. Parent-child agreement was moderate for report of specialty mental health service use and low for report of use of services within the education and primary care sectors.School Mental Health 08/2013; 5(3).