|
Article Excerpt
Increasing populations of students are unprepared for learning due to emotional or behavioral problems. Yet, school-based mental health services are fragmented, marginalized, and underutilized. Despite the federal mandate to improve all student achievement and an increased ability to identify students needing mental health services, school-based mental health services are noticeably absent from school reform initiatives. The research clearly shows family involvement in school-based mental health services is effective in improving student academic performance. By understanding barriers to school-based mental health counseling services and strategies for increasing family enrollment and retention, mental health counselors can help increase students' academic readiness and the integration of mental health services into the structure of the nation's schools.
**********
Students' academic success is a determining factor in successful accomplishment of life tasks and depends greatly on the students' psychological health as well as academic abilities (Becker & Luthar, 2002; Cerio, 1997). Yet, the Surgeon General's 1999 report of children's and adolescent's mental health showed 21% of U.S. children from ages 9 to 17 have diagnosable mental health problems and 70% of those youths do not receive services (U.S. Department of Health and Human Services [USDHHS], 1999). Of the families who do receive services, 40% to 60% terminate prematurely. Researchers have looked at why students in need of mental health services are not receiving services and whether the services students are receiving are effective (USDHHS). Students' underutilization of mental health services has been due to structural barriers, including fragmented and marginalized school-based mental health services, and perceptual barriers (see Figure 1) due to beliefs about mental health problems and services (Adelman & Taylor, 2002a, 2002b, 2002c; Keys & Bemak, 1997). When students do use school-based mental health services, defined as any mental health services along the continuum from prevention to intervention that are initiated through the school, researchers have found family involvement is a key component to both service utilization and effectiveness (Cerio). Although the research on involving families in school-based mental health services has been limited, a review of the literature indicates mental health counselors who are aware of the barriers can increase effective service provision and family involvement. (Edwards, 2002; Fox, Dunlap, & Powell, 2002; Heyne, King, Tonge, & Cooper, 2001; Rones & Hoagwood, 2000).
Schools have several advantages in addressing the mental health needs of students. Schools have a stake in identifying students with emotional and behavioral problems because these issues significantly affect the students' academic performance (Adelman & Taylor, 2002a, 2002b, 2002c). Schools face recent federal and state governmental pressures since the federal legislation and state high-stakes testing were enacted to ensure that every child could meet mandatory academic standards. Schools also have professionals, including teachers, social workers, and school counselors, who can be trained to identify emotional and behavioral problems and are involved with the students most of the day. Schools also have the ability to access federal, state, and community resources to address students' needs (Brener, Martindale, & Weist, 2001; Keys & Bemak, 1997). For example, schools (a) can access federal funds to coordinate student support services since the U.S. Department of Education's Improving America's Schools Act; (b) have access to the two national training and technical assistance centers for improving school-based mental health (Brener et al.); and (c) have federal funding priority for school-based services (Keys & Bemak). Also, schools can plan with other service providers and helping institutions such as community mental health, juvenile justice, social welfare, faith-based groups, parks and recreation, and libraries (Keys & Bemak). Because children spend a large part of their lives in school, schools are able to be a focal point for service delivery (Adelman & Taylor, 2002a, 2002b, 2002c; Keys & Bemak; Rones & Hoagwood, 2000). Of those 30% of children and adolescents in need who received services and had both a diagnosis and impaired functioning, about 40% received services in the specialty mental health sector, about 70% received services from the schools, about 11% from the health sector, about 16% from the child welfare sector, and about 4% from the juvenile justice sector, according to the Surgeon General's report (USDHHS, 1999).
Clearly, it is vital for research to adequately explain the lack of parental use of and retention in available services to increase their children's success in school by decreasing emotional and behavioral problems. Research that can accurately predict factors that effect parental participation could guide schools in making decisions about the design, implementation, and management of student mental health programs. McCurdy & Daro (2001, p 113) suggested "parental decisions to enroll and remain in support programs are shaped by a variety of factors at different 'levels' of influence: individual characteristics of the parent and family, provider attributes, program characteristics, and neighborhood characteristics." Barriers to enrollment and retention can be categorized (Owens, Hoagwood, & Horwitz, 2002) as: (a) structural-lack of services, delays between service referral and initiation, no insurance or ability to pay, lack of transportation, conflicts between service hours and work, childcare conflicts; (b) perceptions of mental health problems-school or families inability to identify students need for mental health services, denial of problem severity, beliefs the problem can be addressed without treatment; and (c) perceptions of mental health...
|
