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Schools offer an advantageous setting for the prevention, early identification, and treatment of mental health problems for youth. However, school mental health (SMH) services are typically not based on evidence for effectiveness, nor are they efficiently delivered, with SMH practitioners (SMHPs) able to only treat a small number of students in need. The current study evaluated the feasibility, acceptability, efficiency, and outcomes of a four-session assessment, engagement, problem-solving, and triage strategy for SMHPs that aimed to improve efficiency while being based on elements of evidence-based care. The study, conducted in 15 US school districts in three states, used stratified random assignment to assign 49 high schools and their participating SMHP(s) to either the Brief Intervention for School Clinicians (BRISC; N = 259 students) or services as usual (SAU; N = 198 students). SMHPs implemented BRISC elements with adequate to excellent fidelity and reported the strategy was feasible and well-aligned with presenting problems. Students assigned to BRISC reported significantly greater engagement in SMH at 2 months and completion of SMH treatment by 6 months. BRISC-assigned SMHPs reported significantly greater treatment completion after four sessions (53.4%) compared to SAU (15.4%). Students in the BRISC condition also reported significantly greater reduction in problem severity as evaluated by the Youth Top Problems Assessment. No differences were found for anxiety or depression symptoms or overall functioning. Results indicate that BRISC is a feasible early intervention and triage strategy that may aid in more efficient provision of SMH services with no compromise to SMH effectiveness. [For the corresponding grantee submission, see ED627858.]

Nearly 14% of all youth display disordered eating patterns. Despite the prevalence of these disorders, there is limited literature on the integration of eating disorder support services in schools. Further, there is often limited eating disorder knowledge and training for school mental health (SMH) professionals. This paper describes a two-phase study involving qualitative and quantitative components examining the perspectives of adolescents in recovery from eating disorders, family members, and SMH professionals. Fourteen participants were recruited from an eating disorder treatment facility in the southeastern USA. Eight adolescent females who received treatment for disordered eating while in primary or secondary school and six of their mothers completed interviews. In addition, 720 SMH and allied professionals were surveyed on their knowledge and training in disordered eating identification and intervention and their perspectives on service provision, with 561 complete and usable surveys. Analyses of adolescent and family data revealed the following themes that hindered or helped recovery: "Isolation," "Perfectionism," "Difficulties with Self-Acceptance and Comparison to Others," "Uncertainty," "Teacher Identification," "Support in Recovery." Themes surrounding the benefits of including SMH services for this population included: "Increased Awareness," "Support in Recovery," "Family Involvement," and "Linking to Resources." Results revealed that the majority of SMH professionals did not receive training in the identification and/or intervention of disordered eating. Data suggested that lack of referrals and limited knowledge, skills, and time interfered with their ability to effectively identify and intervene. Findings provide a foundation for understanding the experiences of adolescents with disordered eating and the role of SMH programs in assisting them.

While there has been encouraging growth in the number of expanded school mental health programs (ESMH) across the country, few programs rigorously evaluate long-term academic outcomes associated with receipt of these services. This study examined the effects of services from an ESMH program on school behavior (number of out-of-school suspensions and attendance rates), and academic outcomes (standardized test scores in reading and math). Participants were 89 students from Kindergarten to 8th grade who received ESMH services and 89 students from a matched comparison group. Results revealed that ESMH services (i.e., treatment) did not have a statistically significant association with any of the school behavior or academic outcome variables. Findings are discussed in the context of theoretical and methodological challenges associated with program evaluations of ESMH. Implications for practitioners and researchers regarding program evaluation and response to stakeholders are addressed.

On the basis of activities of a federally funded national center for school mental health, review of literature on principles for best practice in child and adolescent mental health and school health, and consultation with national experts and family members, a set of 10 principles for best practice in school mental health was developed. A survey was developed enabling 1-6 point Likert ratings ("clearly unimportant" to "clearly important") for each of the 10 principles. With an original sample of 426 people involved in education, school health or mental health, all 10 principles were strongly endorsed, receiving mean ratings ranging between 5.10 and 5.75. On the basis of qualitative feedback from this survey and interactive forums, language for 9 of the 10 principles was revised and a survey reflecting these changes was developed and administered to a validation sample of 86 respondents. As with the original sample, endorsements of the principles were strong, with mean ratings ranging between 5.45 and 5.79. Findings are discussed in relation to advancing interconnected agendas related to quality assessment and improvement and empirically supported practice in school mental health.

Inner-city youth are at high risk for dropping out of high school. Within this article, risk factors associated with dropout and strategies for effective prevention and intervention are reviewed. An example of a school-based drop-out prevention program is highlighted. The FUTURES Program is a school-based drop-out prevention program designed to address the needs of high-risk youth through smaller classes, character development, career preparation, case management/mentoring, positive incentives, and access to mental health services. Components of the program are described in detail and data evaluating the effectiveness of the program are presented. Directions for the future development of programs and conducting research to prevent dropout by inner-city youth are discussed.

Describes an expanded school mental health framework and its goal of improving the mental health status of children and adolescents through collaboration. Addresses current challenges including building advocacy, improving funding, increasing capacity, enhancing quality, and using and expanding the evidence base for mental health in schools. (SD)

Explores the response of school mental health to terrorism and disaster, reviewing literature on child and adult reactions to trauma, discussing the development of crisis response teams, and presenting strategies for schools to respond to crises and disaster. One elementary school's experiences in response to the September 11th attacks are presented, noting challenges facing school mental health programs in improving their ability to respond to significant crises. (Contains references.) (SM)

Purpose - This chapter discusses the promise of and challenges to providing effective and culturally responsive trauma-focused mental health services to immigrant and refugee youth and their families within school settings. Design/methodology/approach - This chapter utilizes "practice-based evidence" to outline successes and address the barriers associated with the implementation of school-based, trauma-focused, evidence-based interventions in four immigrant or refugee-dense cities: Los Angeles, Chicago, Minneapolis, and Boston. Findings - Making cultural adaptations to identified trauma interventions that were consistent with community priorities, cultural norms, and values resulted in more accessible programs and greater engagement in treatment services. Practical implications - The strategies tested in these real-world settings contribute to the development of culturally competent trauma-informed services for immigrant and refugee youth and their families. Mental health providers and program developers will better understand the need for multilevel engagement strategies and for culturally driven modifications when employing evidence-based programs with immigrant and refugee youth. Originality/value - This chapter adds to the scarce evidence about useful methods to engage immigrant and refugee youth and families in treatment and to increase the likelihood of positive outcomes. [ABSTRACT FROM AUTHOR]