A chasm exists between the expanding mental health needs of school-aged youth and the school resources available to address them. Education agencies must efficiently allocate their limited resources by adopting innovative public health models. The need for these effective approaches is acute in rural regions, where resources tend to be scarce. This mixed-methods study of school superintendents illuminates key opportunities to optimize access to care for students struggling with mental health needs in rural communities. Method: Superintendents serving rural California school districts were targeted for a web-based, mixed responsetype, 53-item survey designed to examine their perceptions across three school mental health-related categories: (a) strengths and gaps in community ethos and district infrastructure, (b) school personnel groups' knowledge and skills, and (c) predominant barriers. Of the targeted respondents, 16.7% completed the survey (N = 62). Quantitative data were analyzed using a series of descriptive analyses and paired-sample t tests. Qualitative data were analyzed using a constant comparative method with an open-coding
Internalizing mental health issues are a significant developmental and clinical concern during adolescence, but rarely identified as a problem among school staff. Using data from the National Longitudinal Study of Adolescent Health, this study examined the associations between adolescent emotional distress, school connectedness, and educational achievement by exploring potential mechanistic and interactive roles of perceived school connectedness on the emotion–education association. Emotional distress was negatively associated with adolescents’ perceptions of belonging to school, which, in turn, may negatively influence educational achievement. School connectedness also had both additive and multiplicative interaction effects on the emotion–education relationship. Results support previous evidence of school connectedness as a protective factor for adolescents with internalizing mental health concerns, although much of the work to date has focused on externalizing problems. This study informs our understanding of how, why, and for whom emotional problems influence educational outcomes in light of social support in the school context.
Although it is widely known that the occurrence of depression increases over the course of adolescence, symptoms of mood disorders frequently go undetected. While schools are viable settings for conducting universal screening to systematically identify students in need of services for common health conditions, particularly those that adversely affect school performance, few school districts routinely screen their students for depression. Among the most commonly referenced barriers are concerns that the number of students identified may exceed schools’ service delivery capacities, but few studies have evaluated this concern systematically. System dynamics (SD) modeling may prove a useful approach for answering questions of this sort. The goal of the current paper is therefore to demonstrate how SD modeling can be applied to inform implementation decisions in communities. In our demonstration, we used SD modeling to estimate the additional service demand generated by universal depression screening in a typical high school. We then simulated the effects of implementing “compensatory approaches” designed to address anticipated increases in service need through (1) the allocation of additional staff time and (2) improvements in the effectiveness of mental health interventions. Results support the ability of screening to facilitate more rapid entry into services and suggest that improving the effectiveness of mental health services for students with depression via the implementation of an evidence-based treatment protocol may have a limited impact on overall recovery rates and service availability. In our example, the SD approach proved useful in informing systems’ decision-making about the adoption of a new school mental health service.
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