An ecological model for school-based mental health services that targets urban low-income aggressive children--a highly vulnerable and underserved population--is presented. The goals of the model are to increase children's and teachers' involvement in the delivery of services and to increase the integration of these services into existing school resources and activities. The model proposes that mental health service providers work in collaboration with teachers to deliver services that (1) can be managed by existing school resources and personnel, (2) are related to empirically based factors associated with reduced aggression and increased social functioning, and (3) are group administered to increase the number of children served and to reduce stigmatization associated with mental health services. The model is individualized and flexible by acknowledging that contexts for aggression differ across classrooms and children and by providing services specific to those contexts. Two studies are presented illustrating the application of this model to decrease aggression and increase academic engagement in low-income urban public schools.
Disciplinary records for 3rd through 8th grade students (n = 314) in an inner-city, public school were examined for one school year to assess students' variation in response to discipline. Rates of disciplinary referrals were compared for students who received no detentions or suspensions throughout the year ("never group" n = 117), students who received one or more detention or suspension in the fall but not in the spring ("fall group" n = 62), and students who received one or more detention or suspension in the fall and one or more detention or suspension in the spring ("fall + spring group" n = 75). Results indicated that during the fall, the "fall group" had nearly equivalent rates of referrals to the "fall + spring group"; however, the "fall group" exhibited significantly lower rates of referrals during winter and spring that were nearly equivalent to the "never group," as would be expected for a punishment procedure. In contrast, the "fall + spring group" evidenced increases in referrals across the year, suggesting the possibility that detentions and suspensions were functioning as rewards for this group. The "fall + spring group" was rated by teachers and peers at mid-year as highly aggressive, lacking social skills, and high on hyperactivity, whereas the "fall group" and the "never group" were statistically equivalent on teacher and peer ratings. Implications for mental health programs for urban schools are discussed, especially the need for alternatives to detention and suspension for the subset of students who account for the majority of school discipline.
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