The school setting represents the most common setting by which youth receive mental and behavioral health (MBH) services (Farmer et al., 2003, Psychiatr Serv, 54, 60–66). Nevertheless, many school psychologists are not providing MBH services despite the high prevalence of need. Additional research is needed to understand factors leading to these deficits, as well as potential solutions to ameliorate these concerns. The current study surveyed 341 school psychologists across seven states and found current ratios are one school psychologist for every 1,500–2,000 students. Study results suggest school psychologists are providing a half to full day of universal, prevention‐oriented MBH services each week whereas more targeted, direct services (e.g., individual or small group counseling) are offered 1–4 hr each week. The school psychologist‐to‐student ratios also demonstrated a statistically significant and inverse association with the provision of targeted MBH services, with higher ratios resulting in fewer MBH services. Respondents provided potential solutions for how to expand the delivery of MBH services within schools, including increased awareness and support among school and district administrators, as well as access to training and professional development related to MBH services.

To meet increasing demand for home care, the role of personal support workers (PSWs) is shifting from providing primarily personal and supportive care to include care activities previously provided by regulated health professionals (RHPs). Much of the research examining this shift focuses on specialty programmes, with few studies investigating the daily care being provided by PSWs, frequency of care activities being provided by PSWs, and characteristics of the population receiving more complex tasks. Between January and April 2015, a review of 517 home-care service user charts was undertaken in Ontario, Canada, to: (1) describe the range of tasks being performed by PSWs in home care, (2) identify tasks transferred by RHPs to PSWs, and (3) examine characteristics of service users receiving transferred care. Findings indicate that normally, PSWs provide personal and supportive care commensurate with their training. However, in approximately one quarter of care plans reviewed, PSWs also completed more complex care activities transferred to them by RHPs. Service users receiving transferred care were older and had higher levels of cognitive and functional impairment. Although there is potential for the expansion of home-care services through increased utilisation of PSWs, healthcare leadership must ensure that the right provider is being utilised at the right time and in the right place to ensure safe and effective quality care. Thus, several actions are recommended: PSW core competencies be clearly articulated, processes used to transfer care activities from RHPs to PSWs be standardised and a team-based approach to the delivery of home-care services be considered. Utilisation of a team-based model can help establish positive relationships among home-care providers, provide increased support for PSWs, allow for easier scheduling of initial training and ensure regular reassessments of PSW competence among PSWs providing added skills.

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A new headache clinic in a Canadian downtown quaternary neurological center aimed at supporting clinicians in the community was opened in March 2017. As a means to help appreciate a patient's unique experience of pain, an initially therapeutic history-taking tool has blossomed into a visual tool to advocate, educate, and communicate their headache experience. Over a 10-month period, we asked 375 patients the question, what is the one word you use to describe your headache pain or experience? From this question, we derived 171 unique words with many recurring word themes showing shared experience (table ). These words were recorded in this illustration with increasing font size to represent the frequency of each word (figure). Fun fact-paying homage to the brain, particular words are intentionally placed near the control centers!