Mental Health Clinic Administrators’ Perspectives on the Impact of Clinic-School Partnerships on Youth Mental Health Services Continuity and Quality

Abstract

Partnerships between mental health (MH) clinics and school systems in which providers deliver MH services on school grounds are growing. To date, however, there is little research examining MH clinic administrator perspectives on how this service delivery model affects continuity and quality of MH services among low-income youth. We conducted a state-wide (online and mail) survey of administrators at MH clinics ( n = 60) to assess their perspectives on the advantages and challenges of school MH services for Medicaid-enrolled youth. Among survey respondents ( n = 44), 86% reported that their clinic had at least one school partnership. With respect to advantages, more than four-fifths reported that school-based MH services (compared to clinic-based services) were very helpful or extremely helpful (versus not helpful at all, a little helpful, or somewhat helpful) for: (1) reducing gaps in MH treatment (86.8%); (2) improving communication between MH providers and teachers (86.9%), and (3) improving the overall quality of MH care (89.5%). In addition, the estimated no-show rate for appointments in school settings (7.2%) was lower than the estimated no show-rate for clinic appointments (23.9%; p < 0.01). Several challenges were also reported; more than two-thirds of respondents reported difficulties when delivering school-based services related to parent engagement (i.e., appointment attendance [89.5%], communication [81.6%], timely consent [68.4%]) that occurred sometimes, often, or always (versus rarely or never). As MH clinics continue to enter into and expand partnerships with schools, stakeholders should implement family-centered strategies to enhance engagement. Nevertheless, MH clinic administrators highlight potential benefits of school MH services (compared to clinic-based services) with respect to continuity and quality of MH care.

Availability and Accessibility of Mental Health Services for Youth: A Descriptive Survey of Safety-Net Health Centers During the COVID-19 Pandemic

“…Further, about 20% of the final sample (28.2% of FQHCs and 7.1% of CMHCs) reported not offering outpatient MH services, despite multiple online directories listing them as being offered. A significant number of peer-reviewed studies use the SAMHSA Treatment Locator as their primary source for identifying and characterizing the mental health system in the US (e.g., Cantor et al, 2021 ; Cummings, Wen, Ko, & Druss, 2013 ; Cummings et al, 2022 ; Guerrero & Kao, 2013 ; Shrader et al, 2023 ). The findings from this study suggest that online directories of MH centers (e.g., SAMHSA Treatment Locator), when used for research purposes or otherwise, should be validated against multiple sources to ensure the most accurate sample.…”

Creating a school‐based mental health program to meet the needs of children in underserved communities and schools: The Derner Hempstead Child Clinic

“…Since the early 2000s, partnerships between schools and outside agencies to provide MH services to students in schools and in the community have become more common. These programs can help to break down some of the barriers to the delivery of MH services to children, especially those who live in disadvantaged areas, such as the cost of treatment, lack of insurance, and difficulty in accessing treatment settings (Cummings et al., 2022). Considering that close to three‐quarters of children who receive MH services receive them in school settings (Langley et al., 2010), the development of SBMH programs is of tremendous help to children in need of such services.…”

“…Competing responsibilities among SBMH professionals and administrators and MH providers from outside agencies have been reported to be one of the main barriers to the delivery of SBMH services (Langley et al, 2010). According to Cummings et al (2022), there is often resistance to MH services when they are delivered by outside agencies. Another barrier is the lack of role clarity between the different participants.…”

“…The DHCC is part of a growing trend in the field to create initiatives that foster a closer collaboration between outside MH agencies and schools. The majority of school‐based mental health (SBMH) initiatives consist of partnerships between school districts and outside agencies that deliver MH services in schools (Cummings et al., 2022; Langley et al., 2010). It has been consistently reported that MH services in schools improve when schools partner with MH providers and services are delivered in school settings (Eklund et al., 2020).…”

“…It has been consistently reported that MH services in schools improve when schools partner with MH providers and services are delivered in school settings (Eklund et al., 2020). Cummings and his associates (2022) found that in‐school versus in‐clinic services were rated as “very helpful” by respondents in reducing gaps in MH services as well as treatment dropout. The DHCC primarily provides psychotherapy for children and families of Black and Hispanic origin within a community with high rates of academic challenges, economic stress, foster care placement, and incarceration and a significant aftermath of traumatic carnage in the wake of COVID‐19.…”