Mental health services in schools: A qualitative analysis of challenges to implementation, operation, and sustainability

Abstract

Schools are increasingly recognized as a critical venue for the provision of comprehensive behavioral and mental health services for students. Unfortunately, difficulties associated with operating programs in schools often prevent evidence-based practices from being implemented and sustained as intended. In this study, the experiences of school and community providers who were funded through the Safe Schools/Healthy Students Initiative to implement mental health services in a large, urban school district were investigated using a qualitative focus group methodology. Providers identified the major challenges they encountered with implementing, operating, and sustaining their programs as well as the strategies that they used to overcome those challenges. Strategies to enhance support of school-based mental health programs are discussed.

A Tangled Web: The Challenges of Implementing an Evidence-Based Social Engagement Intervention for Children With Autism in Urban Public School Settings

“…The culture of most schools generally favors academic-related outcomes above other areas of development (Adelman & Taylor, 1998; Massey et al, 2005). Despite its importance for children with autism, socialization often is not prioritized in many schools, and school leadership may not consider socialization as falling under their aegis.…”

“…A growing body of research in implementation of other evidence-based mental health interventions in school settings has examined barriers to implementation (Forman, Olin, Hoagwood, Crowe, & Saka, 2009; Forman et al, 2013; Langley, Nadeem, Kataoka, Stein, & Jaycox, 2010; Massey, Armstrong, Boroughs, Henson, & McCash, 2005). These studies have identified a number of important barriers to implementation, including staff’s competing priorities and responsibilities, the lack of administrator and teacher support, difficulty obtaining resources and materials, and finding time for the intervention in the school day (Forman et al, 2013; Langley et al, 2010; Massey et al, 2005).…”

“…These studies have identified a number of important barriers to implementation, including staff’s competing priorities and responsibilities, the lack of administrator and teacher support, difficulty obtaining resources and materials, and finding time for the intervention in the school day (Forman et al, 2013; Langley et al, 2010; Massey et al, 2005). These barriers may affect implementation of social engagement interventions for children with autism as well; however, to date, these issues have not been studied, leaving the question of the best ways to support schools in their use and implementation of evidence-based autism-related interventions.…”

Supporting Vulnerable Families Through School-Based Mental Health Services: Results of Caregiver and Teacher Focus Groups

“…Qualitative methodology, and in particular the use of focus groups, is particularly effective for exploring feedback, perspectives, and knowledge of multiple stakeholders during program evaluation (Hydén & Bülow, 2003;Massey, 2011;Massey, Armstrong, Boroughs, Henson, & McCash, 2005). Accordingly, focus groups were conducted at the end of the school year with caregivers and teachers of children who were involved in the pilot project.…”

Readiness for Positive Behavioral Interventions and Supports and School Mental Health Interconnection: Preliminary Development of a Stakeholder Survey

“…Massey, Armstrong, Boroughs, Henson, and McCash (2005) recommended that teachers receive ongoing training to increase understanding of the intervention process and how interventions function with the academic curriculum. This training also promotes intervention fidelity and consistency.…”