School Counselors’ Perspectives of a Web-Based Stepped Care Mental Health Service for Schools: Cross-Sectional Online Survey

Abstract

BackgroundMental health problems are common among youth in high school, and school counselors play a key role in the provision of school-based mental health care. However, school counselors occupy a multispecialist position that makes it difficult for them to provide care to all of those who are in need in a timely manner. A Web-based mental health service that offers screening, psychological therapy, and monitoring may help counselors manage time and provide additional oversight to students. However, for such a model to be implemented successfully, school counselors’ attitudes toward Web-based resources and services need to be measured.ObjectiveThis study aimed to examine the acceptability of a proposed Web-based mental health service, the feasibility of providing this type of service in the school context, and the barriers and facilitators to implementation as perceived by school counselors in New South Wales (NSW), Australia.MethodsThis study utilized an online cross-sectional survey to measure school counselors’ perspectives.ResultsA total of 145 school counselors completed the survey. Overall, 82.1% (119/145) thought that the proposed service would be helpful to students. One-third reported that they would recommend the proposed model, with the remaining reporting potential concerns. Years of experience was the only background factor associated with a higher level of comfort with the proposed service (P=.048). Personal beliefs, knowledge and awareness, Internet accessibility, privacy, and confidentiality were found to influence, both positively and negatively, the likelihood of school counselors implementing a Web-based school mental health service.ConclusionsThe findings of this study confirmed that greater support and resources are needed to facilitate what is already a challenging and emotionally demanding role for school counselors. Although the school counselors in this study were open to the proposed service model, successful implementation will require that the issues outlined are carefully addressed.

Evaluating a Web-Based Mental Health Service for Secondary School Students in Australia: Protocol for a Cluster Randomized Controlled Trial

“…During the development of the service, school counsellors, parents, and general practitioners (GPs) outlined various concerns related to the accuracy, effectiveness, and suitability of the service for delivery in the school setting [18-20]. Some parents questioned the effectiveness of a Web-based service for determining the level of care their child required [20] and whether the service would increase stigma among students.…”

“…Codesigned with students, school counsellors [18], general practitioners [19], and parents [20], the Black Dog Institute has developed a Web-based mental health service called Smooth Sailing. On the basis of the principles of stepped care, Smooth Sailing uses a website to screen, assess, allocate, and deliver psychological interventions to improve help-seeking for mental health problems and reduce depressive and anxiety symptoms among secondary school youth.…”

Collaborative Practices Among Australian School Psychologists, Guidance Officers and School Counsellors: Important Lessons for School Psychological Practice

“…That is, to place school psychologists into the essential mix of services that is available to young Australians who are experiencing comorbid or multi-domain and/or multiservice issues. School psychologists are multi-specialists (O'Dea, King, Subotic-Kerry, O'Moore, & Christensen, 2017) and work at the coalface of youth mental health, so it is concerning that they are often precluded from research that attempts to encapsulate the range of mental health support services available to children and youth.…”

General Practitioners’ Attitudes Toward a Web-Based Mental Health Service for Adolescents: Implications for Service Design and Delivery

“…In addition, participants reported that GPs may be worried about data security and privacy. Although this is a common concern of internet-delivered care [ 24 , 25 , 32 ], participants felt that this could be alleviated by clear delineation of roles and responsibilities within the service alongside robust informed consent procedures with the young person. Additional barriers to acceptability of the proposed service included noncompliance by adolescents and GPs, as well as differences in mental health training and youth experience of GPs.…”

“…Acceptability research in health services aims to understand the extent to which people delivering or receiving an intervention consider it to be appropriate and suited to their needs, based on either anticipated or experimentation responses [ 31 ]. A study of the acceptability of the Smooth Sailing service among school counselors [ 32 ] found that personal beliefs, knowledge of e-mental health, internet accessibility, privacy, and confidentiality issues influenced their likelihood of use. Previous research on the adoption of eHealth among GPs has mainly been conducted in relation to adult health services [ 27 ].…”