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Effects of School-Based Mental Health Programs on Mental Health Service Use by Adolescents at School and in the Community

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Mental Health Services Research

Abstract

Many schools provide counseling to adolescents with behavioral and emotional problems on-site, but little is known about the use of school-based counseling services in the United States, and it is unclear whether these services complement or substitute for counseling services available outside of school. In this study data on mental health services offered in schools are used to estimate the probability of receiving emotional counseling at school and elsewhere. Where mental health services were available on-site, students were substantially more likely to see a counselor in the previous year, controlling for mental health status, health insurance coverage, and other factors. The effects of availability were greater for students enrolled in special education programs than for other students. However, these data also suggest that, relative to other schools, schools offering on-site mental health counseling do not increase or reduce use of counseling services outside of school on average.

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REFERENCES

  • Adelman, H. S., & Taylor, L. (1993). School-based mental health care: Toward a comprehensive approach. The Journal of Mental Health Administration, 20(1), 32-45.

    Google Scholar 

  • Adelman, H. S., & Taylor, L. (1999). Mental health in schools and system restructuring. Clinical Psychology Review, 19(2), 137-163.

    Google Scholar 

  • Anglin, T. M., Naylor, K. E., & Kaplan, D. W. (1996). Comprehensive school-based health care: High school students' use of medical, mental health, and substance abuse services. Pediatrics, 97(3), 318-330.

    Google Scholar 

  • Angold, A., Messer, S. C., Stangl, D., Farmer, E. M. Z., Costello, E. J., & Burns, B. J. (1998). Perceived parental burden and service use for child and adolescent psychiatric disorders. American Journal of Public Health, 88(1), 75-80.

    Google Scholar 

  • Armbruster, P., & Lichtman, J. (1999). Are school based mental health services effective? Evidence from 36 inner city schools. Community Mental Health Journal, 35(6), 493-504.

    Google Scholar 

  • Baker, R. P., & Bradburn, N. M.(1993). CAPI: Impacts on data quality and survey costs. In Proceedings, 1991 Public Health Conference on Records and Statistics (pp. 459-464). Washington, DC: U.S. National Center for Health Statistics.

    Google Scholar 

  • Braden, J. S., DiMarino-Linnen, E., & Good, T. L. (2001). Schools, society, and school psychologists: History and future directions. Journal of School Psychology, 39(2), 203-219.

    Google Scholar 

  • Burns, B. J., Costello, E. J., Angold, A., Tweed, D., Stangl, D., Farmer, E. M. Z., et al. (1995). Children's mental health service use across service sectors. Health Affairs, 14(3), 147-159.

    Google Scholar 

  • Chantala, K., & Tabor, J. (1999). National Longitudinal Study of Adolescent Health strategies to perform a design-based analysis using the Add Health Data. Retrieved from Carolina Population Center, University of North Carolina at Chapel Hill Web site: www.cpc.unc.edu/addhealth <http://www.cpc.unc.edu/addhealth>

  • Cohen, P., & Hesselbart, C. S. (1993). Demographic factors in the use of children's mental health services. American Journal of Public Health, 83(1), 49-52.

    Google Scholar 

  • Cunningham, P. J., & Freiman, M. P. (1996). Determinants of ambulatory mental health services use for school-age children and adolescents. Health Services Research, 31(4), 409-427.

    Google Scholar 

  • Davis, M., Fryer, G. E., White, S., & Igoe, J. B. (1995). A closer look: A report of select findings from the National School Health Survey 1993-94. Retrieved from: http://www. uchsc.edu/schoolhealth/closer look paper.htm

  • Dryfoos, J. G. (1994). Full-service schools. San Francisco: Jossey-Bass.

    Google Scholar 

  • Evans, S. W. (1999). Mental health services in schools: Utilization, effectiveness, and consent. Clinical Psychology Review, 19(2), 165-178.

    Google Scholar 

  • Flaherty, L. T., Weist, M. D., & Warner, B. S. (1996). School-based mental health services in the United States: History, current models and needs. Community Mental Health Journal, 32(4), 341-352.

    Google Scholar 

  • Fothergill, K. (1998). Update 1997: School-based health centers. Washington, DC: Advocates for Youth.

    Google Scholar 

  • Garrison, E. G., Roy, I. S., & Azar, V. (1999). Responding to the mental health needs of Latino children and families through school-based services. Clinical Psychology Review, 19(2), 199-219.

    Google Scholar 

  • General Accounting Office. (1994). Health care reform: School-based health centers can promote access to care. Washington, DC: Author.

    Google Scholar 

  • Glied, S., Garrett, A. B., Hoven, C., Rubio-Stipec, M., Regier, D., Moore, R. E., et al. (1998). Child outpatient mental health service use: Why doesn't insurance matter? The Journal of Mental Health Policy and Economics, 1, 173-187.

    Google Scholar 

  • Greene, W. H. (1997). Econometric analysis (3rd ed., pp. 906-911). Upper Saddle River, NJ: Prentice-Hall.

    Google Scholar 

  • Hough, R., Landsverk, J., Karno, M., Burnam, M. A., Timbers, D. M., Escobar, J. I., et al. (1987). Utilization of health and mental health services by Los Angeles Mexican Americans and non-Hispanic Whites. Archives of General Psychiatry, 44, 702-709.

    Google Scholar 

  • Huber, P. J. (1967). The behavior of maximum likelihood estimates under non-standard conditions. In Proceedings of the Fifth Berkeley Symposium on Mathematical Statistics and Probability (Vol. 1, pp. 221-233). Berkeley, CA: University of California Press.

    Google Scholar 

  • Knitzer, J., Steinberg, Z., & Fleisch, B. (1993). Schools, children's mental health, and the advocacy challenge. Journal of Clinical Child Psychology, 20(1), 102-111.

    Google Scholar 

  • Leaf, P. J., Alegria, M., Cohen, P., Goodman, S. H., McCue Horwitz, S., Hoven, C. W., et al. (1996). Mental health service use in the community and schools: Results from the four-community MECA study. Journal of the American Academy of Child and Adolescent Psychiatry, 35(7), 889-897.

    Google Scholar 

  • McKinney, D. H., & Peak, G. L. (1994). School-based and school linked health centers: Update 1993. Washington, DC: Center for Population Options.

    Google Scholar 

  • McMiller, W. P., & Weisz, J. R. (1996). Help-seeking preceding mental health clinic intake among African-American, Latino, and Caucasian youths. Journal of the American Academy of Child and Adolescent Psychiatry, 35(8), 1086-1094.

    Google Scholar 

  • Office of Technology Assessment. (1993). Adolescent health (Congress of the United States). Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  • Pisecco, S., Baker, D. B., Silva, P. A., & Brooke, M. (1996). Behavioral distinctions in children with reading disabilities and/or ADHD. Journal of the American Academy of Child and Adolescent Psychiatry, 35(11), 1477-1484.

    Google Scholar 

  • Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general public. Applied Psychological Measurement, 1(3), 385-401.

    Google Scholar 

  • Rodman, J., Weill, K., Driscoll, M., Fenton, T., Alpert, H., Salem-Schatz, S, et al. (1999). A nationwide survey of financing health-related services for special education students. The Journal of School Health, 69(4), 133-139.

    Google Scholar 

  • Rones, M., & Hoagwood, K. (2000). School-based mental health services: A research review. Clinical Child and Family Psychology Review, 3(4), 223-241.

    Google Scholar 

  • Royall, R. M. (1986). Model robust confidence intervals using maximum likelihood estimators. International Statistical Review, 54, 221-226.

    Google Scholar 

  • Santelli, J., Morreale, M., Wigton, A., & Grason, H. (1996). School health centers and primary care for adolescents: A review of the literature. Journal of Adolescent Health, 18, 357-366.

    Google Scholar 

  • Stata Corporation. (2001). Stata statistical software: Release 7.0, Reference Su-Z (pp. 15-31). College Station, TX: Author.

    Google Scholar 

  • Stiffman, A. R., Horwitz, S. M., Hoagwood, K., Compton, W., Cottler, L., Bean, D. L., et al. (2000). The Service Assessment for Children and Adolescents (SACA): Adult and child reports. Journal of the American Academy of Child and Adolescent Psychiatry, 39(8), 1032-1039.

    Google Scholar 

  • Tomblin, J. B., Zhang, X., Buckwalter, P., & Catts, H. (2000). The association of reading disability, behavioral disorders, and language impairment among second-grade children. Journal of Child Psychology and Psychiatry, 41(4), 473-482.

    Google Scholar 

  • Tuma, J. M. (1993). Mental health services for children: The state of the art. American Psychologist, 44(2), 188-199.

    Google Scholar 

  • U.S. Census Bureau. (2000). Table F-5, race and Hispanic origin of householder-Families by median and mean income: 1947 to 1999. Retrieved from http://www.census.gov/hhes/ income/histinc/f05.html

  • U.S. Census Bureau. (2001). Poverty thresholds in 1995, by size of family and number of related children under 18 years. Retrieved from http://www.census.gov/hhes/poverty/ threshld/thresh95.html

  • Weist, M. D. (1997). Expanded school mental health services: A national movement in progress. In T. H. Ollendick & R. J. Prinz (Eds.), Advances in clinical child psychology (Vol. 19, pp. 319-352). New York: Plenum Press.

    Google Scholar 

  • Weist, M. D. (1998). Mental health services in schools: Expanding opportunities. In H. Ghuman & R. Sarles (Eds.), Handbook of child and adolescent outpatient, day treatment, and community psychiatry (Vol. 47, pp. 1578-1585). Philadelphia: Brunner-Mazel.

    Google Scholar 

  • White, H. (1980). A heteroskedasticity-consistent covariance matrix estimator and a direct test for heteroskedasticity. Econometrica, 48, 817-830.

    Google Scholar 

  • White, H. (1982). Maximum likelihood estimation of misspecified models. Econometrica, 50, 1-25.

    Google Scholar 

  • Willcutt, E. G., & Pennington, B. F. (2000). Psychiatric comorbidity in children and adolescents with reading disability. Journal of Child Psychology and Psychiatry, 41(8), 1039-1048.

    Google Scholar 

  • Wu, P., Hoven C. W., Bird, H. R., Moore, R. E., Cohen, P., Alegria, M., et al. (1999). Depressive and disruptive disorders and mental health service utilization in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 38(9), 1081-1092.

    Google Scholar 

  • Zahner, G. E. P., & Daskalakis, M. S. (1997). Factors associated with mental health, general health, and school-based service use for child psychopathology. American Journal of Public Health, 87, 1440-1448.

    Google Scholar 

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Slade, E.P. Effects of School-Based Mental Health Programs on Mental Health Service Use by Adolescents at School and in the Community. Ment Health Serv Res 4, 151–166 (2002). https://doi.org/10.1023/A:1019711113312

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