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School-Based Mental Health Services for Children Living in High Poverty Urban Communities

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Abstract

Studied the effectiveness of a school-based mental health service model, PALS (Positive Attitudes toward Learning in School), focused on increasing initial and ongoing access to services, and promoting improved classroom and home behavior for children referred for Disruptive Behavior Disorder (DBD) from three high poverty urban elementary schools. Classrooms were randomly assigned to PALS or referral to a neighborhood mental health clinic, with children identified by teacher referral and follow-up parent andeher ratings. Results indicated significant service engagement and retention for PALS (n=60) versus families referred to clinic (n=30), with over 80% of PALS families retained in services for 12 months. PALS services were correlated with positive changes in children’s behavior as rated by parents, and with improvements in children’s academic performance as rated by teachers. Implications for the design and delivery of mental health services for children and families living in high-poverty urban communities are discussed.

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Notes

  1. The university-wide IRB investigation began early in the second year of the grant, which coincided with the beginning of a new school year. The investigation was precipitated by concerns that the university’s IRB was not appropriately reviewing research proposals. The investigation noted discrepancies in procedures and personnel that resulted in a 3-day suspension of the university’s Multiple Project Assurance and a subsequent suspension of all research at the university until a new IRB was established and this board had completed a re-review of all research protocols. Our project obtained a waiver allowing us to continue services to our enrolled families and teachers throughout the investigation, but new enrollments were not allowed until our study was reviewed by the re-constituted IRB several months later. When we received approval in late February, the schools themselves were preparing for statewide testing in March and April, which required that we postpone recruitment until the following September. Since this was the third and final year of the grant, the budget had been intended for follow-up assessments only. Thus, we had only enough funds to support services to two schools, rather than the six we had planned. This necessitated a very difficult discontinuation of services in one of the schools already participating, which reduced the sample of classrooms from 17 to 12 in the third year of the study. In addition, although principals had agreed to maintain the integrity of the PALS and clinic cohorts for Year 2 by retaining children within these groups when promoted to the next grade, following the university research shut-down, principals were no longer able or willing to follow that plan. Because our research design was a nested model, in which each school contained both PALS and control classrooms, this reorganization further disrupted our sample and resulted in a control group that was too small to study in the third and final year of the study.

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Acknowledgments

This study was supported in part by National Institute of Mental Health Grant R01MH56491 and grants from the Grant Health Care Foundation, and the University of Illinois Great Cities Institute. We gratefully acknowledge the contributions of Barbara Baumann, Sarah Beehler, D’Andrea Bell, Jennifer Beyers, Darnetta Byndum, Marrion Gandy, Monica Garcia, Tamara Gathright, Derek Griffith, Tracy Hawkins, Linda Lambrecht, Bridgette Leachman, Richard Renfro, Roslyn Samson, Deborah Starks, Jennifer Treuting, Amanda Webster, and Paulette Wiley.

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Atkins, M.S., Frazier, S.L., Birman, D. et al. School-Based Mental Health Services for Children Living in High Poverty Urban Communities. Adm Policy Ment Health 33, 146–159 (2006). https://doi.org/10.1007/s10488-006-0031-9

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