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School-Based Mental Health Programs for Students Who Have Emotional Disturbances: Academic and Social-Emotional Outcomes

Abstract

Most schools offer some type of school-based mental health service to students, and there is a growing body of empirically rigorous studies examining the effects on academic and mental health outcomes for students. However, students classified as having emotional disturbances are under-represented in these studies. Using a convenience sample of four different types of school-based mental health programs, changes in achievement levels and social and emotional functioning in youth with emotional disturbances served in special education (n = 148) were examined. Longitudinal results reveal there was improvement in either the emotional or social functioning of these youth in all four programs, while results for improvement in achievement levels were less consistent. Results reveal that in the targeted sample of programs with intensive or multifaceted services, there was improvement in academic as well as social and emotional functioning in these youth. Implications for school-based mental health services are discussed.

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References

  • Aberson, C. (2002). Interpreting null results: Improving presentation and conclusions with confidence intervals. Journal of Articles in Support of the Null Hypothesis, 1(3), 36–42.

    Google Scholar 

  • Achenbach, T. (1991). Manual for the child behavior Checklist/4–18 and 1991 profile. Burlington, VT: University of Vermont Department of Psychiatry.

    Google Scholar 

  • Adelman, H. S., & Taylor, L. (2006). Mental health in schools and public health. Public Health Reports, 121, 294–298.

    PubMed  Google Scholar 

  • Atkins, M. S., Hoagwood, K. E., Kutash, K., & Seidman, E. (2010). Toward the integration of education and mental health in schools. Administration and Policy in Mental Health and Mental Health Services Research, 37, 40–47.

    PubMed  Article  Google Scholar 

  • Bickman, L. (2000). The most dangerous and difficult research question in mental health services research. Mental Health Services Research, 2, 71–72.

    Article  Google Scholar 

  • Bird, H., Canino, G., Davies, M., Ramirez, R., Chavez, L., & Duarte, C. (2005). The brief impairment scale (BIS): A multidimensional scale of functional impairment for children and adolescents. Journal of American Academy Child and Adolescent Psychiatry, 44(7), 699–707.

    Article  Google Scholar 

  • Blackorby, J., & Wagner, M. (1996). Longitudinal postschool outcomes of youth with disabilities: Findings from the national longitudinal transition study. Exceptional Children, 62(5), 399–414.

    Google Scholar 

  • Blau, G. M., Huang, L. N., & Mallery, C. J. (2010). Advancing efforts to improve children’s mental health in America: A commentary. Administration and Policy in Mental Health and Mental Health Services Research, 37, 140–144.

    PubMed  Article  Google Scholar 

  • Brener, N. O., Martindale, J., & Weist, M. D. (2001). Mental health and social services: results from the school health policies and programs study. Journal of School Health, 71(7), 305–312.

    PubMed  Article  Google Scholar 

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

    Article  Google Scholar 

  • Burns, B. J., & Kutash, K. (2000). Child and adolescent measures of functional status. In Handbook of psychiatric measures and outcomes (pp. 357–392). Washington, D.C.: American Psychiatric Association.

  • Cappella, E., Frazier, S. L., Atkins, M. S., Schoenwald, S. K., & Glisson, C. (2008). Enhancing schools’ capacity to support children in poverty: An ecological model of school-based mental health services. Administration and Policy In Mental Health, 35(5), 395–409.

    PubMed  Article  Google Scholar 

  • Capraro, M. M. (2005). An introduction to confidence introduction to intervals for both statistical estimates and effect sizes. Research in the Schools, 11(2), 22–33.

    Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). New York: Academic Press.

    Google Scholar 

  • Cumming, G. (2001). Exploratory software for confidence intervals (CIdelta) [Computer software]. Bundoora, AU: La Trobe University. Retrieved from http://www.latrobe.edu.au/psy/esci/.

  • Cumming, G., & Fidler, F. (2009). Confidence intervals: Better answers to better questions. Journal of Psychology, 217(1), 15–26.

    Google Scholar 

  • Cumming, G., & Finch, S. (2001). A primer on the understanding, use, and calculation of confidence intervals that are based on central and noncentral distributions. Educational and Psychological Measurement, 61(4), 532–574.

    Google Scholar 

  • Dedrick, R. F., Greenbaum, P. E., Friedman, R. M., Wetherington, C. M., & Knoff, H. M. (1997). Testing the structure of the child behavior checklist/4–18 using confirmatory factor analysis. Educational and Psychological Measurement, 57(2), 306–313.

    Article  Google Scholar 

  • Department of Health and Human Services. (1999). The surgeon general’s report—Chapter 3: Children and mental health. Mental health: A report of the Surgeon General (pp. 124–220). Atlanta, GA: Department of Health and Human Services.

  • Eber, L., Osuch, T., & Redditt, C. A. (1996). School-based applications of the wraparound process: Early results on service provision and student outcomes. Journal of Child and Family Studies, 5(1), 83–99.

    Article  Google Scholar 

  • Evans, S. W., & Weist, M. D. (2004). Implementing empirically supported treatments in the schools: What are we asking? Clinical Child and Family Psychology Review, 7(4), 263–267.

    PubMed  Article  Google Scholar 

  • Foster, S., Rollefson, M., Doksum, T., Noonan, D., Robinson, G., & Teich, J. (2005). School mental health services in the United States, 2002–2003. DHHS Pub. No. (SMA) 05–4068. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration.

    Google Scholar 

  • Garland, A. F., Brookman-Frazee, L., Hurlburt, M. S., Accurso, E. C., Zoffness, R. J., Haine-Schlagel, R., et al. (2010). Mental health care for children with disruptive behavior problems: A view inside therapists’ offices. Psychiatric Services, 61(8), 788–795.

    PubMed  Article  Google Scholar 

  • Goodman, R. (2001). Psychometric properties of the strengths and difficulties questionnaire. Journal of the American Academy of Child and Adolescent Psychiatry, 40(11), 1337–1345.

    PubMed  Article  Google Scholar 

  • Greenbaum, P. E., Dedrick, R. F., Friedman, R. M., Kutash, K., Brown, E. C., Lardieri, S. P., et al. (1998). National adolescent and child treatment study (NACTS): Outcomes for children with serious emotional disturbances. In M. H. Epstein, K. Kutash, & A. J. Duchnowski (Eds.), Outcomes for children and youth with behavioral and emotional disorders: Programs and evaluation best practices (pp. 21–54). Austin, TX: Pro-Ed.

    Google Scholar 

  • Gyamfi, P., Walrath, C., Burns, B. J., Stephens, R. L., Geng, Y., & Stambaugh, L. (2010). Family education and support services in systems of care. Journal of Emotional and Behavioral Disorders, 18(1), 14–26.

    Article  Google Scholar 

  • Hoagwood, K., & Kolko, D. J. (2009). Introduction to the special section on practice contexts: A glimpse into the nether world of public mental health services for children and families. Administration and Policy in Mental Health and Mental Health Services Research, 36, 35–36.

    PubMed  Article  Google Scholar 

  • Hoagwood, K., Olin, S. S., Kerker, B. D., Kratochwill, T. R., Crowe, M., & Saka, N. (2007). Empirically based school interventions targeted at academic and mental health functioning. Journal of Emotional and Behavioral Disorders, 15(2), 66–92.

    Article  Google Scholar 

  • Hodges, K. (1990). Child and adolescent functional assessment scale (1994th ed.). Ypsilanti, MI: Eastern Michigan University, Department of Psychology.

    Google Scholar 

  • Hodges, K., Doucette-Gates, A., & Kim, C. S. (2000). Predicting service utilization with the child and adolescent functional assessment scale in a sample of youths with serious emotional disturbance served by center for mental health services-funded demonstrations. The Journal of Behavioral Health Services and Research, 27, 47–59.

    Article  Google Scholar 

  • Hodges, K., Doucette-Gates, A., & Liao, Q. (1999). The relationship between the child and adolescent functional assessment scale (CAFAS) and indicators of functioning. Journal of Child and Family Studies, 8, 109–122.

    Article  Google Scholar 

  • Hodges, K., & Kim, C. S. (2000). Psychometric study of the child and adolescent functional assessment scale: Prediction of contact with the law and poor school attendance. Journal of Abnormal Child Psychology, 28, 287–297.

    PubMed  Article  Google Scholar 

  • Hodges, K., & Wong, M. M. (1996). Psychometric characteristics of a multidimensional measure to assess impairment: The child and adolescent functional assessment scale. Journal of Child and Family Studies, 5, 445–467.

    Article  Google Scholar 

  • Hodges, K., & Wong, M. M. (1997). Use of the child and adolescent functional assessment scale to predict service utilization and cost. The Journal of Mental Health Administration, 24, 278–290.

    Article  Google Scholar 

  • Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry, 62(6), 617–627.

    PubMed  Article  Google Scholar 

  • Knapp, M. S. (1995). How shall we study comprehensive, collaborative services for children and families? Educational Researcher, 24(4), 5–16.

    Google Scholar 

  • Kratochwill, T. R., Clements, M. A., & Kalymon, K. M. (2007). Response to intervention: Conceptual and methodological issues in implementation. In S. R. Jimerson, M. K. Burns, & A. M. VanDerHeyden (Eds.), Handbook of response to intervention (pp. 25–52). New York: Springer.

  • Kutash, K., Duchnowski, A. J., & Lynn, N. (2006). School-based mental health: An empirical guide for decision-makers. Tampa: The Research and Training Center for Children’s Mental Health; Louis de la Parte Florida Mental Health Institute. University of South Florida.

  • Lamdin, D. J. (1996). Evidence of student attendance as an independent variable in education production functions. The Journal of Educational Research, 89, 155–162.

    Article  Google Scholar 

  • Leaf, P. J., Alegria, M., Cohen, P., Goodman, S. H., Horowitz, S. M., 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.

    PubMed  Article  Google Scholar 

  • Manteuffel, B., Stephens, R., & Santiago, R. (2002). Overview of the national evaluation of the comprehensive community mental health services for children and their families program and summary of current findings. Children’s Services: Social Policy, Research, and Practice, 5, 3–20.

    Article  Google Scholar 

  • Mellor, D. (2004). Furthering the use of the strengths and difficulties questionnaire: Reliability with younger child respondents. Psychological Assessment, 16(4), 396–401.

    PubMed  Article  Google Scholar 

  • New Freedom Commission on Mental Health. (2003). Achieving the promise: Transforming mental health care in America (Final Report ed.). Rockville, MD: DHHS Pub. No SMA-03-3832.

  • Newman, L., Wagner, M., Cameto, R., Knokey, A. M., & Shaver, D. (2010). Comparisons across time of the outcomes of youth with disabilities up to four years after high school: A report of findings from the national longitudinal transition study (NLTS) and the national longitudinal transition study-2 (NLTS2) (NCSER 2010–3008). Washington, DC: Institute of Education Sciences. Retrieved from http://policyweb.sri.com/cehs/publications/nlts2_report_2010_09.pdf.

  • No Child Left Behind (NCLB). (2002). Act of 2001, Pub. L. No. 107-110, § 115, Stat. 1425.

  • Paternite, C. E. (2005). School-based mental health programs and services: Overview and introduction to the special issue. Journal of Abnormal Child Psychology, 33(6), 657–663.

    PubMed  Article  Google Scholar 

  • Policy Leadership Cadre for Mental Health in Schools. (2001). Mental health in schools: Guidelines, models, resources, and policy considerations. Los Angeles, CA: School Mental Health Project, Department of Psychology, UCLA.

    Google Scholar 

  • Quist, R., & Matshazi, D. (2000). The child and adolescent functional assessment scale (CAFAS): A dynamic predictor of juvenile recidivism. Adolescence, 35, 181–192.

    PubMed  Google Scholar 

  • Reid, R., Gonzalez, J. E., Nordness, P., Trout, A., & Epstein, M. H. (2004). A meta-analysis of the academic status of students with emotional/behavioral disturbance. The Journal of Special Education, 38(3), 130–143.

    Article  Google Scholar 

  • Robbins, V., & Armstrong, B. J. (2005). The Bridges Project: Description and evaluation of a school-based mental health program in eastern Kentucky. In M. H. Epstein, K. Kutash, & A. J. Duchnowski (Eds.), Outcomes for children and youth with emotional disorders and their families: Programs and evaluation best practices (2nd ed.; pp. 355–373). Austin, TX: Pro-Ed.

    Google Scholar 

  • Roby, D. E. (2004). Research on school attendance and student achievement: A study of Ohio schools. Behavioral Research Press, LLC, Grambling, LA. ERIC EJ714746.

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

    PubMed  Article  Google Scholar 

  • Sattler, J. M. (2001). Assessment of children: Cognitive applications (4th ed.). La Mesa, CA: Jerome M. Sattler, Publisher, Inc.

    Google Scholar 

  • Simpson, R. L. (2004). Inclusion of students with behavior disorders in general education settings: Research and measurements issues. Behavior Disorders, 30(1), 19–31.

    Google Scholar 

  • Stroul, B. A. & Friedman, R. M. (1994). A system of care for children and youth with severe emotional disturbances. Tampa: The Research and Training Center for Children’s Mental Health; Louis de la Parte Florida Mental Health Institute. University of South Florida.

  • The Psychological Corporation. (1992). Wechsler individual achievement test. San Antonio, TX: The Psychological Corporation.

    Google Scholar 

  • Thompson, B. (2007). Effect sizes, confidence intervals, and confidence intervals for effect sizes. Psychology in the Schools, 44(5), 423–432.

    Article  Google Scholar 

  • US Department of Education, Office of Special Education and Rehabilitative Services. (2007). 29th Annual report to congress on the implementation of the individuals with disabilities education act. Washington, DC.

  • US Government. (2004). Code of federal regulation, title 34, Section 300.8.

  • US Public Health Service. (2000). Report of the surgeon general’s conference on children’s mental health: A national action agenda. Washington, DC: Department of Health and Human Services.

    Google Scholar 

  • Wagner, M., Friend, M., Bursuck, W., Kutash, K., Duchnowski, A. J., Sumi, W. C., et al. (2006). Educating students with emotional disturbances: A national perspective on school programs and services. Journal of Emotional and Behavioral Disorders, 14(1), 12–30.

    Article  Google Scholar 

  • Wagner, M., Kutash, K., Duchnowski, A. J., & Epstein, M. H. (2005a). The special education elementary longitudinal study and the national longitudinal transition study: Study designs and implications for children and youth with emotional disturbance. Journal of Emotional and Behavioral Disorders, 13(1), 25–41.

    Article  Google Scholar 

  • Wagner, M., Kutash, K., Duchnowski, A. J., Epstein, M. H., & Sumi, W. C. (2005b). The children and youth we serve: A national picture of the characteristics of students with emotional disturbances receiving special education. Journal of Emotional and Behavioral Disorders, 13(2), 79–96.

    Article  Google Scholar 

  • Weist, M. (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 

  • Weisz, J. R., Jensen-Doss, A., & Hawley, K. M. (2006). Evidence-based youth psychotherapies versus usual care: A meta-analysis of direct comparisons. American Psychologist, 61, 671–689.

    PubMed  Article  Google Scholar 

  • Wilkinson, G. S. (1993). Wide range achievement test (3rd ed.). Wilmington, DE: Wide Range.

    Google Scholar 

  • Wilkinson, L., & Task Force on Statistical Inference, American Psychological Association, Science Directorate. (1999). Statistical methods in psychology journals: Guidelines and explanations. American Psychologist, 54(8), 594–604.

    Article  Google Scholar 

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Acknowledgments

This research was partially supported by Grant H133B90004 from the Center for Mental Health Services, Substance Abuse and Mental Health Administration, and the National Institute for Disability and Rehabilitation Research. The opinions contained in this manuscript are those of the authors and do not necessarily reflect those of either the US Department of Education or the Center for Mental Health Services, SAMSHA.

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Correspondence to Krista Kutash.

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Kutash, K., Duchnowski, A.J. & Green, A.L. School-Based Mental Health Programs for Students Who Have Emotional Disturbances: Academic and Social-Emotional Outcomes. School Mental Health 3, 191–208 (2011). https://doi.org/10.1007/s12310-011-9062-9

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  • DOI: https://doi.org/10.1007/s12310-011-9062-9

Keywords

  • School-based mental health services
  • Special education
  • Emotional disturbance