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Teacher Perspectives on Their Role and the Challenges of Inter-professional Collaboration in Mental Health Promotion

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Abstract

This paper explores the teacher role in inter-professional collaboration in mental health promotion and identifies teachers’ perceived challenges to collaborative work in this field. Data are derived from a mixed method design, with three focus group interviews (n = 15) and survey research (n = 771) conducted with Norwegian K-12 teachers. The findings show that teachers perceive their gatekeeping role to be prominent, in that they are front line professionals to identify students’ mental health problems and, if necessary, make referrals to mental health services. However, teachers realize that mental health promotion encompasses more than the assessment of difficulties, and they call for more support and information through inter-professional collaboration in order to extend their engagement in student mental health beyond the gatekeeping role. Based on this, six main challenges to inter-professional collaboration are identified. These are the challenges of: (1) communication and confidentiality, (2) time constraints, (3) contextual presence and understanding, (4) cross-systems contact, (5) school leadership and (6) teacher competence in mental health.

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Notes

  1. In Norway, 83 % of municipalities use inter-professional ‘responsibility groups’ to coordinate services for children and adolescents with mental health needs (Helgesen & Myrvold, 2009).

References

  • Andersson, H. W., Bungum, B., Kaspersen, S., Bjørngaard, J. H., & Buland, T. (2010). Psykisk helse i skolen. Effektevaluering av opplæringsprogrammene Hva er det med Monica? STEP-ungdom møter ungdom og Venn 1.no [School mental health. An effect evaluation of the training programs; ‘What’s up with Monica?’, ‘STEP’ and ‘Venn1.no’]: SINTEF.

  • Askell-Williams, H., & Lawson, M. J. (2013). Teachers’ knowledge and confidence for promoting positive mental health in primary school communities. Asia-Pacific Journal of Teacher Education, 41(2), 126–143. doi:10.1080/1359866X.2013.777023.

    Article  Google Scholar 

  • Atkinson, M., & Hornby, G. (2002). Mental health handbook for schools. London: RoutledgeFarmer.

    Google Scholar 

  • Baker, V. (2008). Working together? Sharing personal information in health and social care services. In C. Clark & J. McGhee (Eds.), Private and confidential? Handling personal information in the social and health services. Bristol: The Policy Press.

    Google Scholar 

  • Ball, A., Anderson-Butcher, D., Mellin, E., & Green, J. (2010). A cross-walk of professional competencies involved in expanded school mental health: An exploratory study. School Mental Health, 2(3), 114–124. doi:10.1007/s12310-010-9039-0.

    Article  Google Scholar 

  • Baskin, T. W., Slaten, C. D., Sorenson, C., & Glover-Russel, J. (2010). Do youth psychotherapy improve academically related outcomes? A meta-analysis. Journal of Counseling Psychology, 57(3), 290–296. doi:10.1037/a0019652.

    Article  PubMed  Google Scholar 

  • Bergman, M. M. (2010). Hermeneutic content analysis. Textual and autovisual analyses within a mixed methods framework. In A. Tashakkori & C. Teddlie (Eds.), Sage handbook of mixed methods in social and behavioral research. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Berzin, S. C., O’Brien, K. H. M., Frey, A., Kelly, M. S., Alvarez, M. E., & Shaffer, G. L. (2011). Meeting the social and behavioral health needs of students: Rethinking the relationship between teachers and school social workers. Journal of School Health, 81(8), 493–501.

    Article  PubMed  Google Scholar 

  • Burke, R. W., & Paternite, C. E. (2007). Teacher engagement in expanded school mental health. In S. Evans, M. Weist, & Z. N. Serpell (Eds.), Advances in school based mental health interventions. Best practice and program models (Vol. 2). Kingston: Civic Research Institute.

    Google Scholar 

  • Choi, B. C. K., & Pak, A. W. P. (2007). Multidisciplinarity, interdisciplinarity, and transdisciplinarity in health research, services, education and policy: 2. Promotors, barriers, and strategies of enhancement. Clinical and Investigative Medicine, 30(6), E224–E232.

    PubMed  Google Scholar 

  • Creswell, J. W. (2012). Educational research: Planning, conducting, and evaluating quantitative and qualitative research. Boston, Mass.: Pearson.

    Google Scholar 

  • DeSocio, J., & Hootman, J. (2004). Children’s mental health and school success. Journal of School Nursing, 20(4), 189–196. doi:10.1177/10598405040200040201.

    Article  PubMed  Google Scholar 

  • Durlak, J. A., Allison, B. D., Taylor, R. D., Weissberg, R. P., & Kriston, B. S. (2011). The impact of enhancing students’ social and emotional learning: A meta-analysis of school-based universal interventions. Child Development, 82(1), 405–432. doi:10.2307/29782838.

    Article  PubMed  Google Scholar 

  • Ekornes, S., Hauge, T. E., & Lund, I. (2012). Teachers as mental health promoters: A study of teachers’ understanding of the concept of mental health. International Journal of Mental Health Promotion, 14(5), 289–310. doi:10.1080/14623730.2013.798534.

    Article  Google Scholar 

  • Feigenberg, L., Watts, C., & Buckner, J. (2010). The school mental health capacity instrument: Development of an assessment and consultation tool. School Mental Health, 2(3), 142–154. doi:10.1007/s12310-010-9041-6.

    Article  Google Scholar 

  • Feinstein, N. R., Fielding, K., Udvari-Solner, A., & Joshi, S. V. (2009). The supporting alliance in child and adolescent treatment: Enhancing collaboration among therapists, parents, and teachers. American Journal of Psychotherapy, 63(4), 319–344.

    PubMed  Google Scholar 

  • Forman, S., Olin, S., Hoagwood, K., Crowe, M., & Saka, N. (2009). Evidence-based interventions in schools: Developers’ views of implementation barriers and facilitators. School Mental Health, 1(1), 26–36. doi:10.1007/s12310-008-9002-5.

    Article  Google Scholar 

  • Franklin, C. G. S., Kim, J. S., Ryan, T. N., Kelly, M. S., & Montgomery, K. L. (2012). Teacher involvement in school mental health interventions: A systematic review. Children and Youth Services Review, 34, 973–982. doi:10.1016/j.childyouth.2012.01.027.

    Article  Google Scholar 

  • Gibbs, G. (2002). Qualitative data analysis: Explorations with NVivo. Buckingham: Open University Press.

    Google Scholar 

  • Gott, J. (2003). The school: The front line of mental health development? Pastoral Care in Education, 21(4), 5–13. doi:10.1111/j.0264-3944.2003.00272.x.

    Article  Google Scholar 

  • Graham, A., Phelps, R., Maddison, C., & Fitzgerald, R. (2011). Supporting children’s mental health in schools: Teacher views. Teachers and Teaching. Theory and Practice, 17(4), 479–496. doi:10.1080/13540602.2011.580513.

    Article  Google Scholar 

  • Greacen, T., Jouet, E., Ryan, P., Cserhati, Z., Grebenc, V., Griffiths, C., et al. (2012). Developing European guidelines for training care professionals in mental health promotion. BMC Public Health, 12(1), 1114–1123. doi:10.1186/1471-2458-12-1114.

    Article  PubMed Central  PubMed  Google Scholar 

  • Hall, P. (2005). Interprofessional teamwork: Professional cultures as barriers. Journal of Interprofessional Care, 19(Suppl 1), 188–196. doi:10.1080/13561820500081745.

    Article  PubMed  Google Scholar 

  • Helgesen, M., & Myrvold, T. M. (2009). Kommunalt psykisk helsearbeid: Organisering, samarbeid og samordning [Municipal health and care services: Organizing, collaboration and coordination] (Vol. 2009:4). Oslo: Norsk institutt for by- og regionforskning [Norwegian Institute for Urban and Regional Research].

  • Holen, S., & Waagene, E. (2014). Psykisk helse i skolen [School mental health]. Oslo: The Nordic Institute for Studies in Innovation, Research and Education (NIFU).

    Google Scholar 

  • Holmesland, A. L., Seikkula, J., Nilsen, O., Hopfenbeck, M., & Arnkil, T. E. (2010). Open dialogues in social networks: Professional identity and transdisciplinary collaboration. International Journal of Integrated Care. http://www.ijic.org/index.php/ijic/article/view/564.

  • Hornby, G., & Atkinson, M. (2003). A framework for promoting mental health in school. Pastoral Care in Education, 21(2), 3–9. doi:10.1111/1468-0122.00256.

    Article  Google Scholar 

  • Jordfald, B., Nyen, T., & Seip, Å. A. (2009). Tidstyvene. En beskrivelse av lærernes arbeidssituasjon [The time-thieves. A description of the teachers’ job situation]. Retrieved from http://www.fafo.no/pub/rapp/20113/20113.pdf.

  • Kaspersen, S., Bungum, B., Andersson, H. W., Bjørngaard, J. H., Ådnanes, M., & Buland, T. (2009). Psykisk helse i skolen. Delrapport fra effektevalueringen av opplæringsprogrammene “Hva er det med Monica?” “STEP-ungdom møter ungdom” og Venn1.no” [School mental health. An effect evaluation of the training programs; ‘What’s up with Monica?’, ‘STEP’ and ‘Venn1.no’. Report B]: SINTEF.

  • Kidger, J., Gunnell, D., Biddle, L., Campbell, R., & Donovan, J. (2010). Part and parcel of teaching? Secondary school staff’s views on supporting student emotional health and well-being. British Educational Research Journal, 36(6), 919–935. doi:10.1080/01411920903249308.

    Article  Google Scholar 

  • Kitzinger, J., & Barbour, R. S. (1999). Introduction: The challenge and promise of focus groups. In R. S. Barbour & J. Kitzinger (Eds.), Developing focus group research. Politics, theory and practice. London: Sage.

    Google Scholar 

  • Kjelvik, J. (2007). Helsestasjons- og skolehelsetjenesten i kommunene [Health clinics and school health services in the municipalities]. Retrieved from http://www.ssb.no/a/publikasjoner/pdf/notat_200732/notat_200732.pdf.

  • Koller, J. R., Osterlind, S. J., Paris, K., & Weston, K. J. (2004). Differences between novice and expert teachers undergraduate preparation and ratings of importance in the area of children’s mental health. International Journal of Mental Health Promotion, 6(2), 40–45. doi:10.1080/14623730.2004.9721930.

    Article  Google Scholar 

  • Langley, A., Nadeem, E., Kataoka, S., Stein, B., & Jaycox, L. (2010). Evidence-based mental health programs in schools: Barriers and facilitators of successful implementation. School Mental Health, 2(3), 105–113. doi:10.1007/s12310-010-9038-1.

    Article  PubMed Central  PubMed  Google Scholar 

  • Leech, N. L., & Onwuegbuzie, A. J. (2008). Qualitative data analysis: A compendium of techniques and a framework for selection for school psychology research and beyond. School Psychology Quarterly, 23(4), 587.

    Article  Google Scholar 

  • Levitt, J. M., Saka, N., Hunter Romanelli, L., & Hoagwood, K. (2007). Early identification of mental health problems in schools: The status of instrumentation. Journal of School Psychology, 45(2), 163–191. doi:10.1016/j.jsp.2006.11.005.

    Article  Google Scholar 

  • Lynn, C. J., McKay, M. M., & Atkins, M. S. (2003). School social work: Meeting the mental health needs of students through collaboration with teachers. Children and Schools, 25(4), 197–209. doi:10.1093/cs/25.4.197.

    Article  Google Scholar 

  • Mariu, K. R., Merry, S. N., Robinson, E. M., Watson, P. D., et al. (2012). Seeking professional help for mental health problems, among New Zeeland secondary school students. Clinical Child Psychology and Psychiatry, 17(2), 284–297. doi:10.1177/1359104511404176.

    Article  PubMed  Google Scholar 

  • Morgan, D. L. (1997). Focus groups as qualitative research (2nd ed., Vol. 16). Thousand Oaks, CA: Sage.

    Google Scholar 

  • Nadeem, E., Kataoka, S., Chang, V., Vona, P., Wong, M., & Stein, B. (2011). The role of teachers in school-based suicide prevention: A qualitative study of school staff perspectives. School Mental Health, 3(4), 209–221. doi:10.1007/s12310-011-9056-7.

    Article  Google Scholar 

  • Norwegian Board of Health Supervision. (2009). Vulnerable children and adolescents—need for better cooperation. Summary of countrywide supervision in 2008 of municipal health, social and child welfare services for vulnerable children. Retrieved from https://www.helsetilsynet.no/upload/Publikasjoner/rapporter2009/helsetilsynetrapport5_2009.pdf.

  • Norwegian Ministry of Education and Research. (2009). NOU 2009:18 Rett til læring [NOU 2009:18 Entitled to learning]. Oslo.

  • Norwegian Minstry of Health and Care Services. (2005). Mental health services in Norway. Preventiontreatmentcare. Oslo: Norwegian ministry of health and care services. Retrieved from http://odin.dp.no/hod/engelsk.

  • Ødegård, A. (2005). Perceptions of interprofessional collaboration in relation to children with mental health problems. A pilot study. Journal of Interprofessional Care, 19(4), 347–357. doi:10.1080/13561820500148437.

    Article  PubMed  Google Scholar 

  • Onwuegbuzie, A. J., & Combs, J. P. (2010). Emergent data analysis techniques in mixed methods research. In A. Tashakkori & C. Teddlie (Eds.), SAGE handbook of mixed methods in social and behavioral research. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Poulou, M., & Norwich, B. (2002). Cognitive, emotional and behavioural responses to students with emotional and behavioural difficulties: A model of decision-making. British Educational Research Journal, 28(1), 111–138. doi:10.1080/01411920120109784.

    Article  Google Scholar 

  • Powers, J. D., Bower, H. A., Webber, C. C., & Martinson, N. (2010). Promoting school-based mental health: Perspectives from school practitioners. Social Work in Mental Health, 9(1), 22–36. doi:10.1080/15332985.2010.522929.

    Article  Google Scholar 

  • Reinke, W., Stormont, M., Herman, K., Puri, R., & Goel, N. (2011). Supporting children’s mental health in schools: Teacher perceptions of needs, roles and barriers. School Psychology Quarterly, 26(1), 1–13. doi:10.1037/a0022714.

    Article  Google Scholar 

  • Ringeisen, H., Henderson, K., & Hoagwood, K. (2003). Context matters: Schools and the “research to practice gap” in children’s mental health. School Psychology Review, 32(2), 153–168.

    Google Scholar 

  • Roeser, R. W., & Midgley, C. (1997). Teachers’ views of issues involving students’ mental health. The Elementary School Journal, 98(2), 115–133.

    Article  Google Scholar 

  • Rothi, D. M., Leavey, G., & Best, R. (2008). On the front line: teachers as active observers of pupils’ mental health. Teaching and Teacher Education, 24(5), 1217–1231. doi:10.1016/j.tate.2007.09.011.

    Article  Google Scholar 

  • Rowling, L. (2009). Strengthening “school” in school mental health promotion. Health Education, 109(4), 357–368. doi:10.1108/09654280910970929.

    Article  Google Scholar 

  • Statistics Norway. (2013). Municipal health service 2013. http://ssb.no/helse/statistikker/helsetjko/aar/2014-07-03?fane=tabell.

  • Stephan, S., Mulloy, M., & Brey, L. (2011). Improving collaborative mental health care by school-based primary care and mental health providers. School Mental Health, 3(2), 70–80. doi:10.1007/s12310-010-9047-0.

    Article  Google Scholar 

  • Stiffman, A., Pescosolido, B., & Cabassa, L. (2004). Building a model to understand youth service access: The gateway provider model. Mental Health Services Research, 6(4), 189–198. doi:10.1023/B:MHSR.0000044745.09952.33.

    Article  PubMed Central  PubMed  Google Scholar 

  • Stormont, M., Reinke, W., & Herman, K. (2011). Teachers’ knowledge of evidence-based interventions and available school resources for children with emotional and behavioral problems. Journal of Behavioral Education, 20, 138–147. doi:10.1007/s10864-011-9122-0.

    Article  Google Scholar 

  • Tashakkori, A., & Teddlie, C. (2008). Quality of inferences in mixed methods research: Calling for an integrative framework. In M. M. Bergman (Ed.), Advances in mixed methods research: Theories and applications. London: Sage.

    Google Scholar 

  • Teddlie, C., & Tashakkori, A. (2009). Foundations of mixed methods research: Integrating quantitative and qualitative approaches in the social and behavioral sciences. Los Angeles, CA: Sage.

    Google Scholar 

  • Viggiani, P. A., Reid, W. J., & Bailey-Dempsey, C. (2002). Social worker–teacher collaboration in the classroom: Help for elementary students at risk of failure. Research on Social Work Practice, 12, 604–620. doi:10.11.77/1049731502012005002.

    Article  Google Scholar 

  • Weare, K., & Markham, W. (2005). What do we know about promoting mental health through schools? Promotion and Education, 12(3/4), 118–122.

    Article  PubMed  Google Scholar 

  • Weare, K., & Nind, M. (2011). Mental health promotion and problem prevention in schools: What does the evidence say? Health Promotion International, 26(Special issue no. 1), i29–i69. doi:10.1093/heapro/dar075.

  • Weist, M. D., & Paternite, C. E. (2006). Building an interconnected policy–training–practice–research agenda to advance school mental health. Education and Treatment of Children, 29(2), 173–196.

    Google Scholar 

  • Wells, J., Barlow, J., & Stewart-Brown, S. (2003). A systematic review of universal approaches to mental health promotion. Health Education, 103(4), 121–197. doi:10.1108/09654280310485546.

    Article  Google Scholar 

  • Williams, J. H., Horvath, V. E., Wei, H.-S., Van Dorn, R. A., & Jonson-Reid, M. (2007). Teachers’ perspectives of children’s mental health service needs in urban elementary schools. Children and Schools, 29(2), 95–107.

    Article  Google Scholar 

  • Wilson, C. J., Deane, F. P., Marshall, K. L., & Dalley, A. (2008). Reducing adolescents’ perceived barriers to treatment and increasing help-seeking intentions: Effects of classroom presentations by general practitioners. Journal of Youth and Adolescence, 37(10), 1257–1269. doi:10.1007/s10964-007-9225-z.

    Article  Google Scholar 

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Acknowledgments

The research presented in this paper was funded by grants from Volda University College, (Project No. 75019). I would like to acknowledge the six teachers who piloted the survey, the 771 teachers who took part in the survey, and the 15 teachers who provided insight into teachers’ lives through their participation in focus group interviews. I would also like to thank the reviewers for their insightful comments on the manuscript, and Dr Trond Eiliv Hauge and Dr Ingrid Lund for their valuable support.

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Ekornes, S. Teacher Perspectives on Their Role and the Challenges of Inter-professional Collaboration in Mental Health Promotion. School Mental Health 7, 193–211 (2015). https://doi.org/10.1007/s12310-015-9147-y

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