School-based mental health is designed for students with, or at risk of, Special Education classifications for emotional/behavioral problems.  Mental health services are provided to children in schools through programs and/or clinics.  The New York State Office of Mental Health (OMH) either funds directly, or in collaboration with the New York State Education Department (NYSED) and the New York State Department of Health (NYSDOH), a significant number of school-based mental health projects and services.   NYSOMH also co-administers school mental health projects funded by NYSED.

For School-Support I and II, OMH Bureau of Children and Families collaborates with the NYSED.  For School-Support III, OMH collaborates with the NYSED and the NYSDOH.   School Support III projects are located in schools with DOH-licensed School-Based Health Centers.

Why Is SBMH Important?

Twelve percent or 7.5 million youths have a mental, behavioral, or developmental disorder (Edmands et al., 1999).  Yet, only one-fifth of young people receive treatment (Edmands et al., 1999).  The Report of the Surgeon General on Children’s Mental Health (U.S. DHHS, 1999) found that 40-60% of families who begin outpatient treatment terminate it prematurely.  The great majority of children who enter outpatient treatment attend only one session, (Kazdin, 1997, Armbruster & Falloon, 1994). 

The Surgeon General’s Report concluded that primary care and schools are the major settings for the potential recognition of mental disorders in children and adolescents, yet trained staff are limited, as are options for referral to specialty care (U.S. DHHS, 1999).

The evidence base for practices which are effective in the school environment is, however, very thin.  A recent focus, at both the federal and state levels, on ensuring that all students--including those diagnosed with emotional and behavioral disabilities--get the supports they need to succeed in school has highlighted the need for evidence-based mental health practices.

In a recent review of thousands of mental health initiatives, which have been developed and tested specifically for use within school settings, researchers found only 34 that met reasonable standards of efficacy (Greenberg et al., 2001).  There is, however, some research that demonstrates the effectiveness of certain clinical practices with children and adolescents (e.g., Cognitive Behavioral Therapy (CBT) for depression and anxiety in children and adolescents, Interpersonal Therapy for Adolescents (IPT-A) for depression in adolescents).  

The development of the descriptions for each OMH Priority Set for Evidence-Based Practices included extensive involvement from clinical experts, mental health recipients, youth and family members, and people who represent culturally diverse viewpoints. Their perspectives are critical to the understanding of these important practices and programs in mental health.

While there is individual variation due to local need, generally the joint agency projects contain the following elements:

The purpose of these school-based initiatives is to examine the effectiveness of school-based mental health services which are well integrated within the school setting and supplemented by family support services and training for school staff and families in behavior management strategies, mental health awareness and promotion, etc. (School Support I and II).  Further, OMH and its partners  will examine the effectiveness of school mental health initiatives which not only include these components, but which also coordinate health and mental health services and provide training in evidence-based clinical practices as well as ongoing supervision of clinicians to ensure fidelity to these practices, (School Support III). Families who have participated in annual reviews of School Support I projects have expressed support for the school-based mental health model, particularly for encouraging the active participation of families in both project-wide and child-specific decision-making processes, as well as for helping to improve communication between the school and the family.   Parents have also noted the lack of stigmatization of children who receive mental health services in the school environment. Parent surveys are being administered in or being developed for all School Support projects.

Armbruster, P., Falloon, T. (1994).  Clinical, sociodemographic and systems risks factors for attrition in children’s mental health clinic.  American Journal of Orthopsychiatry, 64, 577-585.

Edmands, M. S., Hoff, L.A., Kaylor, L., Mower, L., Sorrell, S. (October 1999).  Bridging gaps between mind, body, and spirit:  Healing the whole person.  Journal of Psychosocial Nursing, 37 (10), 35-42.

Greenberg, M., Domitrovich, C., Bumbarger (2001). The prevention of mental disorders in school-aged children:  Current state of the field.  Prevention and Treatment, 4, Article 1.  Available on web at:  http://journals.apa.org/prevention/volume4/pre0040001a.html

Kazdin, A.E., Holland, L., Crowley, M. (1997).  Family experience of barriers to treatment and premature termination from child therapy. Journal of Consulting and Clinical Psychology, 65, 453-463.

U.S. Department of Health and Human Services (1999).  Mental health:  A report of the surgeon general-executive summary.  Rockville, MD:  U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health.

U.S. Department of Health and Human Services (2001). Mental health: Culture, race and ethnicity- A supplement to mental health: A report of the surgeon general. Rockville, MD:  U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health.

Back