Increasing and Sustaining School Mental Health Services

Integrating mental health and education to improve child outcomes

Dates of Project: January 2011–April 2012

Field of Work: School-based mental health services

Problem Synopsis: Between 14 and 20 percent of all children and adolescents have mental health disorders. Very few receive help. Along with other problems, poor mental health prevents students from effective learning. Schools can play a role in promoting mental health prevention and treatment for their students, but school mental health services are not widely available.

Synopsis of the Work: The Center for Health and Health Care in Schools explored strategies to increase the number, quality, and sustainability of school mental health services and programs through:

  • Review of the literature and federal and state education and health policies and practices
  • Interviews and surveys with stakeholders in school mental health
  • Visits and interviews with people involved with three school mental health programs
  • Co-sponsoring, with the Center for School Mental Health Services, a conference on school mental health research

Key Findings:

  • While a plan to sustain mental health services for children should be tailored to the state and the community, common elements that contribute to the effectiveness of school mental health programs are:
    • Maximizing all possible financial sources of support for mental health services, including public and private insurance, in-kind contributions from the school systems, and grants from public and private entities to subsidize nonbillable services
    • Engaging influential individuals and/or organizations that helped bring insurance providers to the table to negotiate
    • Serving all students in need of mental health care regardless of ability to pay, and setting clear productivity expectations for clinicians around maintaining a balance of billable versus nonbillable services
    • Investing in an administrative infrastructure to support billing capacity
  • Knowing the eligible services, clients, and providers of the commercial and public insurers that cover the students served

Project staff concluded that:

  • Children's mental or behavioral health has not historically belonged to any particular local, state, or federal agency. Thus, there has been limited government leadership to assure that a functioning system of preventive and treatment services responds to children's needs. Neither federal nor state leaders have made support for children's mental health a priority.

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