In 2011, researchers at the Center for Health and Health Care in Schools undertook a study to examine children’s mental health services in schools across the US, with the intent of identifying systematic challenges to access and highlighting effective school-based programs.  Eleven states were identified to participate in the study, including North Carolina.  Forty-seven individuals were interviewed about school mental health.

Key findings included the following:

1. The critical challenge to strengthening children’s mental health programs is funding, a result of the low priority assigned to these services.  Often this comes as a result of the stigma associated with mental health.

2. Services for seriously emotionally disturbed children and adolescents remain the primary focus of effort and funding by state governments.

3. The complexity of child mental health service delivery systems and funding streams hampers integration and expansion of services.

4. Court actions have varying impacts on children’s access to mental health services.

5. State action expanding insurance coverage for low-income children and families can lead directly to increased service access.

6. While legislative and judicial actions to improve children’s mental health care have been encouraged by community and family advocates, professional associations and clinical providers have also pressed for change.

7. While most states have prioritized services to support seriously emotionally disabled children, at least one state has implemented a comprehensive approach that links prevention and early intervention services to deep-end care.

8. Locally-controlled school policies and priorities may complicate implementation of state-funded, school-located child mental and behavioral health programs.

9. While underfunding has limited the capacity of child mental health services across the nation, additional promising practices can be found in a number of states.”  One of the examples was related to classroom-based social-emotional learning and positive behavioral instructional supports, which are promoted in North Carolina schools.

North Carolina was also singled out as having “demonstrated the power of partnerships between mental health professionals and physical health providers.”

Although the researchers lamented the underdeveloped state of children’s mental health services, particularly for low-income children, they noted that policymakers, school administrators, and mental health professionals recognize the value of not only integrating primary medical and behavioral health care but also of integrating children’s mental health services and K-12 schools.  They also found broad support for improving services and encouraged states to conduct its own self assessment and determine what is likely to make a difference in moving forward.

Click here for a copy of the full report.

The citation is as follows:

Behrens D, Lear JG, Price OA.  Improving access to children’s mental health care:  Lessons from a study of eleven states.  Washington, DC:  George Washington University Center for Health and Health Care in Schools, March 2013.