A Vignette Study to Understand Teacher Identification of Adolescent Mental Health Needs

• In Event: The Role of Teachers in Identifying and Supporting Students With Mental Health Problems

Abstract

Overview
This study aims to assess the ability of middle and high school teachers to identify students with varied mental health concerns. Teachers typically report limited knowledge of the supports needed for students with mental health problems (Reinke et al., 2011). Findings provide valuable information about variation in teacher attitudes toward mental health supports for students.

Theoretical framework
The Gateway Provider Model (Stiffman, Pescosolido, & Cabassa, 2004) suggests that referral for health and mental health services by gateway providers is a result of the complex interaction of patient and provider individual characteristics, as well as organizational factors. This presentation focuses on teacher perceptions of individual child factors, which include (a) predisposing factors, such as demographic and risk and protective factors, (b) need factors, such as presence and severity of disorder, and (c) enabling factors, such as access to care (Andersen, 2011).

Methods
Middle and high school teachers from across the United States completed an online survey in the spring of 2015 using Qualtrics survey software. Schools were identified for teacher recruitment using a stratified randomized sampling strategy. We downloaded a list of all US public schools from the Department of Education website and stratified schools by region of the country and urbanicity. Schools were randomly selected and, within each school, one teacher was selected for recruitment. 617 teachers received emails inviting them to participate. Of the teachers who opened their email (n=263, 42%), 115 completed the survey (18.6% of total recruited, 43.7% of those who opened recruitment email).

Measures
Teachers were provided two vignettes describing students who varied systematically in the nature of their problem (internalizing vs. externalizing), the severity of their problem (mild/moderate vs. severe), and gender. Vignettes were adapted from vignettes developed by the Center for Multicultural Mental Health Research to study parent perceptions of child mental health needs (Lapatin et al., 2012). As in a previous study (Chavez et al., 2010), teachers were asked to rate the vignettes on the seriousness of the problem and the extent to which they would be worried about the child.

Results
Preliminary analyses indicated that teachers rated internalizing scenarios as more serious than externalizing scenarios (t=2.4, p=.017). Teachers were also more worried about students from internalizing scenarios (t=2.3, p=.021), and indicated that they were more likely to refer those students for services (t=2.4, p=.017). Teachers rated students from the severe vignettes as more seriously concerning than those from the mild vignettes (t=-4.2, p=.000), and were more worried (t=-3.46, p=.001) about those same students. Gender of students in the vignettes was not associated with ratings. We will recruit a second round of teacher participants in the fall and analyze data using multi-level regressions to account for nesting within teacher rater.

Significance
Preliminary results suggest that teachers identify mental health problems based on the severity and type of problem (need factors), but not student gender (a predisposing factor). Further exploration into teacher perceptions is necessary to ensure that all at-risk students are identified and supported.

Authors

• Jennifer Greif Green, Boston University

• Noah Segal, Boston University

• Kathryne Adams, Boston University