BackHome
Refresh: Off
Paper Summary
Share...

Direct link:

Innovating School-Based Mental Health Services: Breaking Boundaries and Building Schools as Centers of Wellness

Sun, April 14, 9:35 to 11:05am, Philadelphia Marriott Downtown, Floor: Level 4, Franklin 11

Abstract

Background
School-based mental health (SBMH) services improve access to care, allow for early identification and treatment, and are linked to better school and mental health outcomes (Hoover & Bostic, 2020). Services located in schools may increase access for underserved populations, specifically from low-income backgrounds (Love et al., 2019). Recent expansions to Medi-Cal (i.e., California’s Medicaid program) will increase the number of covered students; yet, the school sector faces barriers using this health-sector funding stream (MBES/CBES, 2021). Furthermore, workforce shortages present challenges in hiring full-time school-based clinicians (Lambie et al., 2019).

Objectives
One County Office of Education (COE) in California developed the “Schools As Centers of Wellness” (SCOW) Model to support solutions countywide. The COE, partnering with the county Department of Health Services, facilitated school access to Medi-Cal funding, enabling the expansion of multi-tiered mental health services at school sites. The COE hires, trains, and supervises the school-based clinicians, who each work full-time within participating schools. Starting with ten schools in 2020-2021, this model will expand to sixty schools in 2023-2024. The COE has partnered with university researchers to drive continuous improvement and growth – including, now, technical assistance requests from other counties. Broadly, this paper seeks to systematically respond to the frequently asked question “Why and how was this created?” in ways that enable educational leaders to consider fit and initial steps in their contexts. Specifically, the research practice partnership (RPP) investigated: How do the partners describe the motivations for innovating in SBMH (RQ1)? And what shaped the development of the SCOW model (RQ2)?

Method
From June-October 2022, RPP members conducted semi-structured, hour-long interviews via Zoom. The sample (N=23) identified racially as: White (50%), Asian (18%), Latinx (14%), Black (9%), and Two or More Races (4.5%); mostly female (64%); and worked as School-Based Clinicians (36%), County Office of Education Leaders (32%), County Health Partners (18%), and School administrators (14%). Through an iterative deductive coding process using the Human-Centered Design (HCD; Giacomin, 2015) framework, we identified patterns related to the development phases of the initiative. We then engaged in reflexive thematic analysis (Braun & Clarke, 2021) and co-interpretation with partners to generate final themes.

Findings
As the primary conditions that motivated innovation (RQ1), participants reflected on (1) growing student mental health needs coupled with inequitable access to care and (2) the realities of previously unsustained efforts that garnered mistrust. Partners spoke to the following four themes that shaped the development of the initiative (RQ2): 1) relationships and partnerships were foundational; 2) an ecological approach to systemic change, prevention, and inclusion was needed; 3) financial restructuring created new possibilities; and 4) prioritizing equitable conditions for access was central.

Significance
These findings shine a scholarly light on the motivations and realities of innovation in schools, highlighting multiple perspectives across newly forged partnerships, and identifying avenues for SBMH implementation research. Findings have implications for central offices and schools seeking sustainable funding for promoting multi-tiered supports for student wellbeing in their schools and equitable access to mental health services.

Authors