Centering Youth and Caregiver Priorities: Perspectives on School Roles in Supporting Behavioral Health Outcomes

• In Event: From Coordination to Collaboration: Looking Across Healthcare and Educational Contexts to Support Children with Disabilities

Abstract

Objectives:
Youth behavioral health needs have escalated over the last decade, with national leaders, including the US Surgeon General, calling for the more prominent role for schools in addressing mental health. As schools become key access points for behavioral health services, there is a growing urgency to align services with the outcomes that youth and caregivers prioritize. However, limited research has examined how youth and caregivers perceive the roles that schools can and should play in helping them achieve these outcomes. The present student seeks to fill this gap by exploring caregiver and youth perspectives on how schools influence the behavioral health outcomes that matter most to them.
Methods:
This qualitative study engaged caregivers and youth with lived experience of behavioral health service use across six U.S. regions through two rounds of virtual focus groups, totaling 24 sessions. Focus group protocols and recruitment strategies were developed in partnership with a caregiver advisory board composed of parents of children with behavioral health challenges. Between February and May 2023, we conducted 12 focus groups with caregivers (N = 42) and 12 with youth and young adults aged 13 to 26 (N = 34). Participants reported an average of 7.48 years (SD = 5.60) of experience accessing behavioral health services. During the sessions, participants were asked to identify priority behavioral health outcomes and discuss the actual and potential roles schools play in achieving those outcomes. All sessions were audio-recorded, transcribed verbatim, and analyzed using Braun and Clarke’s six-phase thematic analysis approach. Analysis was facilitated using qualitative data management software to code and organize emerging themes.
Results:
Four primary themes emerged from the data: 1) collaborative care is essential; 2) appropriate school responses to behavioral health needs; 3) resource constraints limiting school impact; and 4) the critical role of parent advocacy. Specifically, several caregivers noted that when school personnel working with youth behavioral health needs via special education services coordinate with additional services, such as their doctors and community-based therapists, care becomes “much less complex” and easier to navigate for families. Youth also noted the importance of schools in understanding, supporting, and having the capacity to work with them and their needs beyond specific academic outcomes.
Scientific or scholarly significance:
Findings underscore the need for schools to be integrated partners in behavioral health ecosystems and for educational systems to increase capacity for mental health collaboration. Schools are not only academic institutions but also potential hubs of behavioral health support—particularly when guided by the priorities and lived experiences of youth and families. Future research should investigate the mechanisms that facilitate or inhibit effective collaboration between schools and community-based mental health providers, and how schools can be supported in building behavioral health capacity.

Authors

• Jennifer Murphy, University of Texas - Arlington

• Genevieve Graaf, University of Texas - Arlington