Investigating Effectiveness of Evidence-Based Mental Health Services in Metropolitan School Settings

• In Event: 1-039 - Addressing Mental Health Needs in Vulnerable Youth

Integrative Statement

Introduction
By the age of 18, more than 1 in 5 youth have experienced severe impairment from a mental health disorder at some point in their lifetime (Merikangas et al., 2010). While nearly two-thirds of these youth do not receive mental health services, schools are a frequent provider of services to those that do (Merikangas et al., 2011). However, school based mental health services vary widely in effectiveness. When successfully implemented, these services can improve students’ academic performance, attendance, and graduation rates, while reducing suspension and truancy (reviewed in Carey & Dimmitt, 2012). This study reports on use of school-based mental health services for students across PreK-12 schools in a large metropolitan region.

Method
[Organization] places mental health clinicians trained in CBT and TF-CBT in local urban and suburban schools. Data was collected for 1,411 students receiving evidence-based treatment across 112 schools in the 2016-2017 school year. Teachers rated student progress in January and May using an agency-created form, while clinicians assessed student functioning using the Child and Adolescent Functional Assessment Scale (CAFAS®). Because the CAFAS documents a student’s level of functioning during a given time period, two data points were needed to evaluate progress. Consequently, this analysis relied on teachers’ May assessment of progress and two clinician CAFAS scores. Due to a substantial amount of missing data, an analytic sample was created that includes 808 students (57.3% of the sample). Demographics are reported in Table 1. The analytic sample was compared to the full sample on all demographic and outcome variables; no significant differences were found.
Descriptive and inferential statistics were used to answer these study questions: (1) Did clinicians and teachers report progress for students receiving this intervention? (2) Did clinicians and teachers have similar perceptions of student progress? and (3) What factors were associated with clinicians’ and teachers’ perceptions of student progress?
Clinician ratings were reverse coded to create consistent directionality with teacher ratings; lower scores suggest reduced daily functioning and less progress while higher scores indicate stronger daily functioning and greater progress.

Results
Results indicated that both teachers and clinicians reported student progress. Moderate agreement (r = .38) between teachers and clinicians was observed. Regression analysis revealed factors associated with teachers and clinicians’ ratings. Teachers’ ratings were positively associated with strong attendance and IEP placement and negatively associated with removal from the classroom for emotional or behavioral dysregulation. Meanwhile, clinicians’ ratings were positively associated with strong attendance and negatively associated with IEP placement and suspension. A unique interaction was observed for girls with a behavioral therapy focus; clinicians reported greater impairment in this subgroup of students. Regression models predicting clinicians’ May ratings are shown in Table 2.

Conclusion
While missing data and data collection techniques present limitations to this study, it provides a preliminary report of the effectiveness of this school-based therapy using evidence-based treatments in improving the emotional and behavioral wellbeing of students. Given the high need for mental health services among youth and accessibility of school-based services, documentation of effective services is widely needed.

Authors

• Jessica B. Koslouski, Boston University
  Presenting Author

• Kara Sabalauskas, The Home for Little Wanderers
  Non-Presenting Author

• Shelly Dorman, The Home for Little Wanderers
  Non-Presenting Author