Date of Award

2007

Degree Type

Dissertation

First Advisor

John Boulmetis

Abstract

Untreated mental health problems among our youth result in outcomes, including suicide, homicide, substance abuse, low grades, poor attendance, and dropping out of school (Pfeiffer & Reddy, 1998; Pumariega & Vance, 1999). SBMHC's, a Systems of Care framework, can address the limited accessibility and availability to proper mental health care for children (U.S. DHHS, 1999; Gruttadaro, 2002; Flaherty & Weist, 1999). The ecological model acknowledges the interactions between the person and systems. It is sensitive to how multiple influences (environmental, biological, psychological, social) may impact youth. Despite their increase, the research on the effectiveness of SBMHC's is limited. This study assessed the effectiveness of SBMHC services received by high school students on individual, program, and school-level outcomes. Participants were predominantly white females in grades 9-12, ages 14-18, residing in a rural/suburban area. Students completed the Youth Self Report (YSR) before and after receiving SBMHC services to test individual-level outcomes. Students receiving no SBMHC services (n=34) at a Comparison School completed the YSR at pretest. Treated students (n=39) showed significant improvements on Total scores (t(36)= .018, p < .05); internalizing symptoms (t(36)= .008, p < .05); specifically, depression and anxiety (t (36) =.007, p <.05) and somatic complaints (t (36) =.008, p < .05) following the receipt of SBMHC services. Attention problems and social problems improved. There were no differences in Externalizing scores (t(36) = .847, p > .05). School records and teacher reports were analyzed to determine program-level changes in rates of attendance, behavior, and academics. There were no improvements in attendance (t(36) = .924, p > .05), achievement, or discipline (t(36) = .899, p > .05) rates. Clinical psychological referrals were examined over five years and out of school suspension (OSS) rates analyzed over eight years. Decreases in rates of special education clinical psychological referrals and OSS rates were found. These data provide support for the advancement of SBMHC's as an efficient method for improving the accessibility and availability of effective mental health services for youth. Discussion focuses on implications for theory, practice, policy development, and future research designed to improve the application of emotional and behavioral functioning to educational outcomes.

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