Date of Award


Degree Type


Degree Name

Doctor of Philosophy in Psychology


Clinical Psychology



First Advisor

Ellen C. Flannery-Schroeder


Among the many children with mental health needs, few actually receive mental health services. The children who do receive services are often initially referred by teachers (Sciutto, Terjesen, & Frank, 2000). However, the potential influences of child characteristics, like symptoms, gender, ethnicity, and school professionals’ attitudes on such referral decisions are not well understood. While the existing literature suggests that the students who are most often referred for services present with externalizing problems and are male, there has been little investigation regarding student race or ethnicity and teacher or school personnel referrals for mental health services. The present study used an online survey and vignettes to assess whether student symptoms, gender, and ethnicity influenced school professionals’ recognition of child mental health issues and decision to refer the child for mental health services. Additionally, the school professionals’ years of experience and attitudes toward child mental illness were explored. Participants included 297 teachers and other school personnel. Results indicated that participants’ responses to externalizing symptoms, like ADHD, were influenced by the presence of clinically significant symptoms. With regard to internalizing symptoms, like GAD, participants’ recognition and referral intentions were influenced by clinical symptoms and general attitudes about child mental health. There were no significant indications that student gender or ethnicity influenced participants’ responses, which contradicts previous findings. This study highlights the need for continued research examining ways to support teachers and other school personnel with the common goal of supporting the mental health of students. Implications of the current findings and potential future directions in this area of research are further discussed.



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