Mental Health Care in the Schools – Miranda, Sheryl, Burnam, Adelsheim

Nearly every classroom has one or two children with serious emotional problems. Their problems often go undiagnosed and untreated. That often leads to poor academic performance and, if serious enough, school failure and other destructive outcomes (e.g., juvenile delinquency). Recognizing the problem, many high-profile reports, including the President’s New Freedom Commission on Mental Health, have urged school systems to screen children for mental health problems and then ensure that children who screen positive are linked to high-quality care. Schools have become increasingly receptive, especially after passage of the No Child Left Behind Act, which places emphasis on standardized testing of academic performance. But evidence is meager that screening and treatment of mental health problems improves academic test scores. For that reason, the Network is participating in several projects. One project tackles the formidable problem of how to assess school outcomes. School grades, the most obvious choice for an outcome measure, are somewhat unreliable. More objective outcomes, such as school-based standardized tests, are attractive, but they are neither given frequently enough, nor necessarily at the right time -- at the end of a treatment episode. Another project is part of a randomized controlled trial of looking at the effects of different types of mental health care given in schools. It tests the benefits of three possible interventions linked with school screening: usual care (i.e., the typical care given in a community) and two types of evidence-based services. The project evaluates the comparative impact of these types of care on school mental health outcomes.

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Last modified: June 1, 2006
©2006 MacArthur Foundation Network on Mental Health Policy Research
Last Revised: June 2006