Abstract. Reviews have identified mental health interventions that are relevant to schools; unfortunately, this research pays insufficient attention to the school context. Several aspects of school context likely influence the ability of schools to change current practices or adopt new ones. Relying on an organizational framework, a three-level model of school context particularly relevant to the delivery of mental health interventions: (a) individual, (b) organizational, and (c) state or national-level factors are described. This article argues that effective school-based mental health care will result from the marriage of system reform efforts, capacity building, and the delivery of empirically driven intervention strategies.
In language, a word's content may be less important than the context in which it is embedded. For instance, request a "pop" across most of the United States and you will receive some form of carbonated beverage. Request a "pop" in southern Georgia and you will likely be met with a strange look or possibly a jab to the jaw. Even beyond language, context must be understood prior to interpretation. The public education and mental health systems have unique histories, distinct value sets, principles, and beliefs, as do the traditions of academic research and community practice. When these worlds are brought together, contextual differences become especially important.
In the last 20 years there has been tremendous growth in knowledge about how best to identify and treat behavioral and emotional disorders of childhood (e.g., Lonigan, Elbert, & Johnson, 1998). In addition, available service models for children diagnosed with emotional disturbances have shifted from those predominantly available in inpatient hospitals, residential centers, or outpatient centers to alternative service delivery approaches available in community settings. This growth in empirical knowledge and focus on community-based care has resulted in increased attention to the different worlds of research and practice. In fact, research has demonstrated that child mental health interventions used in everyday clinical practice are not only different from those studied in academic settings, but also potentially less effective (Weisz, Donenberg, Han, & Weiss, 1995; Weisz, Weiss, & Donenberg, 1992). Spurred by the release of the Institute of Medicine Report (1998), Surgeon General's Report on Mental Health (U.S. Department of Health and Human Services, 1999), and the Surgeon General's Conference on Children's Mental Health (U.S. Public Health Service, 2000), overcoming this gap between research and practice in children's mental health has become a national priority.
The mental health research literature describes multiple interventions with potential school application; these interventions range from those targeting select students to broad school-wide prevention programs. Recent reviews have documented efficacious psychopharmacologic (e.g., Vitiello, Jensen, & Bhatara, 1999; Weisz & Jensen, 1999); psychosocial (e.g., Lonigan, Elbert, & Johnson, 1998; Weisz & Jensen, 1999); integrated community and preventive services (e.g., Burns, Hoagwood, & Mrazek, 1999; Greenberg, Domitrovich, & Bumbarger, 2001); and school-based interventions (e.g., Rones & Hoagwood, 2000). Certain approaches appear helpful for individual children with Serious Emotional Disturbances (or SED) (e.g., cognitive problem solving, social skills training, classroom behavior management) and other school-wide programs reduce child disruptive behaviors and/or...
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