Learn More about School-Linked Mental Health Services

Children and youth spend a significant amount of time participating in public education, and, therefore, schools are a location where mental health assessment, prevention, early identification, and treatment can be provided. Untreated, mental health issues can create a significant barrier for children and youth as they seek learning and educational success. Placing children’s mental health services within the school provides a great opportunity for mental health promotion, prevention and early identification and intervention. School-based or school-linked mental health refers to mental health services delivered within the school setting. However, school settings can vary from neighborhood schools to public school programs administered within hospitals, juvenile facilities or other settings. Understanding how evidence-based practices are used within school-linked mental health programs and in what settings are important variables for assessing best practice. School-linked services describe an integrated approach for supporting children and youth by:

• Increasing accessibility for children and youth who are uninsured or underinsured,
• Improving clinical and functional outcomes for children and youth,  and
• Assisting with screening, prevention, assessment, and early intervention.

Different types of school-linked mental health services focus on prevention while others focus on treatment efforts.

Preventing Mental Health Disorders Using a School-linked and School-based Services

One model for preventing mental illness and promoting health has evolved from public health.  The emphasis of this model is to implement a continuum of strategies that increase in intensity.  Over time, this model has included the promotion of mental health and wellness in schools, as well as strategies for early identification and intervention to prevent emotional/behavioral disturbances in children.  These levels of prevention are summarized as follows, with a few important additions that were added as a result of research regarding prevention and treatment in children’s mental health (see Weisz, Sandler, Durlak & Anton, 2005).

• Health Promotion/Positive Development Strategies target a whole population with the aim of enhancing strengths to reduce risk of later problem outcomes, and to increase positive development.
• Universal Preventive Interventions: address risk factors in whole populations of youth (e.g., all students in a classroom, in a school), without attempting to distinguish youths at risk.
• Selective Preventive Interventions: target individuals or a subgroup of the population whose risk of developing mental disorders are significantly higher than average. Risk may be imminent or a lifetime risk. Specific interventions to counter that risk are applied and evaluated.
• Indicated Preventive Interventions: target high risk individuals who are identified as having minimal but detectable signs or symptoms of mental disorders, but do not meet the DSM criteria currently
• Treatment Interventions: target youth who currently experience high symptom levels or diagnosable disorders.

School-linked and School-based Mental Health and Evidenced-based Practice

There are many examples of school-linked and school-based services. A review of the field will show a diverse number of perspectives describing the best way to implement school-linked and school-based services. The diversity often reflects the educational and professional backgrounds of those leading implementation efforts. An example of the types of educational backgrounds and professional disciplines that may influence school-linked and school-based mental health services may include:

• Applied behavior analysis,
• Clinical Psychology,
• Developmental Psychology,
• Psychiatry, and
• Special Education.

These different disciplines tend to use different language and ways in which to describe the elements of school-linked and school-based mental health interventions. There are a number of websites and resources that can be used to choose an evidence-based school-linked program that fits best in your community. Visit The Minnesota Department of Human Services School-linked Behavioral Health Services page to learn more about how to find an evidence-based school-linked program and how to evaluate whether the program your community chooses is working effectively.