Mental health care provided through community school models

Date29 August 2019
Pages297-314
DOIhttps://doi.org/10.1108/JMHTEP-01-2019-0006
Published date29 August 2019
AuthorOluwatoyin Olubiyi,Anne Futterer,Christina D. Kang-Yi
Subject MatterHealth & social care
Mental health care provided through
community school models
Oluwatoyin Olubiyi, Anne Futterer and Christina D. Kang-Yi
Abstract
Purpose The purpose of this paper is to comprehensively identify and synthesize the mental health care
provided through diverse community schools implemented in the USA.
Design/methodology/approach Using PubMed, community school model websites and Google Search,
we identified 21 community school models that publicly reported outcomes and conducted full review of
these models. The authors also conducted e-mail and telephone communication with ten program directors
and evaluators to gain insights into successes and lessons learned through implementingcommunity school
models based on community partnership.
Findings Provision of mental health care though community schools leads to reducing school
suspensions, disciplinary referrals, problem presentation, and risk behaviors, and improving school grades,
personal responsibility, future aspiration, and family engagement.
Research limitations/implications Developing standardized outcome measure for the evaluation of
mental health care provided through community school models is important to establish evidence that leads
policymakers and practitioners into action. Information toolbox to guide mental health administrators and
practitioners about future funding and partnership mechanisms for successful implementationand sustained
mental health care through community school models can be useful.
Originality/value This systematic literature review provides insights into the current practice and future
direction in the provision and evaluation of mental health care through community school models and
addresses concrete research and practical implications to guide mental health professionals.
Keywords Child and adolescent mental health, Community school model, School-based mental health
Paper type Literature review
Background
Despite the fact that about one half of all lifetime mental disorders begin in mid-teens
(De Girolamo et al., 2012; Patton et al., 2014; Sanchez et al., 2018), 80 percent of youth with the
need for mental health services are still found not receiving mental health care (Kataoka et al.,
2002; Howell, 2004; Cooper and Aratani, 2009; Santiago et al., 2013, Costello et al., 2014) and
50 percent of youth with serious mental illness never receive appropriate mental health treatment
(Merikangas et al., 2011; Olfson et al., 2015). Poor mental health has direct impact on both youth
school and mental health outcomes (DeSocio and Hootman, 2004; Dupéré et al., 2018;
Hjorth et al., 2016; Maynard et al., 2015; Neely and Griffin-Williams, 2013). About one third of
youth enrolled in US public high schools drop out of school every year (Fall and Roberts, 2012)
and up to 11 percent of the high school dropout are due to mental illness (Mojtabai et al., 2015).
Studies have also shown that high school dropouts are more likely to lead youth to commit crime
and engage in antisocial behaviors (Neely and Griffin-Williams, 2013; Maynard et al., 2015).
Indeed, 68 percent of prisoners in the US prisons are high school dropouts (Kiley, 2018).
A number of school-based mentalhealth programs have been implemented to ameliorate negative
school outcomes by increasing access to appropriate mental health services. Previous studies
found that school-based mental health services can reduce disciplinary referrals and out-of-school
suspension (KangYi et al., 2013) and improve learning behavior, grade promotion and grades
(Bierman, 2002; Jennings et al., 2000; KangYi et al., 2013; Nelson et al., 2002; Walter et al., 2011).
Received 22 January 2019
Revised 24 June 2019
Accepted 3 July 2019
Oluwatoyin Olubiyi is Senior
Fellow at the University of
Pennsylvania, Philadelphia,
Pennsylvania, USA and
Department of Psychiatry,
University of
Pennsylvania, Philadelphia,
Pennsylvania, USA.
Anne Futterer is based at the
Department of Psychiatry,
University of
Pennsylvania, Philadelphia,
Pennsylvania, USA.
Christina D. Kang-Yi is based at
the Leonard Davis Institute of
Health Economics, Department
of Psychiatry, University of
Pennsylvania, Philadelphia,
Pennsylvania, USA.
DOI 10.1108/JMHTEP-01-2019-0006 VOL. 14 NO. 5 2019, pp. 297-314, © Emerald Publishing Limited, ISSN 1755-6228
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THE JOURNAL OF MENTALHEALTH TRAINING, EDUCATION AND PRACTICE
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PAGE297
Despite the positive outcomes, the effect of school-based mental health programs on youth
outcomes has been limited due to environmental factors that affect youth s choolou tcomes beyond
the control of these programs such as poor socioeconomic status of families, neighborhood safety
and community resources (Epstein et al.,2018;Fosteret al., 2005; Santiago et al., 2013).
Previous research has reported the significant impact of neighborhood safety and parental
attitudes on school outcomes (Woolley and GroganKaylor, 2006). For example, residence in a
disadvantaged neighborhood reduces the chances of graduation from 96 to 76 percent for
African American youth and from 95 to 87 percent for other races (Wodtke et al., 2011). Youth
who live in low-income families are ten times more likely to drop out of high school and experience
mental health problems than youth living in high-income families (Cataldi and Kewal Ramani,
2017; Morrissey et al., 2014; Reiss, 2013). Similar studies show that youth who live in social
housing in wealthier areas had better academic outcomes than those who live in social housing in
poor areas (Martens et al., 2014). Parental positive attitude toward attending school meetings,
checking homework and encouraging children to do well in school are positively correlated with
high academic outcomes and negatively correlated with school dropout and risky behaviors (Day
and Dotterer, 2018; Heers et al., 2016; Woolley and GroganKaylor, 2006).
Community-level interventions such as community school model, the Health Enterprise Zone, the
Promise Neighborhoods Program and the Promise Zone that cover a wide spectrum of services
to meet variety of needs youth and families have in the community have been recently considered
as a promising venue of alleviating the burden of increasing need for mental health care. The
community-level interventions which we categorize as community school models in this review
are expected to maximize the effect of mental health care and minimize the environmental barriers
by addressing diverse needs of youth, families and neighborhoods. For example, the Promise
Neighborhoods Program funded through the US Office of Education supports innovative
strategies to provide comprehensive education, safety and family support services (US
Department of Education, 2016). Community school models aim to revamp schools to reduce
achievement gap between students from low socioeconomic families and students from high
socioeconomic families, and mobilize communities to promote positive youth outcome (Wodtke
et al., 2011). The modern day of community school models implemented in the US for the past
two decades recognize a community school as a place and a set of partnerships connecting a
school, families of students and surrounding community (Coalition for Community Schools, nd).
Although there is great variation among the existing models, community school model is
distinguished from regular public schools by its integrated focus on academics, youth
development, family support, health and social services, and community development (Blank
et al., 2012; Oakes et al., 2017). Community school model expands learning time and
opportunities through connecting students and families to services such as sports, journalism,
traveling, technology, mentoring, tutoring and volunteering in schools (Oakes et al., 2017).
Community school model emphasizes family and community engagement and collaborative
leadership and practices whereby students, teachers and stakeholders with different areas of
expertise work together to achieve common goals (Oakes et al., 2017).
Community school models have demonstrated positive impact on improving youth and family
outcomes. However, information on mental health care delivery through community school
models and its impact on youth outcomes has been limited. Systematic information on mental
health care delivery through community school models can guide mental health policymakers and
practitioners to effectively partner with youth, families, educators, and other community partners
in designing and delivering comprehensive and effective mental health care. This systematic
review aimed to identify existing mental health care provided in schools through community
school models, review its impact on youth outcomes and gain insights into successes and
lessons learned in delivering mental health care through community school models.
Methods
The systematic review included online document review and e-mail and telephone
communication with program administrators and evaluators. The online document search was
conducted through PubMed, comunity school websites and Google Search. PubMed was used
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