Privatization and school mental health

Date27 January 2020
Pages99-107
DOIhttps://doi.org/10.1108/JPMH-06-2019-0065
Published date27 January 2020
AuthorMark Weist,Kathleen Blackburn Franke,Rob Lucio,Jefferson Bass,Terry Doan,Deborah Blalock
Subject MatterHealth & social care,Mental health,Public mental health
Privatization and school mental health
Mark Weist, Kathleen Blackburn Franke, Rob Lucio, Jefferson Bass, Terry Doan and
Deborah Blalock
Abstract
Purpose The purpose of this paper is to describe the relationship between privatization and school
mentalhealth (SMH) in the USA, as well as to present a case study of the SMH system in South Carolina.
Design/methodology/approach The authors reviewed dataregarding states’ mental health systems
(e.g. public,private and hybrid of public and private),mental health budgets and percentagesof schools
with mentalhealth clinicians.
Findings The results demonstratethat the majority of states have public mentalhealth systems. There
is variability between states regarding general funding, as well as funding for SMH. Further, there was
variability in the percentage of schools with SMH clinicians, with South Carolina reporting the greatest
percentage. South Carolina’s mental health system,which is a publicprivate hybrid is reviewed, along
with relevanthistory on the development of SMH programsin the state.
Originality/value This paper contributes to the general knowledge by describing the provision and
funding sources for SMH services within the USA. It yields important implications for integrating public
mentalhealth services within schools.
Keywords School mental health, Privatization, Public funding
Paper type Literature review
Privatization has been broadly defined as the delegation of publicly funded services
to private organizations (Brent, 2008;Donohue and Frank, 2000). In mental health,
privatization has been described as taking place along the arenas of production/
marketization, financing and management (Donohue and Frank, 2000). The production/
marketization domain refers to the deliveryof services by private organizations. This can be
through community-based contracts or privately owned organizations at the for-profit level.
The distinguishing factor is whether the providers of the mental health services are
employed by the public entity or a private organization. Privatization of financing is when
mental health services are financed through private mechanismsrather than public funding.
The notion of applying business principles occurs when insurance funding is used to
replace public funding to support social services and mental health. Finally, privatization of
management suggests that public agencies transfer the oversite, monitoring and
administration of mental health services or systems to private organizations. These
distinctions become important because privatization can happen across all domains or a
single one. In addition, the scope of privatization might be small, such as contracting for
specific services, to transferring the entire mental health system to private organizations.
The level and extent of privatization couldhave a different impact on the system’s operation
and success.
History of privatization in child and adolescent mental health
The early 1900s saw an emphasis of children’s mental health services toward counseling
school children and reducing absenteeism, which coincided with the rise of school-based
health centers (Keeton et al.,2012). Around this time, the first mental health clinic for
Mark Weist is based at the
Department of Psychology,
University of South
Carolina, Columbia, South
Carolina, USA.
Kathleen Blackburn Franke
is based at the Department
of Psychology, University of
South Carolina, Columbia,
South Carolina, USA.
Rob Lucio is based at the
Department of Social Work,
Saint Leo University, Saint
Leo, Florida, USA.
Jefferson Bass and
Terry Doan are both based
at the Department of
Psychology, University of
South Carolina, Columbia,
South Carolina, USA.
Deborah Blalock is based
at the South Carolina
Department of Mental
Health, Columbia, South
Carolina, USA.
Received 9 August 2019
Revised 6 October 2019
28 October 2019
3 December 2019
Accepted 7 December 2019
DOI 10.1108/JPMH-06-2019-0065 VOL. 19 NO. 2 2020, pp. 99-107, ©Emerald Publishing Limited, ISSN 1746-5729 jJOURNAL OF PUBLIC MENTAL HEALTH jPAGE 99

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