Nationally, most mental health treatment for children is provided through schools and is considered a best practice approach for serving children and youth with mental illness.[iii] Providing delivery of services on-site has not only been shown to decrease the negative stigma associated with mental illness due to the normalizing environment, but increases the number of children receiving treatment as well.[iv] Under the federal Individuals with Disabilities Education Act, schools are required to provide mental health services for students in special education with emotional disturbance issues. The Act requires school districts to identify children whose disabilities interfere with their ability to learn, and to provide services as indicated in each identified child's Individual Education Plan.[v]
Children with emotional disturbances have the highest rates of school failure. Nationwide, 50% of emotionally disturbed students drop out of high school.[vi] To confront this, there is increasing research supporting school-based interventions promoting positive child behavior for children and youth at risk of mental, emotional, and behavioral disorders.[vii] It is shown that school-based mental health programs improve educational outcomes by decreasing absences, discipline referrals, and high risk behaviors, as well as improving test scores. Therefore, addressing and treating mental health problems early and with appropriate services is important for a child's academic achievement. [viii]
School-Based Services
Indicative of school-based mental health services in Texas, a 2002-03 SAMHSA report found that the most common types of school-based mental health providers are school counselors, followed by nurses, school psychologists, and social workers. The most frequent mental health problem (73 percent) reported in schools concern youths having issues socially, interpersonally, or with their families. Schools and families report that financial constraints and inadequate school mental health resources are the most frequent barriers to providing mental health services. Over half of schools in the U.S. use contracts or other formal agreements with community-based individuals or organizations to provide mental health services to students. The most frequently used community-based providers are county mental health agencies. Sixty percent of districts reported that referrals to community-based providers had increased, but one-third reported that the availability of outside providers to deliver services to students had decreased.[ix]
A disproportionate number of children with serious emotional disturbances (SEDs) and special education needs end up in disciplinary placements instead of more appropriate services. School administrators have two different disciplinary placement options for students. One disciplinary placement option for students committing serious offenses is the Juvenile Justice Alternative Education Program (JJAEP). The JJAEP is responsible for educating youths who have been expelled from school due to a serious offense found by a court to be a violation of the Texas Education Code.
Discipline and Children with Serious Emotional Disturbances
If a student requires a disciplinary placement but has not been sent to a JJAEP, an administrator's second option is to send the student to a Disciplinary Alternative Education Program (DAEP). [x] Administrators have broad power and discretion to place a student in a DAEP. A school can place a student in a DAEP under any of the circumstances listed in the student code of conduct or if the student has ever been an adjudicated delinquent or placed on probation regardless of when or where the conduct occurred. Also, if the school determines that the student's presence is a threat to the safety of other students or teachers, "detrimental” to the education process, or not in the best interests of the district's students, the student may be placed in DAEP. Students and their guardians cannot appeal such a decision.[xi]
A disproportionate number of special education children with serious emotional disturbances are ending up in disciplinary placements. Twelve percent of the total student population received special education in 2003-04, but 25.8% of the students expelled to JJAEPs and 23.4% removed to DAEPs were children receiving special education services. Special education students are also disproportionately suspended from school: special education students compose 24.1% of students receiving out-of-school suspensions and 20.2% of in-school suspensions.[xii]
RESOURCES
The School Mental Health Project (SMHP) at UCLA was created in 1986 to pursue theory, research, practice and training for mental health concerns through school-based interventions. The SMHP website is an excellent resources for technical assistance and resources for schools and mental health.
SchoolMentalHealth.org is another resource for assistance on mental health promotion, prevention, treatment, and referrals in the school environment. This initiative is part of the Baltimore School Mental Health Technical Assistance and Training Initiative.
The Eastern Area Health Education Center (AHEC), part of The Duke Endowment, is coordinating education in school mental health. AHEC provides a school mental health training series online.
Technical Assistance Partnership for Child and Family Mental Health provides a variety of school-related resources.
The Center for School-Based Mental Health Programs (CSBMHP) at Miami University works on building collaborative relationships with schools and community agencies to address the mental health of children and adolescents through the promotion of expanded school mental health programs and services. CSMHP is committed to ongoing applied research, pre-service education of future clinicians, in-service training of educators and mental health professionals, and direct clinical and consultative service.
A summary of about the state of school mental health services in the United States was prepared by DSHS, SAMHSA, and the Center for Mental Health Services in 2003.
Two grant programs developing new service models for school-connected mental health services are provided here. Grant application periods are closed, but each site provides links to the funded recipients' projects.
The Hogg Foundation provides an in-depth analysis of school discipline and children with serious emotional disturbances in Texas.
