(This item is among the 5-10 highlights posted for ISHN members each week from the ISHN Member information service. Click on the web link to join this service and to support ISHN)
Most of the research and discussion about school mental health has focused on prevention and early identification of students experiencing difficulties. An articles in Issue #8, 2017 of Psychology in the Schools reminds us about the important role that schools can play in supporting students when they return to school after a crisis. "This paper presents results of a study examining a school-based support program model designed to provide short-term academic, social, and emotional support to help students successfully reacclimatize to school after an extended absence. The paper describes demographic, academic, and clinical characteristics of 189 program participants across eight high schools. Improvements were observed in participants’ day-to-day functioning based on the results of pre/postassessments completed by program clinicians. Preliminary data showed positive trends in participants’ school attendance and high school graduation rates. Finally, the paper considers implications for school-based mental health practice and next steps in related research. Read more...
(This item is among the 5-10 highlights posted for ISHN members each week from the ISHN Member information service. Click on the web link to join this service and to support ISHN)
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A news story out of Edmonton, Alberta, Canada has reminded us about the need to monitor wait times as part of the school health/other services component of a comprehensive approach to school health promotion. The story notes that only 41% of young people in Edmonton received mental health treatment within 30 days after referral. The details of the report are important " according to the latest numbers from Alberta Health Services. The Performance Measure Update shows that for the three-month period between April and June of this year, only 41 per cent of children in the Edmonton zone needing mental health treatment received it within 30 days of a referral.That's down sharply from the same period in 2015, when 94 per cent of children in the Edmonton area saw a therapist within 30 days." But more importantly, this trend was noted and discussed intelligently, with representatives of the local hospital and school board responding with more staff being assigned and the roll-out of a Mental Health First Aid course for teachers that will help with early identification. Because this is part of the Alberta health ministry monitoring plan, comparisons were possible over time and with similar cities in the province. In other words, this is a good example of how a monitoring system should work. Read more>>
(This item is among the 5-10 highlights posted for ISHN members each week from the ISHN Member information service. Click on the web link to join this service and to support ISHN) (An item from the ISHN Member information service) A July 15, 2015 news release from the Office for Standards in Education (Ofsted) in England has announced that it will monitor the joint delivery of support services to children and youth. "Joint Targeted Area Inspections (JTAI) are to be introduced from autumn this year by Ofsted, the Care Quality Commission, Her Majesty’s Inspectorate of Constabulary and Her Majesty’s Inspectorate of Probation. They will specifically examine how well local authorities, health, police and probation services work together in a particular area to safeguard children. The new inspections aim to shine a light on both good and poor practice, identifying examples from which others can learn and helping local agencies to improve. The proposals, set out in a consultation launched today (Wednesday 15 July), will give inspectorates more flexibility and the ability to be responsive to certain areas of interest or concern. Each inspection is to include a ‘deep dive’ element, with the first 6 set to focus on children at risk of sexual exploitation and those missing from home, school or care. Further inspections will look at other issues by theme. The experiences of children and young people are at the heart of the proposed model. Inspectors from across all 4 inspectorates will work in small multi-disciplinary teams jointly tracking and sampling cases to assess the progress and outcomes for children and young people at risk of harm. This will complement the single agency inspections and provide a joined up evaluation of how well the agencies work together to protect children. Under the proposals the final report will include a narrative judgement that clearly sets out how the local partnership and the agencies who are part of it are performing and what they need to do to improve.". Read more>>
(An item from the ISHN Member information service) A global overview of School Health Services is provided, with data from 102 countries, in Issue #4, 2015 of Health Behaviour & Policy Review. The report was led by a staff person at the WHO global office in Geneva. "The literature in PubMed and other sources were reviewed using an explicit methodology. Results : School health services exist in at least 102 countries. Usually services are provided within school premises (97 countries), by dedicated school health personnel (59 countries). Services are provided in 16 areas; the top 5 interventions include vaccinations, sexual and reproductive health education, vision screening, nutrition screening, and nutrition health education. Conclusions : Important areas such as mental health, injury and violence prevention may not be given sufficient consideration in routine service provision. We advance several recommendations for research, policy, and practice." Read more>>
(From the ISHN Member information service) An article in the March 2015 issue of Journal of Adolescent Health reports that school-based health centresd can effectively promote sexual health among their clients. The researchers report that "Reproductive health indicators among students at four urban high schools in a single building with an SHC in 2009 were compared with students in a school without an SHC, using a quasi-experimental research design (N = 2,076 students, 1,365 from SHC and 711 from comparison school). The SHC provided comprehensive reproductive health education and services, including on-site provision of hormonal contraception. Students in the SHC were more likely to report receipt of health care provider counseling and classroom education about reproductive health and a willingness to use an SHC for reproductive health services. Use of hormonal contraception measured at various time points (first sex, last sex, and ever used) was greater among students in the SHC. Most 10th–12th graders using contraception in the SHC reported receiving contraception through the SHC. Comparing students in the nonintervention school to SHC nonusers to SHC users, we found stepwise increases in receipt of education and provider counseling, willingness to use the SHC, and contraceptive use. Read More>>
(From the UCLA School Mental Health Project) A part of the ASCD-ISHN global dialogue on integrating health & social programs more effectively within education systems has focused on the need for better coordinated among the various student support services. A recent UCLA planning guide takes this coordination a major step forward and connects it to student learning and success. The guide suggests that "New directions for student and learning supports are key to systemically addressing barriers to learning and teaching. The aim is to unify and then develop a comprehensive and equitable system of student/learning supports at every school.This guide incorporates years of research and prototype development and a variety of examples from trailblazing efforts at local, district, regional, and state levels. The prototypes and examples can be adopted/adapted to design and plan ways to transform the role schools play."
The UCLA analysis of the causes of this fragmentation is revealing. They suggest that " While the range of student and learning supports at schools varies; some have few, some have many. In some instances, community services (e.g.,health and social services, after-school programs) are connected to a school. However, given their sparsity, agencies endeavoring to bring community services to schools usually must limit their activities to enhancing supports at a couple of school campuses in a neighborhood. Moreover, there often is not a good connection between community services and the work of the many school and district-based student support staff whose roles include preventing, intervening early, and treating students with learning, behavior, and emotional problems. Such school employed personnel include psychologists, counselors, social workers, nurses, dropout/graduation support staff, special educators, and others. When school and community efforts are poorly connected, community and school personnel tend to work with the same students and families with little shared planning or ongoing communication. Ironically, some education policy makers have developed the false impression that community resources are ready and able to meet all the support needs of students and their families. This impression already has contributed to serious cuts related to student supports (e.g ., districts laying off student support personnel) in the struggle to balance tight school budgets.An outgrowth of all this has been increased fragmentation, as well ascounterproductive competition for sparse resources related to student and learning supports. Underlying the fragmentation is a fundamental policy problem. That problem is the long-standing and continuing marginalization in school improvement policy and practice of most efforts to directly use student and learning supports to address barriers to learning and teaching and re-engage disconnected students. " The UCLA research and planning guide calls for a transformative change student support services that is based on these four principles: 1) Expand the policy framework for school improvement to fully integrate, as primary and essential, a component that brings together the supports for addressing barriers to learning and teaching and re-engaging disconnected students. (2) Reframe student and learning support interventions to create a unified and comprehensive system of learning supports in classrooms and school-wide. (3) Rework the operational infrastructure to ensure effective daily implementation and ongoing development of a unified and comprehensive system for addressing barriers to learning and teaching. (4) Enhance approaches for systemic change in ways that ensure effective implementation, replication toscale, and sustainability Read more>> (From the ISHN Member information service) The Massachusetts Essential School Health Services (ESHS) program to demonstrate the cost-benefit of school health services delivered by full-time registered nurses.Standard cost-benefit analysis methods were used to estimate the costs and benefits of the ESHS program compared with a scenario involving no school nursing service. Data from the ESHS program report and other published studies were used. A total of 477 163 students in 933 Massachusetts ESHS schools in 78 school districts received school health services during the 2009-2010 school year. Costs of nurse staffing and medical supplies incurred by 78 ESHS districts during the 2009-2010 school year were measured as program costs. Program benefits were measured as savings in medical procedure costs, teachers’ productivity loss costs associated with addressing student health issues, and parents’ productivity loss costs associated with student early dismissal and medication administration. During the 2009-2010 school year, at a cost of $79.0 million, the ESHS program prevented an estimated $20.0 million in medical care costs, $28.1 million in parents’ productivity loss, and $129.1 million in teachers’ productivity loss. As a result, the program generated a net benefit of $98.2 million to society. For every dollar invested in the program, society would gain $2.20. Eighty-nine percent of simulation trials resulted in a net benefit. Read more>>
(An item from the ISHN Member information service) An article in Issue #6, 2013 of Health Organization & Management, prepared by staff at the WHO European office, identifies and compares five different models of school health services used in Europe. The authors note that "The purpose of this article is to produce a taxonomy of organizational models of school health services (SHS) in the WHO European Region, and to reflect upon the potential of each model to be effective, equitable, responsive and efficient. The authors used data from the WHO survey to identify organizational models. To produce a taxonomy of organizational models, three features of SHS organization were analyzed – the presence of health personnel specifically dedicated to school health services provision (school nurse and/or school doctor); the statutory involvement of other health professions in SHS provision; and the proximity of service provision to pupils (school-based or not school-based). There are five organizational models of school health services in the Member States of the WHO European Region: dedicated school-based, dedicated community-based, integrated with primary care, mixed school-based, and mixed community-based. Preliminary reflections show that school based models are more likely to produce better outcomes in terms of effectiveness, equity, responsiveness, and efficiency." Read more>>
(An item from the ISHN Member information service) The "wrap-around" of "full services" model are similar examples of a school-based multi-intervention approach. These two variations are linked to the child protection/social services sector and seek to create a school-based system of care around vulnerable children. An article in Issue #5, 2013 of Community Mental Health Journal describes how such a school-based support services system can address the "cumulative effects of risk and protective factors on internalizing and externalizing problems for a sample of youth who were diagnosed with a severe emotional disturbance and enrolled in an urban school". The researchers report that "The sample included 139 Latino and African American children (ages 5–19; 65 % male) and their families. After controlling for demographic variables, the results of hierarchical multiple regression analyses revealed that cumulative risk and protection were significantly related to internalizing problem behaviors, and cumulative protection was negatively related to externalizing problem behaviors. The findings support the importance of including or increasing strength building approaches, in addition to risk reduction, in order to maximize prevention and intervention efforts for system-of-care populations." Read more>>
(An item from the ISHN Member information service) An article in Issue #4, 2013 of Journal of Adolescent Health examines the impact of school health centres in schools as a means to develop student assets and improved connections with the school. The researchers report that they examined "the relationship between student-reported, school-based health center utilization and two outcomes: (1) caring relationships with program staff; and (2) school assets (presence of caring adults, high behavioral expectations, and opportunities for meaningful participation) using a school district–wide student survey. These relationships were also explored across schools. Using student-reported data from a customized version of the California Healthy Kids Survey from the San Francisco Unified School District (n = 7,314 students in 15 schools), propensity scoring methods were used to adjust for potential bias in the observed relationship between student utilization of services and outcomes of interest. Estimates generally pointed to positive relationships between service utilization and outcome domains, particularly among students using services ≥10 times. Exploratory analyses indicate that these relationships differ across schools. Use of school-based health centers appears to positively relate to student-reported caring relationships with health center staff and school assets. Future research is needed to confirm the robustness of these observed relationships. Read more>>
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