Ellis L. Gesten

The Primary Mental Health Project (PMHP): Evaluation of current program effectiveness

This study evaluated the effectiveness of the Primary Mental Project (PMHP), a program for early detection and prevention of school adjustment problems. Pre- and postprogram assessments were done with 215 primary-grade children seen in PMHP, usig teacher ratings of problem behaviors and competencies, and child-aide ratings of problems. School mental health professionals judged educational and behavioral changes in project children during the year. Significant across-the board improvements were found on all criterion measures. Modest intercorrelations among criterion change estimates suggested that the observed changes were due to program, rather than halo, effects. PMHP children also improved significantly more than matched, retrospective controls.

Teachers' Views of the Treatability of Children's School Adjustment Problems'

One-hundred thirty-four primary grade teachers rated each of nine hypothetical referrals, depicting three predominant types of school adjustment problems (acting-out, shy-anxious, learning), on four dimensions: (a) appropriateness of referring the child to the schools mental health services, (b) ease or difficulty for a mental health person to work with such a child, (c) how much a mental health person would enjoy working with the child, and (d) a treatment-prognosis estimate. Shy-anxious children generally received the most positive ratings. Teacher judgments were compared to prior, similar judgments made by mental health personnel. The latter gave significantly higher appropriateness ratings, indicated that the children would be significantly less difficult and more enjoyable to work with, and judged prognosis to be more favorable. An important deviation from this pattern of findings is considered.

Teachers' Judgments of Class-Related and Teaching-Related Problem Situations

The development of a measure of teacher reactions to a variety of pupil, parent, and class-management problems is described. Factor analyses identified four child factors, two parent factors, and three class-management factors. Less frequently occurring problem situations were found to pose more serious handling difficulties. Situations relating to parents were more difficult for teachers to handle than ones involving individual children or class management. Suburban teachers had more serious handling problems than urban teachers, and less experienced teachers had more serious problems than experienced ones.

Relationships Between Family Background Problems and School Problems and Competencies of Young Normal Children.

Demographically matched groups of normal, nonreferred children who had, or had not, experienced one of four family background problems (lack of educational stimulation in the home, family pressures to succeed, economic difficulties, and general family problems) were compared on teacher ratings of school maladjustment and competencies. Children with each of these family problems had greater school difficulties and fewer resources than matched controls without such histories. Systematic relations, paralleling earlier findings with referred samples, were found between specific types of family and school problems. Thus, children from homes lacking educational stimulation had higher learning and acting-out problem scores than controls, and children under family pressure to succeed had higher anxiety ratings than controls. Some implications of these findings for prevention were considered.

Nonprofessional and professional help-agents' views of interventions with young maladapting school children.

The expectations of nonprofessional and professional help-agents about helping interventions with young children experiencing different types of school adjustment problems (i.e., aggressive-acting out, shy-anxious, and learning problems) were studied. The two groups responded similarly. Shy-anxious children were seen as most appropriate for the intervention, the easiest and most enjoyable group to work with, and as having the best prognoses. These four sets of judgments were relatively independent of each other. A connection was made between the current data and prior findings suggesting that shy-anxious children have more favorable treatment outcomes than other groups.

Judged school problems and competencies of referred children with varying family background characteristics

The school adjustment problems and competencies of referred children with varying family background histories were compared. Children from homes characterized by low parent interest in education had more severe learning problems and fewer competencies than either matched referred controls without such a history or matched referred children under family pressure to succeed. The relationship of these findings to other studies of school adjustment and family background was considered.

An integrated network of preventively oriented school-based mental health approaches

Publisher Summary This chapter focuses on the Primary Mental Health Project (PMHP), a school-based program for early detection and prevention of adjustment problems. Several of PMHPs structural-evolutionary qualities influence how the chapter is written. First, PMHP is 23-years-old. During that period it has grown and changed considerably. Second, it is a complex project-less a single, fixed entity and more a federation of conceptually linked approaches. Thus, PMHP - type programs are located in many schools in the Rochester, New York, area and in some 40 other districts around the country (Cowen, Davidson, & Gesten, 1980). Those programs are, as they must be, individualized. Third, the projects research history and structures are equally complex. No single design or experimentum crucis is sufficient to evaluate it. Those facts lead us to stray somewhat from the organizational structure used in other chapters. To follow that structure here might lose some of PMHPs step-stage evolution, richness, and complexity. For us, a sensible starting point is to describe how and why PMHP came about, and the issues that the project addresses. All that follows rests on that base.