Laura Nabors

Qualitative Evaluation of a High School Mental Health Program

Expanded school mental health (ESMH) programs offer a comprehensive range of mental health services (evaluation, therapy, case management) to youth in special and regular education. Research is needed to document that these programs are in fact providing quality care to youth and leading to enhanced outcomes. In this exploratory study, focus groups were conducted with high school students receiving mental health services and students not receiving services, therapists, parents, administrators, and health care staff to gauge the quality and effectiveness of an ESMH program. It was difficult to schedule parents for group sessions; thus, interviews also were conducted with this group. Focus groups and interviews were effective methods for understanding strengths, areas for improvement, and outcomes for our ESMH program. Participants reported that therapy served as a protective factor, enhancing physical and mental health and reducing risk for teenagers. Ideas for improving clinical practice were developed from study results.

Evaluation of Expanded School Mental Health Programs

Expanded school mental health programs provide a full range of mental health services (assessment, treatment, case management, prevention) to youth in regular and special education, and typically involve close collaboration between schools and community agencies. A major challenge for these programs is documenting that provided services are of high quality and leading to enhanced outcomes for the youth and schools served by them. Dimensions of school mental health evaluations and a step-by-step process for conducting them are presented, using the example of a well established program in Baltimore. Challenges to such evaluation and strategies for overcoming challenges are also presented.

Quality assurance and school-based mental health services

Clinicians affiliated with expanded school mental health (ESMH) programs provide a range of mental health services for youth in schools. ESMH services offer unique opportunities for collaboration between school psychologists and mental health clinicians from the community to increase the quality of care for youth receiving mental health services. The number of ESMH programs is increasing; therefore, developing quality assurance (QA) activities for these programs is important to document accountability and provide evidence for effectiveness. In this paper, suggestions for phases and objectives for QA programs in ESMH programs and examples of suggested activities are presented. Assessment of the program structure as well as treatment process and outcome are critical phases. Important QA activities include examining staff training activities, assessment of stakeholder perceptions of services, conducting satisfaction surveys, examining therapy process, and investigating treatment outcomes. Results of QA evaluations should inform policy.QA programs need to be developed and the impact of QA activities in enhancing the quality of care provided by clinicians in schools should be evaluated.

Relations Between Activities and Cooperative Playground Interactions for Preschool-Age Children with Special Needs

The playground is a setting wherein teachers, therapists, and early intervention specialists may facilitate the inclusion of children with special needs. For this study, the relations among cooperative interactions of children with and children without special needs in groups of only typically developing peers, in groups of only peers having special needs, and in inclusive groups, as well as the complexity of the activities in which they were engaged were investigated. Complex activities were those involving fine motor skills as well as higher levels of cognitive, social, and language abilities. The associations among child and program level factors and the childrens involvement in different cooperative activities also were examined. Findings indicated that children with and children without special needs were likely to engage in cooperative play only with other typically developing children during complex activities (e.g., playing with small toys in the sand or talking). Results also indicated that children with and children without special needs tended to engage in cooperative play in inclusive groups (composed of children with and children without special needs) during less complex or low-demand activities involving predominantly gross motor skills (e.g., sliding or running). Interventions are needed to facilitate involvement of children with special needs in complex activities on the playground. This is an important area for future research and educational practice efforts.