The objective of the study was to evaluate whether mental health problems identified through screens administered in first grade are related to poorer academic achievement test scores in the fourth grade. The government of Chile uses brief teacher- and parent-completed measures [Teacher Observation of Classroom Adaptation-Revised (TOCA-RR) and Pediatric Symptom Checklist (PSC-Cl)] to screen for mental health problems in about one-fifth of the country's elementary schools. In fourth grade, students take the national achievement tests (SIMCE) of language, mathematics and science. This study examined whether mental health problems identified through either or both screens predicted achievement test scores after controlling for student and family risk factors. A total of 17,252 students had complete first grade teacher forms and these were matched with fourth grade SIMCE data for 11,185 students, 7,903 of whom also had complete parent form data from the first grade. Students at risk on either the TOCA-RR or the PSC-Cl or both performed significantly worse on all SIMCE subtests. Even after controlling for covariates and adjusting for missing data, students with mental health problems on one screen in first grade had fourth grade achievement scores that were 14-18 points (~1/3 SD) lower than students screened as not at risk. Students at risk on both screens had scores that were on average 33 points lower than students at risk on either screen. Mental health problems in first grade were one of the strongest predictors of lower achievement test scores 3 years later, supporting the premise that for children mental health matters in the real world.

The world’s largest school-based mental health program, Habilidades para la Vida [Skills for Life, SFL], has been operating at a national scale in Chile for fifteen years. SFL’s activities include using standardized measures to screen elementary school students and providing preventive workshops to students at risk for mental health problems. This paper used SFL’s data on 37,397 students who were in first grade in 2009 and third grade in 2011 to ascertain whether first grade mental health predicted subsequent academic achievement and whether remission of mental health problems predicted improved academic outcomes. Results showed that mental health was a significant predictor of future academic performance and that, overall, students whose mental health improved between first and third grade made better academic progress than students whose mental health did not improve or worsened. Our findings suggest that school-based mental health programs like SFL may help improve students’ academic outcomes.

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Theoretically derived factors (preexisting child characteristics, trauma exposure, caregiver-child relationship, and school-based mental health programming) were examined as potential correlates of distress in children residing in the region closest to the epicenter of the 2010 Chilean earthquake. One year before the earthquake, 2nd-grade students who attended 9 schools that provide government-run mental health intervention programs were assessed via parent and teacher reports for pre-intervention psychosocial difficulties. Between 3-6 months after the earthquake, a preexisting non-trauma focused, school-based intervention was delivered. Approximately 9 months post-earthquake, 117 of these children (randomly selected; mean age ϭ 7.59), were interviewed about their experiences during the earthquake and their subsequent psychological responses. Children were exposed to multiple disaster-related traumatic events (M ϭ 4.90; SD ϭ 1.78); most reported posttraumatic stress (PTS) symptoms and 25.6% met criteria for the Diagnostic and Statistical Manual of Mental Disorders-defined (DSM-IV-TR; APA, 2000) probable PTSD. Female gender and exposure to violent, injurious, or death-related postdisaster traumas were correlated with PTS symptoms. Children's reports of characteristics of the home environment (conflict with their caregiver, caregiver unavailability to discuss the earthquake) were positively associated with PTS symptoms. Children's perceptions of caregiver unavailability to discuss the earthquake were associated with higher ongoing earthquake-related worry. Participation in the mental health intervention was associated with significantly lower earthquake-related worry and appeared to protect at-risk youth from elevated PTS symptomatology. Results suggest that participation in school-based mental health programs may be protective for children postdisaster and a negative family environment may be associated with increased postdisaster distress. Implications and potential applications of findings are discussed.

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