Mental Health Services in School-Based Health Centers

Bains, Ranbir Mangat; Diallo, Ana F.

doi:10.1177/1059840515590607

Cited by 96 publications

(67 citation statements)

References 33 publications

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“…As one example, comprehensive schoolbased health centers are primary medical centers that typically offer integrated preventive, physical, and MH services on school grounds. 34 Prior studies have reported that racial/ ethnic minorities are more likely to receive any MH care 35,36 and receive more MH services at school-based health centers compared with their non-Hispanic white peers. 37 However, these studies have generally been descriptive in nature and more rigorous research is needed on the potential of schoolbased health centers to improve depression care and address racial/ethnic disparities in care in Medicaid-enrolled youth.…”

Section: Discussionmentioning

confidence: 99%

Racial and Ethnic Differences in Minimally Adequate Depression Care Among Medicaid-Enrolled Youth

Cummings

Lally

et al. 2019

Journal of the American Academy of Child & Adolescent Psych

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Objective: To examine racial and ethnic disparities in the receipt of minimally adequate depression treatment in Medicaid-enrolled youth.Method: Medicaid claims data of 2008 through 2011 were used to derive a cohort of youth (5-17 years old) who were diagnosed with a new episode of major depression (N ¼ 45,816) across 9 states. Dichotomous outcomes measured the receipt of minimally adequate psychotherapy (!4 psychotherapy visits within 12 weeks of initiation); minimally adequate medication (filled antidepressants for 84 of 144 days); any minimally adequate treatment (psychotherapy or medication); and no psychotherapy or medication. Racial/ethnic disparities in the outcome measures were estimated using logistic regression models that controlled for predisposing, enabling, and need-related factors. Results: Less than four-tenths (38.3%) of the cohort received minimally adequate psychotherapy, 19.2% received minimally adequate pharmacotherapy, and 49.9% received any minimally adequate treatment; conversely, 16.4% received no treatment. Adjusted percentages of black (42.3%; p < .001) and Hispanic (48.2%; p < .001) youth who received minimally adequate treatment were significantly smaller than for non-Hispanic whites (54.7%) because of lower likelihoods of receiving minimally adequate psychotherapy and/or minimally adequate pharmacotherapy. In addition, adjusted percentages of black (20.2%; p < .001) and Hispanic (15.0%; p < .01) youth who received no treatment were significantly larger than for non-Hispanic white youth (12.9%). Conclusion: The percentage of Medicaid-enrolled youth who receive minimally adequate treatment for depression is small overall and even smaller for racial/ethnic minorities than for whites. Future research is needed to identify strategies that improve the overall quality of depression treatment in Medicaid-enrolled youth and decrease disparities in care.

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Section: Discussionmentioning

confidence: 99%

Racial and Ethnic Differences in Minimally Adequate Depression Care Among Medicaid-Enrolled Youth

Cummings

Lally

et al. 2019

Journal of the American Academy of Child & Adolescent Psych

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“…Given statistics from surveys confirming that women are more prone to experience, or at least report, mental health problems [4, 5, 8] and indications of increased pressure on women to be successful both at home and work [11, 16], the nurses’ perception of girls more frequently experiencing mental health problems could simply reflect reality. However, detailed consideration of the school nurses’ responses and theories on gender suggests that this may be a simplistic interpretation.…”

Section: Discussionmentioning

confidence: 99%

“…According to Hagquist [3], mental health problems doubled among adolescent boys and tripled among adolescent girls in Sweden during the years 1988–2005. Moreover, research articles and reviews show that it is a pattern afflicting multiple countries [4, 5]. Frequently, the conditions are associated with recurring pain symptoms, such as headaches, stomach aches, and neck pain [6, 7].…”

Section: Introductionmentioning

confidence: 99%

Gender-based generalisations in school nurses’ appraisals of and interventions addressing students’ mental health

Rosvall

Nilsson

2016

BMC Health Serv Res

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BackgroundThere has been an increase of reports describing mental health problems in adolescents, especially girls. School nurses play an important role in supporting young people with health problems. Few studies have considered how the nurses’ gender norms may influence their discussions.MethodsTo investigate this issue, semi-structured interviews focusing on school nurses’ work with students who have mental health problems were conducted. Transcripts of interviews with Swedish school nurses (n = 15) from the Help overcoming pain early project (HOPE) were analysed using theories on gender as a theoretical framework and then organised into themes related to the school nurses’ provision of contact and intervention. The interviewees were all women, aged between 42–63 years, who had worked as nurses for 13–45 years, and as school nurses for 2–28 years. Five worked in upper secondary schools (for students aged 16–19) and 10 in secondary schools (for students aged 12–16).ResultsThe results show that school nurses more commonly associated mental health problems with girls. When the school nurses discussed students that were difficult to reach, boys in particular were mentioned. However, very few nurses mentioned specific intervention to address students’ mental health problems, and all of the mentioned interventions were focused on girls. Some of the school nurses reported that it was more difficult to initiate a health dialogue with boys, yet none of the nurses had organized interventions for the boys.ConclusionsWe conclude that generalisations can sometimes be analytically helpful, facilitating, for instance, the identification of problems in school nurses’ work methods and interventions. However, the most important conclusion from our research, which applied a design that is not commonly used, is that more varied approaches, as well as a greater awareness of potential gender stereotype pitfalls, are necessary to meet the needs of diverse student groups.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1710-1) contains supplementary material, which is available to authorized users.

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“…However, in the case of mental health treatment these frequent visits have the potential to benefit youth by ensuring safety and stabilization for their mental health condition. Further, prioritizing positive mental health during adolescence promotes academic achievement and may lessen future morbidity …”

Section: Discussionmentioning

confidence: 99%

Students Seeking Mental Health Services at School‐Based Health Centers: Characteristics and Utilization Patterns

Stempel

Cox-Martin

O’Leary

et al. 2019

Journal of School Health

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BACKGROUND: School-based health centers (SBHC) can address unmet mental health needs. Little is known about how students seek care from different providers at SBHCs. We describe and compare how students' SBHC visits differ for students seen by mental health providers (MH group) relative to students seen only by primary care providers (PC group). METHODS:Using administrative data with ICD-9 codes from 9 SBHCs in Denver, Colorado serving youth 10-19 years old during the 2014-2015 school year, we analyzed predictors of SBHC clinic visits via negative binomial regression and ICD-9 codes for first visit to MH providers. RESULTS:Mental health users (N = 516) had an average of 14.2 ± 12.9 SBHC visits and PC users (N = 4026) had an average of 2.6 ± 2.4 SBHC visits annually. Students in the MH group, those with public insurance, and females had a higher incidence rate ratio for SBHC clinic visits than PC group students, those with private insurance, and males respectively. Depression was the most common primary diagnosis for the first MH visit. CONCLUSIONS:Students accessing MH services at SBHC return for follow up visits at higher rates than students only seeing PC providers. SBHCs represent a valuable opportunity to enhance integrated mental health services. Citation: Stempel H, Cox-Martin MG, O'Leary S, Stein R, Allison MA. Students seeking mental health services at school-based health centers: characteristics and utilization patterns.A dolescents experience a large burden of unmet mental health needs. 1-3 Roughly 1 in 5 youth have a diagnosable mental health condition that can cause lifetime impairment, yet 50-80% of youth with mental health conditions do not receive treatment for these diangoses. 2,4-7 Untreated mental health conditions can result in serious consequences, including troubled peer and family relationships, risky health behaviors, poor school performance, school dropout, and suicide.

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Mental Health Services in School-Based Health Centers

Cited by 96 publications

References 33 publications

Racial and Ethnic Differences in Minimally Adequate Depression Care Among Medicaid-Enrolled Youth

Racial and Ethnic Differences in Minimally Adequate Depression Care Among Medicaid-Enrolled Youth

Gender-based generalisations in school nurses’ appraisals of and interventions addressing students’ mental health

Students Seeking Mental Health Services at School‐Based Health Centers: Characteristics and Utilization Patterns

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