Understanding mental health intervention and assessment within a multi-tiered framework: Contemporary science, practice, and policy.

Abstract

This special topic section features research regarding practices that will support mental health service delivery within a school-based multitiered framework. The articles include data and discussions regarding the evaluation of universal, targeted, or intensive intervention addressing mental health concerns and assessment tools intended for use in screening, progress monitoring, or problem identification. The featured interventions and assessment practices are suitable for use within a service delivery model that prioritizes ecological theory, data-based decision making, and problem solving logic. Each article includes a conceptualization of how the intervention/assessment of interest fits into a school-based multitiered framework and information about feasibility and utility of the practice in school-based settings. These articles highlight the use of mental health intervention and assessment within a multitiered problem-solving framework, and will hopefully stimulate interest in and further scholarship on this important topic.

Generalizability of Universal Screening Measures for Behavioral and Emotional Risk

“…In response to the limitations of referral-based methods, schools are increasingly embracing multi-tiered systems of support (MTSS) to identify and support students' mental health needs. Departing from traditional methods of identification, MTSS rely on the systematic collection and analyses of data to prevent the development of disorders and identify students in need of further support (Jimerson, Burns, & VanDerHeyden, 2015;Kilgus, Reinke, & Jimerson, 2015). Typically, MTSS emphasis on data allows the treatment of students to be conceptualized within three tiers of increasingly intensive mental health services, including universal (Tier 1), selected (Tier 2), and indicated (Tier 3) levels os support (Miller et al, 2015).…”

“…All students at the Tier 1 or universal level receive the same mental health supports. A prime example of universal supports are school-wide positive behavior interventions and supports (PBIS), a framework in which appropriate behavioral expectations are explicitly taught to students and a consistent system to reward good behavior and correct negative behavior is implemented (Jimerson et al, 2015;Sugai & Horner, 2009). Approximately 20% of students in schools utilizing MTSS may require additional schoolbased mental health supports beyond the universal level.…”

“…Although universal screening comprises a heterogeneous group of measurement procedures and tools, the defining feature is assessment of all individuals belonging to a population (e.g., all students within a classroom, school, or district) to detect the presence of a variable of interest (Kamphaus, 2013). Screening for behavioral and emotional risk is important to schools because it offers an opportunity to identify behavior predictive of future mental health disorders (Kilgus, Reinke, & Jimerson, 2015). This early identification data can then be used to provide follow-up treatment, therefore diminishing the severity of a disorder, shortening its duration, and potentially resulting in less expensive treatment options (Forness, Freeman, Paprelle, Kauffman & Walker, 2012).…”

“…Pearson product moment correlations comparing the SAEBRS and SDQ were strong, with most falling above .90. These correlations far surpassed the requirements for high stakes decisions and are similar to previous studies examining the concurrent validity of behavior rating scales (e.g.,Bergeron et al, 2008;Goodman & Goodman 2009;Kilgus et al, 2015;Muris et al 2004; von der Embse et al, 2015). These results suggested that the SAEBRS and SDQ assess similar constructs as measurement error resulting from discrepancies between screening measures is low.…”

Examining the predictive validity of behavior screeners across measures and respondents

“…A 2015 meta‐analysis on the global prevalence of mental health disorders concluded the prevalence of mental health disorders among children was between 11.3% and 15.9% (Polanczyk, Salum, Sugaya, Caye, & Rohde, 2015). The American Academy of Pediatrics (2004) reported only 21% of children and adolescents with mental disorders receive treatment, making this an important public health issue that needs to be addressed (Kilgus, Reinke, & Jimerson, 2015). Because many mental health problems start to develop during adolescence, it is important that evidence‐based interventions are used to target this age group (Kessler et al, 2005).…”