Academic journal article Journal of School Health

Mental Health Services at Selected Private Schools

Academic journal article Journal of School Health

Mental Health Services at Selected Private Schools

Article excerpt

ABSTRACT: Private schools educate a significant percentage of US children and adolescents. Private schools, particularly where students reside during the academic year, assume responsibility for the health and well-being of their students. Children and adolescents experience mental health problems at a predictable rate, and private schools need a mechanism for addressing their students' mental health needs. Understanding that need requires data to guide the services and programs a school may put in place. Having data helps inform those services, and comparative data from other schools provides feedback and perspective. This project surveyed type and frequency of mental health problems experienced by students who received a formal evaluation at 11 private schools in Connecticut during academic year 2001- 2002. (J Sch Health. 2004;74(4): 125-129)

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Private schools represent a relatively small but consistent segment of the educational system in the United States. The National Center for Education Statistics defines a "private school" as a school employing one or more teachers and providing instruction for one or more grades K-12 (or comparable ungraded levels), and one not relying primarily on public funds for operation. (1) The United States has approximately 114,800 schools in operation, and approximately 25% are private. (2) Private schools in Connecticut enroll more than 70,000 students, (1) accounting for about 11% of Connecticut's total enrollment. (3)

Most private schools on the primary and secondary levels educate students who are minors. Many private schools have students reside on campus as "boarding students" who rely on schools to meet many of their physical and mental health needs under the concept of in loco parentis.

During the 1999-2000 academic year, 1,508 private schools had about 102,000 students in residence at their schools (S. Broughman, personal interview, April 24, 2003). Despite the long-standing tradition of offering health care to students (boarders and non-boarders alike) at or through private schools, little formal guidance exists for private schools in structuring such services appropriately, particularly for mental health. (4)

Against this backdrop of private school enrollment and health services, mental health problems among children and adolescents are relatively common. (5) The American Psychiatric Association includes the following diagnoses as problems that, if present, usually become apparent during childhood or adolescence: mental retardation, learning disorders, attention-deficit and disruptive behavior disorders, and eating disorders. (6) Other problems such as mood disorders (eg, depression), anxiety disorders (eg, obsessive-compulsive disorder), psychotic disorders (eg, schizophrenia), and substance abuse, though possibly arising for the first time in previously healthy adults, may arise during childhood and adolescence.6 Young people can suffer simultaneously from more than one type of mental health problem (eg, depression and a learning disability), a situation referred to as co-morbidity.

Although problems exist with prevalence rates of mental health problems for children and adolescents, mean overall prevalence exists at 15.8%, (5) with other authors reporting rates approaching 20%. (7) Mental health problems cross socioeconomic boundaries, (8) including children from upper-middle and upper-class strata who may be more likely to attend private schools.

The Centers for Disease Control and Prevention (CDC) provide data concerning mental health of adolescents through a biennial survey of a representative sample of students attending grades nine through 12 in US public and private schools. (9) The 2001 Youth Risk Behavior Surveillance System (YRBSS) identified 28.3% of students as having two of the most critical diagnostic hallmarks of depression, and 8.8% of students reported attempting suicide at least one time during the 12 months preceding the survey. …

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