Academic journal article School Psychology Review

Gender as a Factor in School-Based Mental Health Service Delivery

Academic journal article School Psychology Review

Gender as a Factor in School-Based Mental Health Service Delivery

Article excerpt

Abstract. There is a large research base indicating numerous gender differences in prevalence rates of psychopathology, the expression of psychopathology, and the etiology of psychopathology across different disorders (Zahn-Waxler, Shirtcliff, & Marceau, 2008). Such documented gender differences in mental health among children and adolescents have significant implications for the provision of school-based mental health services. This article provides an overview of the research documenting differences in mental health among children and adolescents and a description of the delivery of gender-informed mental health services through a public health model framework of service delivery. Gender-informed prevention and intervention strategies are presented using specific examples to provide practitioners with a greater awareness of gender differences and their implications for providing mental health services to children and adolescents. The article concludes with recommendations for the field of school psychology.

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Mental health in childhood and adolescence is defined by the achievement of expected developmental milestones and by establishing effective coping skills, secure attachments, and positive social relationships (U.S. Department of Health and Human Services [U.S. DHHS], 1999). Mentally healthy children and adolescents enjoy a positive quality of life; are free of symptoms of psychopathology; and function well at home, in school, and in their communities (Hoagwood, Jensen, Petti, & Burns, 1996). Unfortunately, recent epidemiologic studies have found that anywhere from 17% to almost 40% of children in the United States meet criteria for a diagnosable mental or addictive disorder associated with at least minimum impairment (Brown, Riley, & Wissow, 2007; U.S. DHHS, 1999).

Several important federal initiatives have brought children's mental health to the forefront of national issues (New Freedom Commission on Mental Health, 2003; The National Advisory Mental Health Council Workgroup on Child and Adolescent Mental Health Intervention Development and Deployment, 2001; U.S. DHHS, 1999). These initiatives have highlighted research showing that many children in need of mental health services are not receiving them and that substantial disparities exist in access to mental health care for specific youth populations. To improve access to mental health services among youth, The New Freedom Commission on Mental Health (2003) noted the potential of schools to provide all children with a comprehensive continuum of mental health promotion and intervention services. In recent years, the education system has expanded its role in providing mental health services and is now commonly considered the de facto provider of mental health services for children and youth (Farmer, Burns, Philip, Angold, & Costello, 2003), with an estimated 70%-80% of children who receive mental health services receiving them in school (Rones & Hoagwood, 2000).

Despite the expanding literature base on school-based mental health (SBMH), many questions about how to best provide these services remain unanswered (Power, 2003). One important question is how to specifically tailor mental health services for different types of children. This question is important because although what is considered mentally healthy may be similar for diverse types of children, what is needed to achieve this outcome may vary for different groups of children (Ringeisen, Henderson, & Hoagwood, 2003; Weist et al., 2000). For example, the needs of children in rural schools may be quite different from those of children in urban schools. Similarly, the needs of children with developmental disabilities may be different from the needs of those who are intellectually gifted. Indeed, there has been growing evidence that supports the influence of group differences on children's vulnerability to risk, presentation of symptomology, etiology of disorders, access to care, response to interventions, and mental health outcomes (The National Advisory Mental Health Council Workgroup on Child and Adolescent Mental Health Intervention Development and Deployment, 2001). …

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