Academic journal article School Psychology Review

Modeling the Factors Associated with Children's Mental Health Difficulties in Primary School: A Multilevel Study

Academic journal article School Psychology Review

Modeling the Factors Associated with Children's Mental Health Difficulties in Primary School: A Multilevel Study

Article excerpt

Although there have been a large number of studies examining school correlates of students' academic attainment (Caldas & Bankston, 1999; Goddard, Sweetland, & Hoy, 2000; Lee & Bryk, 1989; MacBeath & Mortimore, 2001; see Rutter & Maughan, 2002), for a review), the school factors associated with their mental health difficulties (MHD) have been given relatively little attention (Sellstrom & Bremberg, 2006). There is intuitive logic that schools can and should make a difference in MHD (Weare & Markham, 2005), but few studies have examined the effects that schools can have on children's mental health (Gutman & Feinstein, 2008). Further research in this area is important for several reasons. First, there has been an increase in child and adolescent mental health problems in the last 30 years (e.g., Collishaw, Maughan, Goodman, & Pickles, 2004). Second, the long term consequences of MHD can include an increased risk of leaving school without qualifications (Colman et al., 2009), unemployment (Farrington, Healey, & Knapp, 2004), family and relationship problems (Colman et al., 2009), mental health problems in adulthood (Hofstra, van der Ende, & Verhulst, 2002), and increased financial costs to society (Scott, Knapp, Henderson, & Maughan, 2001).

Governmental and professional directives in England (e.g., Department For Education and Skills, 2005) and internationally (e.g., American Psychological Association, 2001; Commonwealth of Australia, 2009; National Association of School Psychologists, 2008) have increasingly emphasized the role of schools in promoting mental health and wellbeing. In the United States, the implementation of the Positive Behavior Support (PBS) system in over 9,000 schools (Bradshaw, Mitchell, & Leaf, 2009) reflects this trend, by promoting school-wide strategies to prevent challenging behaviors and promote social competence using a tiered approach (Cohn, 2001; Sugai & Horner, 2006). The emerging evidence for PBS is favorable, with several randomized trials demonstrating the system's effectiveness in promoting positive outcomes among schools and students (e.g., Bradshaw et al., 2009; Horner et al., 2009), but additional research is needed regarding the continuum of school-based behavior support (Sugai & Horner, 2006). In this vein, determining the nature and extent of relationships between different school factors (including school-wide policies and practices) and children's mental health can help to develop our understanding of how to use current educational resources in an efficient and equitable manner.

Multilevel natural variation studies can help to provide insights into the relationships between different school factors and children's mental health--both in determining the amount of variance in children's difficulties that is attributable to differences between schools, and in identifying which school factors contribute to that variance. Sellstrom and Bremberg's (2006) review identified six studies that had focused on "problem behavior/ well-being" and found reported intraclass correlations (ICCs), which are a measure of how much variation at the individual level is attributable to differences at the cluster (school) level, that ranged anywhere from .01 to .25. School-level factors and characteristics found to be influential in these studies included school size, urbanicity, and socioeconomic status (SES; George & Thomas, 2000); average parental education levels, and school climate (Konu, Lintonen, & Autio, 2002); and sex ratio (Mooij, 1998). More recently, Gutman and Feinstein's (2008) found school-level variance of less than .03 for children attending primary school. The authors reported that SES, school type, and parental involvement/ relationships had marginal influences on student-level mental health outcomes, and cautioned that "much of the variation in children's well-being remains unexplained" (p. ii). Hum phrey, Lendrum, and Wigelsworth's (2010c) study reported an ICC of less than . …

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