Academic journal article Journal of School Health

Promoting Mental Health in Schools in the Midst of School Reform

Academic journal article Journal of School Health

Promoting Mental Health in Schools in the Midst of School Reform

Article excerpt

It is not a new insight that mental health and psychosocial problems must be addressed if schools are to function satisfactorily and if students are to learn and perform effectively. Everyday, teachers ask for help in dealing with problems; often they also would like support to facilitate their students' healthy social and emotional development and help in involving parents. Yet, despite long-standing and, widespread acknowledgment of need, relevant programs and services continue to be a supplementary item on a school's agenda. This is not surprising. After all, schools are not in the health or social service business. Their mandate is to educate. Thus, they tend to see any activity not directly related to instruction as taking resources away from their primary mission.

Nevertheless, over the years, schools have instituted programs designed with a range of health, mental health, and psychosocial problems in mind, such as school adjustment and attendance problems, dropouts, physical and sexual abuse, pregnancy prevention, substance abuse, relationship difficulties, emotional upset, delinquency and violence -- including gang activity. School-based and school-linked programs were developed for purposes of early intervention, treatment, crisis intervention, and prevention, including programs to foster positive social and emotional development. A large body of research exists supporting the promise of such interventions. However, with expansion of school-based mental health and psychosocial interventions has come growing concerns about their effectiveness and place in schools.

Among some segments of the population, schools continue to be seen as an inappropriate venue for mental health interventions. The reasons vary from concern that such activity will take time away from the educational mission to fear that such interventions are another attempt by society to infringe on family rights and values. Further, with proliferation of school-based and linked services, a variety of systemic concerns has arisen. In particular, planning and implementing programs and services often occurs in an unsystematic and ad hoc fashion. As widely discussed, the ensuing fragmented and piecemeal activities are an inefficient use of limited resources. And even more fundamental is the degree to which schools marginalize all efforts to address barriers to student learning. With a view to enhancing understanding and resolving these problems, this paper first explores the policy deficiencies that perpetuate the status quo and then offers a framework for moving forward. A second paper in this issue[1] amplifies on these matters and discusses specific mechanisms for systemic change.


If schools are to work effectively on mental health and psychosocial concerns, greater efforts must be made to develop comprehensive, multifaceted, and integrated intervention approaches. For greater efforts to be realized, initiatives for mental health in schools must be developed, coordinated, and fully integrated with each school site's school reform policy.

We begin with the fact that there is clear acknowledgment that some special programs and services may be needed to enable students to benefit from instruction. Prominent examples of how policymakers have responded to the need are seen in funding for pupil services personnel, compensatory and special education, safe and drug-free schools, dropout prevention, pregnancy prevention, and home involvement in schooling. Related policy initiatives designed to increase health and human service agency collaboration and program integration emphasize school-community partnerships to foster school-linked services. All these initiatives have relevance for mental health in schools.

At the same time, it is clear from analyses of current policy and practice that no cohesive policy vision exists, and pupil services and school health programs do not have high status in the educational hierarchy and in current health and education policy initiatives[2-6] The continuing trend is for schools and districts to treat such activity, in policy and practice, as desirable but not essential. …

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