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School Policies Show Promise, Problems in Providing Mental Health Care

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School-related policies can both hinder and encourage the provision of mental health services to children, the Center for Health and Health Care in Schools at George Washington University writes in a new report.

The authors looked at how mental health services are provided for children in 11 states.

Especially since the December shootings at Sandy Hook Elementary in Newtown, Conn., mental health services—especially for children, have been in the spotlight. But the report cited a number of fundamental barriers that keep kids who need mental health services from getting them: It's a low priority among agencies that can pay for these services, in part because of the stigma associated with mental health problems.

Here's an example of how school policies can get in the way of getting needed services to kids, the report says. When Connecticut passed a law intending to reduce use of out-of-school suspensions, local districts responded both positively and negatively. And then, the

"Connecticut state government, together with several private foundations, funded local projects to reduce the number of children and adolescents arrested in schools. However, the state must be invited in by the school district and not all districts were welcoming. In a related effort, the state supports an emergency mobile psychiatric service for children with behavioral problems. These initiatives not only provide an alternative to calling police for urgent matters occurring in local districts and individual schools but these particular services also help link youth to ongoing services. In both instances, state initiatives intended to encourage school districts to handle students' behavioral problems through less punitive approaches have been embraced by some, but rejected by others."

But there could be good things ahead for the delivery of mental health services for people of all ages, the report notes. By next January, provisions of the Affordable Care Act kick in that are expected to substantially increase insurance coverage of mental health and substance abuse services. It's also expected that prevention, early-intervention, and treatment services and programs will expand.

Also related to education, the report found that there is promise in a couple of areas. In Minnesota, as part of the state's five-year re-accreditation process, educators must now have some mental health training to meet the continuing education requirement.

And, the authors of the report found, there's increasing interest with problem-prevention initiatives in schools, including social-emotional learning and positive behavioral interventions and supports, or PBIS.

"While they go by many names, classroom-based strategies and practices that build respectful, positive school communities and teach children social and emotional competencies are being promoted in a number of states. Interviewees in nearly half the states—Minnesota, New Mexico, North Carolina, Oregon, and Texas—pointed specifically to these initiatives, which can help students at every point along the spectrum of social, emotional, and mental well-being."

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