School-Based Mental Health on a United States Army Installation

In 2000, the report of the Surgeon General's Conference on Children's Mental Health dramatically summarized the state of our nation's mental health system for children and adolescents as follows: “Children and families are suffering because of missed opportunities for prevention and early identification, fragmented treatment services, and low priority for resources.” The Surgeon General, Dr. David Satcher, made the analogy that “there is no mental health equivalent to the federal government's commitment to childhood immunization,” implying that such an approach is necessary to address the mental health crisis for youth in our nation (U.S. Public Health Service, 2000)

School-based mental health programs are a centerpiece of the Surgeon General's report and are improving access to effective prevention, early intervention, and treatment for students and families around the nation (Adelman et al., 1999; Weist, 2001). As reviewed in other chapters in this book, these programs are showing progressive growth related to the increasing recognition that they reduce barriers to the receipt of mental health services by children, adolescents, and families (Catron, Harris,&Weiss, 1998), while at the same time reducing barriers to student learning (Adelman&Taylor, 1999). Further, preliminaryevaluation findings support the impact of the programs in improving student emotional and behavioral functioning (Armbruster, Gerstein,&Fallon, 1997; Nabors&Reynolds, 2000; Weist et al, 1996), school behavior (Hall, 2000; Jennings, Pearson,&Harris, 2000), and student attendance (Britto&Klostermann, 2000; Jennings et al., 2000)

However, research on school-based mental health programs remains limited (Rones&Hoagwood, 2000), and issues related to the effective implementation of these programs in diverse contexts remain to be explored (see Weist&Albus, in press). One context that has received almost no attention in the published literature on school mental health is military schools. In this chapter, we describe the development of a school-based mental health program in an elementary school serving military children in Hawaii

Military families are unique in many ways as compared to their civilian counterparts (see Isay, 1968; LaGrone, 1978). On average, a military family will move every 3 years, often to locations overseas. Children are therefore required to change schools and make new friends on a frequent basis. In many families both parents are in the military, potentially compounding disruptions at home. There are also many single-parent military families. Often children go exclusively to schools dominated by military children and recognize that their lives are different from those of “civilian” children. Military parents are required to have a plan that specifies who is to take care of their children if they are deployed, and deployment itself places enormous strain on the military family

These stresses clearly operate in the lives of military families in Hawaii, where the 25th Infantry Division of the U.S. Army operates. Deployment for soldiers from this division occurs on a fairly frequent basis. Often the children are cared for by the other parent, a relative, or, at times, by a good family friend. Many times the nonmilitary spouse and children move back to the mainland to be with relatives, an event that is difficult for the children's social and academic adjustment. Whenever there is a national crisis, many children begin to worry if their parents are going to leave and, more importantly, if they will return

An additional stress for military families in Hawaii is being isolated from extended family members and friends on the mainland. In Hawaii, children are several thousand miles from their relatives, and sometimes this separation is from one of the biological parents (as with children of divorce). In addition, Hawaii has a high cost of living that strains family budgets, resulting in many spouses being required to take jobs outside the house, leaving less time for their families. Junior-enlisted families frequently fall below the poverty level. Moreover, Hawaii's culture and multiethnic composition is very different from that of the mainland, which presents an adjustment challenge for many families. Related to these unique stresses, many military children in Hawaii view themselves differently from other children (e.g., as “Army Brats”)

In this chapter, we describe the Solomon Wellness for Education Program, a school mental health program being developed on a military base in Hawaii. We describe a range of services being developed in the school along with plans for assessing and improving program quality and for evaluating program outcomes. We then discuss unique issues the program is confronting related to the events of September 11, 2001. The chapter concludes with a discussion of challenges and opportunities that lie ahead in the advancement of school-based mental health-based mental health programs in U.S. schools with largely military populations, and DePartment of Defense schools abroad