Expanded School Mental Health Services

A National Movement in Progress
  • Mark D. Weist
Part of the Advances in Clinical Child Psychology book series (ACCP, volume 19)


In 1982, Knitzer’s compelling Unclaimed Children underscored the tremendous gap between the mental health needs of children in the United States and services actually available to them. Throughout the 1980s and into the 1990s, some progress has been made to improve the mental health system of care for youth, as exemplified by national reform efforts that improve the coordinated delivery of services (e.g., the Child and Adolescent Service Systems Program [CASSP]; Day & Roberts, 1991), the growth of family preservation models of treatment (Knitzer & Cole, 1989), and the development of “multisystemic” treatment approaches for youth with severe disturbances (Henggeler & Borduin, 1990). In spite of these improvements, a large gap between youth who need and receive services remains (Duchnowski & Friedman, 1990), mental health services continue to be fragmented and uncoordinated (Burns & Friedman, 1990), and university-based applied research efforts have not been effectively integrated into communities on a wide scale (Weisz & Weiss, 1993).


Mental Health Mental Health Service Violence Exposure Mental Health Provider School Health 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Abel, R. R., and Burke, J. P. (1985). Perceptions of school psychology services from a staff perspective. Journal of School Psychology, 23, 121–131.CrossRefGoogle Scholar
  2. Adelman, H. S. (in press). Restructuring education support services: Toward the concept of an enabling component. American School Health Association Monograph.Google Scholar
  3. Adelman, H. S., Sr Taylor, L. (1991). Early school adjustment problems: Some perspectives and a project report. American Journal of Orthopsychiatry, 61, 468–474.PubMedCrossRefGoogle Scholar
  4. Adelman, H. S., and Taylor, L. (1993). School-based mental health: Toward a comprehensive approach. Journal of Mental Health Administration, 20, 32–45.CrossRefGoogle Scholar
  5. Advocates for Youth. (1994). Unpublished survey of school-based and school-linked health services. Washington, DC: Author.Google Scholar
  6. Alexander, C. S., and Klassen, A. C. (1988). Drug use and illnesses among eighth grade students in rural schools. Public Health Reports, 103, 394–399.PubMedGoogle Scholar
  7. Barker, L. A., and Adelman, H. S. (1994). Mental health and help-seeking among ethnic minority adolescents. Journal of Adolescence, 17, 251–263.Google Scholar
  8. Barnett, S., Niebuhr, V., Baldwin, C., and Levine, H. (1992). Community-oriented primary care: A process for school health intervention. Journal of School Health, 62, 246–248.PubMedCrossRefGoogle Scholar
  9. Blum, R. (1987). Contemporary threats to adolescent health in the United States. Journal of the American Medical Association, 257, 3390–3395.PubMedCrossRefGoogle Scholar
  10. Burns, B. J., and Friedman, R. M. (1990). Examining the research base for child mental health services and policy. Journal of Mental Health Administration, 17, 87–97.PubMedCrossRefGoogle Scholar
  11. Butler, J. A. ( 1988, August). National special education programs as a vehicle for financing mental health services for children and youth. Paper presented at the workshop, The Financing of Mental Health Services for Children and Adolescents, National Institute of Mental Health, Washington, DC.Google Scholar
  12. Caplan, G. (1964). The principles of preventive psychiatry. New York: Basic Books.Google Scholar
  13. Center for Population Options. (1993). Unpublished survey of school-based and school-linked clinics. Washington, DC: Author.Google Scholar
  14. Comer, J. (1988). Educating poor minority children. Scientific American, 259, 42–48.CrossRefGoogle Scholar
  15. Conoley, J. C., and Conoley, C. W. (1991). Collaboration for child adjustment: Issues for school-and clinic-based child psychologists. Journal of Consulting and Clinical Psychology, 59, 821–829.PubMedCrossRefGoogle Scholar
  16. Cowen, E. L. (1967). Emergent approaches to mental health problems: An overview and directions for future work. In E. L. Cowen, E. A. Gardner, and M. Zax (Eds.), Emergency approaches to mental health problems. New York: Appleton-Century-Crofts.Google Scholar
  17. Cowen, E. L., Trost, M. A., Lorton, R. P., Dorr, D., Izzo, L. D., and Isaacson, R. V. (1975). New ways in school mental health: Early detection and prevention of school maladaptation. New York: Human Sciences Press.Google Scholar
  18. Day, C., and Roberts, M. C. (1991). Activities of the Children and Adolescent Service System Program for improving mental health services for children and families. Journal of Clinical Child Psychology, 20, 340–350.CrossRefGoogle Scholar
  19. Dolan, L. J. (1992). Models for integrating human services into the school (Tech. Rep. No. 30 ). Baltimore: Johns Hopkins University, Center for Research on Effective Schooling for Disadvantaged Students.Google Scholar
  20. Dryfoos, J. G. (1988). School-based health clinics: Three years of experience. Family Planning Perspectives, 20, 193–200.PubMedCrossRefGoogle Scholar
  21. Dryfoos, J. G. (1994). Full-service schools. San Francisco: Jossey-Bass.Google Scholar
  22. Duchnowski, A. J. (1994). Innovative service models: Education. Journal of Clinical Child Psychology, 23, 13–18.CrossRefGoogle Scholar
  23. Duchnowski, A. J., and Friedman, R. M. (1990). Children’s mental health: Challenges for the nineties. Journal of Mental Health Administration, 17, 3–12.PubMedCrossRefGoogle Scholar
  24. Duncan, G. (1991). The economic environment of childhood. In A. C. Huston (Ed.), Children in poverty (pp. 23–50 ). New York: Cambridge University Press.Google Scholar
  25. Elliot, D. S., Huizinga, D., and Menard, S. (1989). Multiple problem youth: Delinquency, substance abuse, and mental health problems. New York: Springer-Verlag.CrossRefGoogle Scholar
  26. Farie, A. M., Cowen, E. L., and Smith, M. (1986). The development and implementation of a rural consortium program to provide early, preventive school mental health services. Community Mental Health Journal, 22, 94–103.PubMedCrossRefGoogle Scholar
  27. Feigelman, S., Stanton, B. F., and Ricardo, I. (1993). Perceptions of drug selling and drug use among urban youths. Journal of Early Adolescence, 13, 267–284.CrossRefGoogle Scholar
  28. Fisher, G. L., Jenkins, S. J., and Crumbley, J. D. (1986). A replication of a survey of school psychologists: Congruence between training, practice, preferred role and competence. Psychology in the Schools, 23, 271–279.CrossRefGoogle Scholar
  29. Flaherty, L. T., Weist, M. D., and Warner, B. S. (in press). School-based mental health services in the United States: History, current models, and needs. Community Mental Health Journal.Google Scholar
  30. Fleisch, B., Knitzer, J., and Steinberg, Z. (1990). At the schoolhouse door: An examination of programs and policies for children with behavioral and emotional problems. New York: Bank Street College of Education.Google Scholar
  31. Garbarino, J. (1976). A preliminary study of some ecological correlates of child abuse: The impact of socioeconomic stress on mothers. Child Development, 47, 178–185.PubMedCrossRefGoogle Scholar
  32. Goodwin, L. D., Goodwin, W. L., and Cantrill, J. L. (1988). The mental health needs of elemen-tary school children. Journal of School Health, 7, 282–287.CrossRefGoogle Scholar
  33. Henggeler, S. W. (1994). A consensus: Conclusions of the APA Task Force Report on Innovative Models of Mental Health Services for Children, Adolescents, and Their Families. Journal of Clinical Child Psychology, 23, 3–6.Google Scholar
  34. Henggeler, S. W., and Borduin, C. M. (1990). Family therapy and beyond: A multisystematic approach to treating the behavior problems of children and adolescents. Pacific Grove, CA: Brooks/Cole.Google Scholar
  35. Henggeler, S. W., Melton, G. B., and Smith, L. A. (1992). Family preservation using multi-systemic therapy: An effective alternative to incarcerating serious juvenile offenders. Journal of Consulting and Clinical Psychology, 60, 953–961.PubMedCrossRefGoogle Scholar
  36. Henggeler, S. W., Schoenwald, S. K., Pickrel, S. G., Rowland, M. C., and Santos, A. B. (1994). The contribution of treatment outcome research to the reform of children’s mental health services: Multisystemic therapy as an example. Journal of Mental Health Administration, 21, 221–239.CrossRefGoogle Scholar
  37. Hofferth, S., and Hayes, C. (1987). Risking the future: Adolescent sexuality, pregnancy, and childbearing: Statistical appendices. Washington, DC: National Academy Press.Google Scholar
  38. Hyche-Williams, J., and Waszak, C. (1990). School-based clinics:1990. Washington, DC: Center for Population Options.Google Scholar
  39. Johnston, N. S. (1990). School consultation: The training needs of teachers and school psychologists. Psychology in the Schools, 27, 51–56.CrossRefGoogle Scholar
  40. Juszczak, L., Fisher, M., Lear, J. G., and Friedman, S. B. (1995). Back to school: Training opportunities in school-based health centers. Journal of Developmental and Behavioral Pediatrics, 16, 101–104.PubMedGoogle Scholar
  41. Kellam, S. G., and Rebok, G. W. (1992). Building developmental and etiological theory through epidemiologically based preventive intervention trials. In J. McCord and R. E. Tremblay (Eds.), Preventing antisocial behavior: Intervention from birth through adolescence. New York: Guilford Press.Google Scholar
  42. Kelleher, K. J., Taylor, J. L., and Rickert, V. I. (1992). Mental health services for rural children and adolescents. Clinical Psychology Review, 12, 841–852.Google Scholar
  43. Knitzer, J. (1982). Unclaimed children: The failure of public responsibility to children and adoles-cents in need of mental health services. Washington, DC: Children’s Defense Fund.Google Scholar
  44. Knitzer, J., and Cole, E. (1989). Family preservation services: The policy challenge to state child welfare and child mental health systems. New York: Bank Street College of EducationGoogle Scholar
  45. Lavoritano, J., and Segal, P. B. (1992). Evaluating the efficacy of a school counseling program. Psychology in the Schools, 29, 61–70.CrossRefGoogle Scholar
  46. Lear, J. G., Gleicher, H. B., St. Germaine, A., and Porter, P. J. (1991). Reorganizing health care for adolescents: The experience of the school-based adolescent health care program. Journal of Adolescent Health, 12, 450–458.PubMedCrossRefGoogle Scholar
  47. Lee, C. C. (1995). Counseling for diversity: A guide for school counselors and related professionals. Needham Heights, MA: Allyn Sr Bacon.Google Scholar
  48. Lusterman, D. D. (1985). An ecosystem approach to family school problems. American Journal of Family Therapy, 12, 22–30.CrossRefGoogle Scholar
  49. Maryland Department of Health and Mental Hygiene. (1995). School-based mental health: Charting program development and exploring issues in service delivery. Baltimore: Author.Google Scholar
  50. National Association of School Psychologists. (1995). School psychologists: Helping educate all children. Bethesda, MD: Author.Google Scholar
  51. National Mental Health Association. (1989). Invisible Children Project: Final report. Alexandria, VA: Author.Google Scholar
  52. Office of Technology Assessment. (1991). Adolescent health. Congress of the United States, Washington, DC: U.S. Government Printing Office.Google Scholar
  53. Offord, D. R., Boyle, M. H., Szatmari, P., Rae-Grant, N. I., Links, P. S., Cadman, D. T., Byles, J. A., Crawford, J. W., Blum, H. M., Byrne, C., Thomas, H., and Woodward, C. A. (1987). Ontario child health study. Archives of General Psychiatry, 44, 832–855.PubMedCrossRefGoogle Scholar
  54. Prothrow-Stith, D. (1991). Deadly consequences: How violence is destroying our teenage population and a plan to begin solving the problem. New York: HarperCollins.Google Scholar
  55. Prout, H. T., and DeMartino, R. A. (1986). A meta-analysis of school-based studies of psychotherapy. Journal of School Psychology, 34, 285–292.CrossRefGoogle Scholar
  56. Pryzwansky, W. B. (1989). Private practice as an alternative setting for school psychologists. In R. C. D’Amato and R. S. Dean (Eds.), The school psychologist in nontraditional settings (pp. 76–87 ). Hillsdale, NJ: Erlbaum.Google Scholar
  57. Pynoos, R. S., and Nader, K. (1990). Children’s exposure to violence and traumatic death. Psychiatric Annals, 20, 334–344.Google Scholar
  58. Rhodes, J. E., and Jason, L. A. (1988). Preventing substance abuse among children and adolescents. New York: Pergamon Press.Google Scholar
  59. Ritter, D. R. (1989). Teachers’ perceptions of problem behavior in general and special education. Exceptional Children, 55, 559–564.PubMedGoogle Scholar
  60. Rosenthal, B., and Hinman, E. (1995, June). Negotiating relationships between managed care and SBHCs. Paper presented at the first annual meeting of the National Assembly on School-Based Health Care, Washington, DC.Google Scholar
  61. Rutter, M., and Quinton, D. (1977). Psychiatric disorder: Ecological factors and concepts of causation. In H. McGurk (Ed.), Ecological factors in human development. Amsterdam: North Holland.Google Scholar
  62. Schutt, J. J., Rickett, K. D., Montgomery, L. L., and Lear, J. G. (1994). State initiatives to support school-based health centers. Washington, DC: Making the Grade.Google Scholar
  63. Schoenwald, S. K., Henggeler, S. W., Pickrel, S. G., and Cunningham, P. B. (in press). Treating seriously troubled youths and families in their contexts: Multisystemic therapy. In M. C. Roberts (Ed.), Model programs in service delivery in child and family mental health. Hillside, NJ: Erlbaum.Google Scholar
  64. Shakoor, B. H., and Chalmers, D. (1991). Co-victimization of African-American children who witness violence: Effects on cognitive, emotional, and behavioral development. Journal of the National Medical Association, 83, 233–238.PubMedGoogle Scholar
  65. School Health Policy Initiative. (1993). Ingredients for success: Comprehensive school-based health centers. Bronx, NY: Author.Google Scholar
  66. Slavin, R. E., Madden, N. A., Karweit, N. L., Dolan, L. J., and Wasik, B. A. (1992). Success for All: A relentless approach to prevention and early intervention in elementary schools. Arlington, VA: Educational Research Service.Google Scholar
  67. Stewart, K. J. (1986). Innovative practice of indirect service delivery: Realities and idealities. School Psychology Review, 15, 466–478.Google Scholar
  68. Sue, S., and Zane, N. (1987). The role of culture and cultural techniques in psychotherapy: A critique and reformulation. American Psychologist, 42, 37–45.PubMedCrossRefGoogle Scholar
  69. Thomas, A. (1987). School psychologists: An integral member of the school health team. Journal of School Health, 57, 465–468.PubMedCrossRefGoogle Scholar
  70. Thomas, P. A., and Texidor, M. S. (1987). The school counselor and holistic health. Journal of School Health, 57, 461–463.PubMedCrossRefGoogle Scholar
  71. Theut, S. K., and Bailey, H. G. (1994). What is the outcome for children’s mental health needs in national health care reform? Journal of the American Academy of Child and Adolescent Psychiatry, 33, 1219–1222.PubMedCrossRefGoogle Scholar
  72. U.S. Department of Health and Human Services. (1994). School-based clinics that work. U.S. Department of Health and Human Services, Public Health Service, Bureau of Primary Health Care. Rockville, MD: Author.Google Scholar
  73. Warner, B. S., and Weist, M. D. (1996). Urban youth as witnesses to violence: Beginning assessment and treatment efforts. Journal of Youth and Adolescence, 25, 361–377.CrossRefGoogle Scholar
  74. Way, N., Stauber, H. Y., Nakkula, M. J., and London, P. (1994). Depression and substance abuse in two divergent high school cultures: A quantitative and qualitative analysis. Journal of Youth and Adolescence, 23, 331–357.CrossRefGoogle Scholar
  75. Weissberg, R. P., Caplan, M., and Harwood, R. L. (1991). Promoting competent young people in competency-enhancing environments: A systems-based perspective on primary prevention. Journal of Consulting and Clinical Psychology, 59, 830–841.PubMedCrossRefGoogle Scholar
  76. Weist, M. D., Myers, M. P., and Baker, M. E. ( 1995, June). Violence exposure and behavioral functioning in inner-city youth. Paper presented to the Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore.Google Scholar
  77. Weist, M. D., Paskewitz, D. A., Warner, B. S., and Flaherty, L. T. (1996). Treatment outcome of school-based mental health services for urban teenagers. Community Mental Health Journal, 32, 149–157.PubMedCrossRefGoogle Scholar
  78. Weist, M. D., Proescher, E. L., Freedman, A. H., Paskewitz, D. A., and Flaherty, L. T. (1995). School-based health services for urban adolescents: Psychosocial characteristics of clinic users versus nonusers. Journal of Youth and Adolescence, 24, 251–265.CrossRefGoogle Scholar
  79. Weisz, J. R., and Weiss, B. (1993). Effects of psychotherapy with children and adolescents. Newbury Park, CA: Sage.Google Scholar
  80. Weisz, J. R., Weiss, B., and Donenberg, G. R. (1992). The lab versus the clinic. American Psychologist, 47, 1578–1595.PubMedCrossRefGoogle Scholar
  81. Winett, R. A., and Anderson, E. S. (1994). HIV prevention in youth: A framework for research and action. In T. H. Ollendick and R. J. Prinz (Eds.), Advances in clinical child psychology, Vol. 16 (pp. 1–44 ). New York: Plenum Press.Google Scholar
  82. Zahner, G. E., Pawelkiewicz, W., DiFrancesco, J. J., and Adnopoz, J. (1992). Children’s mental health service needs and utilization patterns in an urban community: An epidemiological assessment. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 951–960.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1997

Authors and Affiliations

  • Mark D. Weist
    • 1
  1. 1.Department of PsychiatryUniversity of MarylandBaltimoreUSA

Personalised recommendations