School-Based Behavioral Health Services in a Diverse, Urban Setting: Making a Difference

Research shows that one in five children have a mental, emotional or behavioral health disorder; however the majority of youth who need services do not receive them. Furthermore, poor mental health can lead to other development concerns, including poor educational outcomes and substance use. For many youth who do receive services, the public school system is their sole provider. An evaluation of a school-based behavioral health program serving elementary, middle and high school youth in 30 schools in a diverse, urban county in California assessed the impacts of services on clients' behavioral health outcomes. Client intake and discharge assessments (n=513) completed by providers demonstrated significant improvements (p<.0001) in all presenting problem subscales over time, including academic/school needs (7 items; mean score 6.0 pre; 5.3 post); emotional/behavioral needs (11 items; 7.9 pre; 6.5 post); social/relationship needs (7 items; 5.5 pre; 4.7 post); and health/basic needs (4 items; 1.3 pre; 1.0 post). Clinician assessments also demonstrated significant improvements in the internal resiliency factors domain (11 items; 14.0 pre; 15.9 post; p<.0001), however significant improvements were not found in the external resiliency factors domain. Middle/high school client pre/post surveys (n=140) revealed similar significant improvements, particularly within anxiety, depression and peer/social skills domains. Interviews with providers (n=52) support the benefits demonstrated by the quantitative data, while also providing insights into the successes and challenges of providing services in the school setting. These findings hold important relevance to demonstrating the value of school-based programs in meeting youth's behavioral health needs, particularly in large, urban settings.