Youth descriptions of mental health needs and experiences with school-based services: Identifying ways to better meet the needs of low-income adolescents

Background: Poor mental health during adolescence is common and associated with adverse behavioral, academic, and health outcomes. Schools are well positioned to be ‘frontline’ mental health providers given their access to and familiarity with students over time. Although schools serve as a common entry point into mental health services, identification and engagement of students in need of care remains a problem. Little is known about the ways schools can best recognize and meet the mental health needs of students, especially from a youth perspective.

Methods: We used a community-partnered qualitative research approach, comprising data collection via in-depth interviews with 18 youth who had a history of poor mental health. A Grounded Theory analysis explored a) how youth described and expressed symptoms of poor mental health; and b) youth experiences with and perceptions of school-based mental health services.

Findings: Results suggest that youth experienced a variety of overlapping symptoms, only a portion of which they identified as emotionally rooted. A large percentage of students did not have their needs identified by school personnel. Furthermore, not all who were offered treatment services by schools were willing to accept them.

Implications: In the present study, we explored the reasons for these missed opportunities and potential strategies to build a more responsive system for youth with mental health needs. Promising policies and programs to integrate mental health services into schools, including approaches to reduce stigma and improve mental health literacy at the school and community level, will be discussed.