Integration of a Children's Mental Health Initiative into a School System in Connecticut

Background: Identifying Children and Responding Early (iCARE) is a system that identifies children who are at risk of behavioral health problems and provides evidence-based, culturally competent preventive interventions. We evaluated the integration of this early identification, assessment, intervention, and referral initiative into one community’s school-based mental health service delivery system. Teachers, social workers, parents, and the Ministerial Alliance, a faith-based group of African-American churches were trained in assessment, positive behavioral support and community referral activities.

Methods:   Children between the ages of 6 and 11 in two elementary schools were assessed between 2009 and 2014. 1177 childern were screened of which 21% identified as at-risk, and 15% were referred to interventions. Quantitative measures included frequencies of universal screening and paired t- testing of iCARE student and parent Ohio Scales assessment scores.  Systems change and community ownership was measured through qualitative reports and analysis of the future funding. 

Findings:  Children experienced a significant decrease in problem severity (p=.0012) and an improvement in functioning (p=.0088).  Parent and caregiver stress decreased and they also reported high satisfaction with the program.   A school data team and community collaborative partnership remains integrated into the system. The school system will assume partial funding for iCARE beginning in the 2015-2016 school year.

Implications: Successful integration of community-based mental health services within the school setting and buy-in from families through the participation of community partners facilitated systems change, and a shift in community decision-making process about policies, programs and the allocation of resources for children’s mental health.