Improving quality in school mental health

Abstract

School mental health (SMH) quality assessment and improvement has been a primary overarching theme of this journal since its inception. In recent decades, dimensions of SMH quality have moved beyond bureaucratic processes (e.g. credentialing, adherence to paperwork requirements) and/or liability protection (e.g. procedures for handling crises) toward better articulated and perhaps nuanced dimensions including: (a) quality of stakeholder involvement in program development, guidance, evaluation and continuous improvement; (b) quality of collaborative relations among families, school staff and community providers; (c) the range of preventive and treatment services provided; (d) productivity of staff; (e) quality of training and supervision of staff; (f) team building and service coordination; (g) emphasis on evidence-based prevention and intervention; (h) cultural responsiveness of interventions; (i) use of appropriate evaluation strategies; (j) use of evaluation findings to continuously improve programs and services and (k) connecting evaluation findings to advocacy and policy improvement agendas (Ambrose, Weist, Schaeffer, Nabors, & Hill, 2002; Evans, Sapia, Axelrod, & Glomb, 2002; Nabors, Lehmkuhl, & Weist, 2003; President’s New Freedom Commission on Mental Health, 2003). Simultaneously, systems for measuring SMH quality have evolved, with several measures being developed to help schools and their broader authorities (e.g. school districts) assess and monitor progress (e.g. School Mental Health Quality Assessment Questionnaire, Weist, Stephan, Lever, Moore, & Lewis, 2006; Mental Health Planning and Evaluation Template, National Assembly on School-based Health Care, 2010; School Mental Health Capacity Instrument, Feigenberg, Watts, & Buckner, 2010). Access to and quality of school-based health services vary greatly at all local and state levels across the United States, with many youth unable to access high-quality services. In 2014, two national leaders in school health, the national Center for School Mental Health (CSMH, http://csmh.umaryland.edu) and the School-Based Health Alliance (www. sbh4all.org), were charged by the federal Department of Health and Human Services, Health Resources and Services Administration with further advancing quality and sustainability efforts across the country. The $2.8 million 4-year cooperative agreement will support the efforts of partnering organizations’ to improve the quality of care delivered by school-based health centres (SBHCs) and comprehensive school mental health systems (CSMHSs) nationwide. Specific project activities include: