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Getting help to our young

By Lara Jakobsons, Special to the Times
In print: Saturday, October 4, 2008

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Children are back at school, but how many of them will receive the mental health care they need?

In Hillsborough County alone, University of South Florida researchers estimate that 38,000 children have a diagnosable mental disorder, but only 11,400 will receive help. Of those who need help, about 7,980 children will receive services from their school.

Many children do not receive the services they need due to lack of transportation. One advantage of receiving mental health services through schools is that it provides easier access for children and their families.

At a local school where I was treating a child whose mother died, I encouraged her to receive grief therapy through a community mental health center. She told me, "If I can't talk to you at school, I can't talk to anyone. My grandmother won't drive me to see a counselor."

At the federal level, the need for more school-based mental health services has been emphasized in the president's 2003 New Freedom Commission on Mental Health. The federal government is using initiatives to drive local educational and mental health systems to work together to increase students' access to services.

An early example of a federally funded program that provided comprehensive and integrated services across different educational and mental health systems was the Fort Bragg Demonstration Project. Researchers from Vanderbilt University found that children who participated in this program had greater access to care, received more types of services, were more likely to remain in services and had higher parental satisfaction with services.

Although integrated efforts involving school systems have been initiated by the federal government, the necessary funding is not present at the local level.

Given the large number of children in need of mental health care, we need to ask ourselves as a community: What can we do to help children get the services they need?

One way in which Hillsborough County schools are addressing this need is through a federal grant awarded by the U.S. Education Department's initiative to "Integrate Schools and Mental Health Systems." This initiative aims to improve mental health services to students by more smoothly knitting together educational, crisis, juvenile justice, and community-based mental health services.

My research, supported by USF, examined communities across the nation that were awarded grants through the same initiative. I found that the more these services were integrated and agencies collaborated in the development of programs, the greater the students' access to mental health services.

Findings from my research also revealed that communities awarded the integration grants were able to develop protocols and resource directories that facilitated the referral process of students from schools to mental health services agencies. During my interviews with respondents from the communities, it was clear that these protocols could help students receive more appropriate services quicker.

The benefits of the integration grants even went as far as affecting services in schools, as teachers learned classroom strategies to work better with students who have mental health concerns. I also found that communities that received these grants reported an increase in the provision of services by mental health providers in school settings.

Better coordination of services for students in Hillsborough County could mean that students receive services more quickly through their school or local mental health agencies. Given past research, children with mental health concerns may also be more likely to remain in services.

How can we make sure initiatives, such as this one, last over time? Policy recommendations include the continued funding of initiatives such as this one and the continued support from local community agencies, particularly organizations that serve families. Local family organizations can help support family-centered policies and help sustain the impact of initiatives like these over time. We also need to focus on activities across service systems that create greater access for students in need of mental health services.

If we want children in our community to receive the mental health services they need, schools, family and mental health organizations need to work together. The greater the collaboration, the more we benefit.

Lara Jakobsons has more than 10 years of experience working with children at schools and community mental health centers. She is receiving her doctorate in clinical psychology from Florida State University.