Evaluating the Role of School in Adolescent Mental Health Service Provision

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DESCRIPTION (provided by applicant): This Career Development Award (K01) will provide the candidate with skills to establish an independent program of research focused on evaluating the role of schools in mental health service provision for adolescents. Schools are identified as a primary provider of mental health services and a gateway to other service sectors. However, there is a great deal of variability in school service provision and relatively little is known about the mechanisms by which schools are involved in identifying adolescents with psychiatric disorders and providing referrals for mental health services. While the candidate has experience providing services in schools and assessing indicators of school climate, this training plan is designed to provide her with skills in psychiatric epidemiology and services evaluation research to address gaps in her training. Specifically, the candidate will (a) develop proficiency in statistical techniques for analyzing large multilevel and longitudinal datasets and (b) gain in-depth knowledge of mental health services research, through study and direct experience with the evaluation of mental health services in schools. A combination of didactic training, guided readings, a research apprenticeship, and the completion of a mentored research project will address these gaps in knowledge. The first phase of the mentored research project will involve studying variability in adolescent service system contact as a function of modifiable school characteristics and identifying the influence of referrals for treatment from the school sector on subsequent treatment trajectories and mental health outcomes. Aims will involve analysis of data from the National Co-morbidity Survey Replication Adolescent Supplement (NCS-A) and Center for Mental Health Services' system of care evaluation, providing the candidate will skills in mental health services research and multilevel and longitudinal data analysis. These skills will be applied to the second phase of the project, which will involve conducting interviews and developing of a new survey to measure identification and referral strategies used by school psychologists and school counselors. Training activities and study results will be used to develop an R01 proposal to test mechanisms for improving access to mental health services by enhancing detection and referral provision by schools. PUBLIC HEALTH RELEVANCE: This study aims to clarify the role of schools in identifying psychiatric disorders and providing referrals for mental health services. Delineating these roles is critical to informing the development of interventions that can increase access to mental health services. A substantial proportion of adolescent mental health services are provided by schools or at their behest, interventions to improve effective service provision have important public health implications.