Using Network Analysis to Assess School Mental Health Organizational Structure

描述(由申请人提供)：尽管我们越来越重视以学校为基础的精神健康服务的提供，但在理解如何在学校环境中有效地实施、整合和维持精神健康服务方面仍然存在障碍。这种困难的部分原因在于，在高风险的学校环境中，教育工作者面临着巨大的负担，在这些环境中，成绩责任制处于历史最高水平。同样造成这一困难的还有实施中的障碍以及将项目从“板凳到床边”的转换，这些障碍不仅包括领导力和对变革的准备问题，还包括专业能力和培训问题，以及组织和结构上的运作障碍。在学校环境中，组织障碍尤其突出，因为心理健康专业人员 教育专业人员不仅必须解决自己的组织障碍，而且还必须解决其他专业群体的障碍。因此，推进以学校为基础的心理健康科学的一个必要步骤包括更彻底地了解学校服务的组织如何有助于心理健康服务质量。拟议的试点研究的目的是利用服务系统研究方法--社会网络分析--来评估和了解学校心理健康专业人员和教师之间沟通和角色结构的性质。由于以学校为基础的精神卫生服务包括以预防为导向的、有针对性的、密集的服务和危机干预，网络分析包括所有级别的服务强度。基于资助机制的有限能力和研究的试点性质，这项研究将限于中学生群体，这将允许有足够的学校从其中选择适当的样本，同时最大限度地利用与心理健康服务特别相关的人群。社会网络分析将被用来确定学校内所有专业群体之间的沟通结构和角色。将比较不同服务强度的沟通和角色结构的差异，并评估这些结构对心理健康整合质量的贡献。这项试点研究将由一个由研究团队、学区学生服务负责人以及全国公认的校本心理健康服务和实施科学专家组成的顾问小组协调。根据我们的研究结果，这项研究将通过R01资助机制扩大，以更彻底地评估沟通和角色结构如何有助于儿童个性化的心理健康结果，组织结构如何有助于以学校为基础的心理健康服务的效率和可持续性，以及通过R34资助，学校如何通过培训和专业发展实践更好地鼓励和促进最有利于有效服务的沟通和角色结构。

DESCRIPTION (provided by applicant): Despite our increasing attention to the provision of school based mental health services, barriers remain to our understanding of how mental health services may be effectively implemented, integrated and sustained in school settings. Part of this difficulty rests with the tremendous burden facing educators in high stakes school environments where performance accountability is at an all-time high. Equally contributing to this difficulty are barriers in implementation and the translation of programs from 'bench-side to bedside' that include not only issues of leadership and readiness for change, but also issues of professional competencies and training, and organizational and structural barriers to operation. In school settings organizational barriers are particularly salient, as mental health professionals and education professionals must address not only their own organizational barriers, but those of the other professional group as well. Therefore a necessary step in advancing the science of school based mental health involves a more thorough understanding how the organization of services in schools contributes to mental health service quality. The purpose of the proposed pilot study is to utilize a service systems research methodology, social network analysis, to assess and understand the nature of communication and role structures among school based mental health professionals and teachers. Because school based mental health services are inclusive of prevention oriented, targeted, intensive services, and crisis interventions, the network analysis includes all levels of service intensity. Based on the limited capacity of the funding mechanism and the pilot nature of the research, the study will be limited to middle school populations, which will allow a sufficient set of schools from which to choose appropriate samples, while maximizing the use of a population for whom mental health services are particularly relevant. The social network analysis will be used to identify the structure of communications and roles among all professional groups within schools. Differences within communication and role structures across service intensity will be compared, and the contribution these structures make to the quality of mental health integration will be assessed. This pilot study will be coordinated by an advisory team composed of the research team, school district student service leaders, and nationally recognized experts in school based mental health services and implementation science. Contingent on our findings, the research will be expanded through R01 funding mechanisms to more thoroughly assess how communication and role structures contribute to individualized mental health outcomes for children, how organizational structures contribute to efficiency and sustainability of school based mental health services, and through R34 funding, how schools may better encourage and facilitate the communication and role structures that are most conducive to effective services through training and professional development practices.