Mental Health Services in the Education Sector: Effectiveness and Systemic Impact

说明(由候选人提供)：大多数需要心理健康干预的青年没有得到任何服务(Kataoka等人，2002年)。这一问题在社会经济地位较低的青年和少数民族青年中尤为明显，他们最有可能经历精神健康问题，最不可能接受服务，因此更有可能遭受精神健康问题的有害影响(美国国土安全部，2001年)。以学校为基础的预防和干预方案是减少青年中已查明的服务差距和差距的最有希望的机会之一，因为小学和中学教育几乎是普遍的。作为进入支离破碎的精神卫生系统的最常见切入点，改善以学校为基础的服务并了解其对未来护理的影响的努力对整体公共卫生具有深远的影响(Farmer等人，2003年)。目前的申请旨在提供必要的技能培训，以建立一个长期的研究计划，调查以学校为基础的计划在解决不同青年群体未得到满足的心理健康需求方面的作用。我的总体目标是走向独立的研究生涯，在这个职业中，我将应用复杂的研究方法来研究和补救心理健康差距和差异，并将研究结果应用于服务提供模式的开发。为了实现这些目标，我将参加一次将个人指导、课程作业和实地经验相结合的强化培训经验。这项培训将为一系列与精神健康服务利用有关的研究问题提供信息并形成分析，并形成职业发展补助金申请的基础。该项目的主要研究部分将利用以学校为基础的青少年抑郁症预防计划--高中过渡研究(HSTS；McCauley等人，2008年)--的丰富现有数据集，进行超出原始研究范围的分析。拟议的项目将使我能够在分析影响计划有效性的与学校相关的因素方面积累专业知识，并获得关于评估计划对各服务部门(如专科精神卫生、初级保健、教育)精神卫生服务利用的影响的知识。这些成果将提供信息，说明以学校为基础的干预措施如何融入整个服务提供系统，以及它们在减少获得服务和青年成果方面的差距方面的潜力。我的具体研究目的包括使用种族和社会经济多样性的HSTS样本来探索学生的学校依恋和支持如何中介干预结果，并考察HSTS项目参与对不同群体青年的心理健康服务利用的影响。

DESCRIPTION (provided by candidate): The majority of youth in need of mental health interventions do not receive any services (Kataoka et al., 2002). This problem is particularly notable among low socioeconomic (SES) and ethnic minority youth, who are most likely to experience mental health problems, least likely to receive services, and are consequently more likely to suffer the deleterious effects of mental health problems (US DHHS, 2001). School-based prevention and intervention programs represent one of the most promising opportunities for reducing identified service gaps and disparities among youth because of the nearly universal nature of primary and secondary education. As the most common point of entry into a fragmented mental health system, efforts to improve school-based services and understand their implications for future care carry profound implications for overall public health (Farmer et al., 2003). The current application is designed to provide training in the skills necessary to build a long-term program of research investigating the role of school-based programs in addressing the unmet mental health needs of diverse groups of youth. My overarching goal is to move toward an independent research career in which I will apply sophisticated research methodologies to the study and remediation of mental health gaps and disparities and apply the findings to the development of a service delivery model. To accomplish these goals, I will engage in an intensive training experience that will combine individual mentorship, coursework, and field experiences. This training will inform and shape the analyses of a set of research questions pertaining to mental health service utilization and form the basis for a Career Development grant application. The primary research component of this project will take advantage of a rich, existing data set from a school-based prevention program for adolescent depression, the High School Transition Study (HSTS; McCauley et al., 2008), to conduct analyses beyond the scope of the original study. The proposed project will allow me to build expertise in the analysis of school-related factors that influence program effectiveness and to gain knowledge about the assessment of program impact on mental health service utilization across service sectors (e.g., specialty mental health, primary care, education). Results will provide information about how school-based interventions fit into the overall service delivery system, and their potential for reducing disparities in access to services and youth outcomes. My specific research aims include using the ethnically and socioeconomically diverse HSTS sample to explore how students' school attachment and support mediate intervention outcome and to examine the impact of HSTS program participation on the mental health service utilization of different groups of youth.