Evaluating the Role of School in Adolescent Mental Health Service Provision

描述（由申请人提供）：此职业发展奖（K01）将为候选人提供技能，以建立一个独立的研究项目，重点是评估学校在为青少年提供心理健康服务方面的作用。学校被确定为心理健康服务的主要提供者和通往其他服务部门的门户。然而，学校提供的服务有很大的可变性，相对而言，人们对学校参与识别患有精神疾病的青少年和提供转介心理健康服务的机制知之甚少。虽然候选人有在学校提供服务和评估学校气氛指标的经验，但该培训计划旨在为她提供精神病学流行病学和服务评估研究方面的技能，以解决其培训中的差距。具体而言，候选人将(a)熟练掌握分析大型多层次和纵向数据集的统计技术；(b)通过学习和对学校心理健康服务评估的直接经验，深入了解心理健康服务研究。教学训练、指导阅读、研究学徒和完成指导研究项目的结合将解决这些知识差距。辅导研究项目的第一阶段将涉及研究青少年服务系统接触的可变性，作为可改变的学校特征的功能，并确定学校部门转介治疗对后续治疗轨迹和心理健康结果的影响。目的将包括分析来自国家共发病调查复制青少年补充（NCS-A）和精神卫生服务中心的护理评估系统的数据，为候选人提供精神卫生服务研究和多层次和纵向数据分析的技能。这些技能将应用于该项目的第二阶段，该阶段将包括进行访谈和制定一项新的调查，以衡量学校心理学家和学校辅导员使用的识别和转诊策略。培训活动和研究结果将用于制定一项R01提案，以测试通过加强学校提供的检测和转诊服务来改善获得精神卫生服务的机制。

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.