Copyright @ 2007 American Academy of Child and Adolescent Psychiatry. Unauthorized reproduction of this article is prohibited. The Federal Case for School-Based Mental Health Services and Supports

By all indicators, the need for mental health services has been more not less. Not everybody is in agreement that schools should be doing this. The long and short of it is there is some confusion about what constitutes mental health.VU.S. Department of Education official, 2006 Provision of health care in schools is a logical component of an advanced industrial society; however, health care providers have struggled to make universal school health and mental health a reality. Despite the President_s New Freedom Commission Report that stressed the need for school-based mental health in the context of a wider public health agenda, school mental health services and supports continue to be frag-mented.1 Instead of riding a wave of new resources, knowledge, and a quality focus, the school-based mental health movement struggles to answer basic questions about identity. Is school mental health the provision of services similar to those found in a community mental health center? Is it psychosocial services? Or is it a cluster of prevention strategies that engage the entire school? These questions remain largely unanswered. Federal and state health policy is not only a necessary component of any strategy to advance mental health for children and youth but also requires consideration of issues central to the identity of school-based programs: what is at stake, how services are integrated, and who pays