Under the Radar: Comprehending Mental Health Needs and Services in School-Based Health Centers for Children and Adolescents

Among children and adolescents, one in five suffers from mental health disorders. Those belonging to diverse racial and ethnic groups are less likely to receive adequate treatment than their white counterparts. They are also more likely to reside in households at or below the poverty level. Though public schools are the largest providers of mental health services, the services they provide are inconsistent. School-based health centers (SBHC) have been providing comprehensive health and mental health services within or near schools for over 40 years. Majority are located in urban, inner cities and evidence for their success in providing mental health services to children and adolescents has been growing. The purpose of this dissertation was to holistically understand the mental health needs of children and adolescents and the role of SBHCs in providing mental health services in underserved areas. To attain this, three independent research studies were conducted. The first study was a metasynthesis to understand the experiences of African American adolescents in dealing with mental health conditions and accessing care. The second study was a systematic review to evaluate and assess the evidence of SBHCs in providing mental health services to children and adolescents. The third study was a secondary analysis of an existing database on the use of SBHC services in Connecticut. The philosophical foundations of this dissertation were routed in pragmatism and the ecobiodevelopmental framework guided the study. The three studies yielded abundant information on provision of mental health services in SBHCs. The experiences of the adolescents provided insight into the process of coming to terms with their mental health conditions and seeking help. The systematic review provided evidence that SBHCs provided much needed access to students with mental health issues and they were more likely to use the services. The descriptive study provided evidence that most of the visits were for mental health reasons and males made more mental health visits than females. Together these findings provide a deeper understanding of mental health services in SBHCs