The Status of School-based Mental Health Services for Students with Disabilities

Mental health problems in children and adolescents are a rising nationwide and global issue. Disabilities put youth in poorer mental health conditions and pose a higher risk for mental health disorders. Schools have become the primary providers of mental health services. It was reported that schools served the overwhelming majority of children (70% to 80%) who received any mental health services. Study 1 investigated the effects of school-based mental health (SBMH) services on academic achievement and behaviors over five years for students diagnosed with disabilities by analyzing data from the Special Education Elementary Longitudinal Study (SEELS). Results were based on latent growth curve modeling. Results indicated that SBMH predicted faster improvement of academic performance and confirmed the bidirectional relationship between behavior and academic achievement, in which the initial behavior positively predicted the improvement of academic achievement over time, and vice versa. Moreover, these findings varied depending on participant characteristics. Specifically, initial positive behavior level positively predicted initial academic performance for both boys and girls, Caucasians, low-incidence disabilities, medium and high suspension, medium and high SES, and suburban students; initial behavior level positively predicted improvement in academic performance for girls, high-incidence disabilities, low SES, and rural students; and initial academic performance level positively predicted improvement in positive behaviors for boys, Caucasians, low-incidence disabilities, medium suspension, medium and high SES, and urban students. Study 2 evaluated the effectiveness of evidence-based SBMH programs for students diagnosed with disabilities using meta-analysis. One hundred and nine (109) evidence-based programs were identified and 30 randomized controlled trials were included for analyses. The overall treatment effect size (Cohen’s d) was .40, indicating that disabled youths who received evidence-based mental health interventions improved .4 standard deviation more than those who did not receive or received other services on the outcome measures. Moderation analyses indicated that intervention length significantly explained the variations among effect sizes, with less-than-18 sessions more effective than more sessions. Implications for research and practice were discussed