Research Citations

By Jeffrey L. Charvat, PhD, NASP Director of Research and Information Services

Academic–Mental Health Links
Interventions that strengthen students’ social, emotional, and decision-making skills also positively impact their academic achievement, both in terms of higher standardized test scores and better grades (Fleming et al., 2005).

There is a strong tie between students’ overall health and resilience and their academic achievement (WestEd, 2003). 

Behavior Problems

Among the general population, 21% of secondary school students have been suspended or expelled during their school careers, whereas the figures are 27% for those with learning disabilities, 73% for those with emotional disturbances, and 41% for those with other health impairments (including ADHD when it is the primary disability) (SRI International, 2006).

Consultation in the Schools

Consultation has been found to yield positive results such as remediating academic and behavior problems for children in school settings; changing teacher’s and parent’s behavior, knowledge, attitudes, and perceptions; and reducing referrals for psycho-educational assessments (MacLeod et al., 2001; Reddy et al., 2000).

Cost–Benefit Analysis of Early Interventions

The Seattle Social Development Project, an intervention for teachers, parents, and students in grades one through six, has been estimated to provide measured benefits of $9,837 per student in averted long-term social problems, after subtracting the costs of the program (Aos et al., 2004). 

School-based drug abuse prevention programs have been conservatively estimated to provide a benefit of $840 in social benefit per student, compared to a program cost of $150 per student (Caulkins et al., 2004). 

Depression

Approximately 2.2 million adolescents aged 12 to 17 reported a major depressive episode in the past year and nearly 60% of them did not receive any treatment (Substance Abuse and Mental Health Services Administration, Office of Applied Studies, 2005). 

Drug Use

Interventions that promote students’ bonding with those with prosocial beliefs and standards can keep them from more frequent alcohol and marijuana use (Brown et al., 2005). 

Early Childhood Interventions

Research has demonstrated that participation in pre-K programs increases children’s cognitive, motor, and language test scores, especially among Hispanic and Black children (Gormley et al., 2005). 

Preschool programs have positive effects on children’s cognitive and social-emotional functioning and parent-family wellness, enduring into grades K-8, with effect sizes in the small to moderate range (Nelson, Westhues, & MacLeod, 2003). 

Prevention and early intervention programs that target elementary school-aged students who are academically and socially at risk have been shown to produce declines in special education referrals and placement, suspension, grade retention, and disciplinary referrals (National Research Council and Institute of Medicine, 2000).

Education Statistics

In 2003-04, there were 88,113 public schools in the country, with 3,250,600 teachers and 47,315,700 students (Strizek et al., 2006).  

Emotional Disturbance

From 1993-94 through 2001-02, students with emotional disturbance had substantially higher dropout rates than any other disability category (Office of Special Education and Rehabilitative Services, U.S. Department of Education, 2005).

Students with emotional disturbance are significantly more likely to have been suspended or expelled in one school year or over their school careers than youth in all other disability categories (SRI International, 2006).

Functional Behavioral Analysis

Research supports the use of functional behavioral assessments in increasing the efficacy of interventions.  Of 148 intervention cases based on functional assessment, 98.7% had outcomes indicating successful behavior change (Ervin et al., 2001).

Gay, Lesbian, Bisexual, Transgender, and Questioning Youth

A 2005 survey revealed that LGBT students are three times more likely as non-LGBT students to feel not safe at school (22% vs. 7%) (Harris Interactive, Inc., 2005).  

Anti-LGBT language and bullying and harassment of students on the basis of sexual orientation or gender identity are common in America ’s schools (Kosciw & Diaz, 2006).

Health and the Health Care System

In 2004, 8% of children ages five through 17 experienced activity limitations resulting from one or more chronic health conditions (Federal Interagency Forum on Child and Family Statistics, 2006).

Juvenile Justice

More than 9,000 children per year are placed in juvenile justice systems just so that they can receive mental health care (U.S. General Accounting Office, 2003), even though these services are often actually unavailable in juvenile justice systems (Sage, 2006).

The number of youth under age 18 serving time in adult jails on any given day increased by 208% between 1990 and 2004 (Hartney, 2006).

Mental Health Promotion

Mental health promotion is an integral component of a comprehensive new model of prevention and treatment programs for youth (Weisz et al., 2005). 

Interventions that promote students’ bonding with those with prosocial beliefs and standards can keep them from more frequent alcohol and marijuana use (Brown et al., 2005). 

Mental Health Screening in Schools

When implemented as part of a coordinated and comprehensive school mental health program, mental health screening complements the mission of schools, identifies youth in need, links them to effective services, and contributes to positive educational outcomes (Weist et al., 2007). 

Positive Youth Development

Positive youth development programs produce positive behavior outcomes and prevent youth problem behaviors (Catalano et al., 2002).

Prevalence of Mental Illness

Over 5% of children under 17 years of age were reported to have a persistent emotional, developmental, or behavioral problem lasting for 12 months or more in the National Health Survey of Children's Health, the largest and most comprehensive survey of the health of children in the United States (Blanchard, Gurka, & Blackman, 2006).

The National Health Survey of Children's Health found that the most commonly diagnosed problems among children six to 17 years of age were learning disabilities (11.5%), ADHD (8.8%), and behavioral problems (6.3%); among preschoolers, speech problems (5.8%) and developmental delay (3.2%) were most common (Blanchard, Gurka, & Blackman, 2006).

Prevention

School-based prevention and youth development programming can positively influence a diverse array of social, health, and academic outcomes (Greenberg et al., 2003). 

Health promotion is a major component of many prevention efforts—though this fact often goes unacknowledged (Durlak et al., 2004). 

Despite the demonstrated effectiveness of prevention programs, many schools do not use them because of the difficulty in changing school programming and because the emphasis on academic accountability leads school personnel to make the false choice of emphasizing academics only (Greenberg et al., 2003).     

Federal prevention policies tend to focus on treating problems in isolation, resulting in the marginalization of target populations (Ripple & Zigler, 2003). 

The National Institute of Mental Health has since the early 1980s emphasized the “biological–brain defect–genetic theory” of the origins of mental illness, resulting in decreased research on the social causes of emotional disorders (Albee, 2004). 

Psychotropic Medications

The estimated number of office visits by youth that included antipsychotic treatment increased from approximately 201,000 in 1993 to 1,224,000 in 2002 (Olfson et al., 2006).

According to surveys of parents, stimulants such as Ritalin and Adderall are the most common psychotropic medications used by special education students: Fourteen percent of early elementary students take them, 18% of middle school students, and 11% of students ages 15 to 17 (Office of Special Education Programs, U.S. Department of Education, 2003). 

Resilience

Research suggests that resilience is a common phenomenon that results from the operation of basic human systems of adaptation; when protected and in good working order, development is robust even in the face of severe adversity (Masten, 2001). 

School Climate

A 2005 survey revealed that 53% of teachers see bullying and harassment of students as a serious problem at their school (Harris Interactive, Inc., 2005). 

School Mental Health

Overall, African American, Asian Pacific, and Latino students are less likely than non Hispanic White students to receive school-based mental health services (Wood et al., 2005). 

Expanded school mental health services in elementary schools have been found to reduce special education referrals, improve aspects of the school climate (Bruns et al, 2004), and produce declines in disciplinary referrals, suspension, grade retention, and special education referrals and placement among at-risk students (National Research Council and Institute of Medicine, 2000).

Intensive school-based mental health services for elementary school children experiencing severe emotional and behavioral difficulties have demonstrated reductions in conduct disordered behavior, attention deficit/hyperactivity, and depression (Hussey & Guo, 2003).

When school-based mental health services are available, students are substantially more likely to seek help, especially those enrolled in special education programs (Slade, 2002). 

Schools are already the major providers of mental health services to children, insofar as they receive any services at all (Rones & Hoagwood, 2000). 

In a recent survey, two thirds of school districts reported that the need for mental health services had increased since the previous year, while one third reported that funding for mental health services had decreased since the previous year (Foster et al., 2005).

School Psychology Shortage

There will be a shortage of almost 9,000 school psychologists in the U.S. between 2000 and 2010, with a cumulative shortage of almost 15,000 by 2020.  This estimate is in terms of existing positions, with the assumption of no growth in the number of positions needing to be filled (Curtis et al., 2004). 

Data projections suggest that nearly four out of 10 school psychologists will retire by 2010, more than half by 2015, and two out of three by 2020 (Curtis et al., 2004). 

On average, approximately 1,750 new school psychologists graduate and enter the field each year (Curtis et al., 2004). 

The personnel shortage is most acute in terms of doctoral-level school psychologists, and this has already impacted graduate programs, potentially compounding the shortage by limiting the ability to prepare new school psychologists (Curtis et al., 2004). 

School Safety

Six percent of high school students surveyed in 2005 said they missed at least one day of school in the previous month because they felt unsafe at school or on their way to or from school, up from 5.4% in the last survey in 2003 (Centers for Disease Control and Prevention, 2006).     

Social and Emotional Learning

Students who receive social-emotional support and prevention services achieve better academically in school (Greenberg et al., 2003; Welsh et al., 2001; Zins et al., 2004).

Suicide

In a recent national survey, 16.9% of students reported having seriously considered attempting suicide and 8.4% reported having attempted suicide one or more times during the preceding 12 months (Centers for Disease Control and Prevention, 2006). 

Suspension/Expulsion from School

Parents report that 46% of secondary school African American students with disabilities have been suspended or expelled from school during their school careers, compared to 30% of White students and 28% of Hispanic students (SRI International, 2006). 

Students with emotional disturbance are significantly more likely to have been suspended or expelled in one school year or over their school careers than youth in all other disability categories (SRI International, 2006).

References

Albee, G. W. (2004).  Prevention of mental disorders.  In W. E. Pickren, Jr., & S. F. Schneider (Eds.), Psychology and the National Institute of Mental Health: A historical analysis of science, practice, and policy (pp. 295-315).Washington, DC: American Psychological Association.     

Anderson, J. A., Meyer, R. D., Sullivan, W. P., & Wright, E R. (2005).  Impact of a system of care on a community’s children’s social services system.  Journal of Child and Family Studies, 14, 505-520.  (Data Trends No. 131, April 2006)

Aos, S., Lieb, R., Mayfield, J., Miller, M., & Pennucci, A. (2004).  Benefits and costs of prevention and early intervention programs for youth.  Olympia, WA: Washington State Institute for Public Policy. 

Blanchard, L. T., Gurka, M. J., & Blackman, J. A. (2006).   Emotional, developmental, and behavioral health of American children and their families: A report from the 2003 National Survey of Children's Health. Pediatrics, 117, 1202-1212.

Brown, E. C., Catalano, R. F., Fleming, C. B., Haggerty, K. P., & Abbott, R. D. (2005).  Adolescent substance use outcomes in the Raising Health Children Project: A two-part latent growth curve analysis.  Journal of Consulting and Clinical Psychology, 73, 699-710.

Bruns, E.J., Walrath, C., Glass-Siegel, M., & Weist, M.D. (2004).  School-based mental health services in Baltimore: Association with school climate and special education referrals.  Behavior Modification, 28, 491-512. 

Catalano, R. F., Berglund, M. L., Ryan, J. A. M., Lonczak, H. S., & Hawkins, J. D. (2002).  Positive youth development in the United States : Research findings on evaluations of positive youth development programs.  Prevention & Treatment, 5.  Retrieved August 9, 2007, from http://journals.apa.org/prevention/volume5/pre0050015a.html

Caulkins, J. P., Liccardo Pacula, R., Paddock, S., & Chiesa, J. (2004).  What we can—and cannot—expect from school-based drug prevention.  Drug and Alcohol Review, 23, 79-87.

Centers for Disease Control and Prevention. (2006).  Youth Risk Behavior Surveillance— United States , 2005.  Surveillance Summaries, MMWR, 55(SS-5). 

Curtis, M. J., Chesno Grier, J. E., & Hunley, S. A. (2004).  The changing face of school psychology: Trends in data and projections for the future.  School Psychology Review, 33(1), 49-66. 

Durlak, J. A., Weissberg, R. P., Quintana, E., & Perez, F. (2004).  Primary prevention: Involving schools and communities in youth health promotion.  In L. A. Jason, C. B. Keys, Y. Suarez-Balcazar, R. R Taylor, & M. I. Davis (Eds.), Participatory community research: Theories and methods in action (pp. 73-86).Washington, DC: American Psychological Association.     

Ervin, R. A., Radford, P. M., Bertsch, K., Piper, A. L. Ehrhardt, K. E., & Poling, A. (2001). A descriptive analysis and critique of the empirical literature on school-based functional assessment.  School Psychology Review, 30, 193-210.

Federal Interagency Forum on Child and Family Statistics. (2006).  America ’s children in brief: Key national indicators of well-being, 2006.Washington, DC: U.S. Government Printing Office.     

Fleming, C. B., Haggerty, K. P., Brown, E. C., Catalano, R. F., Harachi, T. W., Mazza, J. J., & Gruman, D. H. (2005). Do social and behavioral characteristics targeted by preventive interventions predict standardized test scores and grades?  Journal of School Health, 75, 342-349.

Foster, S., Rollefson, M., Doksum, T., Noonan, D., Robinson, G., Teich, J. (2005).  School mental health services in the United States, 2002-2003.  DHHS Pub. No. (SMA) 05-4068.  Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. 

Gormley, Jr., W. T., Gayer, T., Phillips, D., & Dawson, B. (2005).  The effects of universal pre-K on cognitive development.  Developmental Psychology, 41, 872-884. 

Greenberg, M. T., Weissberg, R. P., Utne O’Brien, M., Zins, J. E., Fredericks, L., Resnik, H., & Elias, M. J. (2003).  Enhancing school-based prevention and youth development through coordinated social, emotional, and academic learning.  American Psychologist, 58, 466-474. 

Harris Interactive, Inc. (2005).  From teasing to torment: School climate in America : A survey of students and teachers.New York: Gay, Lesbian and Straight Education Network.        

Hartney, C. (2006).  Youth under age 18 in the adult criminal justice system (Fact Sheet).  Oakland, CA: National Council on Crime and Delinquency.  Retrieved August 9, 2007, from http://www.nccd-crc.org/nccd/pubs/2006may_factsheet_youthadult.pdf 

Hussey, D.., & Guo, S. (2003).  Measuring behavior change in young children receiving intensive school-based mental health services.  Journal of Community Psychology, 31, 629-639. 

Kosciw, J. G., & Diaz, E. M. (2006).  The 2005 national school climate survey: The experiences of lesbian, gay, bisexual and transgender youth in our nation’s schools.New York: Gay, Lesbian and Straight Education Network.      

MacLeod, I. R., Jones, K. M., Somer, C. L.,& Havey, J. M. (2001).  An evaluation of the effectiveness of school-based behavioral consultation.  Journal of Educational  and Psychological Consultation, 12, 203-216. 

Masten, A. S. (2001).  Ordinary magic: Resilience processes in development.  American Psychologist, 56, 227-238. 

National Research Council and Institute of Medicine. (2000).  From neurons to neighborhoods: The science of early childhood development.  Committee on Integrating the Science of Early Childhood Development, J. P. Shonkoff & D. A. Phillips (Eds). Board on Children, Youth, and Families, National Research Council and the Institute of Medicine.  Washington, DC: National Academy Press. 

Nelson, G., Westhues, A., & MacLeod, J. (2003).  A meta-analysis of longitudinal research on preschool prevention programs for children.  Prevention & Treatment, 6.  Retrieved August 7, 2007, from http://journals.apa.org/prevention/volume6/pre0060031a.html

Office of Special Education and Rehabilitative Services, U.S. Department of Education, Office of Special Education and Rehabilitative Services. (2005).  26^th annual report to Congress on the Implementation of the Individuals with Disabilities Education Act.Washington, DC: Author.     

Office of Special Education Programs, U.S. Department of Education. (2003, April).  Facts from OSEP’s National Longitudinal Studies: Use of psychotropic medications by children with disabilities.Washington, DC: Author.      

Olfson, M., Blanco, C., Liu, L., Moreno, C., & Laje, G. (2006).   National trends in the outpatient treatment of children and adolescents with antipsychotic drugs.   Archives of General Psychiatry 63, 679-685.

Reddy, L. A., Barboza-Whitehead, S., Files, T., & Rubel, E. (2000).  Clinical focus of consultation outcome research with children and adolescents.  Special Services in the Schools, 16, 1-22. 

Ripple, C. H., & Zigler, E. (2003).  Research, policy, and the federal role in prevention initiatives for children.  American Psychologist, 58, 482-490. 

Rones, M., & Hoagwood, K. (2000).  School-based mental health services: A research review.  Clinical Child and Family Psychology Review, 3, 223-241. 

Sage, M. (2006).  A shortage of mental health services drives inappropriate placements in juvenile detention.  FOCAL POiNT: Research, Policy and Practice in Children’s Mental Health, 20, 28-30.   

Slade, E. P. (2002).  Effects of school-based mental health programs on mental health service use by adolescents at school and in the community.  Mental Health Services Research, 4, 151-166. 

SRI International. (2006, November).  Facts From NLTS2: School behavior and disciplinary experiences of youth with disabilities.  Washington, DC: National Center for Special Education Research, Institute of Education Sciences, U.S. Department of Education.

Strizek, G. A., Pittsonberger, J. L., Riordan, K. E., Lyter, D. M., & Orlofsky, G. F. (2006).  Characteristics of schools, districts, teachers, principals, and school libraries in the United States : 2003-04 schools and staffing survey (NCES 2006-313).U.S. Department of Education, National Center for Education Statistics.  Washington, DC: U.S. Government Printing Office.       

Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (2005, December).  Depression among Adolescents.  The NSDUH Report.  Rockville, MD: Author.

U.S. General Accounting Office. (2003).  Child welfare and juvenile justice: Federal agencies could play a stronger role in helping states reduce the number of children placed solely to obtain mental health services (Pub. No. GAO-03-397).Washington, DC: Author.      Retrieved August 8, 2007, from http://www.gao.gov/new.items/d03397.pdf

Weist, M. D., Rubin, M., Moore, E., Adelsheim, S., & Wrobel, G. (2007).  Mental health screening in schools.  Journal of School Health, 77, 53-58.  

Weisz, J. R., Sandler, I. N., Durlak, J. A., & Anton, B. S. (2005).  Promoting and protecting youth mental health through evidence-based prevention and treatment.  American Psychologist, 60, 628-648. 

Welsh, M., Parke, R. D., Widaman, K., & O'Neil, R. (2001).  Linkages between children's social and academic competence: A longitudinal analysis.  Journal of School Psychology, 39, 463-482.

WestEd. (2003).  Student well-being: Essential to academic success.  R&D Alert, 5, 1, 8-9.

Wood, P.A., Yeh, M., Pan, D., Lambros, K. M., McCabe, K. M., & Hough, R.L. (2005).      Exploring the relationship between race/ethnicity, age of first school-based services utilization, and age of first specialty mental health care for at-risk youth.  Mental Health Services Research, 7, 185-196.  

Zins, J. E., Bloodworth, M. R., Weissberg, R. P., & Walberg, H. J. (2004).  The scientific base linking social and emotional learning to school success.  In J. Zins, R. Weissberg, M. Wang, and Walberg, H. J. (Eds.), Building academic success on social and emotional learning: What does the research say? (pp. 3-22).  NY: Teachers College Press.