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Research Citations

By Jeffrey L. Charvat, PhD, NASP Director of Research

Academic-Mental Health Links

A meta-analysis of school-based social and emotional learning programs involving more than 270,000 students in grades K-12 revealed that students who participated in these programs improved in grades and standardized test scores by 11% compared to students in control groups (Durlak, Weissberg, Dymnicki, Taylor, & Schellinger, 2011).

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).

Autism

The largest and most rigorous twin study of its kind to date has found that shared environment influences susceptibility to autism more than previously thought. An NIH-supported study found that shared environmental factors—experiences and exposures common to both twin individuals—accounted for 55 percent of strict autism and 58 percent of more broadly defined autism spectrum disorders (Hallmayer et al., 2011).

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).

Bullying

In 2009, about 28% of 12- to 18-year-old students reported having been bullied at school during the school year and 6% reported having been cyber-bullied (Robers, Zhang, Truman, & Snyder, 2011).

A meta-analysis of 153 studies on bullying among students found difficulty with social problem solving to be a significant marker of bullies, victims, and those who are both. Academic problems were found to compound the risk of bullying, while negative attitudes about self were found to compound the risk of being bullied (Cook, Williams, Guerra, Kim, & Sadek, 2010).

Frequent exposure to victimization or bullying others is associated with high risks of depression, suicidal ideation, and suicide attempts (Klomek et al., 2007).

Greater parental support of adolescents is associated with less bullying and less victimization through bullying, across all forms of bullying, including physical, verbal, relational, and cyber bullying (Wang, Iannotti, & Nansel, 2009).

Class Size

Very large class-size reductions (i.e., seven to 10 fewer students per class) can have significant, long-term, positive effects on student achievement (Whitehurst & Chingos, 2011).

Consultation

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).

Corporal Punishment

There is a substantial research evidence that corporal punishment is ineffective as a disciplinary practice and that it can have unintended negative effects on children (Gershoff & Bitensky, 2007).

Cost–Benefit Analysis of Early Interventions

Nationwide implementation of effective school-based drug-abuse prevention programs could save an estimated $18 per $1 invested (Miller & Hendrie, 2008).

The Child-Parent Centers program in the Chicago Public School System, an early education program that provides intensive instruction in reading and math for children from low-income families, generates an estimated $4 to $11 of economic benefits over a child's lifetime for every dollar spent on the program (Reynolds, Temple, White, Ou, & Robertson, 2011).

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

In 2009, an estimated two million adolescents (8.1% of 12- to 17-year-olds) had major depressive episode in the past year, and females were more than twice as likely as their male counterparts to have had an episode (11.7% vs. 4.7%) (U.S. Substance Abuse and Mental Health Services Administration, Office of Applied Studies, 2011).

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).

A large-scale national study funded in part by the National Institute on Drug Abuse found no difference in rates of drug use between students in schools that use drug testing and those that do not (Yamaguchi, Johnston, & O'Malley, 2003a, 2003b).

Testing students for drug use has several unintended negative consequences, including that (1) students may turn to more dangerous drugs (because they leave the system more quickly) or binge drinking (because the tests do not detect alcohol); (2) students may attempt to cheat the test by trying dangerous home remedies or purchasing products widely available on the Internet; and (3) students may learn that they are guilty until proven innocent (Kern et al., 2006).

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

Of the estimated 16,330 public school districts operating in the county in the 2007-08 school year, 7,770 (48%) were located in rural communities, 3,480 (21%) in suburban areas, 2,900 (18%) in towns, and 2,190 (13%) in cities (Aritomi & Coopersmith, 2009).

Total public school enrollment is projected to set new records each year from 2009 through 2018, reaching a high of 53.9 million students in 2018 (Planty et al., 2009).

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 (U.S. Department of Education, Office of Special Education and Rehabilitative Services, 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).

Foster Children

There were an estimated 423,773 children in foster care in 2009, with a mean age of 9.6 years (U.S. Department of Health and Human Services, Administration for Children and Families, 2009).

A study of former foster children revealed that at ages 23 and 24 they had fared poorly in comparison to a nationally representative sample across a wide range of outcome measures, including educational attainment, employment, housing stability, receipt of public assistance, and involvement with the criminal justice system (Courtney, Dworsky, Lee, & Raap, 2010).

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 2009 national survey of nearly 7,300 middle and high school students revealed that nearly 90% of gay, lesbian, bisexual, and transgender students experienced harassment at school in the past year and nearly two-thirds felt unsafe because of their sexual orientation (Kosciw, Greytak, Diaz, & Bartkiewicz, 2010).

In middle and high schools in 2009, nearly 19% of gay, lesbian, bisexual, and transgender students reported being physically assaulted at school in the past year because of their sexual orientation (Kosciw et al., 2010).

Graduation and Dropout

In school year 2008–09, more than three-quarters of public high school students graduated on time with a regular diploma (Aud et al., 2012).

The status dropout rate among 16- through 24-year-olds in the civilian, noninstitutionalized population in 2010 was 7.4%; by race/ethnicity: White: 5.1%; Black: 8.0%; Hispanic: 15.1%; Asian/Pacific Islander: 4.2%; and American Indian/Alaska Native: 12.4% (Aud et al., 2012).

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).

Homelessness

More than 1.5 million American children are homeless during the course of each year (National Center on Family Homelessness, 2009).

Homeless children are twice as likely as other children to repeat a grade in school, to be expelled or suspended, or to drop out of school, and their estimated high school graduation rate is less than 25% (National Center on Family Homelessness, 2009).

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).

Mental Health Services

About 36% of youth with any lifetime mental disorder receive services and only half of youth who are severely impaired by their mental disorder receive professional mental health treatment (Merikangas, He, Burstein, Swendsen et al, 2011).

Military Dependents

A retrospective study of more than 640,000 children (mean age = 5.0 years) revealed that parental military deployment is associated with an 11% increase in childhood outpatient visits for mental and behavioral health issues, a 19% increase in behavioral disorders, and an 18% increase in stress disorders (Gorman, Eide, & Hisle-Gorman, 2010).

Compared to national samples, children in families with a deployed parent have more emotional difficulties, and older youth and girls of all ages have significantly more school-, family-, and peer-related difficulties (Chandra et al., 2010).

Positive Youth Development

Longitudinal evaluation of a positive youth development initiative in 11 Alaska school districts revealed that not only are several aspects of school climate and connectedness related to student achievement, but positive change in school climate and school connectedness is related to significant gains in student scores on statewide achievement tests (Spier, Cai, & Osher, 2007; Spier, Cai, Osher, & Kendziora, 2007).

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

Prevalence of Mental Illness

According to a survey by the National Institute of Mental Health, about 20% of U.S. youth are affected by some type of mental disorder during their lifetime to an extent that they have difficulty functioning (Merikangas, He, Burstein, Swanson et al., 2010).

Over 5% of children less than 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

“Mental, emotional, and behavioral disorders are as common among young people as among adults. The majority of adults with a mental, emotional, or behavioral disorder first experienced a disorder while young, and first symptoms precede the full-blown disorder, providing an opportunity for prevention and early intervention” (National Research Council and Institute of Medicine, 2009, p. 55).

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 use of antipsychotic drugs for very young children with behavior problems approximately doubled between 1999-2001 and 2007. Yet fewer than half of these children received a mental health assessment, a psychotherapy visit, or a visit with a psychiatrist while taking these medications, reveals a new study (Olfson, Crystal, Huang, & Gerhard, 2010).

Of the estimated 100,340 emergency department visits in 2008 involving accidental ingestion of drugs (primarily pharmaceuticals), 69,121 were made by children aged five or younger (U.S. Substance Abuse and Mental Health Service Administration, Office of Applied Studies, 2010).

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 (U.S. Department of Education, Office of Special Education Programs, 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

Longitudinal evaluation of a positive youth development initiative in 11 Alaska school districts revealed that not only are several aspects of school climate and connectedness related to student achievement, but positive change in school climate and school connectedness is related to significant gains in student scores on statewide achievement tests (Spier, Cai, & Osher, 2007; Spier, Cai, Osher, & Kendziora, 2007).

A 2009 national survey of nearly 7,300 middle and high school students revealed that nearly 90% of gay, lesbian, bisexual, and transgender students experienced harassment at school in the past year and nearly two-thirds felt unsafe because of their sexual orientation (Kosciw, Greytak, Diaz, & Bartkiewicz, 2010).

A national study of more than 15,000 students and more than 1,500 school staff revealed that staff at all school levels tend to underestimate the number of students involved in frequent bullying (Bradshaw, Sawyer, & O'Brennan, 2007).

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 cumulative shortage of almost 15,000 school psychologists in the U.S. 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 more than 50% of school psychologists will retire 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

In 2007-08, about 17% of public schools reported at least one serious violent incident and about one percent reported 10 or more (Aud, Hussar, Planty, Snyder et al., 2010).

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).

Schoolwide Positive Behavioral Interventions and Supports

A longitudinal study involving more than 12,000 public elementary school children revealed that children in schools that implemented a program of schoolwide positive behavioral interventions and supports displayed significantly less bullying behavior and experienced lower levels of rejection over time compared to children in the comparison schools (Waasdorp, Bradshaw, & Leaf, 2012).

Social and Emotional Learning

A meta-analysis of school-based social and emotional learning (SEL) programs involving more than 270,000 students in grades K-12 revealed that students who participated in these programs improved in grades and standardized test scores by 11 percentile points compared to control groups. In addition, they showed significant improvement in social and emotional skills, caring attitudes, and positive social behaviors, and a decline in disruptive behavior and emotional distress (Durlak, Weissberg, Dymnicki, Taylor, & Schellinger, 2011).

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 the US in 2007, there were 34,598 suicides of which 4,324 were among children and young adults under the age of 25 (Xu, Kochanek, Murphy, & Tejada-Vera, 2010).

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).

Violence

According to the U.S. Substance Abuse and Mental Health Services Administration (2010), nearly 23% of adolescents aged 12 to 17 participated in a serious fight at school or work in the past year.

The Task Force on Community Preventive Services concluded that there is strong evidence for the effectiveness of universal school-based programs to prevent violent and aggressive behavior, and it recommended their use (Hahn et al., 2007).

Violence and Media

Boys who view violent television programming at ages two to five years are at increased risk for antisocial behavior at ages seven to 10 years (Christakis & Zimmerman, 2007).

A large-scale study funded by the Centers for Disease Control and Prevention has established a conclusive link between exposure to media violence and adolescents' violent behavior and general aggression (Boxer et al., 2009).

References

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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.

Aritomi, P., & Coopersmith, J. (2009). Characteristics of public school districts in the United States: Results from the 2007-08 Schools and Staffing Survey (NCES 2009-320). Washington, DC: National Center for Education Statistics, Institute of Education Sciences, U.S. Department of Education. Retrieved from http://nces.ed.gov/pubs2009/2009320.pdf

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Aud, S., Hussar, W., Planty, M., Snyder, T., Bianco, K., Fox, M., . . . Drake, L. (2010). The condition of education 2010 (NCES 2010-028). Washington, DC: National Center for Education Statistics, U.S. Department of Education.

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.

Boxer, P., Huesmann, L. R., Bushman, B., O'Brien, M., & Moceri, D. (2009). The role of violent media preference in cumulative developmental risk for violence and general aggression. Journal of Youth & Adolescence, 38, 417-428.

Bradshaw, C. P., Sawyer, A. L., & O'Brennan, L. M. (2007). Bullying and peer victimization at school: Perceptual differences between students and school staff. School Psychology Review, 36, 361-382.

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Christakis, D. A., & Zimmerman, F. J. (2007). Violent television viewing during preschool is associated with antisocial behavior during school age. Pediatrics, 120, 993-999.

Cook, C. R., Williams, K. R., Guerra, N. G., Kim, T. E., & Sadek, S. (2010). Predictors of bullying and victimization in childhood and adolescence: A meta-analytic investigation. School Psychology Quarterly, 25, 65-83.

Courtney, M. E., Dworsky, A., Lee, J. S., & Raap, M. (2010). Midwest evaluation of adult functioning of former foster youth: Outcomes at age 23 and 24. Chicago: Chapin Hall at the University of Chicago.

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

Durlak, J. A., Weissberg, R. P., Dymnicki, A. B., Taylor, R. D., & Schellinger, K. B. (2011). The impact of enhancing students' social and emotional learning: A meta-analysis of school-based universal interventions. Child Development, 82, 405-432. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.1467-8624.2010.01564.x/pdf

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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.

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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.

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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.

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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.

Merikangas, K. R., He, J., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., . . . Swendsen, J. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Study-Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49, 980-989.

Merikangas, K. R., He, J., Burstein, M. E., Swendsen, J., Avenevoli, S., Case, B., . . . Olfson, M. (2011). Service utilization for lifetime mental disorders in U.S. adolescents: Results from the National Comorbidity Survey Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 50,32-45.

Miller, T, & Hendrie, D. (2008). Substance abuse prevention dollars and cents: A cost-benefit analysis (DHHS Pub. No. SMA 07-4298). Rockville, MD: Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services Administration. Retrieved from http://store.samhsa.gov/shin/content/SMA07-4298/SMA07-4298.pdf

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