Mental Health Promotion: The School Psychologist’s Responsibility
By Ralph E. “Gene” Cash
“...mental health is inexorably linked with general health, child care, and success in the classroom and inversely related to involvement in the juvenile justice system.” (U.S. Department of Health and Human Services, 1999)
Mental health needs in the United States go largely unmet (U.S. Department of Health and Human Services, 2003). More than 80% of children and adolescents who have a diagnosable mental disorder which impairs their functioning, learning, and, in many cases, the learning of others do not receive the help they need, compared with 50% of adults. Clearly we discriminate against our youth in access to mental health care. Minority children and adolescents in need of mental health care receive it even less frequently: More than 85% of minorities who need mental health intervention receive no services (U.S. Department of Health and Human Services, 1999). Educational systems did not cause these inequities, but when mental health problems impair learning, those involved in education must step up to the plate! We have a responsibility to do better, but how?
NASP is undertaking an historical, collaborative effort with Division 16 of the American Psychological Association to promote the critical importance of school-based and school-linked mental health service delivery. This effort is historic not because of the collaboration between NASP and Division 16, but because of the intended scope of the project. The intention is to help accomplish the major goals of the report of the President’s New Freedom Commission on Mental Health (2003); i.e.,(a) Americans understand that mental health is essential to overall health; (b) disparities in mental health services are eliminated; (c) early mental health screening, assessment, and referral are common practices; and (d) mental health services will be delivered in optimal settings, especially in schools. One large step toward these goals was achieved recently when Congress passed and President Bush signed into law the Wellstone–Domenici Mental Health Parity and Addiction Equity Act of 2008. This federal legislation requires insurance coverage for the treatment of mental disorders and substance abuse to be the same as the coverage for physical disorders with some limitations. That is a huge victory for fairness and a move in the direction of helping to reduce the stigma which has been so deeply embedded in our national psyche for such a long time. Hopefully, the parity legislation, despite its limitations, will go a long way toward making it politically and legally incorrect to treat those afflicted with mental health and addiction problems as second class citizens.
NASP and Division 16 will continue to move forward in our mental health public awareness efforts, but what can individual school psychologists do? The key is to become advocates for school-based and school-linked services designed to prevent social/emotional/behavioral problems and to intervene effectively when mental health issues interfere with positive student outcomes. Read Transforming School Mental Health Services (Doll & Cummings, 2007). Collaborate with other school psychologists and other mental health service providers. Determine whether your schools, district, and state have comprehensive mental health service provision plans. Volunteer to help in guiding, implementing, evaluating, and modifying existing plans or in developing such a plan if one doesn’t exist. Make your voice heard to policy makers such as principals, superintendents, school boards, state departments of education, and legislators. Help to ensure that all stakeholders are involved in and facilitative of the process and that the methods employed are culturally competent and sensitive. Tailor the curriculum and interventions to the characteristics of the community and the populations served. Utilize evidence-based methods to the extent possible. Emphasize that comprehensive mental health service delivery plans affect the entire community and require community involvement and collaboration in order to succeed. Devise effective methods to assess outcomes, to interpret the data, and to communicate results and implications to all stakeholders. Avoid conflicts with other service providers: There is plenty of work for all of us. Above all, maintain the focus on the well-being of students and families.
You can be an effective advocate for mental wellness; it’s the humane thing to do and the right thing to do! You can help to maintain the “psychology” in school psychology. You can make a difference!
Doll, B. & Cummings, J. (Eds.) (2007). Transforming school mental health services. Bethesda, MD: National Association of School Psychologists.
U.S. Department of Health and Human Services (1999). Mental health: A report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health.
U.S. Department of Health and Human Services. (2003). Achieving the promise: Transforming mental health care. Report of the President’s New Freedom Commission on Mental Health.
Gene Cash, PhD, NCSP, is a Florida licensed psychologist and a faculty member at the Nova Southeastern University Center for Psychological Studies in Ft. Lauderdale, FL.