School-Based Mental Health Services for Urban Children
Condition: Conduct Disorder; Oppositional Defiant Disorder; Attention Deficit Disorder With Hyperactivity
MeSH terms: Attention Deficit Disorder with Hyperactivity; Conduct Disorder; Attention Deficit and Disruptive Behavior Disorders
Study type: Interventional

Summary: 
      This study will evaluate the effectiveness of school- and home-based mental health services
      and training modules in supporting learning and behavior in financially disadvantaged
      children who live in urban areas.
    

Detailed description: 
      There are an estimated 4.5 to 6.3 million children with mental disorders in the United
      States. Emotional and behavioral problems associated with childhood mental disorders have a
      significant impact, with affected children at an increased risk of reduced quality of life
      and school dropout. If left untreated, childhood mental disorders may continue into
      adulthood, often impairing ability to function as an adult. It is believed that, compared to
      clinic-based services, school- and home-based mental health services may lead to greater
      improvements in children's learning and behavior at school and home. Especially important to
      this type of approach is a collaborative effort among parents, teachers, and children to
      encourage and maintain positive behaviors and academic performance both at home and in the
      classroom. This study evaluated the effectiveness of school- and home-based mental health
      services and training modules in supporting learning and behavior in financially
      disadvantaged children who live in urban areas.

      This 3-year study involved parent, child, and teacher participants. During Year 1, teacher
      participants attended a professional development series that focused on strategies that
      classroom teachers can use to help children with learning and behavior problems at school.
      The series involved weekly 30-minute sessions, which were held before and after school hours,
      for a total of 6 months. Teachers completed a brief survey about the content and structure of
      sessions at the end of each session and gave a monthly review on how they applied their new
      strategies in the classroom setting. Teachers continued to attend booster sessions of up to 1
      hour each month during Year 2. Teachers also participated in periodic case consultation
      meetings with parents and mental health providers to further develop ways to improve student
      participants' learning and behavior.

      Child participants received either the community mental health program associated with their
      school or received general clinic-based services (Treatment as usual). The school component
      of the mental health program consisted of a classroom environment in which the teachers
      implemented their newly learned strategies to enhance the academic and behavioral performance
      of the child participants. Parents of child participants in the community mental health
      program were invited to attend a series of parent/teacher meetings and home visits where
      mental health service providers discussed strategies that parents and teachers can use to
      help improve their children's learning and behavior. Parents completed a brief questionnaire
      at the end of each meeting and gave a monthly review of how they implemented their new
      strategies in the home setting. Parents continued to communicate with research staff
      regarding services provided throughout the study.

      Assessments for all participants occurred five times over 3 years. Assessments for parent
      participants included questions about their child's behavior at school and home, their
      child's use of mental health services, involvement in their child's schooling, and possible
      stresses in life. Assessments for teachers included questions about the behavior and academic
      performances of the child participants, parent involvement with the children's schooling, and
      stresses in their work environment. A research staff member also conducted a 2-hour classroom
      observation five times over 3 years. Individual child participants were also observed in the
      classroom by research staff for three 15-minute intervals five times over the study period.
    

Intervention name(s): Community mental health consultation model program; Treatment as usual (TAU)
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The community mental health consultation model program included collaboration among community mental health providers and (1) parent advocates to effectively maintain families in a school-based mental health program, (2) classroom teachers to enhance children's academic performance, and (3) peer-identified influential teachers to influence classroom teachers' use of behavior management strategies. This model further focused on the strongest teacher and parent predictors of student learning.; TAU included referral to community mental health clinic-based services, where participants received standard care for mental health-related problems.
Other intervention name(s): Links to Learning (L2L)
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Health Services Research
Keywords: Children; School-Based Mental Health Services; Urban Poverty