Commentary: Promoting Paradigmatic Change in Child and Adolescent Mental Health and Schools.

This is an important series in School Psychology Review reflecting growing efforts to reform and enhance systems of education and mental health for youth, while connecting them together. This article by Maurice Elias and colleagues (Elias, Zins, Graczyk, & Weissberg, 2003) from the Collaborative for Academic, Social, and Emotional Learning (CASEL) is an impressive effort that will both inspire future work and provide a roadmap for key challenges and ideas for overcoming them. In this commentary, I expand on two of the article's prominent themes. My comments reflect my 12 years of experience as a clinical psychologist working in a program that is now in 22 Baltimore schools; and my experiences in research, training, and technical assistance in school mental health through a federally funded national center (the Center for School Mental Health Assistance; see http:// csmha.umaryland.edu) that was established in 1995. Please note that some, including Elias et al. (2003) avoid the term school mental health, which I presume is to avoid the stigma of the term mental health and concerns that schools are not in the mental health business. However, there is an international effort to reclaim the term mental health (Rowling, 2002; Weare, 2000) to reflect emotional, behavioral, and cognitive processes that influence personal health and success in life. In addition, our work in the program in Baltimore and at the national center has focused on the effective joining of education and mental health systems (see Weist, 2001). For these reasons, and for simplicity in language, I use the term school mental health generally, and in the discussion that follows. Theme 1: Bridging the Vision-Reality Gap Elias et al. (2003) cogently present that the relatively advanced knowledge base regarding implementation of social and emotional learning (SEL) programs in schools is often a stark contrast with the reality of the school setting. They emphasize the critical importance of context, given that efforts to implement evidence-based programs lead to positive outcomes in some but not other schools. The significant environmental and staff issues confronted in implementing these programs in urban schools are articulated forcefully, and will resonate for people who work in them. In urban schools it is easy to succumb to feelings of defeatism, as educational, administrative, and mental health staff contend with high levels of problems in youth, too limited resources, and a confusing mishmash of disconnected and often severely limited "support" services. Such realities underscore the importance of systematic approaches to influence policy and organize school mental health efforts to enable student learning (Adelman & Taylor, 1999). In urban schools as well as in other schools, these realities also emphasize the significant limitations in staff, training, materials, and other resources to implement a full and coordinated continuum of mental health promotion and intervention. In the area of prevention research, CASEL and its collaborators (e.g., Graczyk, Domitrovich, & Zins, 2003) are helping to lead the way in ensuring that programs include adequate levels of support, training, and technical assistance to promote effective implementation. Elias et al. (2003) also emphasize that true integration of social-emotional and academic development in public schools requires a tremendous commitment that sustains through the progressive seasons of the innovation, including the secondary phases when the early momentum and many of the early leaders are gone. It is critical to match innovations to schools that are ready for change and to promote and maintain commitment for change within them. These are extremely important tasks, and although the diffusion of intervention literature provides some guidance, this research is limited. Mechanisms to assess school readiness for change are needed, as are empirical studies that explore various strategies to promote commitment and maintenance of change efforts. …