基于学校的心理健康服务对小学年龄段儿童的有效性：一项荟萃分析。

The Effectiveness of School-Based Mental Health Services for Elementary-Aged Children: A Meta-Analysis.

机构信息

Center for Children and Families, Florida International University, Miami.

出版信息

J Am Acad Child Adolesc Psychiatry. 2018 Mar;57(3):153-165. doi: 10.1016/j.jaac.2017.11.022. Epub 2017 Dec 24.

DOI:10.1016/j.jaac.2017.11.022

PMID:29496124

Abstract

OBJECTIVE

Given problems and disparities in the use of community-based mental health services for youth, school personnel have assumed frontline mental health service roles. To date, most research on school-based services has evaluated analog educational contexts with services implemented by highly trained study staff, and little is known about the effectiveness of school-based mental health services when implemented by school professionals.

METHOD

Random-effects meta-analytic procedures were used to synthesize effects of school-based mental health services for elementary school-age children delivered by school personnel and potential moderators of treatment response. Forty-three controlled trials evaluating 49,941 elementary school-age children met the selection criteria (mean grade 2.86, 60.3% boys).

RESULTS

Overall, school-based services demonstrated a small-to-medium effect (Hedges g = 0.39) in decreasing mental health problems, with the largest effects found for targeted intervention (Hedges g = 0.76), followed by selective prevention (Hedges g = 0.67), compared with universal prevention (Hedges g = 0.29). Mental health services integrated into students' academic instruction (Hedges g = 0.59), those targeting externalizing problems (Hedges g = 0.50), those incorporating contingency management (Hedges g = 0.57), and those implemented multiple times per week (Hedges g = 0.50) showed particularly strong effects.

CONCLUSION

Considering serious barriers precluding youth from accessing necessary mental health care, the present meta-analysis suggests child psychiatrists and other mental health professionals are wise to recognize the important role that school personnel, who are naturally in children's lives, can play in decreasing child mental health problems.

摘要

目的

鉴于青少年使用社区心理健康服务方面存在问题和差异，学校人员承担了一线心理健康服务角色。迄今为止，大多数关于基于学校的服务的研究都评估了具有高度训练有素的研究人员实施服务的模拟教育环境，而对于由学校专业人员实施的基于学校的心理健康服务的有效性知之甚少。

方法

使用随机效应荟萃分析程序综合了由学校人员提供的针对小学年龄儿童的基于学校的心理健康服务的效果，以及治疗反应的潜在调节因素。有 43 项对照试验评估了 49,941 名小学年龄的儿童，符合选择标准（平均年级 2.86，60.3%的男孩）。

结果

总体而言，基于学校的服务在减少心理健康问题方面显示出小到中等的效果（Hedges g=0.39），针对目标干预的效果最大（Hedges g=0.76），其次是选择性预防（Hedges g=0.67），与普遍预防（Hedges g=0.29）相比。将心理健康服务纳入学生的学业教学中（Hedges g=0.59）、针对外化问题的服务（Hedges g=0.50）、纳入应急管理的服务（Hedges g=0.57）和每周实施多次的服务（Hedges g=0.50）显示出特别强的效果。