Cummings Janet R, Zhang Yidan X, Wilk Adam S, Marcus Steven C
Department of Health Policy and Management, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Room 650, Atlanta, GA 30322 USA.
School of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA USA.
School Ment Health. 2022;14(4):1086-1097. doi: 10.1007/s12310-022-09531-4. Epub 2022 Aug 9.
Partnerships between mental health (MH) clinics and school systems in which providers deliver MH services on school grounds are growing. To date, however, there is little research examining MH clinic administrator perspectives on how this service delivery model affects continuity and quality of MH services among low-income youth. We conducted a state-wide (online and mail) survey of administrators at MH clinics ( = 60) to assess their perspectives on the advantages and challenges of school MH services for Medicaid-enrolled youth. Among survey respondents ( = 44), 86% reported that their clinic had at least one school partnership. With respect to advantages, more than four-fifths reported that school-based MH services (compared to clinic-based services) were very helpful or extremely helpful (versus not helpful at all, a little helpful, or somewhat helpful) for: (1) reducing gaps in MH treatment (86.8%); (2) improving communication between MH providers and teachers (86.9%), and (3) improving the overall quality of MH care (89.5%). In addition, the estimated no-show rate for appointments in school settings (7.2%) was lower than the estimated no show-rate for clinic appointments (23.9%; < 0.01). Several challenges were also reported; more than two-thirds of respondents reported difficulties when delivering school-based services related to parent engagement (i.e., appointment attendance [89.5%], communication [81.6%], timely consent [68.4%]) that occurred sometimes, often, or always (versus rarely or never). As MH clinics continue to enter into and expand partnerships with schools, stakeholders should implement family-centered strategies to enhance engagement. Nevertheless, MH clinic administrators highlight potential benefits of school MH services (compared to clinic-based services) with respect to continuity and quality of MH care.
心理健康（MH）诊所与学校系统之间的合作关系日益增多，在这种合作关系中，服务提供者在学校提供MH服务。然而，迄今为止，几乎没有研究探讨MH诊所管理人员对于这种服务提供模式如何影响低收入青少年MH服务的连续性和质量的看法。我们对MH诊所的管理人员（n = 60）进行了一项全州范围的（在线和邮寄）调查，以评估他们对为参加医疗补助计划的青少年提供学校MH服务的优势和挑战的看法。在调查对象（n = 44）中，86%报告称他们的诊所至少有一个学校合作伙伴关系。关于优势，超过五分之四的人报告说，与基于诊所的服务相比，基于学校的MH服务对于：（1）减少MH治疗差距（86.8%）；（2）改善MH服务提供者与教师之间的沟通（86.9%）；以及（3）提高MH护理的整体质量（89.5%）非常有帮助或极其有帮助（与完全没有帮助、有点帮助或有些帮助相对）。此外，学校环境中预约的预估失约率（7.2%）低于诊所预约的预估失约率（23.9%；P < 0.01）。也报告了一些挑战；超过三分之二的受访者报告在提供与家长参与相关的学校服务时遇到困难（即预约出席率[89.5%]、沟通[81.6%]、及时同意[68.4%]），这些困难有时、经常或总是出现（与很少或从不出现相对）。随着MH诊所继续与学校建立并扩大合作关系，利益相关者应实施以家庭为中心的策略来加强参与。尽管如此，MH诊所管理人员强调了学校MH服务（与基于诊所的服务相比）在MH护理的连续性和质量方面的潜在益处。
