![]() ![]() SBH programs are most beneficial when appropriately tailored to meet a school’s needs using comprehensive data on the functioning of the entire student body ( Dowdy et al., 2010). Universal Mental Health Screening in Schools Further, because these approaches focus on emotional and behavioral health concerns at the level of the individual student, they are unlikely to have a meaningful impact at the population level. Given the reactive nature of these traditional approaches, students with unmet mental health needs may be overlooked or their need for services may not be recognized until after their symptoms have intensified and early intervention services are no longer likely to be beneficial ( Dvorsky et al., 2014). Similarly, under the “wait-to-fail” model ( Glover & Albers, 2007), students are referred for services in response to emotional or behavioral difficulties that are apparent and have become a cause for concern. ![]() This service model emphasizes assessment and treatment services for students at the highest levels of risk. ![]() Traditional mental health services in the school setting have largely operated under a refer-test-place model that focuses primarily on the assessment of individual students to determine their eligibility for special education services or referrals for other supports ( Dowdy et al., 2010). However, the type and quality of services provided in schools vary considerably as do the underlying assumptions about what role schools should play in addressing students’ mental health needs. Studies examining service use patterns have found SBH programs to be the primary source of services for youth with emotional and behavioral health concerns ( Angold et al., 2002 Burns et al., 1995 Costello et al., 1996 2014). Over the past two decades, the field of SBH has been gaining momentum in the United States and in other countries ( Foster et al., 2005 Rowling & Weist, 2004). Therefore, timely identification of concerns and intervention are critical to disrupt this trajectory. Left untreated, behavioral and emotional concerns are more likely to persist into adulthood and to require more intensive services ( Hefiinger et al., 2015 Torio et al., 2015). This low utilization is directly related to numerous barriers that limit service accessibility, including availability of services, lack of transportation, and financial and time costs ( Owens et al., 2002). In national studies, 50% or less of children and adolescents with a mental health disorder had received services in the previous 12 months ( Costello et al., 2014 Merikangas et al., 2010a). Assessing a broader array of disorders in a national sample of 13- to 18-year-old adolescents, the prevalence rate was 40.3% for 12-month disorders ( Kessler et al., 2012) and 49.5% for lifetime disorders ( Merikangas et al., 2010b).ĭespite the prevalence of mental health disorders among children and adolescents in the United States, the utilization of services to treat these disorders is broadly lacking ( Dvorsky et al., 2014). In a national sample, 13.1% of children and adolescents ages 8 to 15 years met criteria for at least one mental health disorder in the previous 12 months ( Merikangas et al., 2010a). Studies of community samples have generally found that approximately one in five children and adolescents meet criteria for an emotional or behavioral health disorder ( Carter et al., 2010). The prevalence of emotional and behavioral health disorders and unmet mental health need among children and adolescents highlight the need for effective interventions. Mental Health Disorders and Unmet Need in Children and Adolescents ![]()
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