Indeed, of the small percentage of youth who receive services, the majority do so at school ( Costello, He, Sampson, Kessler, & Merikangas, 2014). Schools are an important setting for implementing evidence-based services, as they provide access to nearly every child and adolescent ( New Freedom Commission on Mental Health, 2003 Weist, Goldstein, Morris, & Bryant, 2003), thereby assisting youth who may not be reached through traditional mental health services. Dissemination involves examining the adoption of services as they were originally designed (without modification), but when utilized by the individuals themselves within that setting. Specifically, this explores which modifications to treatment protocols and practice settings are warranted so that effective treatments can be delivered in real-world settings. Generally, transportability typically occurs before dissemination and examines the movement of efficacious treatments into usual-care settings. These processes are complex and differentiation between transportability and dissemination involves consideration of many factors (see Schoenwald & Hoagwood, 2001, for more information). Nevertheless, challenges remain in bridging the gap between positive outcomes achieved under highly controlled conditions and the typical clinical environment ( Burns, Hoagwood, & Mrazek, 1999 Weersing & Weisz, 2002). Further, the Centers for Disease Control and Prevention recognize mental health disorders as one of the most costly conditions to treat ($247 billion annually Perou et al., 2013), highlighting the importance of preventing or treating youths’ mental health problems as early as possible.įor more than a decade, mental health professionals have promoted transporting and disseminating evidence-based interventions in community contexts where they may be accessed and utilized ( Schoenwald & Hoagwood, 2001). Multiple barriers prevent youths’ access to and utilization of services, including attitudinal (e.g., denial, stigma) and structural barriers (e.g., insufficient transportation, limited insurance coverage Fontanella, Gupta, Hiance-Steelesmith, & Valentine, 2015 McLoone, Hudson, & Rapee, 2006 Owens et al., 2002).
These findings underscore a serious concern, as the majority of youth with mental health problems do not receive treatment.
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Epidemiological surveys show only one fourth to one half of youth with mental health disorders receive professional services ( Merikangas et al., 2011), with estimates of as few as 10% of school-age children receiving treatment ( Ghandour, Kogan, Blumberg, Jones, & Perrin, 2012). Finally, the paper offers recommendations for researchers and clinicians interested in implementing school-based mental health services for adolescents.īy age 14, roughly half of all lifetime mental health disorders emerge (e.g., Kessler et al., 2007). This provides a context for the section that describes implementation issues and highlights specific challenges and potential solutions for intervention implementation. Next, we provide a brief overview of the preventive intervention we implemented in schools. First, we highlight key programs and findings on preventive interventions for adolescents at risk for depression and anxiety.
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This paper discusses some expected and unexpected challenges experienced during the implementation of an open trial and a pilot randomized controlled trial examining the acceptability and effectiveness of a school-based preventive intervention for adolescents at risk for internalizing disorders. Despite being able to reach a large number of adolescents and minority youth, the process of implementing evidence-based interventions to schools is challenging. The majority of youth with mental health problems do not receive treatment, highlighting the critical need to transport evidence-based interventions into community settings, such as schools.
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