Promoting mental health in schools in the midst of school reform.

Efforts to promote mental health in schools have encountered a variety of systemic problems. Of particular concern is that planning and implementing programs and services often occurs in an unsystematic and ad hoc fashion resulting in fragmented and piecemeal activities and an inefficient use of limited resources. Even more fundamental is the degree to which schools marginalize all efforts to address barriers to student learning. With a view to enhancing understanding and resolution of these problems, this paper explores the policy deficiencies that perpetuate the status quo and presents a framework for moving forward.

Toward ending the marginalization and fragmentation of mental health in schools.

For efforts to address mental health and psychosocial concerns in schools to be effective, practices must not be marginalized and must be implemented cohesively at each school and among families of schools. Mechanisms and processes must be established to minimize marginalized and fragmented practice, weave together school and community resources, and develop comprehensive and multifaceted approaches. A school-based, resource-oriented team represents one key mechanism. In addition, schools working in the same neighborhoods and with the same families can use a collaborative council to coordinate school and community resources. Resource team and collaborative council functions include mapping, analyzing, and redeploying existing resources, and formulating plans for evolving a comprehensive, multifaceted continuum of school-community interventions to address barriers to student learning and promote healthy development.

Mental health in schools and system restructuring.

Because health is not the primary business of schools, a school's response to mental health and psychosocial concerns usually is limited to targeted problems seen as direct barriers to learning. And because resources are sparse, priority is given to problems defined in legislative mandates. As a result, school-based mental health services are available only to a small proportion of the many students who require assistance, and interventions generally are narrowly focused and short-term. To better meet the needs of those served and to serve greater numbers, emerging trends are pushing for restructuring of school-owned services and greater linkage with community resources to develop multifaceted, comprehensive, integrated approaches. This review (a) provides an overview of what schools currently do related to mental health and psychosocial concerns, (b) clarifies key emerging trends, and (c) explores implications for major systemic changes.

Mental health in schools: expanded opportunities for school nurses.

Emerging trends are reshaping the work of school nurses and other school service personnel. With respect to direct service and consultation, school nurses increasingly are called upon to deal with psychosocial and mental health problems. Beyond that, school nurses must continue to actuate their roles as advocates, catalysts, brokers, and facilitators of the type of reforms that can effectively address barriers to student learning and promote healthy development. Continuing education is seen as key to enabling school nurses to build capacity for such roles and functions. The newly formed Center for Mental Health in Schools at the University of California, Los Angeles (UCLA) hopes to be of assistance in this respect. This presentation highlights the Center's orientation to mental health in schools and offers a draft outline for related continuing education.

Addressing barriers to learning: beyond school-linked services and full-service schools.

To enhance services in the schools, there are calls for coordination, integration, comprehensiveness, and other systemic reforms. These topics are explored from the perspective of the role of school and community in addressing barriers to learning. Current approaches are critiqued, and new directions for policy and practice are outlined.

Utilization of a school-based clinic for identification and treatment of adolescent sexual abuse.

Implementation of a mental health facet of a school-based clinic provided a special opportunity to gain more detailed information about the nature and scope of sexual abuse among Hispanic adolescents. A system was implemented to gather ongoing data on the number identified as having been sexually abused. Over the 16-month period covered by this report, in-depth semi-structured interviews were conducted with 22 Hispanics, and 50% were seen in therapy. Findings are reported regarding the abuse and its consequences, as well as implications for research and practice.

Early school adjustment problems: some perspectives and a project report.

A kindergarten and elementary school intervention program for dealing with early school adjustment problems is described. It is designed to accommodate greater individual differences in classrooms, improve and augment regular support, and provide specialized staff development and interventions. Initial findings are presented, and the evolution of the program so as to address problems of school newcomers is discussed.

Intrinsic motivation and school misbehavior: some intervention implications.

The intrinsic motivational concepts of self-determination, competence, and relatedness to others are highlighted to underscore their value in identifying motivational underpinnings for deviant and devious behavior. These constructs are woven into a working schema to differentiate intentional misbehavior in terms of whether it is reactive or proactive. Finally, from the perspective of such motivational thinking, implications for formal intervention research and experimental practice are illustrated.

Motivational readiness and the participation of children with learning and behavior problems in psychoeducational decision making.

Efficacy of a brief cognitive-affective intervention to enhance motivational readiness for participating in a psychoeducational decision-making conference was explored. Although outcomes specific to the preconference intervention were not found, findings of relevance to the hypothesized positive relationship between motivational readiness and actual participation in decision making are reported. The positive and negative findings are discussed in terms of implications for enhancing motivational readiness and for understanding the limited impact of skill training to improve participation and decision making.

School avoidance behavior: motivational bases and implications for intervention.

Intrinsic motivational constructs relevant to understanding and ameliorating school avoidance are discussed. Specifically, the concepts of self-determination, competence, and relatedness are highlighted in differentiating proactive and reactive avoidance behavior. From this perspective, five groups are described. Intervention implications are illustrated for proactive and reactive school avoiders, with special attention to strategies for the crucial period of transition back to school.

Toward solving the problems of misidentification and limited intervention efficacy.

The learning disabilities (LD) field has "boxed itself in" and, as a result, is not making satisfactory progress in reducing misdiagnoses and improving intervention efficacy. Evolving trends are not seen as reflecting fundamental changes in thinking and practice. With a view to the future, the position is taken that the field must (1) address causality in differentiating LD from other learning problems, (2) expand prevailing approaches to individualizing instruction so that intrinsic motivation is accounted for in a systematic and comprehensive manner, and (3) move beyond piecemeal programs to implement a fully integrated and coordinated continuum of interventions.

Perceptions of control at school among students in special education programs.

Data are reported on special and regular education students' perceptions of control at school and the importance to the students of having such control. For both special and regular education populations, comparisons were made between students enrolled in experimental and nonexperimental programs. Findings indicate comparability among the four groups with regard to areas in which control is valued. Perceptions of control at school for those in the standard special education group were lower than the ratings of regular education students and lower than those given by special education students in the experimental program.

Toward a procedure for minimizing and detecting false positive diagnoses of learning disability.

Assessment procedures that can significantly enhance motivation to perform are needed so that poor performance due to low or avoidance motivation is not misdiagnosed as indicating ability deficits or as symptomatic of learning disabilities (LD). In this connection, research is under way to investigate the degree to which a highly motivating computer game learning task can improve differential diagnoses of LD. Findings from the initial investigation indicate that a large proportion of students diagnosed as LD were able to learn effectively when pursuing such a task. The results illustrate the key role motivation plays in determining the validity of diagnostic assessment and demonstrate the potential value of similar tasks for use in differentiating, from among individuals diagnosed as LD, those who do not have impaired learning processes.

Learning problems, anger, perceived control, and misbehavior.

Fifty-four students diagnosed as having learning disabilities (LD) and 73 students in regular education were administered the School Anger Inventory and the Perceived Control at School Scale. Teachers and parents rated student deportment and motivation. Predictably, those in the LD sample indicated higher school anger levels and were rated as exhibiting more negative behavior, less positive behavior, and lower motivation for on-task performance. The samples did not differ in their ratings of perceived control, which was moderate, and were given comparable positive teacher ratings for recall of relevant and interesting material. Significant correlations between school anger and behavior were found only in the LD sample, and there was no significant overall relationship between school anger, behavior, and perceived control within either sample. Overall, however, students who reported both a high level of anger and high perceived control were found to exhibit more negative behavior than those with high anger and low perceived control.

Minors' dissatisfaction with their life circumstances.

To expand the scope of clinical research on youngsters' subjective well-being, the present work gathered data on the degree of satisfaction/dissatisfaction with respect to major aspects of daily living and on the relationship between life dissatisfaction and perceived control at school of children and adolescents. The self-reports of students in regular classrooms and those referred for mental health services are contrasted. In addition, data on the relationship between dissatisfaction and scores on the Children's Depression Inventory are reported for the mental health sample.

Anger, perceived control and school behavior among students with learning problems.

With regard to students with learning problems, findings indicate that the more severe the learning problem, the greater the tendency toward anger in response to conflicts at school. The relationship between learning problem severity and perceptions of control at school was not significant, but anger was negatively correlated to perceived control. None of the variables were significantly related to misbehavior. A stepwise regression analysis indicated perceived control as the most potent single variable accounting for the variance in anger scores. Overall, findings highlight implications for work focused on reactions to learning problems and factors associated with their cause and correction.