Coordinated School Health Programs

Clearly, policy initiatives for specific elements of school health or for coordinated school health programs are negatively affected by the piecemeal and categorical ways in which school-related intervention policies are enacted. Indeed, this is the case for all school-owned and -linked support programs and services. The roots of the problem lie in the marginalized status of such efforts vis- -vis school reform. The s miptoms of this problem are seen in the ensuing firagmentation that usually results in costly redundancy, dysfunctional competition, and limited intervention effectiveness. 

Given these data, some advocates then suggest that it is self-evident that schools should expand what they do related to mental health. This position echoes the call of many others who have recognized that schools provide an important venue for enhancing the health status of children and adolescents. Such a view is well articulated, for instance, in an Institute of Medicine report (Allensworth et al., 1997) and in initiatives funded by the federal government designed to foster coordinated school health programs and mh in schools (Adelman et al., 1999 Marx, Wooley, Northrop, 1998 Weist, 1999). 

Marx, E., Wooley, S. F., Northrop, D. (Eds.). (1998). Health is academic A guide to coordinated school health programs. New York Teachers College Press. 

Coordinator, Practical Nurse Program Skeston Public Schools—Health Occupations Hayti, Missouri... 

Jeanne Bronk, Coordinator Environmental Health Science Program School of Pnblic Health Berkeley, CA 94720 510-643-5160... 

Some have argued that schoolwide interventions to address mental and social problems, which are the major reasons for school failure, be included as an essential aspect of school reform and school restructuring (Adelman Taylor, 2000). Comer s School Development Program, which includes a mental health team that coordinates schoolwide activities to address the mental health needs of all students, is an example (Comer, 1988), as is the three-level comprehensive approach to school safety that links school safety, school reform, and addressing the mental health needs of all students (Dwyer Osher, 2000). Services range in level of intensity in accordance with need and include preventive services. 

In many ways the ideal arrangement is when an expanded school mental health program operates out of a school-based health center. This partnership promotes a coordinated approach to student health and mental health issues, helps to... 

New programs will need to have a clear role within a broader social policy enda to ensure quality service provision and effective coordination between demand- and supply-side approaches. CCT programs alone will not be able to break the intergenerational transmission of poverty if the quality of health clinics and schools is inadequate or no jobs or adequate livelihoods are available when assisted children become earners in their own right. 

CCMHP is the current federal program providing coordinated, community-based, family-centered, cultmally competent, accessible, and least restrictive services for children and adolescents with serious emotional, behavioral, or mental disorders accompanied by functional impairment. Development of these systems of care is based on the premise that the mental health needs of children, adolescents, and their families can be met in their home, school, and community environments (Substance Abuse and Mental Health Services Administration, 1999). A variety of community agencies are involved, including mental health, child welfare, education, and juvenile justice. Funded service systems are tailored to the needs of individual children and adolescents and include evaluation and diagnosis. 

CASSP advocated for interagency coordination among child- and family-serving agencies in the provision of services for children and adolescents with sed. Many children are involved with various mental health providers, receive mentoring, attend after-school or summer school programs, receive alternative educational or residential placements, are involved with the juvenile justice system, etc. If youth are to achieve the most positive outcomes possible, especially children with more serious problems, clinicians—school-based or not— will need to collaborate actively with family members and other service providers. 

The federal and state governments have presented a number of opportunities to integrate school-based mental health systems into a communitywide system of care, even if these programs and funding sources were not developed specifically for that purpose. For example, the ss-hs programs funded by a consortia of federal agencies attempt to increase the coordination of care for many of America s children. Four federal departments— Education, Health and Human Services, Labor, and Justice—collaborate to fund projects entitled Safe Schools, Healthy Students (ss-hs) projects in over 80 communities across the coimtry. In the ss-hs project in Baltimore, the Baltimore City Public School System (bcpss) collaborates with the Baltimore Mental Health Systems, Baltimore City Police Department, Mayor s... 

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