Evidence-Based Mental Health

Armbmster, R, Lichtman, J. (1999). Are school-based mental health services effective Evidence from 36 inner city schools. Community Mental Health Journal, 55(6), 493-504. 

Evidence from our initial study of a model for school-based mental health services provided support for a broadly defined parental involvement program (Atkins, Adil, Jackson, Talbott, et al., 2001). Extensive efforts to recruit and engage families in services resulted in initial recruitment rates above 90%, and of those 60 families, 86% remained involved in services at 9-month follow-up (Atkins et al., 2001). Because only about half of the families attended one or more parent groups, and fewer than a third attended sessions regularly, all families received home-based services in addition to consultation with the child s teacher and other... 

Hoagwood, K. (2000). State of the evidence on school-based mental health services—NIMH perspectives. Report on Emotional Behavioral Disorders in Youth, 1,13-17. 

For this chapter, we focus on the prescriptive portion of the model as it has been applied to school-based prevention and mental health-promotion programs. The model is presented in a format that facilitates its use as a guide to school-based mental health providers and educators in their efforts to provide their students with evidence-based practices. The prescriptive model has three components. The first refers to characteristics of the intervention, the second to training and technical support, and the third to the environment in which the program is to be implemented. For conceptual and evaluation purposes, the three components of the prescriptive model can be viewed as mediators or moderators of program outcomes. Descriptions of each component follow, and factors within each component are listed in Table 2. 

For some mental health problems such as severe dementia, effectiveness might actually be achieved by slowing down a deteriorative trend or accelerating an upward trend. This makes effectiveness difficult to assess without a control or comparison group, or a set of norms, and emphasizes why naturalistic studies alone are rarely sufficient as an evidence base for clinical or policy decisions. 

After World War II (WWII), the National Institute of Health broadened its research scope to include chronic diseases such as cancer and mental illness. In 1948, the institute was expanded and the name was changed to the National Institutes of Health (NIH). At present, the NIH consists of 17 institutes and is an agency within the U.S. Public Health Service, Department of Health and Human Services. Its budget in 1999 was U.S. 15.6 billion. The establishment and subsequent growth of the NIH reflects the emerging priority placed on scientific inquiry and treatments based on xmderstanding pathologic processes at a fundamental level. This trend continues currently as evidence-based medical practice. 

On April 7-9,1999, an international working group of scientists met at the National Institutes of Health in Bethesda, Maryland (USA) to discuss the scientific evidence relative to dietary recommendations of omega-6 and omega-3 fatty acids (Simopoulos, et al., 1999). The latest scientific evidence based on controlled interventiontrials in infant nutrition, cardiovascular disease, and mental health was extensively discussed. Tables Al and A2 include the Adequate Intakes (Al) for omega-6 and omega-3 essential fatty acids for adult and infant formula/diet, respectively. 

Substance Abuse and Mental Health Services Administration, 2005. SAMHSA model programs SAMHSA national r istry of evidence-based programs and practices (NREPP). http //modelprograms.samhsa.gov/template.cfin page=nreppover. 

But, two events finally motivated me to write this book. The first was an initiative called the Strategic Prevention Framework State Incentive Grants funded by the Center for Substance Abuse Prevention in the Substance Abuse and Mental Health Administration, apart of Health and Human Services. These grants started in fiscal year 2004. They are awarded to states and are for 2.35 million a year for 5 years. Nineteen states were funded in fiscal year 2004, 5 in fiscal year 2005, and 12 to 15 more are planned for fiscal year 2006. These grants are designed to help states and communities develop and implement comprehensive, evidence-based prevention programs and strategies. 

Drake, R. E. (2001). Implementing evidence-based practices in routine mental health service settings. Psychiatric Services, 52, 179-182. Equal opportunity pays. (1993, May 4). Wall Street Journal, p. 1. 

Growing evidence base for physical and mental health problems, e.g. chronic pain, recurrent depression, anxiety disorders... 

Advancements in the science of child and adolescent mental health and the growth of the evidence base on effective interventions (Burns, Hoagwood, Mrazek, 1999 Durlak Wells, 1997, 1998 Greenberg, Domitrovich, Bumbarger, 1999 Hibbs Jensen, 1996 Nutbeam, 2001). 

The recommendations of the National Strategy for Suicide Prevention were developed independently from the recommendations of the conference report on children s mental health, yet the two sets of recommendations are highly consistent with each other. The recommendations for strategies to decrease suicide rates represent concrete examples of how the more general recommendations of the conference report on children s mental health can be operationalized. Training of school personnel, use of evidence-based programs, and enhancing access to... 

The large gap between efficacy and effectiveness research has resulted in a new consensus regarding the need for research that will inform practice (National Institute of Mental Health, 1999 Weisz, 2000). Epidemiological studies indicate that fewer than 20% of children who need mental health care actually receive any services (Goodman et al., 1997). Earlier studies indicated that of those children who did receive services, fewer than 50% received the appropriate service relative to their need (Kazdin, 1996). These realities have led to two important movements in child mental health services efforts to increase the effectiveness of services principally by advocating evidence-based treatments (Hibbs Jensen, 1997 Weisz, 2000) and calls for alternative models for mental health services (Bums, 1999 National Institute of Mental Health, 1999). 

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