Science to Practice in Underserved Communities: The Effectiveness of School Mental Health Programming

Abstract

This study examined the effectiveness of a treatment program comprised of several components based on evidence-based treatments (EBTs) for disruptive behavior problems delivered to youth participating in a school mental health program in an underserved community in the Appalachian region. Participants were 117 children in kindergarten through 6th grade including 91 children (78% male) from 5 schools who were consecutively referred to the intervention program and 26 children (73% male) from 3 schools in which program implementation was delayed for 1 year. Treatment outcome was measured via parent and teacher ratings of child symptoms and functioning. The treatment condition resulted in significant reduction in hyperactivity/impulsivity and early aggressive and delinquent behavior, as well as significant improvement in several other functional domains. Results suggest that EBTs can retain their effectiveness when transported to a community context.

This project was supported in part by funding from the Health Resources and Services Administration's Quentin Burdick Program for Rural Interdisciplinary Training (D36HP03160), the Ohio Department of Mental Health Residency and Training Program (Grant s OU-05-26 & OUSP 06-12), the Logan-Hocking School District, the Ohio Department of Youth Services via the Hocking County Juvenile Court, the R. Alvin Stevenson Fund of the Columbus Foundation (Grant TFB03-0260 STE(, and the Holl Foundation.

We extend our gratitude to the Y.E.S.S. Programming Partners (listed alphabetically): Athens City School District; Hocking County Behavioral Heath Care; Hocking County Juvenile Court; Logan-Hocking School District; Ohio University's Departments of Psychology, Social Work, and the College of Medicine; and Tri-County Mental Health and Counseling Center. We particularly thank the children, parents, teachers, and school administrators who participated in and supported this project.

Notes

Note: School A is District in 1, whereas Schools B, C, D, E, and F are all in District 2. To identify the waitlist control school in Year 1, District 2 representatives prioritized two schools as eligible for services (based on school size and need for services). Once identified, one school was randomly selected (coin flip) to receive treatment. The other school was assigned to a waitlist condition. The waitlist school received treatment in the subsequent year and the random assignment procedure was repeated (i.e., two schools were prioritized, a coin was flipped, and one school was put on the waitlist). After Year 2, District 2 was rezoned, and School D was closed. Selected data from Year 1 have been presented elsewhere (Owens et al. 2005).

^a N = 30

^b N = 12

^c N = 20

^d N = 6

^e N = 23

^f N = 8

^g N = 18

Note: Values are N(%) unless indicated otherwise. ADHD = attention deficit/hyperactivity disorder.

^a N = 91

^b N = 26

^c A significant difference between treatment and waitlist control conditions

Note: SES = socioeconomic status.

^a N = 91

^b N = 26

^c Scores ranged from 5.00 to 56.00. Strata I represents the lowest SES strata

Note: DBD = Disruptive Behavior Disorders; Hyper/Impul = Hyperactivity/Impulsivity; Opp/Defiant = Oppositional Defiant Disorder Symptoms; IRS = Impairment Rating Scale; GPA = grade point average.

Note: DBD = Disruptive Behavior Disorders; Hyper/Impul = Hyperactivity/Impulsivity; Opp/Defiant = oppositional defiant symptoms; IRS = Impairment Rating Scale; GPA = grade point average.

∗p < .05

∗∗p < .01

^† p < .10