Clearing hurdles: the challenges of implementation of mental health evidence-based practices in under-resourced schools

Abstract

Schools have become the main provider of services to children with mental health needs. Although there is substantial literature on barriers to implementation of evidence-based practices (EBPs) in under-resourced school districts, less has been written on how to overcome those barriers. Providing mental health services in the school setting presents a tremendous opportunity to increase access to quality mental health care for underserved youth. This review provides a brief overview of the barriers to successful implementation and sustainment of EBPs in under-resourced public schools and provides recommendations for overcoming them. The discussion is organized around an established conceptual framework adapted for the delivery of services in under-resourced schools that focuses on interdependent factors that exist at the individual-, team-, school-, and macro-levels. This manuscript explores some recommendations and strategies for effectively addressing challenges related to implementation of EBPs. Research ideas are offered to bridge the research-to-practice gap that impacts many under-resourced public school districts.

Keywords::

• implementation
• sustainment
• evidence-based practices
• mental health services
• under-resourced schools

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Funding was provided by grant numbers [NICHD R01 HD073430 (Eiraldi), NIMH MH103955 (Benjamin Wolk)], the Autism Science Foundation [grant number 13-ECA-01L] and FARFund Early Career Award (Locke), and NIMH MH099179 (Beidas). The preparation of this article was supported in part by the Implementation Research Institute (IRI) at the George Warren Brown School of Social Work, Washington University in St Louis through an award from the National Institute of Mental Health (R25 MH080916) and Quality Enhancement Research Initiative (QUERI), Department of Veterans Affairs Contract, Veterans Health Administration, Office of Research & Development, Health Services Research & Development Service. Dr Beidas was an IRI fellow from 2012 to 2014.