In a time when resources are scarce and problems are many, professionals are choosing evidence-based practices to improve outcomes related to services. Evidence is emerging that school-based mental health services are an effective and cost efficient way to improve school performance and mental health and reduce behavioral problems.

To assess the effectiveness of school based mental health (SBMH) services to provide these outcomes in students from Pre-K - 12th grades, Robert Schmidt, M.Ed. and Kathryn Seifert, Ph.D. collaborated on the evaluation of outcomes for a SBMH program for a mid-Atlantic rural school district.

The project began in 1999 after a Federal grant was awarded to the school district. The children's scores on the Devereaux, BASC, CARE and several school measures such as absenteeism, disciplinary referrals, and suspensions were measured from the beginning of services and at the beginning and end of each school year.

Youth were referred to the project from teachers, guidance counselors, parents, student self-referrals and other agencies such as the Departments of Social Services and Juvenile Services of which resulted in 1,247 SBMH referrals during a five-year period.

From 1999 to 2004, 36% of these students were referred because of symptoms of depression, 26% because of family problems, and 24% because of behavior problems. There were 84 referrals to the program in 1999, compared to 437 students in 2002 and 239 students in 2003. Peak referral times were consistently observed during the months of October and February. Youth in the transition years of sixth and ninth grades were referred to the program most often. More Caucasian females participated in the project than any other ethnic/gender group. In 2000, 2,132 mental health sessions were provided, in contrast to an amazing 15,763 sessions during the 2003/04 school year.

A group of one hundred thirty-two students who participated in the program showed significantly improved attitudes toward teachers and school, decreased mental health symptoms, and increased self-esteem after one year of services. From the 2001 to the 2002 school year, students participating in SBMH had significantly improved school attendance (from approximately 4600 to 4200 days absent). One hundred seventy-eight students had a significant (49%) decrease in disciplinary referrals and violence related disciplinary referrals from the 2001 to the 2002 school year. One hundred thirty-four participants had a significant decrease (54%) in suspensions from school. Parents of 103 students reported that their children were having significantly fewer problems after receiving services. Ninety-nine youth self-reported significantly improved commitment to school, interpersonal relationships and self-esteem, as well as fewer stress related problems. Two hundred fifty students reported significantly reduced school maladjustment and clinical maladjustment and improved attitudes toward parents and emotional well-being.

This project demonstrated that school based mental health services improved student well-being, behavior and school success, while showing a significant decrease in the initial presenting mental health symptoms, violence and other behavior problems at home and at school. Although these services and study enter into it's sixth year and is on-going, other school-based mental health services must be provided, expanded, and studied. This project provides a framework for improved student health/success and decreased school violence while positively enhancing the community of which we live, work and play.