A program of comprehensive school-based mental health services in a large urban public school district: The Dallas model

Adolescent Psychiatry, 1999 by Pearson, Glen, Jennings, Jenni, Norcross, James

SERVICE DELIVERY PROCESS

Referral

Referrals to the YFCs are initiated by several sources: parents, school staff, and community agencies. School student support teams (SSTs), trained by YFC staff, screen student referrals and request YFC services in one or more of five major components: intensive mental health care, physical health care, counseling, family/home involvement, and youth development activities.

The major student referral categories for intensive mental health services are behavioral/emotional issues, family/home issues, and delinquent behavior. Behavioral issues include such symptoms as hyperactivity, impulsivity, aggressive behavior, conflict with teachers, and peer relationship difficulties; emotional issues include depression, anxiety, social withdrawal, and somatic complaints; family/home referrals may reflect issues relating to divorce, separation, marital conflict, abuse, or neglect; and referrals for delinquent behavior are characterized by truancy, stealing, assault, or gang involvement.

Service Prototype

The YFC program provides a collaborative multidisciplinary mental health treatment team, co-led by the child and adolescent psychiatrist and the YFC manager (licensed mental health professional). The team approach is reflected in every phase of service delivery: intake, evaluation/assessment, treatment, and follow-up. Concomitant with the multidisciplinary professional teamwork, the school staff participates in the child-centered plan of treatment and related service, which is developed and implemented across the contexts of school, home, and community; successful outcomes depend on the involvement of adults in all these sectors who touch the students' lives.

Upon enrollment in a YFC, a child can expect to receive services throughout his or her school life, from preschool through Grade 12. School success indicators for each student are tracked each school year, and aggregate data on these indicators are reported as feedback to YFC staff and sponsoring partner agency administrators and boards of trustees.

YFCs are open 5 days a week, with extended evening hours (until 8 or 9 p.m.) available Monday through Thursday. Twenty-four-hour, 7-day backup crisis services including emergency room and hospital care are provided by Parkland and Dallas MH/MRC.

Procedures

Mental health service delivery occurs in several steps, with full family participation expected throughout the process.

Step 1. The school campus SST compiles school data (records of grades, attendance, disciplinary referrals, special education services) on the referred student. The SST member interviews the student and family, observes the student in class, completes the Teacher Report Form of the Child Behavior Check List (CBCL; Achenbach and Edelbrock, 1986), and obtains parent permission for the child to receive YFC services. The compiled student data are forwarded to the YFC with a one-page summary referral form. Frequently, the school's campus liaison will consult with the YFC manager about the referred student.