152 research outputs found
From Thought to Action in School Mental Health Promotion
In the global mental health movement, school mental health (SMH) promotion is an increasingly prominent approach and emerging field. Here, we chronicle the development of three innovations in SMH in the United States, from the early idea stage through development, current status and future directions. The innovations are The Ohio Mental Health Network for School Success, a prominent state initiative that is attempting to build a cogent shared school-family-community system agenda for SMH in one state, Expanded School Mental Health in Baltimore City, a prominent local initiative that has grown from involvement in four to 105 schools in 20 years, and the Mental Health Planning and Evaluation Template, an internet-based and user-friendly approach for quality assessment and improvement of mental health promotion in schools. Each example includes challenges and opportunities, and collectively they represent powerful ideas for moving school mental health promotion from thought to action
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Implementation strategies to promote measurement-based care in schools: evidence from mental health experts across the USA
Background
Despite an established taxonomy of implementation strategies, minimal guidance exists for how to select and tailor strategies to specific practices and contexts. We employed a replicable method to obtain stakeholder perceptions of the most feasible and important implementation strategies to increase mental health providers’ use of measurement-based care (MBC) in schools. MBC is the routine use of patient-reported progress measures throughout treatment to inform patient-centered, data-driven treatment adjustments.
Methods
A national sample of 52 school mental health providers and researchers completed two rounds of modified Delphi surveys to rate the relevance, importance, and feasibility of 33 implementation strategies identified for school settings. Strategies were reduced and definitions refined using a multimethod approach. Final importance and feasibility ratings were plotted on “go-zone” graphs and compared across providers and researchers to identify top-rated strategies.
Results
The initial 33 strategies were rated as “relevant” or “relevant with changes” to MBC in schools. Importance and feasibility ratings were high overall for both survey rounds; on a scale of 1 to 5, importance ratings (3.61–4.48) were higher than feasibility ratings (2.55–4.06) on average. Survey 1 responses resulted in a reduced, refined set of 21 strategies, and six were rated most important and feasible on Survey 2: (1) assess for readiness and identify barriers and facilitators; (2) identify and prepare champions; (3) develop a usable implementation plan; (4) offer a provider-informed menu of free, brief measures; (5) develop and provide access to training materials; and (6) make implementation easier by removing burdensome documentation tasks. Provider and researcher ratings were not significantly different, with a few exceptions: providers reported higher feasibility and importance of removing burdensome paperwork than researchers, providers reported higher feasibility of train-the trainer approaches than researchers, and researchers reported higher importance of monitoring fidelity than providers.
Conclusions
The education sector is the most common setting for child and adolescent mental health service delivery in the USA. Effective MBC implementation in schools has the potential to elevate the quality of care received by many children, adolescents, and their families. This empirically derived, targeted list of six implementation strategies offers potential efficiencies for future testing of MBC implementation in schools
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