School Safety and School-Based Mental Health Services in a Large Metropolitan School District

This project will develop knowledge about how expanding and enhancing school-based mental health (SBMH) programs can promote school safety and improve student well-being. Research has shown that SBMH can reduce behavior problems in children who receive services and improve overall school climate for others, but more evidence is needed to understand the role of evidence-based programs and implementation in SBMH. RTI International will conduct a rigorous evaluation including process, outcome, and cost evaluations to better understand the effects of three levels of SBMH implemented in Charlotte-Mecklenburg Schools (CMS), a large, culturally diverse system. CMS will build upon its current SBMH framework in 24 middle and K8 schools by randomly selecting 8 schools each to receive enhanced therapies SBMH (SBMH-ET), expanded SBMH (SBMH-EX), or SBMH treatment as usual (SBMH-TAU). During the first year of the study, SBMH-ET schools will provide training in two evidence-based treatments to mental health providers and student services staff: Dialectical Behavior Therapy (DBT) for students exhibiting significant mental health problems and Structured Psychotherapy for Adolescents Responding to Chronic Stress (SPARCS) group treatment for students exhibiting behavior problems. At SBMH-ET and SBMH-EX schools, treatment will be expanded to include students who are unable to pay for services. In SBMH-ET schools, we will use a process evaluation to explore how often and how well providers use their training to implement the evidence-based intervention with students, using clinician logs, questionnaires, and interviews about barriers and supports. A primary source of school safety outcome data will result from a survey administered four times during the project to a random selection of 100 students per school. We will work closely with the CMS Office of Accountability to use administrative data collected by CMS about discipline infractions, attendance, and academic performance. SBMH-ET and SBMH-EX are expected to show improved individual student behaviors and school-level safety and climate over SBMH- TAU using weighted multilevel latent growth models. Schools with any SBMH program are expected to show improved results over a control group of eight schools without SBMH. Differences between school characteristics before intervention will be controlled for using propensity scores. A cost-effectiveness analysis will be conducted on each type of SBMH. We anticipate reporting our results in scholarly works including peer-reviewed journal articles and presentations at national conferences. We will provide a toolbox to help other schools evaluate their SBMH programs and provide evidence to policymakers for the benefits of SBMH. This project contains a research and/or development component, as defined in applicable law. ca/ncf