1 / 20

Models of School Based Health Services and Evidence Based Practice

Models of School Based Health Services and Evidence Based Practice. Alexa Bagnell, M.D. IWK Health Centre, Halifax, NS. Canadian Youth Mental Health Statistics. 1.1 million children in Canada with psychiatric disorders (~14%) (Waddell et al, 2002)

hayden
Télécharger la présentation

Models of School Based Health Services and Evidence Based Practice

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Models of School Based Health Services andEvidence Based Practice Alexa Bagnell, M.D. IWK Health Centre, Halifax, NS

  2. Canadian Youth Mental Health Statistics • 1.1 million children in Canada with psychiatric disorders (~14%) (Waddell et al, 2002) • Only 1 out of 5 children receive mental health services (Stats Can, 2000/2001) • Ontario Child Health Survey- Mental Health • MORE physical health and school problem • 40-60% with 2 or more disorders • 2/3 never receive mental health services

  3. The Changing Role of the School

  4. HEALTH PROMOTING SCHOOLS Global movement #1 healthy children are Better able to learn #2 school’s can directly Influence children’s health

  5. MODELS of SCHOOL BASED MENTAL HEALTH SERVICES A GROWING FIELD

  6. School-based health clinics

  7. Evidence for School Based Health Services IMPROVED EDUCATIONAL OUTCOMES • 32% decrease in absences • 31% decrease in course failures • 95% decrease in discipline referrals • Dallas Youth & Family, 2001 • IMPROVED SCHOOL CLIMATE • Heightened awareness of mental health • Staff more likely to refer to mental health • Less referrals to special education • Baltimore Expanded School Mental Health Services, Bruns, Weist, et al, 2004

  8. Benefits • Services to those most in need/crisis • Identify resource allocation • Can foster enhanced communication with family, school, community Limitations • Service delivery primarily, not prevention/promotion • Extensive resource use, still reaching only minority in need

  9. Evidence for Consultation Models • School based behavioural consultation: • 80 teachers involved in recent consultation • Increased problem solving skills • 2/3 of student functioning improved • Outcomes related to consultation quality and skills • MacLeod et al, 2001 • In-service/Workshop: Evidence for knowledge acquisition but not follow up of behavioural change

  10. SCHOOL INTERVENTIONS AND PREVENTION PROGRAMS WHAT WORKS?

  11. Intervention/Prevention Programs • Social Skills and Resiliency Enhancement • Bullying Prevention • Anxiety/Depression/Suicide Prevention • Substance Abuse Prevention • Whole school/community • Integrated in curriculum • Skill based • Long term • Evaluation: RCT or quasi experimental

  12. Suicide Prevention Programs • Examples of Programs: • Suicide and self harm education • Telephone hotlines/crisis centres • Depression/Suicide Screening days • Gatekeeper training • Little outcome data, no evidence of efficacy • Best evidence in firearm legislation, • Some evidence in responsible media reporting • Integrated screening/risk identification and access to service (gatekeeper) shows potential • Szumalis & Kutcher, 2008

  13. Substance Abuse Prevention Drug Abuse Resistance Education Core: Social influence and health education Studies:Large randomized control trials, long term follow up Results:Improved immediate knowledge and attitudes but no significant difference in drug use Lynham et al, 1999 Life Skills Training Core: Social and Competency Skills Studies: Large randomized control trials Results: Decreased alcohol, marijuana and tobacco use- maintained at 6 year follow up Botvin et al, 1995

  14. Connecting to the Internet • MindMatters- whole school approach to mental health promotion ( teacher, school resources) • YOOMagazine- interactive health literacy tool for youth and schools • Interactive resources, screening, evaluation, Promoting health and help seeking

  15. SIMPLIFYING WHAT THE EVIDENCE TELLS US

  16. Something is not always better than nothing • evidence base and ongoing evaluation • skills based programs better outcomes vs knowledge based alone • adequate supports for school (ex. screening programs connected to Rx) • integrated, long-term programs • sustainable

  17. All schools are not created equal: • flexibility and multi component to suit school and individual needs • school/community commitment and engagement, fidelity of implementation • targeted (risk) and indicated (symptoms) Focus on the positive not the negative: • prosocial and cognitive behavioural skills • promoting protective factors • specific interventions (ex. depression/anxiety) most effective when indicated

  18. School health web resource sites • http://www.safehealthyschools.org – Resources in school health promotion, Canadian School Health Knowledge Network • http://smhp.psych.ucla.edu -Clearinghouse of important mental health/school/education/ evaluation materials • http://csmha.umaryland.edu - Up to date information about school-based health centers • http://captus.samhsa.gov- Evidence based substance abuse and mental health programs • http://www.excelgov.org – US Dept of Education Coalition for Evidence-based policy • http://www.schoolpsychiatry.org- Mass General Hospital site with resources for educators, parents and clinicians

More Related