Thriving in School: School-Based Mental Health for Children and Youth with Special Health Care Needs (CYSHCN)
This environmental scan maps current school-based mental health services and programs for CYSHCN to the Multi-Tiered System of Supports (MTSS) framework, outlining key barriers and facilitators to operationalization.
AcademyHealth, in partnership with Econometrica and Family Voices, conducted a literature scan, key informant interviews, survey, and listening session in order to highlight gaps in the evidence base and surface priorities among key interest holders (e.g., researchers, youth and family/caregiver advocates, school-based providers, and state Medicaid policymakers). The resulting environmental scan explores how school-based mental health services for CYSHCN with emotional and behavioral needs are currently delivered and funded, where gaps exist, and what opportunities might help improve access and quality of care for these students. Findings are structured around the essential and connecting components of the Multi-Tiered System of Supports (MTSS) framework, which include:
- Essential components: Screening, multi-level prevention system, progress monitoring, and data-based decision making.
- Connecting components: Leadership and policy, professional capacity, and communication and collaboration.
The scan surfaced several considerations and gaps in knowledge and/or consensus that must be addressed to better support school-based mental health services for this target population. At a high level, these considerations include:
- Refinement and cross-sector consensus on defining this population, given that there is currently not a universal definition of CYSHCN with emotional and behavioral needs. An operationalizable population definition is vital to creating systems and policies that enable high quality service provision.
- Centering youth and family/caregiver engagement in the design, implementation, and evaluation of school-based mental health programs for CYSHCN.
- Building upon existing best and promising practices for school-based mental health services, scaling successful models to address diverse needs of this population.
- Funding opportunities within and beyond Medicaid to support the provision and sustainment of school-based mental health services.
This environmental scan was developed as part of the initiative, Thriving in School: A CYSHCN-Driven Roadmap for High Impact School-Based Mental Health Patient Centered Comparative Effectiveness Research (CER). The initiative was funded through the Eugene Washington PCORI Engagement Award, an initiative of the Patient-Centered Outcomes Research Institute® (PCORI®) (#EASCS-38921).