Thriving in School: A Patient-Centered Comparative Effectiveness Research Agenda on School-Based Mental Health for Children and Youth with Special Health Care Needs (CYSHCN)
This report presents a prioritized research agenda inclusive of seven research domains to address evidence gaps regarding school-based mental health services and programs for CYSHCN with emotional and behavioral needs.
The foundational systems that support children and youth’s present—and future—mental health and well-being face not only significant threats from a rapidly shifting policy landscape but also persistent evidence gaps. Fragmented services, infrastructure, resources, and support present challenges to ensuring that all areas of the nation meet the needs of children and youth with special health care needs (CYSHCN). AcademyHealth, in partnership with Econometrica and Family Voices, launched a 12-month project in November 2024 to unite lived and learned expertise via a national agenda-setting exercise to help address pressing evidence gaps.
This research agenda supports efforts to bridge the gap between generating timely, responsive, and high-impact evidence and bringing the field closer to an ideal state of school-based mental health services for CYSHCN with emotional and behavioral needs. The research questions aim to guide efforts in navigating the high variability of school-based mental health services in order to better identify what strategies and interventions are most effective for these students.
Prioritized research questions are categorized into seven domains:
- Date & Measurement
- Equity
- Financing & Regulation
- Models of Care & Support
- School & District Climate
- Workforce
- Youth/Family Engagement
The report also outlines considerations for the successful adoption and implementation of the research agenda regarding:
- Ongoing challenges with defining the population for research studies
- Implications for evidence generation
- Assessing the policy landscape in 2025
- Opportunities for alignment and actionable uptake of the agenda
This report 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).
No policy briefs or policy activities were completed during the award term. As such, the next iteration of this work would benefit from targeted engagement of Medicaid directors and federal and/or foundation program officers to directly integrate their financing needs into the research designs, ensuring the agenda is fiscally sustainable and relevant to policymakers’ budget priorities.