Reducing Unmet Mental Health Need of African-American Children
- Conditions
- Mental Health
- Interventions
- Behavioral: Screening OnlyBehavioral: Enhanced Screening
- Registration Number
- NCT05450094
- Lead Sponsor
- University of Florida
- Brief Summary
The purpose of this study is to compare two versions of school-based mental health screening to improve the receipt of mental health services among elementary school students.
- Detailed Description
School-based mental health (SBMH) is a critical pathway for accessing mental health services for African American/Black (AAB) youth who experience the greatest gap in unmet mental health need in comparison to their White, non-Hispanic peers, but are twice as likely to access mental health services in schools as outpatient or specialty clinics. Unfortunately, AAB children's access to SBMH is dependent on school intervention team decision making, which often involves consideration of factors other than student need. School personnel on intervention teams disproportionately attribute AAB youth's behavior problems as disciplinary issues rather than mental health needs, reducing the likelihood AAB students receive SBMH services. Consistent with the empirical literature, patient families and stakeholders recommend universal mental health screening to better identify AAB children with mental health needs and enhancements to address unintentional racial biases and poor mental health literacy of school personnel making intervention referral decisions. Thus, we will evaluate the comparative effectiveness of the SBMH delivery system enhanced with screening to a package of enhancements implemented with screening in SBMH to increase the likelihood AAB students receive the services they critically need. The enhancements include three components: (1) unintentional racial bias training and (2) mental health literacy training for voluntary school team members, and (3) a refinement to school teams' data-based decision-making process in which they also voluntarily review screening, mental referral/receipt, and discipline data disaggregated by race/ethnicity to identify and problem solve system-level inequities. We will test both whether and how (i.e., mediational analyses of causal pathway including knowledge, attitudinal, and behavioral observation of unintentional bias and mental health literacy) these enhancements impact student-level intervention and disciplinary referral outcomes. In a mixed method process evaluation and comparative analysis, we will also examine school-level contextual factors (i.e., team member tenure, pre-intervention discipline rates, racial/ethnic and socioeconomic composition of student body, and perceptions of intervention impact and acceptability) and implementation outcomes (i.e., fidelity, dosage/exposure, and reach).
Recruitment & Eligibility
- Status
- ENROLLING_BY_INVITATION
- Sex
- All
- Target Recruitment
- 19106
- Students at study school
- School intervention teams at study school
- Students who are wards of the state or any other institution, agency, or entity
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Comparator Screening Only The comparator arm enhances school-based mental health (SBMH) with universal screening and trains voluntary school teams to use the school-wide data to plan and make intervention referrals using an evidence-based in-service training and coaching model called Team-Initiated Problem Solving (TIPS). Enhanced Enhanced Screening The enhanced arm involves the enhancements to school-based mental health (SBMH) of the comparator arm with the addition of 3 additional empirically supported enhancements to mental health screening: 1) voluntary school teams will review screening and service receipt data disaggregated by racial/ethnic subgroups to identify and problem solve inequities; 2) Unintentional bias training for voluntary school teams, involving teaching participants to conceptualize prejudice as well as strategies to reduce bias; and 3) Mental Health Literacy training for voluntary school teams in awareness and understanding of students' mental health well-being and need for intervention.
- Primary Outcome Measures
Name Time Method Mean change from baseline in student referral to a mental health intervention as measured by the number of students referred to mental health interventions each quarter From first day of school in year 1 to last day of school in year 2 Intervention referrals refer a student to a mental health intervention to address an identified mental health need. The number of students referred to a mental health intervention will be counted. The minimum score is 0 and there is no maximum score.
- Secondary Outcome Measures
Name Time Method Mean change from baseline in student disciplinary encounters as measured by the number of Office Discipline Referrals each quarter From first day of school in year 1 to last day of school in year 2 Office Discipline Referrals are official school records recorded for each school behavioral infraction warranting referral to the school office. Office Discipline referrals for aggressive behavior (i.e. bullying, fighting, making threats) will be counted. The minimum score is 0 and there is no maximum score.
Trial Locations
- Locations (1)
Name withheld to protect anonymity of study site
🇺🇸Gainesville, Florida, United States