Mental health services in schools: utilization, effectiveness, and consent.

The integration of education and behavioral health services in schools continues to evolve at a rapid pace. Proponents argue that school-based behavioral health programs have many benefits, including greater access to care and improved effectiveness as compared to clinic- or hospital-based services. While preliminary research is encouraging, in general the claims of school behavioral health are not supported by data. Some critics focus on negative aspects of school behavioral health. They claim that behavioral health is being forced upon students and can cite many examples of counseling and treatment administered to children without parental consent. Utilization, effectiveness, and consent are three topics that deserve a great deal of attention in this emerging field, and are the focus of this review.