Are school based mental health services effective? Evidence from 36 inner city schools.

In an effort to bridge the gap between service need and service utilization, an urban based, university-affiliated children's psychiatric outpatient clinic implemented a program which provides mental health services in inner city schools. Since impressions of school and mental health personnel affirmed the effectiveness of such services, an evaluation of this program was conducted, despite the difficulties inherent in implementing research in "naturalistic settings." A clinic sample of children (N = 220) was compared with a sample served in the urban schools (N = 256). The findings revealed that both sets of children showed improvement as indicated by the Children's Global Assessment Scale (C-GAS) and Global Assessment of Functioning Scale (GAF). The improvement was comparable, even though the school children were seen for a slightly shorter period of time (an average of 5 versus 8 months) but had an equally frequent level of service (3 sessions per month in each setting). This finding may have important implications for the managed care environment. These results indicate that school based mental health services show improvement comparable to the clinic-based services, and have the potential for bridging the gap between need and utilization by reaching disadvantaged children who would otherwise not have access to these services.