Do Youth More Effectively Receive Mental Health Services in

Schools or Community Health Centers?

By Sonya Adler
December 11, 2020

Outpatient community mental health centers are not effective for all youth who need mental
health support. Leaders in education and on school boards are starting to understand that schools
need to up their game with the mental health support they provide because the current programs
are not successfully supporting the full population.

A study was conducted over a two-year period from November 1993 to November 1995 in South
and Southwest Baltimore including 265 youth, ages 10-19. The youth included 79 who are from
community mental health centers (CMHC’s) and 186 from schools.

According to Weist et al., “Findings support the conclusion that school-based mental health
programs are reaching youth who need mental health services, who otherwise may not receive
them.” These “expanded” school mental health (ESMH) programs provide assessment and
treatment for the children rather than just the assessment, like schools had solely been doing
previously.

It was found that community mental health centers only reach students who do not display
externalizing behaviors while the expanded school mental health programs reach youth who have
more internalized disturbances.

A boy at a local high school in San Anselmo, California sets up for a mental health awareness week
Image courtesy of Keri Brenner, “Drake High School Celebrates Opening of Student Wellness Center,” Marin Independent
Journal July 19, 2018.
“These findings support the notion held in many communities that youth need to “act out” in
order to gain entree into the mental health system,” says Weist et al. However, introducing more
support into schools would change this.

Though both CMHCs and ESMHs are running to help the wellbeing of youth, Weist et al
assesses which are more effective by implementing surveys and questionnaires for the subjects
on violence exposure, life stress, family-supportive behaviors, self-concept, and
behavioral/emotional problems.

This two-way table shows the means of psychosocial measures surveyed for male and female youth in the school programs as
compared to in CMHCs.
Image courtesy of Weist, Mark D., C. Patrick Myers, Eileen Hastings, Hari Ghuman, and Yu Ling Han., “Psychosocial
Functioning of Youth Receiving Mental Health Services in the Schools versus Community Mental Health Centers.”

They found that school programs are more effective in reaching youth with more internalized
mental health problems. They also found that youth from the schools were less likely to have
past mental issues than the youth from the CMHCs.

According to Weist et al, “Youth seen in the schools reported levels of emotional and behavioral
problems comparable to youth in the CMHC’s.” However, this study provides the quantitative
data that school-based mental health programs reach youth who may not otherwise get support
from CMHC services with mental health problems like depression and anxiety.
As mental health services improve and become more effective, this research needs action to be
taken within school boards and districts who will turn these mediocre services into fully
functioning in-school mental health support systems.