Frequently Asked Questions (FAQs)
Many individuals in schools have common questions about school mental health, the answers to which may be provided below. If you cannot find an answer to your concern below, or if you wish to make a suggestion, please fill out a comment form.
Q: If I have a student in my school that does not have insurance, can they get mental health services?
A: If the student has no health insurance coverage, the family should be assisted to apply for coverage through MCHP (Maryland Children's Health Program), by contacting Baltimore Health Care Access (410-643-0512, or for assistance in Spanish 410-643-0515).
Most licensed Outpatient Mental Health Center (OMHC) programs will accept referrals for uninsured clients; however, if school personnel assist with supporting the parent or guardian to begin the MCHP application process, the referral for services will go more smoothly.
If a student's family has private insurance coverage for him or her, mental health services will need to be requested through their health insurance system, most of which have a specific procedure for approval of mental health services.
Q: I'm interested in violence prevention programs as part of school mental health. Are there any resources you can suggest?
A: Schools can be an ideal setting for violence prevention programs, because they are a primary place for children's social development over many years. Programs within schools can address conflicts as they occur and provide opportunities to reinforce skills taught in the programs (Farrell, Meyer, Kung & Sullivan, 2001). Research shows that the most effective early intervention programs 1) build cognitive, emotional and affective skills, 2) encourage collaboration between parent, teacher and child, 3) focus on the strengths of teachers, parents and staff, and 4) are culturally sensitive.
Below is a selection of several programs that have been demonstrated to be effective or promising. For a full listing, download the program matrix at http://www.colorado.edu/cspv/blueprints/matrix.html
Universal Violence Prevention Programs for Children and Adolescents:
Targeted Early Intervention Programs for Aggressive Children
Q: I am a school mental health clinician and want to include some assessment measures as part of our school mental health services. Unfortunately, we do not have the funds to purchase them. Are there any measures that you would recommend that are available at no cost?
A: There are a number of good assessment measures for clinicians that are available for free online. Below is a list of clinical measures used to assess symptoms of clinical disorders (e.g. depression, anxiety, ADHD). Also included below are measures to assess school climate that may also be useful for school mental health. For more information about the measures, please refer to the Center for School Mental Health’s Summary of Free Assessment Measures or refer to the links provided below for each of the measures.
Center for Epidemiological Studies Depression Scale for Children (CES-DC)http://www.brightfutures.org/mentalhealth/pdf/professionals/bridges/ces_dc.pdf
Spence Children's Anxiety Scale
Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS
NICHQ Vanderbilt Assessment Scales (ADHD)
Parent/Teacher Disruptive Behavior Disorder Scale
Strengths and Difficulties Questionnaire (SDQ)
Parent Version of the Young Mania Rating Scale
Child Dissociative Checklist (CDC) Version 3
Narrative Description of Child's Impairment – Home and School Versions
School Climate Measures
World Health Organization's Psycho-Social Environment (PSE) Profile
School as a Caring Community Profile-II (SCCP-II)
Measuring Violence-Related Attitudes, Behaviors, and Influences among Youths: A Compendium of Assessment Tools - Second Edition
For more information on this topic, please review the attached Summary of Free Assessment Measures.
Q: What are some funding strategies for school mental health? What are some examples of what other people have done to fund their services?
A: One of the biggest challenges in the delivery of school mental health services is developing and sustaining funding sources. Most solutions to the funding challenges for school mental health involve using multiple, braided sources of funding. With funding being such a challenge, it is never to early to plan for sustainability. To have an impact on funding, it is also important to connect with policy makers who may be involved in funding decisions related to school mental health. Policy makers need to be educated about what school mental health is and how it is effective. Collecting outcome data that demonstrates the impact that school mental health services have on academic and behavior success needs to be a priority. Further, being able to demonstrate the overall cost savings as a result of school mental health services (e.g. reductions in special education referrals, reductions in non-public placements, reduction in emergency room usage for psychiatric emergencies) and developing effective partnerships between public and private sectors can be integral in procuring funding for school mental health.
An overview of common funding opportunities is presented below:
- Federal Grants – Several federal grants have been created in recent years in which a portion of funds can be allocated for expanded school mental health services. These include the Safe Schools/Healthy Students Initiative (Departments of Education, Justice and Health and Human Services), Title XX Social Services block grant, Preventive Health and Health Services block grant, and the Maternal and Child Health block grant.
- State Funding – Some states have begun to include school-based heath and mental health services in their budgets. For example, services can be financed partially by state allocations (e.g. budget line item) or by implementing specific programs (e.g. Safe and Drug Free Schools) that also come with budgets to supplement general money for school mental health programs. State health initiatives and state taxes (e.g. tobacco tax, property tax) may also offer some support for school mental health services.
- Fee-for-service Reimbursements - Third-party payers including State Children’s Health Insurance Programs, commercial insurance, and Medicaid provide support for school mental health through fee-for-service reimbursements. Important considerations for this line of funding are whether school-based services are viewed as primary care centers or whether the service provided is non-duplicative care, characteristics of service which would allow for a larger portion of a school mental health budget to be covered in this capacity. There are also disadvantages to this line of funding including the large bureaucratic and administrative load required to recover funds, the necessity of diagnosing students for fee reimbursement, and the lack of reimbursement for many activities included in the expanded school mental health model (e.g. consultations with parents and teachers, classroom observations, and case management). However, given the limited grant funding options for school mental health services, fee-for-service revenue is seen as an integral part of long-term financial success for school mental health services.
- Outpatient Mental Health Center Funding – Partnering with an already existing outpatient mental health center is an excellent way of facilitating the ability to bill public and private insurance programs for services. That is, while expanded school mental health programs have the staff, capability and connections to serve children in schools, the outpatient program has the structure mechanisms, and recognition needed to bill for services.
- Solicited Funds – Many expanded school mental health programs obtain at least some of their funding from private donors, private foundations, and federal agencies. This source of funding can comprise a portion of a general budget or they may be solicited to fund specific initiatives as part of broader school mental health services.
- Pooled, Blended or Braided Funds – Relying on multiple funding streams through a pooling, blending or braiding of sources in an important component of successfully funding school mental health. This is a key component to ensure that the services continue even if one of the funding sources should end. An additional advantage of this approach to funding is that services tend to be more comprehensive since funding sources often differ on which services, providers and clientele are covered.
 This information is taken from Evans, Glass-Siegel, Frank, Van Treuren, Lever & Weist (2003). “Overcoming the Challenges of Funding School Mental Health Programs”. In Weist, Evans & Lever (Eds.) Handbook of School Mental Health: Advancing Practice and Research. New York: Kluwer Academic Publishers