Background: More than 20% of children and youth in the U.S. experience mental health difficulties, with only about 30% receiving adequate mental health treatment services. School based health centers (SBHCs)—a comprehensive service delivery model integrating physical and mental health services within school settings—reduce barriers to health services faced by low-income families and children. Given the potential of SBHCs to improve the lives of children with mental healthcare needs, it is necessary to explore the delivery of mental health (MH) services among SBHCs longitudinally, and identify key structural characteristics, networks, and state level supports that promote delivery of MH services across U.S. states. Method: Guided by the contextualist approach, secondary analyses of two longitudinal datasets (National SBHC Census & State Policy Survey) were carried out to: (1) identify the number of MH services reported to be delivered by state over time, and (2) identify inner and outer contexts of SBHCs with a MH component related to number of services. The consolidated framework for implementation (CFIR) was used to organize variables and guide interpretation of findings related to the interplay of contexts and delivery of services. Findings: Results suggest that specific inner and outer setting variables are related to more MH services from 2005 to 2014, but the variables had differential impacts on which type of MH service was delivered. Moreover, mandatory policies for state-funded SBHCs demonstrated more MH services over time than those otherwise. Discussion: Understanding the factors facilitating delivery of MH services is necessary to better inform policy efforts that can increase service access among underserved youth.
Read
