School Mental Health: Role of the Substance Abuse and Mental Health Services Administration and Factors Affecting Service Provision

GAO-08-19R Published: Oct 05, 2007. Publicly Released: Nov 05, 2007.
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The U.S. Surgeon General reported in 1999 that about one in five children in the United States suffers from a mental health problem that could impair their ability to function at school or in the community. Yet many children receive no mental health services. While many of the existing mental health services for children are provided in schools, the extent and manner of school mental health service delivery vary across the country and within school districts. Federally led initiatives have identified schools as a potentially promising location for beginning to address the mental health needs of children. Both the report of the Surgeon General's Conference on Children's Mental Health and the 2003 report of the President's New Freedom Commission on Mental Health--Achieving the Promise: Transforming Mental Health Care in America--identified school mental health services as a means of improving children's mental and emotional well-being. At the federal level, the Department of Health and Human Services' (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA) has a stated mission of building resilience and facilitating recovery for people--including children at risk for mental health problems. Although SAMHSA is the federal government's lead agency for mental health services, other federal agencies and departments, such as HHS's Centers for Disease Control and Prevention (CDC) and the Department of Education (Education), engage in, or coordinate, activities related to school mental health services in various ways. SAMHSA works to achieve its mission chiefly by providing grants and technical assistance. For example, the agency uses grant funds and technical assistance to support the expansion of mental health service capacity and the use of evidence-based practices in mental health services. Typically, efforts that have been validated by some form of documented scientific data are referred to as evidence-based. Congress asked us to provide information on school mental health services and the role of SAMHSA in this area. In this report, we describe (1) SAMHSA's coordination with other federal departments and agencies to support mental health services in schools, (2) the efforts SAMHSA has made to identify and support evidence-based school mental health services and best practices for service delivery, and (3) factors that affect the provision of mental health services in schools.

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