Bringing Mental Health Treatment Bringing Mental Health Treatment to Youth: Integrated School-Based Health Centers in Urban Schools
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Abstract
Background: The youth health problems are very prevalent in the United States. Approximately, one in five children and adolescents experience mental health problems, yet many have limited access to appropriate treatment, contributing to increased suicidal risks and school failure. School-based health centers (SBHCs) offer a promising avenue to deliver care where students spend most of their time.
Aim: This study examined associations between SBHC-delivered mental health services and changes in students’ mental health symptoms, functioning, and school-related outcomes in a large urban district.
Methods: Mental health symptoms and functioning were assessed using the Ohio Youth Problem Functioning and Satisfaction Scales at baseline and approximately 3 and 6 months after initiation of school-based mental health treatment. Linked educational records provided grade point average (GPA), attendance, and behavioral incident data for 1,238 students receiving services between 2010 and 2019. One-way repeated measures analysis of variance was used to examine within-student changes over time, including analyses stratified by baseline symptom severity and functional impairment.
Results: School-based mental health treatment was associated with reduced problem severity, particularly among students with the highest baseline symptom burden, including self-harm, thoughts of death, and sadness/depression, and with improved functioning in those with severe initial impairment. GPA increased modestly and behavioral incidents decreased by about half in the year following treatment compared with the prior year, while attendance showed smaller improvements. Youth and parent reports demonstrated similar patterns of change.
Conclusion: In this urban SBHC system, participation in school-based mental health services was associated with improvements in student mental health and favorable changes in school-related behaviors and performance. Although causal inference is limited by the observational design, these results add to evidence that SBHC mental health services may play an important role in supporting youth functioning, behavior, and academic outcomes.
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Copyright (c) 2026 Ladegard KM, et al.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Christian C Thurstone, Division of Substance Dependence University of Colorado Denver, Medical Director of Behavioral Health Denver Health and Hospital Authority 723 Delaware Street, Denver, CO 80204, USA
Medical Director of Behavioral Health Denver Health and Hospital Authority
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