Rural School-Based Mental Health Services: Parent Perceptions of Needs and Barriers

Apr 30, 2018

school desks in rowsThe benefits of school-based mental health services have been supported in prior research and literature. Studies have shown that approximately one in five youths in schools today have diagnosable mental health disorders. However, research has identified that close to 70 percent of those youths do not receive the services they need. This gap in care has a significant impact on the academic, social, and emotional well-being of youths. Parent involvement is essential in bridging services. However, parents often face barriers in accessing mental health care for their child.

In a recent issue of the journal Children & Schools, published by NASW Press, researchers published their findings on school-based mental health services in a rural environment. The aim of this study was to explore parent perceptions of needs and barriers to school-based mental health services. This exploratory study included 607 parent and guardian respondents. Findings showed that parents were overwhelmingly in support of schools being involved in addressing the mental health needs of students. Anxiety, depression, and bullying were the top emotional and behavioral issues that parents recognized as the main challenge for their child. However, lack of parent support, understanding that mental health issues even exist in youths, and lack of supportive school programs were identified as key factors that place youths at risk of not receiving the services they need.

As school-based mental health programs have been implemented, studies on their effectiveness have been promising. However, barriers for service access have been identified for those children living specifically in rural areas. Rural areas in general have been found to face shortages in mental health providers. In a nationally represented sample, children in rural areas were found to be at a greater risk of having insurance limitations, living in families facing financial challenges, and having limited community resources. In addition, children in the rural environments were also at a higher prevalence of having a parent who faced her or his own mental health challenges. These barriers are also in addition to transportation limitations and general lack of knowledge about the needs for and benefits of mental health services. A goal of school-based mental health services is to reach those disadvantaged youths who would not necessarily be able to access services in the community. The hope is that schools would offer another avenue to engage parents and guardians in promoting early mental health identification and treatment in their children. Parents and guardians often serve as the bridge for linking their children to those needed services. Studies have shown that level of parent involvement is directly linked to both student academic and emotional functioning.

The article shows findings from a study that was part of a larger initiative by the Eastern Shore School Mental Health Coalition of Maryland (ESSMHC) which received funding from the Maryland State Department of Education, Division of Special Education/Early Intervention Services, to explore school-based mental health needs and develop strategies to improve a system coordination for improved academic outcomes for students with behavioral health disorders. ESSMHC, led by the Mental Health Association of the Eastern Shore of Maryland, is made up of community service providers, educators, and family representatives serving the nine rural counties on the Eastern Shore. Understanding that youths in rural areas are less likely to receive mental health services due to access and coordination challenges, ESSMHC aims to serve as a resource for the rural community providers, families, and schools in sharing knowledge for improved mental health and academic outcomes for youths.

Specific to this study, the researchers wanted to understand parent perspectives of the needs, gaps, and barriers for school-based mental health services of the nine rural counties on the Eastern Shore of Maryland. To clarify, we define parents as the parent or legal guardian serving as caregiver of the child. We also define youths as school-age children and adolescents. This exploratory study aimed to answer the following two research questions:

  • What are the needs identified by parents and guardians of school-age children regarding school-based mental health services?
  • What are the perceived barriers of school-based mental health services for youths in the rural counties of the Eastern Shore of Maryland?

The researchers looked at the expressed needs of parents and guardians; the perceptions of the role of schools in meeting mental health needs; the reasons for not receiving services; and service access and additional information. The results of the study are detailed in the article.

Findings from this study provide insight on needs and perceived barriers for school-based mental health services from the parent perspective. More than three out of four parent respondents agreed that schools should be involved in addressing the mental health needs of students. However, they identified lack of parental support for the child, lack of knowledge about mental health, and limited support services in the schools as barriers that resulted in youths falling through the cracks and not receiving the services they need. Parents and guardians were also overwhelmingly in support of curriculum-based social–emotional lessons being implemented in the classroom. Understanding what challenges are currently present in rural areas is helpful in deciding which evidence-based practices should be implemented in the schools. Furthermore, understanding where the parents and guardians would turn for information about services provides insight to where resource information and education should be disseminated. Parents in the study indicated that their child’s primary care providers would be the initial contact if they had concerns about their child’s mental health in general. In addition, they said that the school guidance counselor would be their contact if they wanted specific information about services in the school.

The researchers note the study’s limitations and call for more research. Very few studies have aimed to understand the parent perspectives in exploring school-based mental health needs of youths. The information from this study offers insight on key areas where funding, education, and services can be targeted to address the gaps in mental health assessment and treatment for youths living in rural areas.