Issues and Opportunities in the Organization and Financing of Mental Health Services in School Julia Graham Lear, Center for Health and Health Care in.

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Presentation transcript:

Issues and Opportunities in the Organization and Financing of Mental Health Services in School Julia Graham Lear, Center for Health and Health Care in Schools, The George Washington University MacArthur Foundation Mental Health Network Meeting, Miami Beach, FL December 6, 2001

Mental health services in schools: an overview Lurking issues in school-based mental health services Current approaches to service delivery Organization-of-care issues Financing challenges Related activities Possible directions for MacArthur Network

Lurking issues in school-based mental health services Population-targeted practice v. individual-targeted practice? What are the services to be offered? Prevention? Screening? Diagnosis? Short-term interventions? Long-term services? Whose goals? Is mental health care in schools supporting an education agenda or a health agenda?

Current approaches to service delivery School -system organized care School-based health centers School-based mental health services

Organization-of-care issues Who’s in charge? Clinical practices: methods, quality measurement, confidentiality, parent consent Staffing: credential and training requirements, continuing education, union issues

Financing challenges Multiple sources of funding: state grant funds; Medicaid; managed care -- carve outs, carve-ins, falling in-between; local health and education budgets Meeting requirements of funding agencies Ability of provider organization to bill and collect from 3rd party payers Reluctance of primary care providers to diagnose children with billable disorders

Thinking ahead: Related activities The Survey of the Characteristics & Financing of School Mental Health. Abt Associates, SAMHSA funded. Depression in Primary Care: Linking Clinical & System Strategies. RWJF multi-site grant program. Caring for Kids: Expanding Mental & Dental Health Services through School-Based Health Centers. RWJF multi-site grant program

Possible directions Synthesis of post SGR work: at national, state & local level Research opportunities: content of school-based mental health care, patient care outcomes An invitational workshop for Mental Health Commissioners, researchers & educators: to discuss demonstrations & test political and financial feasibility of expanding mental health services in schools