Reducing Unmet Mental Health Need of African-American Children

University of Florida

Status: Invitation-only

Conditions: Mental Health

Treatments: Behavioral: Enhanced Screening; Behavioral: Screening Only

Study type: Interventional

Funder types: Other

Identifiers

NCT05450094

AD-2021C1-22495 (Other Grant/Funding Number)

IRB202200678

Details and patient eligibility

About

The purpose of this study is to compare two versions of school-based mental health screening to improve the receipt of mental health services among elementary school students.

Full description

School-based mental health (SBMH) is a critical pathway for accessing mental health services for African American/Black (AAB) youth who experience the greatest gap in unmet mental health need in comparison to their White, non-Hispanic peers, but are twice as likely to access mental health services in schools as outpatient or specialty clinics. Unfortunately, AAB children's access to SBMH is dependent on school intervention team decision making, which often involves consideration of factors other than student need. School personnel on intervention teams disproportionately attribute AAB youth's behavior problems as disciplinary issues rather than mental health needs, reducing the likelihood AAB students receive SBMH services. Consistent with the empirical literature, patient families and stakeholders recommend universal mental health screening to better identify AAB children with mental health needs and enhancements to address implicit social cognitions that impact decision-making processes and poor mental health literacy of school personnel making intervention referral decisions. Thus, we will evaluate the comparative effectiveness of the SBMH delivery system enhanced with screening to a package of enhancements implemented with screening in SBMH to increase the likelihood AAB students receive the services they critically need. The enhancements include implementation supports, including training, coaching, and data-based feedback. We will test both whether and how (i.e., mediational analyses of causal pathway including knowledge, attitudinal, and behavioral observation of unintentional bias and mental health literacy) these enhancements impact student-level intervention and disciplinary referral outcomes. In a mixed method process evaluation and comparative analysis, we will also examine school-level contextual factors (i.e., team member tenure, pre-intervention discipline rates, racial/ethnic and socioeconomic composition of student body, and perceptions of intervention impact and acceptability) and implementation outcomes (i.e., fidelity, dosage/exposure, and reach).

Enrollment: 19,106 estimated patients

Sex: All

Ages: 5 to 105 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Students at study school
• School intervention teams at study school

Exclusion criteria

• Students who are wards of the state or any other institution, agency, or entity

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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19,106 participants in 2 patient groups

Comparator

Active Comparator group

Description:

The comparator arm enhances school-based mental health (SBMH) with universal screening and trains voluntary school teams to use the school-wide data to plan and make intervention referrals using an evidence-based in-service training and coaching model called Team-Initiated Problem Solving (TIPS).

Treatment:

Behavioral: Screening Only

Enhanced

Experimental group

Description:

The enhanced arm involves the enhancements to school-based mental health (SBMH) of the comparator arm with the addition of 3 additional empirically-based implementation supports, including training, coaching, and data-based feedback. Enhancement aim to increase school teams' awareness and understanding of students' mental health well-being and need for intervention.

Treatment:

Behavioral: Enhanced Screening