 | ||||
Many grants request a Literature Review with updated information to support your funding request. Below is an example of a Literature Review supporting mental health initiatives in a school setting.
Student Mental Health and Academic Performance
Literature Review
Funding for school-based mental health prevention, early identification and management interventions, mental health screenings and community-based partnerships continues to be an ongoing concern. In recent years, schools have voiced concern about the mental health and psychosocial well-being of their students who are unable to fully participate in the learning process. Students who experience psychological, emotional or behavioral difficulties face many challenges, which have the potential to interfere with their family life, their ability to learn, and their ability to form friendships. These mental health problems can seriously impede a student’s ability to acquire social competence and educational skills, thereby impairing their ability to learn. If these difficulties persist throughout a child's development it could lead to lifelong disability. Educators are examining the cause of underachievement and frequently identifying poor health, psychological or social problems as factors (Bell Smith Foundation & Ed. Dept Ctr., 1994).
The United States Department of Health and Human Services (2003)2 reports that fifty-three million of America's children spend more than one third of their day at school. Hootman, Houck and King (2003)3 state, “The school setting is a central context in which children are not only educated but also grow and develop in community with other children. School personnel are potentially key agents in the socialization of children. Although initially designed to provide education, academic institutions are increasingly required to meet a range of needs and demands. In addition to special education, these include providing early intervention with younger children, support for chronically ill students and attention to children with emotional problems and mental illness”
School personnel see the increase in the numbers of children diagnosed with or at high risk for mental and emotional disorders. (Symptoms for High Risk Students - Appendix A) Shalala (2003)4 states that almost 21% of children ages 9 to 17 years suffer from a diagnosable mental or addictive disorder in the United States, with an additional 6 to 9 million youngsters thought to have serious emotional disturbances without receiving the help they need. There is a wide range of psychosocial factors that interfere with school learning and performance such as depression, anxiety and eating disorders. School age is a common time for the onset of mental health problems. Attention deficit/hyperactivity disorder (ADHD) is typically diagnosed by age 7 and affects 3–7% of school-age children (Althoff, Rettew, & Hudziak, 2003)5. The American Academy of Pediatrics (2003)6 reports that as many as 1 in 33 children and 1 in 8 adolescents may experience childhood depression. It also states that in a survey of high school students, 60 percent of students had thought about hurting themselves and about 9 percent of students had tried at least once to kill themselves. According to the U.S. Department of Health and Human Services report, the number of school-age children diagnosed with mood disorders is approximately 6 percent (NIMH, 2002)7. Overall, one in five children and adolescents (20%) experience mental health problems that significantly interfere with their developmental functioning and achievement (National Mental Health Association, 2005)8.
Alderman (1998)9 writes that the problems students exhibit in school are attributable to conditions they bring with them when they enter kindergarten – conditions associated with poverty, difficult and diverse family situations, violent neighborhoods, physical and emotional problems and inadequate health care. Vandivere, Moore, & Zaslow (2000)10, concur that children living in stressful family environments have been found to be nearly twice as likely to exhibit low levels of school engagement and four times as likely to have high levels of behavioral and emotional problems. Aviles, Anderson & Davila (2005)11 found that children and adolescents exposed to violence often develop mental health problems, impacting their ability to develop appropriate social-emotional skills. Schools are realizing that the increased numbers of children who are identified as at risk because of negative psychosocial influences is alarming.
As the needs and concerns of youth and their families change, schools must also adjust to meet these needs. The challenges students face today are more complex, with new morbidities such as AIDS, STD’s, eating disorders, substance abuse, violence and depression. Marx, Wooley, & Northrop (1998)12 state, “The number deemed “at risk” in many schools serving low-income populations, exceeds the 50% mark. Most school administrators, board members, teachers, parents, and students realize that, for students to benefit from their schooling, society must address social, emotional, and physical health problems and other major barriers to learning”.
“The 2010 Health Objectives include enhanced mental health as a priority for our nation's youth. This objective exists in the face of the World Health Organization's projection that depression will be the second leading cause of "lost healthy years" by 2020” (Kennedy, 2000)13. According to Hootman, Houck, & King (2003)14 “It is time to develop strategies for meeting this objective; otherwise crisis management will prevail and our children will continue to suffer. Schools can and should be used for prevention, early identification and management intervention of mental health conditions.” The National Institute of Public Health (2003)15 report that the provision of support services to schools such as mental health and mental illness education to students, parents and staff members and appropriate ratio of school nurses, health counselors, psychiatrists etc., has been found to relate to a reduction in the number of students diagnosed with depression and anxiety, using illicit drugs, becoming pregnant, leaving school, and avoiding school due to fear of violence. Schools require designated mental health resources and effective community partnerships to assume such roles in addition to their primary responsibility for educating children (Hootman, 2003)16.
A grant from the Stuart Foundation implemented by the California Department of Education funded WestEd to analyze how school-level health risk and resilience factors are related to the academic achievement using student standardized test results as the responsible variable (Student Health Risks, Resilience, and Academic Performance in California: Two Year Report, Longitudinal Analysis, 2000)17. One result found that gains in test scores were smaller in schools with high percentages of students who reported being sad or depressed and suggest that addressing the health and developmental needs of youth is a critical component of a comprehensive strategy for improving academic performance. Crime, violence, antisocial behavior, and other types of social disorganization in schools have adverse consequences on student learning and should be targeted with comprehensive prevention programs. Findings from this study suggest that efforts to improve schools should go beyond the current emphasis on standards and accountability measured by test scores.
Despite awareness of the many barriers to learning, school reformers tend to concentrate on improving instruction and school management, ignoring the programs and services needed to address barriers to student learning. Effective mental health education, counseling, psychological, and social services for children, youth, their families, and school personnel benefit not only schools but also society as a whole. It is important to consider that children spend many of their waking hours at school and under the supervision of highly qualified school personnel. This situation can be viewed as an ideal opportunity to organize and optimize resources that place the students’ overall well-being at the heart of the academic program. Schools have the ability to be the initial point of contact. They can and should serve as a primary site for prevention activities, early identification and management of unhealthy psychosocial indicators. Without additional opportunities, supports and services, many of today’s youth will not necessarily acquire the knowledge and skills that enable them to become responsible, successful and productive adults.
The time has come for a new design and new partnerships, which could help to nurture a healthier, more teachable student population and significantly improve student health outcomes. The importance of providing school health psychosocial services to students in schools is beginning to be appreciated but is threatened by lack of evidence-based data and lack of funding and all but mandated services could be eliminated. Prevention, early identification, management and stakeholders at the community, state and national level are key to responding to student mental health and academic achievement. Educational reforms will only be effective if student health is identified as contributors to student well-being and academic success and are at the heart of decision and policy making. This pioneer effort could bring awareness to the forefront regarding student psychosocial barriers to learning with relationship to how it impacts mental health outcomes and academic performance using standardized testing results. Results of this study could increase accountability and justification for educational reformers, national policy makers and allocates of federal funding to increase school health funds.
References
1 BellSmith Foundation & Education Department Center. (1994). Education and health: Partners in school reform. Atlanta, GA: BellSmith Foundation.
2 U.S. Department of Health and Human Services. (2003). A Public health action plan. Atlanta:
Author
3 Hootman, J., Houck, G., & King, M. (2003). Increased mental health needs and new roles in
school communities. Journal of Child and Adolescent Psychiatric Nursing, 16 (3), 93-101.
4 Shalala, D. (2003). U.S. Surgeon General mental health report. Retrieved April 18, 2003, from
www.surgeongeneral.gov//library/mentalhealth/home.
5 Althoff, R., Rettew, D., & Hudziak, J. (2003) Attention deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder. Psychiatric Annals, 334, 245–252.
6 American Academy of Pediatrics, (n.d.). Some things you should know about preventing teen
suicide. Retrieved April 18, 2004, from http://www.aap.org/advocacy/ childhealthmonth/
prevteensuicide.htm.
7 National Institute of Mental Health. (2001). U.S. Department of Health and Human Services Report.
8 National Mental Health Association. (2005) Children's mental health statistics. Retrieved
November 25, 2005, from www.nmha.org/children/prevent/stats.cfm.
9 Aldelman, H. (1998). School counseling, psychological and social services. Health is Academic: A guide to coordinated school health programs. (p.143-163). NY: Teachers College Press.
10 Vandivere, S., Moore, K., & Zaslow, M. (2000). Stressful family lives: Child and parent well-
being [No. B-17 in a series, "New Federalism: National Survey of America's Families].
Retrieved February 19, 2001, from ttp://newfederalism.urban.org/html/series_b/b17/b17. html
11 Aviles A. M., Anderson, T. R., Davila, E.R. (2005). Child and adolescent social-emotional
development within the context of school. Adolescent Mental Health. Online publication
date: 29-Jul-2005
12 Marx, E., Wooley, S.F. & Northrop, D. (1998). Health is Academic: A guide to coordinated
school health programs. NY: Teachers College Press.
13 Kennedy, M. (Ed.). (2000). WHO calls for better diagnosis and treatment of depression.
American Journal of Nursing, 100(1), 19.
14 Hootman, J., Houck, G., & King, M. (2003). Increased mental health needs and new roles in
school communities. Journal of Child and Adolescent Psychiatric Nursing, 16 (3), 93-101.
15 National Institute of Public health. (2003) http://w ww.nimh.nili.gov/publicat/ NIMHdepchildrenfact. Depression in Children and Adolescents: A fact sheet for physicians.
16 Hootman, J., Houck, G., & King, M. (2003). Increased mental health needs and new roles in
school communities. Journal of Child and Adolescent Psychiatric Nursing, 16 (3), 93-101.
17 Hanson, T., & Austin, G., (2003). Student Health Risks, Resilience, and Academic Performance in California: Two Year Report, Longitudinal Analysis. Los Alamitos, CA. WestEd.
