After initially visiting a school psychologist, adolescents in the United States with a mental disorder often go to seek care from their pediatricians or family doctors. Fewer of them continue their treatment directly with a psychotherapist or doctor specialized in mental disorders. This shows an analysis conducted by scientists at the University of Basel that has just been published in the academic journal PLOS ONE. The results are based on a nationally representative cohort of 6,500 U.S. teenagers.
A considerable number of children and adolescents suffer from a mental disorder at some point of their time in school. In these cases, school psychologists are an important first contact point. However, their ability to provide comprehensive psychotherapeutic treatment directly is limited. Ideally, school psychologists should guide the way through the health care system in order to ensure children get access to adequate mental care from specialists.
But what does the reality look like? Which role do school psychologists play in the trajectory of children and adolescents with mental disorders in the health care system? PD Dr. Marion Tegethoff and her research team from the Faculty of Psychology at the University of Basel tried to answer this question in a research project funded by the Swiss National Science Foundation. They analyzed data from a nationally representative United States cohort of 6,483 students aged 13 to 18.
Medical care could be improved
The researchers found that adolescents with mental disorders were more likely to seek help in the medical specialty sector, namely from family doctors or pediatricians, after having visited a school psychologist initially. In addition, they were also more likely to use other services such as telephone hotlines, self help groups or family preservation workers. However, visiting a school psychologist did not influence whether teenagers subsequently went to see doctors and therapists specialized in mental disorders, despite the fact that they are experts for the treatment of children and adolescents with mental disorders.
The researchers interpreted these results as indication that U.S. school psychologists already play an important role in the improvement of mental medical care. "However, it remains to be studied whether the collaboration between schools psychologists, psychotherapists and doctors specialized in mental disorders should be further improved in order to ensure the best care possible," explains Marion Tegethoff. Further analysis has to show to what extent these results obtained in the U.S. can be applied to other countries. So far, many countries lack studies that could help to answer this question.
Marion Tegethoff, Esther Stalujanis, Angelo Belardi and Gunther Meinlschmidt
School mental health services: signpost for out-of-school service utilization in adolescents with mental disorders? A nationally representative United States cohort.
PLOS ONE. Published: June 09, 2014 | DOI: 10.1371/journal.pone.0099675