While it is estimated that 12% of the general population in the United States under 18 suffers from a mental disorder, estimates of mental disorders among socially/economically disadvantaged children are as high as 20%. Unfortunately, these at-risk youth often do not receive the needed psychological resources because of a lack of appropriate and accessible mental health services, or because their families lack the transportation or financial resources to obtain mental health services. The purpose of the proposed study is to evaluate a school-based treatment program designed to meet the mental health needs of these children by providing a range of mental health services within the school. Children in need of services will be identified through a school-wide screening at 6 Metro Nashville Public Schools (3 elementary, 3 middle schools). Three additional schools will serve as non-host Comparison (no treatment program) schools, to determine whether the school-based program has school-wide """"""""diffusion"""""""" effects on children not receiving services. Children identified as in need of services will be randomly assigned to: a) a school-based counseling program; b) community-based counseling at a local community mental health center; or c) academic tutoring (no-treatment control group). Children dropping out of treatment from the community mental health center will serve as an additional """"""""no-treatment"""""""" comparison group in the study; a group of children not receiving services but identified as """"""""marginally in need of services"""""""" will serve as the comparison group for the Treatment versus Comparison schools. All subjects, as well as their classroom peers, will receive five assessments of their behavioral, emotional, and social functioning over the three- year course of the project. Analyses of these data will determine whether: a) the school-based program increases accessibility to mental health services; b) whether the program is as effective or more effective than a community-based program; and c) a series of secondary questions (e.g., whether parental psychopathology influences child outcome).
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