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<p>More mental health intervention services are received in schools than any other child-serving sector. School mental health clinicians deliver mental health early intervention (Tier 2) and treatment (Tier 3) to students at risk of and with a wide array of disabilities in general and special education. Given the reach and range of their services, school clinicians should be supported to use evidence-based and data-informed practices. However, implementation of&#xa0;evidence-based mental health intervention&#xa0;practices in schools is unique to the&#xa0;school setting.&#xa0;We sought to understand measurement-based care (MBC) implementation determinants&#xa0;and implementation rates among school social workers in the context of a district-wide quality improvement initiative. MBC is the routine collection and use of student- and parent-reported progress measures to inform collaborative intervention decisions. A mixed method, single-arm MBC implementation study was conducted during the 2022–2023 school year with 31 school social workers in a Northeastern school district. MBC was supported by a multicomponent implementation strategy called Feedback and Outcomes for Clinically Useful Student Services (FOCUSS). Implementation determinants (i.e., barriers and facilitators)&#xa0;were assessed by clinician self-reported surveys at baseline, 3-, and&#xa0;6-month&#xa0;follow-up, and 9-month qualitative interviews (<i>N</i> = 11). Monthly implementation rates were assessed by monitoring measures entered in a feedback system. MBC was adopted for 78 students, with 12 out of 31 (39%) clinician completing one or more measures with at least one student. Some determinants differentiated “implementers” from “under-implementers,” and qualitative data underscored the importance of implementation supports tailored to the school setting. Our findings inform future MBC efforts in schools to serve students with or at risk of disabilities.</p>

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Clinician-Reported Determinants for District-Wide Measurement-Based Care Implementation in School Mental Health

  • 期刊论文

  • 发表日期：

    2025年9月25日

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  • E. H. Connors,
  • R. R. Ouellette,
  • S. Selino,
  • J. Tebes

摘要

More mental health intervention services are received in schools than any other child-serving sector. School mental health clinicians deliver mental health early intervention (Tier 2) and treatment (Tier 3) to students at risk of and with a wide array of disabilities in general and special education. Given the reach and range of their services, school clinicians should be supported to use evidence-based and data-informed practices. However, implementation of evidence-based mental health intervention practices in schools is unique to the school setting. We sought to understand measurement-based care (MBC) implementation determinants and implementation rates among school social workers in the context of a district-wide quality improvement initiative. MBC is the routine collection and use of student- and parent-reported progress measures to inform collaborative intervention decisions. A mixed method, single-arm MBC implementation study was conducted during the 2022–2023 school year with 31 school social workers in a Northeastern school district. MBC was supported by a multicomponent implementation strategy called Feedback and Outcomes for Clinically Useful Student Services (FOCUSS). Implementation determinants (i.e., barriers and facilitators) were assessed by clinician self-reported surveys at baseline, 3-, and 6-month follow-up, and 9-month qualitative interviews (N = 11). Monthly implementation rates were assessed by monitoring measures entered in a feedback system. MBC was adopted for 78 students, with 12 out of 31 (39%) clinician completing one or more measures with at least one student. Some determinants differentiated “implementers” from “under-implementers,” and qualitative data underscored the importance of implementation supports tailored to the school setting. Our findings inform future MBC efforts in schools to serve students with or at risk of disabilities.