STUDENTS IDENTIFIED AS SERIOUSLY EMOTIONALLY-DISTURBED IN SCHOOL-BASED DAY TREATMENT - COGNITIVE, PSYCHIATRIC, AND SPECIAL-EDUCATION CHARACTERISTICS

In the continuum of services for students with emotional and behaviora l problems, school-based day treatment programs are at the point at wh ich maximum collaboration and coordination between school and mental h ealth is typically involved. With shared diagnostic and program respon sibility, a mutually identified student cohort, and frequent interacti on across agency boundaries, this interface between school and mental health presents a unique opportunity to examine diagnostic similaritie s and differences between the two systems. Archival record searches we re conducted to gather data regarding the diagnostic and treatment his tories of 85 children and adolescents served in two exemplary school-b ased day treatment programs in California. Findings suggest a signific ant lag time between first symptoms, referral for services, and treatm ent; marked instability of psychiatric diagnoses over time; and lack o f concordance between DSM diagnoses and IDEA SED characteristics. Thes e data raise serious concerns regarding the availability of prevention and early intervention services, even in locales striving to develop a coordinated system-of-care approach to treatment. They also raise qu estions about the integrity and congruity of the psychiatric and educa tional diagnostic systems utilized by school and mental health personn el.