Expanded school mental health services: Assessing needs related to school level and geography

We surveyed 62 school administrators from three midatlantic (MD, VA, WV) an d one northeastern (CT) state on factors relevant to developing school-base d mental health programs. Administrators were from schools that varied on e ducation level (elementary, middle, and high) and geographic location turba n, suburban, and rural, with equivalent numbers in each subgroup. Administr ators provided ratings to questions grouped in five categories: (a) Stressf ul Conditions, (b) Internalizing Behavioral Problems, (c) Externalizing Beh avioral Problems, (d) Substance Abuse, and (e) Barriers to Mental Health Ca re, and provided open-ended comments on needs of youth and mental health pr ograms for them. They rated behavioral and substance abuse problems as prog ressively more serious as students advanced in school level. Urban youth we re reported to encounter higher stress and present more severe internalizin g problems than suburban or rural youth. Suburban and rural schools provide d more health and mental health services than urban schools. Across geograp hic locales, physical health services far outnumbered mental health service s. Findings related to barriers to mental health care, and the viability of schools as delivery sites for comprehensive mental health services, are di scussed.