Advancing Evidence-Based Assessment in School Mental Health: Why Schools Should Implement Chartam Mental Health Planners
Evidence-based practice (EBP) in psychology means using scientific evidence to guide how we assess and help people. Evidence-based assessment (EBA) is one part of EBP. It involves using research and theory to decide…
What to assess
How to do it
How to use the information effectively
But what does EBA mean? It means turning mental health symptoms into quantitative data to assess a patient. One tool to help in this process is the Chartam Mental Health Planner. When students use this planner, they create data that shows the frequency and severity of their mental illness. By filling out the planner every day, students can answer assessments more accurately, allowing professionals to help them more effectively.
EBA is essential for various aspects of psychological practice. It is useful for diagnosing, planning treatment, and monitoring progress. Despite its importance, EBA is not used enough in clinical practice and research. This is because the mind acts more like a door than a window. This is to say that it is difficult to understand how mental illness changes over time for a patient. The Chartam Mental Health Planner helps with this understanding. The problem is that schools didn’t have access to this brand-new tool before 2022.
Mental health services are crucial, especially for young people. That said, there are limits when trying to access these services. Schools provide many services. 70-80% of youth receive mental health support. School-based services can mean several things, including…
About 63 % of schools provide prevention services
50% of schools delivering interventions
75% of schools provide school-wide programs to promote safe and substance-free environments
School personnel often deliver these services. Such personnel include school counselors, school nurses, school psychologists, and social workers. Schools, communities, and families need to work together to support students' mental health.
Providing mental health services in schools has several advantages. It's convenient for families, and it integrates with the school environment. It also allows professionals to observe and work with students in their everyday settings. However, there are challenges in implementing EBP in schools.
EBA in schools can help the schools and other organizations collaborate better. It can also help them understand the needs of students. It can improve the quality of services and lead to better outcomes. That said, there are practical and perceptual barriers to using EBA in the real world. One example includes time constraints and a lack of training.
Recent efforts tried to promote the use of EBA in school mental health. Still, we need more research to overcome the barriers and make EBA a standard practice.
"Advancing Evidence-Based Assessment in School Mental Health: Key Priorities for an Applied Research Agenda” is a research paper that proposes five priority areas for future research:
Identifying what to assess
Choosing the right assessment tools
Evaluating readiness for evidence-based assessment
Providing support for implementation
Making sure school mental health professionals use assessment data effectively.
In this article, we will focus on identifying what to assess, choosing the right assessment tools, and looking at the integration and utilization of the data.
So where does the Chartam Mental Health Planner come into play with these five priorities? How does it assist in the treatment process?
Table of Contents
Priority Area 1: Identify Assessment Targets
Include Assessment Targets Measuring Academic Outcomes
Include Targets Matched to Theory of Change
Priority Area 2: Select Appropriate Measures
Consider Pragmatism of Measures
Consider Nomothetic and/or Idiographic Measures
Priority Area 3: Investigate Organizational Readiness
Priority Area 1: Identify Assessment Targets
To create good evidence-based assessments (EBA) in school mental health, it's crucial to pick the right things to assess. Professionals do this based on research and theory.
But sometimes, it's not clear which things we should focus on assessing in school mental health.
Figuring out what to assess should come from what the school community needs. We should also consider other things that might affect how students thrive, like how engaged they are in their schoolwork or how their families are getting along.
The Chartam Mental Health Planner can assist in this process. If most students in a high school system use this tool to document their lives, routines, symptoms, and behavioral patterns, then schools will have better insight into the needs of their schools. This could mean hiring more mental health professionals or providing family counseling for enrolled students.
When we research this area, it should help clinicians decide what to assess in school mental health to give the right care.
Include Assessment Targets Measuring Academic Outcomes
Traditionally, when we assess how well someone is doing in therapy, we look at their mental health and how they're coping. This includes things like specific problems they might be having and how well they're functioning in general. These are important, especially in school mental health. After all, they're the most direct things we can help with.
But we also need to consider other things. We need to consider how well a student is doing in school. This is important because schools are places to help students learn and succeed. Many people believe that we should think about a student's academic performance as part of their mental health assessment. This means looking at how well they're doing in subjects and how they feel about learning.
We can measure how they feel about learning using the Chartam Mental Health Planner. Each month, a student can color code their mood related to each of their courses. In the indicator log, a student would simply need to write down each of their subjects as an “indicator”. Each day, they would color in the respective square with the correlating mood’s color.
It's essential to understand the connection between mental health and school performance because they often influence each other. If a student is struggling with their mental health, it can affect their grades and attendance. On the other hand, if they're doing well in school, it can boost their mental health.
To measure academic success, we can use various things, like checking how students are engaging with their schoolwork, their attitudes toward learning, and their academic self-confidence. We can also look at their grades, attendance, and the overall school environment. What we measure can vary based on the student's age and the focus of the school's mental health program.
A student can document all of this in the Chartam Mental Health Planner. Students can document things like…
How they feel about classwork
If they attended school that day
If they got detention or a form of suspension
Intrusive thoughts about themselves
If they felt bullied or isolated
Academic achievements like grades
Recent research shows that school mental health programs can help improve students' academic and educational outcomes. They found that these programs can make a real difference in how well students do in school.
But even though it's crucial to consider academic outcomes, many studies about school mental health don't include them. Some focus on skills or behaviors, like attendance. They rarely look at students' attitudes or beliefs about learning. So, even though we know it's important to measure both immediate and long-term academic goals, not enough research does this. There's an opportunity for more research in school mental health to pay attention to academic outcomes and use them to improve the programs.
Include Targets Matched to Theory of Change
We should not just pick what to assess based on the results we want from treatment. We should also think about how we get there.
The theory behind our choices should consider not only the main factors but also the things that might influence the outcomes. These factors could include…
How well doctors carry out treatment
E.g. sticking to the plan
What percentage of treatment a patient completes
How engaged the people involved are,
How many people it reaches,
If a patient can maintain health over time
We should also look at why the treatment helps with the specific issue we're targeting. This could involve understanding the thoughts or cognitive processes involved, or social factors that affect behavior. Some recent research started to identify what we should monitor and assess over time, but we still need more research to understand these strategies better.
Priority Area 2: Select Appropriate Measures
Lately, people noticed that using the typical means to measure emotions and behaviors in school mental health can be tricky. We can look at what other people say about how practical these measures are and whether we should use more general or individualized approaches to choose the right measures.
Consider Pragmatism of Measures
One crucial decision when choosing assessment methods for use in schools is whether they are suitable for the school environment and easy for the people involved to use. This is especially important because there are many practical obstacles to using these methods in schools. These barriers include…
Limited time to do the assessments
Lack of funds for services
The challenge of interpreting the data
The Chartam Mental Health Planner helps break down two of these three barriers. Because the students are filling out their indicator logs every day, the data is already available. If the clinician wanted the student to fill out a standardized questionnaire in addition to filling out the Planner, the student could do so with accuracy.
Additionally, because the nature of the indicator log is visual, interpreting the data is relatively easy. A mental health professional can easily see how mood changes over time, if a student is experiencing significant anxiety, or if their depression is changing.
There's a description of "pragmatic measures" that could help guide our choice. They list various features, some of which are “strongly recommended”, like using measures that are…
Relevant to the people involved
Not too burdensome
Actionable
Can show changes
Other criteria are "desirable", like…
Being broadly useful
Suitable for comparing with standard data
Unlikely to cause harm
Having strong scientific backing
Being based on a theory or model
A recent review looked at outcome measures for child and adolescent mental health. The study supported the idea of choosing pragmatic measures, especially for places with limited resources like schools. They focused on the criteria listed above, including being not too burdensome, relevant, scientifically sound, and standardized against normal data.
They found twenty available measures that met these criteria, including ones for general mental health, like…
The Strengths and Difficulties Questionnaire (SDQ)
The Brief Problem Checklist (BPC)
The Spencer Children's Anxiety Scale (SCAS)
The challenge with these assessments is that they rely on memory. Patients might not answer the questionnaires accurately because the brain isn't designed to hold onto memories.
There's also a phenomenon known as "transience." Memories tend to fade over time. Some memories stay fresh in our minds, while others slip away. We often forget when events occurred and their timeline. Transience means that memories become less accessible as time passes.
For instance, questions like, "How many panic attacks did you have in the last month? Did you experience more or fewer thoughts about death this month compared to last month? What was the intensity of your desire to self-harm, and how did it change over time?" can be challenging for our brains to answer accurately. This makes measuring psychiatric symptoms a difficult and unreliable task.
Chartam Mental Health Planners addresses this issue. Users record events as they occur. By using a Chartam Planner, patients can describe the severity of their depressive symptoms accurately. They don't have to rely on memory to recall all their symptoms since the last questionnaire. Patients create a continuous record over time, enabling them to provide accurate answers to symptom rating scales.
Consider Nomothetic and/or Idiographic Measures
When it comes to choosing the right measures for EBA in school mental health, we need to think about two important factors. We consider whether we should collect data in a "nomothetic" or "idiographic" way.
Nomothetic assessment means using individual data to compare with data from large groups to classify or predict things. It usually involves asking everyone the same set of questions and scoring them using standard guidelines.
In the context of schools, nomothetic measures help us monitor a student's progress based on age or grade standards. This is similar to how most academic assessments in schools work. They also allow us to combine data to see how well a program is working for a group of students over time.
On the other hand, idiographic assessment means measuring specific variables tailored for an individual to make the information as relevant as possible. Instead of comparing data to a standard group, it's compared to the individual's own previous data points.
The Chartam Mental Health Planner falls into the latter category. Each day, a student fills out their indicator logs. This creates data for clinicians to understand what happened during that 24-hour period. Once a few weeks pass, clinicians compare each day to the next, This helps them understand trends in behavior. Trends could include improvements in mental health or the opposite: a decrease in mental wellness.
It's become clear that we need more idiographic assessments in schools. These assessments are important because they consider…
Cultural factors
Individual change
Differences between people
In school mental health, idiographic assessment aligns with some familiar measurement practices. Individualized education plans and cognitive-behavioral therapy are a few examples. Recent evidence suggests that both school-based clinicians and students may prefer idiographic assessments over standardized ones.
Priority Area 3: Promote Integration and Utilization of Assessment Data
Schools have a lot of information about students. They aim to make decisions based on this data. They're also under pressure to prove that their efforts are producing results.
However, the problem is that, in many cases, this student data isn't put to good use within the school. There are several reasons for this, including limited time, resources, and support for school staff. There is also the absence of comprehensive data systems. All of these things can hinder the meaningful and effective use of data in schools.
To make better use of data in schools, we can learn from research that looks at how we develop and improve data systems.
Develop and Refine Data Systems
To make the best use of assessment data from EBA in schools, we can improve the systems for collecting, using, and sharing this data. These systems, often called "measurement feedback systems" (MFS), can help clinicians work with data more effectively. There is a link between MFS and better care.
The Chartam Mental Health Planner is one such MFS. It helps clinicians understand students’ mental health and academic needs. The planner is an easy-to-use system for collecting, using, and sharing data.
However, we still don't know much about how schools use these systems, such as…
Who uses them (like clinicians or teachers)
For what kind of services (like individual therapy or classroom support)
For different priorities (like attendance or school safety)
In theory, the Chartam Mental Health Planner could be useful for all of the above. It could help illustrate how classroom dynamics need to change or if a treatment plan is effective. There's a lot of potential for using these systems in schools.
Research on data systems is ongoing. For example, there are educational technologies like the Schoolwide Information System that help track disciplinary events and other educational data, and they generate reports to assist educators in making decisions. These systems are being used more and more.
Schools could also adapt these systems to support mental health services by considering both academic and school functioning, in addition to the usual mental health symptom changes.
Conclusion
Schools have the potential to make a big difference in improving the mental health of our kids. To do this, they need to offer effective services and support, which includes Evidence-Based Assessment (EBA). EBA helps us keep track of how students are doing, check if the treatments are working, and make sure everything goes as planned.
Schools can implement EBA by using Chartam Mental Health Planners in their everyday curriculum. By having students generate data in the indicator log, schools can gain a better understanding of things like…
Student mental health
Student success in academics
Social dynamics and bullying trends
We also need to work together with everyone involved in schools, like students, parents, teachers, and school staff. They can tell us what works best for them and how we can make EBA fit into their busy schedules.
It's important to share what we learn with others in the community and make it easy for everyone to use. By doing this, we can improve mental health care for students in schools and help them when they need it the most.
