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abstract In response to PA-00-111, this application seeks to systematically enhance the quality, appropriateness and effectiveness of mental health services in schools. The last two decades in the United States have witnessed the progressive development of expanded school mental health (ESMH) programs, which provide comprehensive mental health care to youth in general and special education through partnerships between schools and community agencies. The Center for School Mental Health Assistance (CSMHA) is one of two federally funded centers to advance school-based mental health programs. Since its inception in 1995, the center has had a major focus on school mental health quality and for the past two years has been working to develop a set of 10 principles and corresponding quality indicators reflecting the vision of best practice for the ESMH field. Through a survey and interactive forums with school health, mental health and education staff nationwide the principles and quality indicators have been refined, and a quality assessment and improvement (QAI) intervention based on them has been developed. The study will involve ESMH programs in three locations: Delaware, Maryland and Texas. Within each program, through stratified random assignment we will assign ESMH clinicians in schools to either receive a systematic Quality Assessment and Improvement (QAI) intervention (targeted group: 35 clinicians in 40 schools) or receive an intervention on Staff Wellness Plus Information on the ESMH Principles (comparison group: 35 clinicians in 40 schools). In the proposed three-year study, clinicians in targeted and comparison schools will participate in the respective interventions in Years 1 and 2. Between groups (targeted versus comparison) analyses will be conducted on dependent variables of the quality of services provided by clinicians, clinician attitudes and behavior, satisfaction ratings provided by students, parents and schools staff, and student grades, attendance, lateness and discipline problems. Year 3 will focus on analyses, writing and broad dissemination of findings and lessons learned through the CSMHA's networks.
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