"Given the limited accessibility of traditional mental health services for children school-based mental health services are a tremendous vehicle for overcoming barriers to mental health care and meaningfully expanding the reach of supports and services for so many children in need," said lead author Amanda Sanchez, from the Florida International University.
"Treating children in schools can powerfully overcome issues of cost, transportation, and stigma that typically restrict broad utilization of mental health services," Sanchez added.
The findings of the study, published in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), are based on a meta-analysis of 43 controlled trials that collectively had almost 50,000 elementary-aged children participate in school-based mental health services.
The researchers examined the overall effectiveness of school-based mental health services, as well as the relative effectiveness of various school-based intervention models that differed according to treatment target, format, and intensity.
In addition to supporting the overall effectiveness of school-based mental health care, follow-up analyses revealed that school-based services targeting child behaviour problems were particularly effective, relative to services targeting child attention problems, mood and anxiety problems.
Moreover, treatments that were implemented multiple times per week were more than twice as effective as treatments that were only implemented on a weekly (or less) basis.
In the study, published in the journal Development and Psychopathology, children reported to have chronic health problems showed higher rates of mental illness at 10 years, and those health problems continued to be associated with poor mental health at the ages of 13 and 15.
"This research provides the strongest evidence of it to date in the years of late childhood and early adolescence. The difference chronic conditions make to mental health is concerning, and the first impact can be seen even before adolescence, in late childhood," said study author, Dr Ann Marie Brady from the Queen Mary University of London in the UK.
For the findings, the research team reviewed a sample of approximately 7000 children to investigate the occurrence of mental health disorders, including anxiety or depression, and chronic illness.
The measure of chronic illness was based on mothers assessing their child's health at 10 and 13. Since chronic conditions are defined as those that cannot be cured but can be controlled by medication and other therapies and may have little disease activity, this measure included children presenting with minor health problems.
The researchers found that children with chronic health conditions were approximately twice as likely at 10 and at 13 to present with a mental health disorder than the control group (children reported by their mothers to be 'healthy, no problems').
At age 15, children with chronic health problems were 60 per cnet more likely to present with such disorders.
To investigate this pattern further, the researchers looked at a subset of the children with chronic illness: those who had been diagnosed with asthma.
Asthma symptoms are generally mild and well-controlled. Nevertheless, researchers found that asthmatic children showed a similar pattern, having a higher rate of mental illness at 10, 13 and 15 than healthy children.
The study also reviewed what additional factors might account for the link between chronic conditions and mental illness. The sample was taken from the Children of the 90s study, which also contains information from parents and children about other issues including family functioning, friendships, children's activity levels, bullying and health-related absenteeism from school.
Researchers analysed which of these might contribute to mental illness rates among children with chronic illness.
They found that bullying and health-related school absenteeism emerged as the most significant additional factors for children with mental health issues.
Health-related school absenteeism was identified as the most consistent factor predicting mental health problems over time, the study noted.
(IANS)