Evidence for the Effectiveness of a National School-Based Mental Health Program in Chile

A national school-based mental health program that is now reaching almost one quarter of all elementary school students in Chile appears to have produced significant improvements in both behavioral and academic outcomes, such as attention problems and school attendance, among participating students. The results of a study by a team of Chilean and U.S. investigators appear in the October issue of the Journal of the American Academy of Child & Adolescent Psychiatry.

J. Michael Murphy, EdD, of the Massachusetts General Hospital (MGH) Department of Psychiatry, senior author of the JAACAP paper, notes that this is the first study to document the positive impact of a large-scale pediatric mental health intervention using validated mental health measures and real-world benchmarks like end-of-the-year promotion and school attendance. “These findings suggest that school-based mental health programs could play an important role in achieving better educational outcomes for whole countries as well as individual children. Our findings also provide evidence that non-pharmacological interventions can be effective. ”

A multidisciplinary team of child psychologists, psychiatrists, pediatricians and educators from Chile consulted with some of the world’s leading child mental health experts to create a program based on the best available research, eventually adopting an approach that taught key mental health skills in a child-, parent- and teacher-friendly manner. Starting out in a handful of schools in 2001, the program is now offered in more than 1,600 schools.

First-grade students in participating schools are screened with surveys completed by their parents – a Chilean version of the MGH-developed Pediatric Symptoms Checklist – and by their teachers. The surveys ask about symptoms of anxiety, depression, attention and conduct problems, along with evaluating students’ disruptiveness, emotional maturity and concentration in the classroom. Children identified by the surveys as at risk for psychosocial problems are offered a series of workshops during second grade – ten for the students, three for their parents and two for their teachers.

The student workshops are led by psychologists or social workers and include innovative techniques for social and emotional learning – including physical activities and arts and crafts projects designed to teach children concepts such as respect for themselves and others, the importance of keeping their word and following directions. Both parent surveys – used to identify problems like depression that may not be evident in school – and teacher surveys are repeated for all students in third grade so that the impact of the program can be evaluated.

The current study began with a sample of more than 40,000 students who were screened in first grade. Of the approximately 4,000 who were identified as at risk for mental health problems and offered the ten-session group intervention during second grade, those who participated in a greater number of sessions showed significantly greater improvements in third-grade outcomes than did the at-risk students who participated in fewer sessions. The Skills for Life program also includes two other major components – mental health promotional activities in all schools and referrals to mental health specialists for children with the most serious problems – which were not the focus of this study.

Population of focus: Children in Chile

Links to resource:

Date: 2015

Journal: Journal of the American Academy of Child & Adolescent Psychiatry