Education
School-Based Behavioral Health Services logic model
In a district of 9,800 students, the student-to-school-psychologist ratio is 1,960 to 1 and the average wait for an outside therapist is 7 weeks. Chronic absenteeism at the two middle schools reached 27%, and student surveys show rising anxiety and depression symptoms.
Inputs
- 4.0 FTE licensed school-based clinicians placed through a community mental health partner
- Universal screening tool and parent consent workflow
- Private counseling rooms at 6 schools
- Data-sharing agreement compliant with FERPA and HIPAA
Activities
- Screen students in grades 6-12 twice a year with a validated brief instrument
- Deliver individual and group therapy on campus during the school day
- Train teachers in a tiered MTSS referral protocol
- Coordinate with families and outside providers for students who need a higher level of care
Outputs
- 4,700 students screened each year
- 430 students receive on-campus clinical services each year
- 6,100 therapy sessions delivered annually
- 310 staff complete referral protocol training
Short-term outcomes
- Time from referral to first session drops from 7 weeks to under 10 school days
- 60% of students in treatment show reduced symptom scores at 12 weeks
Intermediate outcomes
- Chronic absenteeism among served students falls by 18%
- Office discipline referrals among served students fall by 20%
Long-term impact
- Improved graduation rates and course pass rates for served students
- District sustains clinician positions through Medicaid school-based services billing
Indicators and data sources
| Indicator | Source | Frequency |
|---|---|---|
| Depression and anxiety symptom scores | PHQ-A and GAD-7 administered by clinicians | Intake, 12 weeks, exit |
| Chronic absenteeism rate (missing 10% or more of days) | District student information system | Quarterly |
| Office discipline referrals | District behavior management system | Quarterly |
| Referral-to-first-session time | Clinical partner EHR | Monthly |
| Student-reported persistent sadness | Youth Risk Behavior Survey or state school climate survey | Every 2 years |
Assumptions
- Parents consent to screening and services at rates near the pilot year
- The state Medicaid plan continues to reimburse school-based behavioral health services
Programs this model suits
- U.S. Department of Education School-Based Mental Health Services grants (recompeted in 2025 under revised priorities)
- SAMHSA Project AWARE subgrants through the state education agency
- State school mental health and Medicaid school-based services funds
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