This is discussed at length by Fusick and Bordeau (2004) "...school-based counselors need to be aware of the disturbing inequities that exist in predominantly Afro-American urban school districts, where nearly 40% of Afro-American students attend school in the United States" (Fusick and Bordeau, 2004) This again places emphasis on the need for mental health programs in these areas of concern. This is also related to findings from a study by McDavis et al. (1995) Counseling African-Americans, which refers to research that stresses the "...widening achievement gap between Afro-American and Euro-American students." (McDavis, et al. 1995)
An important study Laura a. Nabors, Evaluation of Outcomes for Adolescents Receiving School-Based Mental Health Services (2002) refers to the particular issue and problems experience at inner-city schools. The author states that, "School mental health (SMH) programs are an important setting for providing mental health services to adolescents, especially urban youth who typically face in- creased exposure to risk factors." (Nabors, 2002, p.105) This study explores the fact that the youth in many urban areas are often deprived of adequate mental health care facilities, which can result in serious health risks.
The study y places emphasis on the fact that "School mental health (SMH) programs may be an optimal avenue for providing services to these youth who other- wise might not receive treatment." (Nabors, 2002, p.105) This study was particularly interesting in terms of its results; which indicate that those adolescents in inner-city schools who received mental health care showed a significant improvement in their general academic and emotional functioning over a period of time. (Nabors, 2002, p.105) These findings also suggest that males tend to benefit in particular in terms of overall functioning. (Nabors, 2002, p.109)
There are a number or areas of this study that are of particular note and which tend to emphasize the necessity for mental health program in schools and among high-risk students. An important study that sheds light on the value and the need for these programs is Are School-Based Mental Health Services Effective? Evidence from 36 Inner City Schools (1999) by Armbruster and Lichtman. This study also indicates significant improvement among students in many developmental areas as a result of these programs.
A very useful resource in terms of understanding the general trends and areas that are in need of improvement in these programs is Educational Resilience in Inner-City America: Challenges and Prospects by Margaret C. Wang and Edmund W. Gordon (1994).This work make the following pertinent points.
The lives of many inner-city children and families across this country are indeed in disorder, and they are floundering, as are the community agencies to which they traditionally turn for help. As with all social problems and the modern morbidities of our time, children and youth in the inner cities are hit hardest. At a time when they should be learning more and developing broader competencies in better schools, the trend is disastrously otherwise. They should be provided with support for healthy development and constructively engaged in stimulating exchanges with the educational and cultural institutions of their community, but they are not.
Wang & Gordon, 1994, p. ix)
2. Problems faced by school-based mental health programs.
The literature on this aspect is extensive and is to be found in articles on general discussion on the subject, as well as in more specialized and focused studies. One of the central issues of concern in the literature is that there is evidence of possible negative stereotypes that exist within mental health programs that may impact on the efficacy of that program. As Fusick and Bordeau, state in their study, Counseling at- risk Afro-American Youth: An Examination of Contemporary Issues and Effective school-based Strategies (2004), multicultural counselor training programs face many challenges in actually enhancing multicultural competence; although multicultural training has been associated with counselors' self-perceived multicultural counseling competence and case-conceptualization abilities, little data currently exist to indicate whether and how this training impacts the actual work between counselors and diverse students (Fusick and Bordeau, 2004)
This problematic area also relates to studies that focus on accountability among counselors and effective measures to ensure positive results from programs. The verifiability of the results of these programs is another problem that is extensively discussed in the literature. These aspects are also linked in the literature to the problem of sensitivity to ethnic and cultural difference and to the social and historical context of many students. Fusick and Bordeau (2004) for example, refer to the many challenges that confront multicultural counselor training programs that are involved in enhancing multicultural competence. The training of counselors in various mental health programs is a cardinal problem area in the appropriate implementation of these programs. Furthermore, the comprehensive study by Fusick and Bordeau, citing research undertaken by Constantine (2001), states that, "... little data currently exist to indicate whether and how this training impacts the actual work between counselors and diverse students." (Fusick and Bordeau, 2004) it is enlightening to note that,
The ASCA National Model (2002) challenges school counselors and administrators to be accountable for their practice and to demonstrate the effectiveness of their work in "measurable terms," such as results reports, adherence to performance standards, and program audits." (Fusick and Bordeau, 2004)
The above references echo a general sentiment that is evident in much of the literature; which refers to the view that there is still a critical lack of sensitivity to ethical and cultural factors, as well as the social context of the students. As one study emphasizes, "To facilitate therapeutic relationships, competent Euro-American counselors serving Afro-American children must first be prepared to deal with their clients' historical hostility, feelings of mistrust, and fear resulting from 300 years of oppression." (Fusick and Bordeau, 2004) There is also, according to various studies, a need for the development of trust and for the reduction of any skepticism that might be felt or experienced by Afro-American students. (Harris, 1995)
Another important aspect noted in the above studies and in others is that while in theory many mental health counselors and professional are able to offer assistance and opportunities for at-risk students, yet in practice these counselors only make contact with these students after they have been in trouble and have been punished. The study by Fusick and Bordeau (2004) notes that this creates a problematic situation in that the mental health program takes effect at a stage which is sometimes too late in terms of the progression of the problem that the student might be experiencing. This study goes on to emphasize the point that mental health programs should implement a policy that facilitates interaction and rapport at an early stage with at-risk students.
Related to the above is the need for a development for ethnic identity and the "affirmation" of this identity. This is important as it is seen as a "...important correlate to academic achievement and social success..." (Fusick and Bordeau, 2004) There are many studies that emphasize the problematics of bias in mental health programs. A study by Bradley, C. (2001) entitled, a counseling group for African-American adolescent males. Professional School Counseling stresses the point that mental health counselors are often unaware of their biases.
In addition, there is another more general problematic area which is often cited in the literature. This refers to the social stigma that is still attached in some case to mental health problems. As Nabors, Reynolds and Weist, (2000) state in their study, Qualitative Evaluation of a High School Mental Health Program, (2000), "...the "stigma of being crazy" associated with treatment impedes student participation in therapy. "(Nabors, Reynolds & Weist, 2000, p. 1) This study therefore focuses on various ways and means of overcoming this stigma. There are also references to problem areas of a more practical nature, such as the incongruity between mental health programs and the environment and the context in which they function. A well written and insightful article in this regard is Commentary: Promoting Paradigmatic Change in Child and Adolescent Mental Health and Schools by Weist (2003).
Besides the literature that focuses on racial and ethnic aspects that can be problematic, there are also wide array of more practical aspects that have been identified in the literature as being problematic in the implementation of school-based mental health programs. One of these issues that is also emphasized by Fusick and Bordeau (2004) is the problem surrounding tracking. As this study points out, "School counselors also can assist at-risk students by consulting with other personnel to ensure that tracking practices, or placing students together in terms of academic ability, do not further discriminate and disenfranchise at-risk Afro-American youth." (Fusick and Bordeau, 2004) This also refers to a wide range of articles and studies that explore the debate surrounding tracking in the United States and the allegations that Afro-American students have been unfairly and disproportionately placed by school counselors into lower, remedial tracks, where they often remain and which also exacerbates…