School mental health care coordination practices: A mixed methods study

Mental health services are increasingly being delivered within schools via a multi-tiered system of supports. Although care coordination, or the deliberate organization of activities and personnel required to facilitate care, is viewed as an imperative for meeting student needs in school, there is a paucity of research on practices for coordinating mental health care for students receiving intensive, Tier 3 services. With a national participant sample from the United States and a convergent mixed methods design, the purpose of the present study was to explore the nature of care coordination practices implemented by school mental health providers for students with intensive mental health needs. Through both survey (N = 163) and interview (N = 13) responses, school mental health providers indicated mental health care coordination practices are not systematized and follow informal, provider-initiated procedures. However, providers endorsed engaging in more than one type of care coordination practice at a time and highlighted the importance of communication practices for coordinating mental health care. We detail the prevalence and associations among reported engagement with (a) broad care coordination, (b) communication, (c) transition facilitation, and (d) information sharing practices, and describe subthemes for the qualitative theme: School transition planning for students with mental health needs is currently patchwork and requires effective collaboration. We discuss limitations, implications for practice, and future directions.