Global school mental health: Considerations and future directions

Abstract

Emerging themes This rich and varied compilation of descriptions of school mental health (SMH) interventions in 18 different countries around the world raises numerous issues for our consideration, now and in the future. It is clear that SMH, which up until recently has been largely limited in its scope and development to North America, Europe, and Australia/New Zealand, is rapidly expanding and the complexities of SMH conceptualization and applications that globalization brings are considerable. It is one thing, for example, to apply theoretically sophisticated SMH approaches in settings of relative wealth and socio-political stability; it is quite another to do so in settings of severe or absolute poverty and civil unrest. It is one thing to apply SMH approaches in settings where basic literacy and numeracy are well established, and quite another to do so where these are not. It is one thing to apply SMH approaches in settings where basic health and human rights conditions are reasonable, and quite another to do so where these are not. We have much to learn from how SMH is applied in non-Western settings and those lessons should inform us everywhere (Wei and Kutcher, 2012). This monograph has provided us with a glimpse of the depth and breadth of SMH initiatives globally. As such, it is, to our knowledge, the first such compilation. And, a number of themes have clearly emerged. First, it is clear that in some jurisdictions, sophisticated frameworks have been developed to help guide the integration of schools with mental healthcare provision, as well as to address a variety of in-school mental health domains – such as mental health literacy and mental health promotion, prevention, and intervention. For example, in the United States (systems of care approach), Turkey (therapeutic school consultation), Canada (school-based integrated pathway to care approach), and Singapore (the REACH program approach), the roles of schools in enhancing access to mental healthcare delivery, integrated with existing health system structures and functions, demonstrates how SMH can be applied to this purpose. Such models may become useful templates, not in terms of the specific structures that they have identified, but in the conceptual approaches that they provide.