# The Outcomes of Mental Health Services for Students in Rural Schools

## TL;DR

This study shows that school-based mental health services in rural areas significantly improve students' emotional and behavioral health outcomes.

## Contribution

The study provides empirical evidence on the effectiveness of Tier 3 mental health services in rural schools.

## Key findings

- Over half of students had Borderline or Abnormal SDQ scores at baseline.
- Students showed significant improvements in total difficulties and emotional problems after services.
- High satisfaction with services was reported, but no significant changes in peer problems or prosocial behavior.

## Abstract

The location of mental health services in schools increases access for children and youth. This may be especially important in rural communities, where youth have more significant mental health needs and less access to services. Yet, few studies exist that explore the outcomes of student participation in school-based services. The present study evaluates student behavioral health needs and outcomes, as measured by the strengths and difficulties questionnaire (SDQ), of students (N = 43) participating in therapeutic mental health services (Tier 3) provided in three rural Midwest communities in the United States. At baseline, SDQ scores indicated that over half of students’ total difficulties scores fell in the Borderline or Abnormal categories, and over 40% of students demonstrated high needs related to emotional problems and hyperactivity. At the conclusion of services, students experienced statistically significant improvements in mean scores (compared to baseline) in total difficulties, externalizing problems, and internalizing problems, and on subscales measuring emotional problems, conduct problems, and hyperactivity. Significant differences were not found in the subscales measuring peer problems and prosocial behavior. High levels of satisfaction with services were also reported. Limitations and conclusions are discussed.