John S. Carlson - School Psychopharmacology: Translating Research into Practice

The Pediatric School Psychology series presents evidence-based research and practices for prevention, intervention, and treatment of pediatric health issues in school settings. As school psychologists and other educational professionals apply their skills to promote the social and academic success of all students, the information presented in each book in the series facilitates their efforts to understand various health and mental health disorders and target educational delivery to maximize success. Each volume in the series provides analysis by leading experts, who evaluate, synthesize and summarize key research findings and school-related considerations on a specific pediatric disorder. Volume authors critically assess the quality and scholarly design of the extant literature and provide readers with a comprehensive, in depth review of the topic. The information presented in each volume helps scholars and practitioners make informed decisions about identification, evaluation, and treatment of the pediatric health or mental health issue. The overarching goal of the series is to inform and facilitate efforts to enhance the health, mental health, and educational development of students.

More information about this series at http://www.springer.com/series/13561

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Students are only eligible for special education services if demonstratable school-related functioning deficits are present. This presents numerous challenges both ethically and professionally when working with interdisciplinary teams regarding diagnostic decision-making for those school-aged children with mental health disorders (e.g., ADHD, social anxiety) who are responding favorably to physician-prescribed psychotropic treatments. If the effects of medication treatment no longer result in significant functioning deficits in the school setting, does this mean that psychotropic medications can prevent a students need for more resource-intense special education services? If so, does this mean that it might be cost-effective for public school funding to go towards medication consultation by physicians and/or psychotherapy consultations by psychologists with such investments focused on reducing the cost of special education services through prevention efforts?

Siloed approaches to promoting childrens developmental functioning and care for when mental health challenges are present are not best practice. Schools, hospitals, physician offices, and community-based mental health centers often work in isolation around a childs mental health needs. The investigative report surrounding the Sandy Hook Elementary School Shootings provides a very clear example of the problems with these current siloed systems of care. Collaboration around integrative mental health treatment is best practice and aligns with the etiological complexity surrounding serious mental health disorders impacting children and adolescents. Mental health providers and systems of care must adapt to better meet the needs of children, families, and school systems serving children with mental health challenges. This is a public health issue. One with significant costs when inadequate siloed care is provided. What will it take to break down silos? How do we better integrate care across these silos, especially for our children and families most in need?

Health Service Psychologist training programs (i.e., clinical, counseling, school) rarely attend to the role of medications when preparing professionals in the area of mental health treatments. Evidence clearly indicates higher rates of psychotropic medication treatment utilization when compared to psychotherapy. Insurance, marketing, pragmatic barriers, misinformation/lack of information surrounding evidence-based treatments, family values, and other social factors play a role in treatment selection. Mental health professionals, especially those working in schools must seek out a balanced knowledge base across psychiatry/psychology and play an active role in disseminating evidence-based biopsychosocial practices to those in need. How do we better expose mental health professionals to all evidence-based mental health practices? What will it take to improve communication and consultation skills across school and community settings?