This Web site is a component of the SAMHSA Health Information Network
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This Web site is a component of the SAMHSA Health Information Network |
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This Web site is a component of the SAMHSA Health Information Network. |
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Survey of the Characteristics and Funding of School Mental Health
Services2002-2003
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Public reporting burden for this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of the collection of information, including suggestions for reducing this burden to SAMHSA Reports Clearance Officer; Paperwork Reduction Project (0930-0241); Room 16-105, Parklawn Building; 5600 Fishers Lane, Rockville, MD 20857. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this project is 0930-0241. Approval expires 10/31/2005.
The focus of this survey is on mental health interventions for students in your district. The following definitions are furnished for your convenience:
· Mental health interventions are defined as services and supports delivered to individual students who have been referred and identified as having psychosocial or mental health problems.
When answering questions about these mental health services, please include:
Ø Mental health services for all students, both special education and general education students.
Ø Mental health services supported by your district, both those provided directly by the district or schools, and those provided by community-based organizations with which your district or schools have a contractual or formal agreement;
Ø Mental health services delivered in district/school settings and in community settings, if provided through contract or formal agreements;
Ø Mental health services delivered by mental health staff (whether they are school-based, district-based, or community-based staff) if provided by organizations or providers with which the school or district has a formal agreement for services.
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If you have any questions about this questionnaire, please call the toll-free number at
1-866-373-1024 or email at: SchoolMH@abtassoc.com.
We would like to know how your district is organized to deliver mental health services to students. In particular, we are interested in whether your system for providing mental health services includes services for all students, both general education and special education students, or whether you have separate systems, one for general education students and one for special education students.
1. Which students receive district-supported mental health services?
q1 All students 9/
q2 Special Education students only
2. Where is administrative responsibility for district-supported student mental health services located? [Check all that apply].
q1 At the school district 10/
q2 At an Intermediate Unit, or Collaborative or Cooperative - An administrative unit 11/
smaller than the state which exists primarily to provide consultative, advisory,
administrative, or statistical services to local education agencies, or to exercise
regulatory functions over local education agencies. It may operate schools and
contract for school services. Where there is a supervisory union board, the union
is included as an intermediate unit.
q3 Each school administers its own mental health services 12/
q4 No unit has administrative responsibility 13/
q95 Other (Please describe) 16-17/_______________________________ 14-15/
18-19/
3. Are services for general education and special education students administered together by one unit or staff or separately by different units or staff?
q1 Together 20/
q2 Separately
q3 No unit has administrative responsibility
4. Which of the following statement(s) describe the arrangement for staffing mental health services for students in your district? [Check all that apply].
q1 Mental health staff are school-based (i.e. each staff person is assigned to an 21/
individual school and works only in that school).
q2 Mental health staff are district-based (i.e. each staff person is assigned to the 22/
district and travels to different schools to provide mental health services).
q3 Schools or clusters of schools determine what combination of staff meet their needs 23/
and assign staff accordingly.
q4 District operates a mental health unit or clinic that serves multiple schools. 24/
q5 Mental health staff are provided through contracts with outside providers. 25/
q95 Other arrangements. Please describe: 28-29/______________________ 26-27/ 30-31/
5. Are mental health services in your district budgeted separately from other education expenditures?
q1 Yes 32/
q2 No
6. Are mental health services for special education students budgeted separately from those for other students?
q1 Yes 33/
q2 No
q3 Not Applicable
7. The next series of questions ask about the sources of funding used to support mental health services for the students in your district.
In the first column please check either “YES” or “NO” to indicate whether or not your district uses the source for mental health services. For each funding source used, check if used for prevention activities, intervention activities or both.
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Is source used for mental health services? |
If Yes - Check if source used for… |
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Yes |
No |
Prevention Activities? |
Intervention Activities? |
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Federal sources |
a. Individuals with Disabilities Education Act (IDEA)
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q1 34/ |
q2 |
q1 35/ |
q2 36/ |
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b. Title I
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q1 37/ |
q2 |
q1 38/ |
q2 39/ |
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c. Community Mental Health Services Block Grant
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q1 40/ |
q2 |
q1 41/ |
q2 42/ |
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d. Title IV - Safe & Drug-Free Schools and Communities
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q1 43/ |
q2 |
q1 44/ |
q2 45/ |
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e. Safe Schools, Healthy Students Initiative
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q1 46/ |
q2 |
q1 47/ |
q2 48/ |
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State sources |
f. State Special Education Funds
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q1 49/ |
q2 |
q1 50/ |
q2 51/ |
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g. State General Fund
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q1 52/ |
q2 |
q1 53/ |
q2 54/ |
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h. Tobacco Tax or Settlement
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q1 55/ |
q2 |
q1 56/ |
q2 57/ |
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i. Lottery funds
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q1 58/ |
q2 |
q1 59/ |
q2 60/ |
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Local sources |
j. Local funds (taxes)
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q1 61/ |
q2 |
q1 62/ |
q2 63/ |
Service Reimbursement |
k. Medicaid reimbursement
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q1 64/ |
q2 |
q1 65/ |
q2 66/ |
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l. Third party payments (e.g. private health insurance, Tri-care)
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q1 67/ |
q2 |
q1 68/ |
q2 69/ |
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m. SCHIP
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q1 70/ |
q2 |
q1 71/ |
q2 72/ |
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n. Self-pay
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q1 73/ |
q2 |
q1 74/ |
q2 75/ |
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Private revenue sources |
o. Private foundation grants (e.g. Robert Wood Johnson Foundation, Casey Grant)
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q1 76/ |
q2 |
q1 77/ |
q2 78/ |
Other |
p. Other source of funding (Please describe) _____ _______________________________________79-80/
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q1 81/ |
q2 |
q1 82/ |
q2 83/ |
8. Of the sources listed below, please check which 5 are the top sources used for funding
mental health services.
q1 Individuals with Disabilities Education Act (IDEA) 84/
q2Title I 85/
q3 Community Mental Health Services Block Grant 86/
q4 Title IV - Safe & Drug-Free Schools and Communities 87/
q5 Safe Schools, Healthy Students Initiative 88/
q6 State Special Education Funds 89/
q7 State General Fund 90/
q8 Tobacco Tax or Settlement 91/
q9 Lottery funds 92/
q10 Local funds (taxes) 93-94/
q11 Medicaid reimbursement 95-96/
q12 Third party payments (e.g. private health insurance, Tri-care) 97-98/
q13 SCHIP 99-100/
q14 Self-pay 101-102/
q15 Private foundation grants (e.g. Robert Wood Johnson Foundation, Casey Grant) 103-104/
q95 Other sources of funding (Please describe) _____________________________ 107-108/ 105-106/
109-110/
9. Of your total expenditures for mental health services for all students, please estimate what percentage is allocated to each of the following. For each category not funded, enter a ‘0’. All sources combined should total 100%.
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a. Administrative overhead
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________% 111-113/ |
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b. Salaries for mental health staff
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________% 114-116/ |
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c. Contracts with community organizations or providers to provide MH services
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________% 117-119/ |
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d. Technical assistance, professional development and training
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________% 120-122/ |
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e. Other (Please list major categories)
________________________________________ |
________%
123-125/ |
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Total |
= 100%
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10. How are mental health resources directed to students in your district? [Check all that apply]
q1 On a per pupil basis (based on student enrollment) 138/
q2 Targeted to schools based on mental health needs of students 139/
q3 Resources are equally distributed to schools (regardless of size) 140/
q95 Other (Please describe)_____________________________________________________141-142/
143-144/
11. To what extent do the following restrictions impede the delivery and coordination of mental health services for students in your district?
(Check only one box on each line)
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Restrictions imposed by funding sources |
Not at all |
Minor extent |
Moderate extent |
Major extent |
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a. Restrictions on the location in which mental health services can be provided (on-site vs. in the community) |
q1 |
q2 |
q3 |
q4 145/ |
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b. Restrictions on types of mental health services provided
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q1 |
q2 |
q3 |
q4 146/ |
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c. Restrictions on types of staff who can provide services
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q1 |
q2 |
q3 |
q4 147/ |
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d. Limitations on the providers considered eligible to provide service
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q1 |
q2 |
q3 |
q4 148/ |
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e. Limitations on the number of sessions or duration of mental health services
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q1 |
q2 |
q3 |
q4 149/ |
Other funding obstacles
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150/ blank |
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f. Complexities of using multiple funding sources to fund mental health positions or programs
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q1 |
q2 |
q3 |
q4 151/ |
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g. Lack of administrative support for 3rd party billing for third party reimbursement
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q1 |
q2 |
q3 |
q4 152/ |
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h. Insufficient community mental health resources
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q1 |
q2 |
q3 |
q4 153/ |
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i. Competing priorities for use of funds (e.g. focus on improving academic achievement)
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q1 |
q2 |
q3 |
q4 154/ |
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j. Restrictions with insurance and HMOs |
q1 |
q2 |
q3 |
q4 155/ |
11. To what extent do the following restrictions impede the delivery and coordination of mental health services for students in your district?
(Check only one box on each line)
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Other Obstacles |
Not at all |
Minor extent |
Moderate extent |
Major extent |
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k. Barriers involving parents or guardians
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q1 |
q2 |
q3 |
q4 156/ |
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l. Resistance from non-mental health school or district staff
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q1 |
q2 |
q3 |
q4 157/ |
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m. Resistance from community
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q1 |
q2 |
q3 |
q4 158/ |
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n. Other obstacles (Please describe) ________________________________________160-161/ ________________________________________162-163/
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q1 |
q2 |
q3 |
q4 159/ |
12. Since the beginning of the 2000-2001 school year, what has happened to the level of funding for mental health services for general education students in your district? (Check only one box)
q1 Decreased 164/
q2 Remained the Same
q3 Increased
q4 Not Applicable
13. Since the beginning of the 2000-2001 school year, what has happened to the need of general education students for mental health services in your district? (Check only one box)
q1 Decreased 165/
q2 Remained the Same
q3 Increased
q4 Not Applicable
14. Since the beginning of the 2000-2001 school year, how has the provision of mental health services for general education students in your district changed in each of the following areas? (Check only one box on each line)
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Decreased |
Remained the same |
Increased |
Not applicable
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a. Number of mental health staff has: |
q1 |
q2 |
q3 |
q4 166/ |
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b. Number of general education students served has:
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q1 |
q2 |
q3 |
q4 167/ |
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c. Range of mental health services offered has:
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q1 |
q2 |
q3 |
