Students Identified as Seriously Emotionally Disturbed in School-Based Day Treatment: Cognitive, Psychiatric, and Special Education Characteristics

Abstract

In the continuum of services for students with emotional and behavioral problems, school-based day treatment programs are at the point at which maximum collaboration and coordination between school and mental health is typically involved. With shared diagnostic and program responsibility, a mutually identified student cohort, and frequent interaction across agency boundaries, this interface between school and mental health presents a unique opportunity to examine diagnostic similarities and differences between the two systems. Archival record searches were conducted to gather data regarding the diagnostic and treatment histories of 85 children and adolescents served in two exemplary school-based day treatment programs in California. Findings suggest a significant lag time between first symptoms, referral for services, and treatment; marked instability of psychiatric diagnoses over time; and lack of concordance between DSM diagnoses and IDEA SED characteristics. These data raise serious concerns regarding the availability of prevention and early intervention services, even in locales striving to develop a coordinated system-of-care approach to treatment. They also raise questions about the integrity and congruity of the psychiatric and educational diagnostic systems utilized by school and mental health personnel.