Date of Award

Spring 5-11-2018

Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Dr. Brian Barger

Second Advisor

Dr. Emily Graybill


INTRODUCTION: In the United States, approximately one out of five people experience a mental illness (CDC, 2018, SAMHSA, 2013) and half of mental health concerns start during adolescence (Belfer, 2008). Due to regular contact with children and adolescents, school-based mental health (SBMH) programs have emerged a promising solution to increase access to mental health services (Belfer, 2008).

AIM: This study aims to answer two questions. 1) Do participants in a school-based mental health program display a decrease in risk behaviors, as measured by the Child and Adolescent Needs and Strengths (CANS) assessment? 2) What intake measures predict a decrease in risk behavior at six months?

METHODS: This study is a preliminary analysis of an evaluation of a SBMH program being implemented in three rural school districts in the western part of Georgia. A Behavioral Health Assessment (BHA), the Columbia-Suicide Severity Scale (C-SSRS), and a CANS assessment are administered to students by school-based clinicians at intake. The CANS is followed up at six months. Primary research questions were answered using a non-parametric Wilcoxon-Sign Rank Test and a logistic regression.

RESULTS: The Wilcoxon-Sign Rank Test demonstrated a statistically significant reduction of student risk behavior. The final multi-logistic regression model included emotional lability, risk behaviors, emotional needs, and race. The logistic regression analysis indicated risk behavior, emotional needs, and emotional lability predictors of student risk reduction.

Conclusion: Findings from this study suggests that CANS can be utilized as an outcome measurement of risk behavior for student participating in a SBMH program. Furthermore, this study demonstrated that SBMH programs may be effective interventions for students in rural communities and adds to the growing body of literature which position SBMH programs as a promising intervention to increase access to mental health services for students in rural communities. Limitations of this study include possible therapist bias, lack of data, and generalizability of sample. Future research should continue to explore the impact of SBMH programs on student risk outcomes over time. In sum, this study provides preliminary evidence for the effectiveness of SBMH programs to meet student’s mental health needs and the utility of the CANS as an outcome measure.

Available for download on Monday, April 29, 2019