(PS3-72) Improving Comprehensive School Behavioral Health and the Influence of Student Perceived School Climate

Abstract Text: There has been a growing recognition of the important for youth mental health services, particularly as mental health challenges among youth continue to rise and the demand for services increases across settings. Schools have emerged as an essential setting for early identification and integration of youth mental health services, leading to an increase in effective school behavioral health (CSBH) programs. Research suggests that there are a variety of factors at the individual, dyadic, or school level that can influence treatment outcomes for youth when involved in CSBH programs. One school-level factor, school climate, can vary substantially between schools and likely impact a student’s access to, benefit from, or the quality of mental health services provided. School climate is defined as quality, character, and perceptions of school life, and encompasses aspects such as the engagement of students and staff, a sense of safety within school, and the general environment for which learning takes place. To understand the influence of school climate on CSBH programs, we examined the association between school-level climate with aggregate individual conditional average treatment effects (ICATE aggregated at the school level) using the Bayesian Additive Tree Approach (BART) described by Hill and collogues (2022) within a larger randomized control trial. Using a comparison-control design, 22 schools with diverse populations across two states (Greenville, SC and Baltimore, MD), were randomized to one of two approaches to CSBH. Both groups included core-evidence based practices in CSBH, with the treatment group including additional stakeholder-recommended enhanced components. Extensive student report surveys were completed at intake, 3-, and 6-month timepoints, and included measures of social-emotional-behavioral (SEB) functioning and school climate. We evaluated the treatment effect heterogeneity using BART, estimating how aspects of school climate (safety, engagement, environment) influences the causal estimate of SEB functioning at 6-months. Results indicate that school climate predicted the aggregate (i.e. school level) ICATEs of the treatment group on students SEB functioning. The correlation between the aggregate ICATEs and school-level values on student safety, student engagement, and student environment, were X=.39, R=.74, R=.66, respectively. In each model, there was a negative linear trend indicating that, as school climate improved, the predicted effectiveness of the intervention also improved. The results of this study enhance our understanding of the impact of school climate on youth mental health treatment outcomes. This and future research regarding school climate and other school-level factors can inform the development of more effective ways to construct, implement, and improve CSBH programs and school mental health services overall.