Implementation and Outcomes of a National School-Based Mental Health Program for Middle School Students in Chile

Katia M Canenguez; Alyssa M Farley; Ana María Squicciarini; Anamika Dutta; Ariela Simonsohn; Juliana M Holcomb; Felipe Peña; Loreto Leiva; Talia S Benheim; Javier Guzmán; Michael Jellinek; J Michael Murphy

doi:10.1007/s12310-022-09541-2

Implementation and Outcomes of a National School-Based Mental Health Program for Middle School Students in Chile

School Ment Health. 2023;15(1):165-176. doi: 10.1007/s12310-022-09541-2. Epub 2022 Sep 20.

Authors

Katia M Canenguez^{1

2}, Alyssa M Farley³, Ana María Squicciarini⁴, Anamika Dutta¹, Ariela Simonsohn⁴, Juliana M Holcomb¹, Felipe Peña⁵, Loreto Leiva⁶, Talia S Benheim¹, Javier Guzmán⁴, Michael Jellinek^{1

2

7}, J Michael Murphy^{1

2}

Affiliations

¹ Department of Psychiatry, Massachusetts General Hospital, Yawkey 6A, 55 Fruit Street, Boston, MA 02114 USA.
² Department of Psychiatry, Harvard Medical School, Boston, MA USA.
³ Center for Anxiety and Related Disorders, Boston University, Boston, MA USA.
⁴ Department of School Health, Junta Nacional de Auxilio Escolar y Becas, Santiago, Chile.
⁵ Santiago, Chile.
⁶ Department of Psychology, University of Chile, Santiago, Chile.
⁷ Department of Pediatrics, Harvard Medical School, Boston, MA USA.

Abstract

Background: Chile's national school-based mental health program, Skills for Life (SFL), has demonstrated effectiveness in improving behavioral and academic outcomes in first- through third-grade students. The current study assessed the feasibility and outcomes of SFL's program for sixth- through eighth-grade students.

Methods: We assessed the percentage of students who participated in the program and longitudinal changes on teacher-reported Teacher Observation of Classroom Adaptation Re-Revised (TOCA-RR) scores, youth-reported Pediatric Symptom Checklist-Chile (PSC-Y-CL) scores, grade-point average, and school attendance from sixth to eighth grade (2016-2018) for SFL's workshop intervention. Linear mixed effects models analyzed the association between outcome variables and workshop attendance.

Results: Of the 30,649 sixth graders who attended the 754 participating schools in 2016, 28,204 (92.0%) were screened with the TOCA-RR. Of the 1829 students who screened at risk, 1344 had available workshop data for seventh grade, with 86.9% of them participating in most (≥ 7) workshop sessions. Workshop attendance was significantly associated with improvements in school attendance and peer relationships (a TOCA-RR subscale) in eighth grade.

Conclusions: With high rates of behavioral health screening and workshop attendance, this study demonstrated the feasibility of implementing SFL's middle school program on a national scale. Higher workshop attendance by at-risk students was associated with better school attendance and peer relationships in eighth grade, as well as better but not significantly different outcomes on other measures (e.g., teacher-rated school performance and aggressive behavior in the classroom). Overall, these findings provide preliminary evidence of the feasibility and benefits of SFL's middle school program.

Keywords: Adolescence; Classroom adaptation; Prevention; Psychosocial functioning; School-based mental health.

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