The Design of School-Based Mental Health Services in the United States: An Analysis and Understanding of Policy Implications

This thesis first examines the history and contemporary landscape of school mental health, offering evidence for schools as an essential component of the child and adolescent system of care. It then provides contemporary discussion around the importance of design in public administration, as well as analyzes the current design model of school-based mental health services, including key actors, normative assumptions, and underlying conceptual models to demonstrate the outdated presumptions that have led to a model that is not designed to adapt to the unique needs of students, especially after the COVID-19 pandemic. Building on contemporary theory of design in public administration, I argue that the largely fragmented, decentralized, bureaucratic, complex, and underdeveloped design of school-based mental health services mainly developed in the 1970s and 1980s has reached its limits and cannot adapt to new societal variables. Lastly, I discuss said limitations of this model to argue for a conceptual and practical re-design of the current system of school-based mental health systems in the United States.