Model Development of School Mental Health Service: 1. A School-Based Study on the Emotional and Behavioral Problems of Elementary Students / 신경정신의학

ABSTRACT

As an initial step for promoting a mental health service for elementary school children, a school-based epidemiologic study on children's mental problems and their social background was conducted. The subjects were 3,021 students from 20 elementary schools in a rural community in Korea. The epidemiologic study consisted of two stages, initial screening using the Child Behavior Check List(CBCL) and a structured psychiatric evaluation. After the study, we received feedback from teachers and parents. The results were as follows 1) Initially, 251(8.3%) students with total CBCL score higher than 54 were selected as problem children. Among the 251 students, only 31 had completed a structured psychiatric evaluation, and 71%(22 students) of them met the DSM-III-R citeria of psychiatric disorders. 2) Attention deficit hyperactivity disorder was the most common problem in both sexes, followed by oppositional defiant disorder in males and depression and anxiety disorder in females. Other students also had borderline intellectual functioning, learning disorders, somatoform disorder, sleep disorder and obsessive-compulsive disorder 3) The socio-environmental factors that were significantly related with mental health problems were poor economic status and little education in parents, no family religion, and children living with their maternal grandmother or with a single parent. Students who had mental problems also showed low levels of social competence. 4) The feedback from parents and teachers showed that the stigma of mental disorders, limitations of available time, and a poor understanding and lack of knowledge on the par of parents and teachers were the major obstacles in mental health service. Based on these results, the future direction of research and practice of school mental health was discussed.