GAINESVILLE, Fla.  – Access to mental health services can be critical in bolstering the well-being of children, but research tells us African American and Black youth are at the greatest risk of having their mental health needs left unmet.

Joni Splett, associate professor in the School of Special Education, School Psychology and Early Childhood Studies, has received $5,845,320 from the Patient-Centered Outcomes Research Institute (PCORI) to examine strategies to best tackle this disparity within the elementary school setting.

Because African American and Black youth are twice as likely to utilize school-based mental health services compared with outpatient or specialty clinics, access to these services is crucial in addressing their mental health needs. However, to receive school-based services students must be referred by school personnel, and often students’ behavior is wrongly attributed to disciplinary challenges and not mental health challenges.

Joni Splett

Historically, there’s been a large gap in unmet mental health needs, and that’s particularly true for minoritized children,” said Splett, principal investigator. She also noted that African American and Black students are approximately 50 percent less likely to receive needed services than their white peers.

Children who do not receive necessary mental health supports have an increased likelihood of facing damaging life outcomes, such as exclusionary discipline, drug dependency and suicidality. To ensure students receive the interventions they need, Splett will work alongside co-principal investigator Colleen Halliday, assistant professor at Medical University of South Carolina, and study the effectiveness of two school-based strategies: a universal screening process and an equity-enhanced universal screening process.

The project will span 40 schools across two diverse school districts in Florida and South Carolina. Half of the schools will implement a universal screening process, where all K-5 students are screened for potential mental health needs. The other 20 will adopt the same universal screening process with additional enhancements for school personnel, including training on unconscious biases and mental health literacy and in-depth data review to identify and tackle relevant system-level inequities that may impact the referral process.

 Colleen Halliday

“If we can help educators, who are fantastic at teaching academics, if we can also help them recognize mental health needs and know how to refer, then we can reduce the discipline problems and increase access and mental health well-being,” Splett said.

Both conditions are designed to recognize underlying needs and improve outcomes for all students, but the equity-enhanced test group is expected to show even greater improvements for African American and Black students and their families.

“My focus is a lot more on how are we supporting and preparing educators and mental health professionals so that they create the environment that improves outcomes,” Splett said. “… It’s hard to sleep at night knowing how my kids — what their days are going to look like tomorrow — versus what I know occurs for other kids and what they’re experiencing. That doesn’t sit well with me, and I think that we can and should do better.”

Through a patient and stakeholder advisory board and community advisory board, families and stakeholders from school, community and mental health systems will play an active role in guiding the study and its efforts.

“This study was selected for PCORI funding not only for its scientific merit and commitment to engaging patients and stakeholders in research, but also for its potential to fill an important evidence gap and give people information to help them better assess their care options,” said PCORI Executive Director Nakela L. Cook, MD, MPH. “We look forward to following the study’s progress and working with the University of Florida to share the results.”

This funding award has been approved pending completion of a business and programmatic review by PCORI staff and issuance of a formal award contract. It is expected to be completed in 2026.

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PCORI is an independent, nonprofit organization authorized by Congress in 2010. Its mission is to fund research that will provide patients, their caregivers and clinicians with the evidence-based information needed to make better-informed healthcare decisions. For more information about PCORI’s funding, visit www.pcori.org.

The UF College of Education, founded in 1906, consistently ranks among the top 25 public education schools in the elite Association of American Universities. The college encompasses three different schools with 28 bachelor’s and advanced degree programs, within nine academic specialties. With several centers, institutes, affiliates and initiatives, the college works to build a brighter future by preparing exemplary practitioners and scholars and working to solve critical educational and human problems in a diverse global community. Find more information at https://education.ufl.edu/.

Research reported in this article was funded through a Patient-Centered Outcomes Research Institute (PCORI) Award (AD-2021C1-22495). The views in this article are solely the responsibility of the authors and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute (PCORI), its Board of Governors or Methodology Committee.