School Nurses' Perspectives on the Implementation of a Behavioral Health Referral Process

Area of Science:

• Public Health
• Nursing
• Behavioral Health

Background:

• Rising youth behavioral health needs in the US highlight the critical role of school nurses.
• The District of Columbia Department of Health developed a standardized Behavioral Health Referral Process (BHRP).

Purpose of the Study:

• To assess the strengths and opportunities of the BHRP.
• To understand factors impacting the implementation of the BHRP.
• To evaluate the integration of school nurses into multidisciplinary teams for improved student behavioral health access.

Main Methods:

• Key informant interviews were conducted with seven school nurses and managers in DC schools.
• The RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework guided the assessment.
• Qualitative data were analyzed to identify perceived benefits and challenges.

Main Results:

• Nurses anticipate challenges such as managing competing priorities and overcoming stigma.
• The BHRP is expected to facilitate a more coordinated referral process.
• The process is anticipated to improve student linkage to behavioral health services.

Conclusions:

• The BHRP has the potential to enhance school-based behavioral health referral systems.
• Findings can inform the optimization of referral processes within comprehensive care systems.
• Addressing implementation challenges is key to maximizing the BHRP's effectiveness.