Impact of Medical-Educational Collaboration on School-Based Mental Health Support in Japan

In Japan, school-based mental health support is becoming increasingly critical, owing to rising rates of school non-attendance and suicide among students. However, barriers in accessing medical facilities remain high. In Nagoya, the "Children's Advocacy Committee" has implemented a medical-educational collaboration model. This study evaluated the impact of physician participation in school case review meetings and observation of outpatient consultations on the support skills of school-based professionals.

An anonymous self-administered questionnaire was distributed to 178 members of the Children's Advocacy Committee who participated in the collaboration program in fiscal year 2025. The participants rated the degree of change in their interactions with students, parents, and school and medical staff using a 5-point Likert scale.

A high percentage of the 155 respondents reported positive changes across all categories. In the case review meetings, 68% perceived positive changes in support approaches toward students. In outpatient observations, 72% perceived positive changes in support approaches toward parents. Spearman's rank correlation analysis revealed significant negative correlations between years of professional experience and the degree of perceived change, particularly for outpatient observations (e.g., students: ρ = -0.395, p < 0.01). This indicates that staff members with fewer years of experience perceived greater benefits from the program.

Both collaborative activities were associated with perceived positive changes in support approaches among school-based professionals. The clinical exposure provided by outpatient observations was particularly impactful for early-career staff. Establishing a tiered collaborative system tailored to professional experience can further strengthen school-based mental health support.