Barriers to Learning: The Case for Integrated Mental Health Services in Schools

D. S. Lean & V. A. Colucci (2010). Barriers to learning: The case for integrated mental health services in schools. Plymouth, UK: Rowman & Littlefield Education. 120 pp., ISBN 978-1-60709-638-2 (paperback) Barriers to Learning: The Case for Integrated Mental Health Services in Schools, which brings timely attention to the issue of increasing pediatric mental health problems, presents a need for integrated mental health resources in the school setting. The title of this book accurately summarizes the focus of the work: the issues that impede student learning and the solutions necessary to improve student achievement. Although Michael Fullan, in his preface, suggests that this book is a must read for education reformers, I would encourage a read by individuals interested in pediatric health and education. As the authors point out, silos exist in the present education system and creating understanding of the barriers among concerned stakeholders and their agencies can be achieved by reading this book. The book, well organized into seven chapters, begins with a prologue where the authors capture the attention of the readers by presenting a vivid and realistic depiction of a typical school day in a non-integrated school system. The detailed account of each character, their behaviors and the particular barriers they faced, immediately drew my interest into the book. In the first chapter, the authors outline the increase in mental health issues and distinguish the two classifications of support services presently available: school-based and school-linked. Further, they define barriers to learning as a temporary or permanent factor, condition, or situation that obstructs or impedes academic progress, resulting in mild to severe effects. A detailed conceptualization depicts two types of barriers to learning, biological-psychological and environmental-circumstantial, as well as two types of outcomes, negative and positive. This conceptualization (represented diagrammatically) depicts how a reduction and prevention of barriers can ameliorate student symptoms and increase student achievement. Additionally, these authors argue that a broad base of professionals, situated uniquely in a school, is necessary to make accurate diagnoses and to recommend appropriate early interventions. The authors also recommend a universal preventative approach to target interventions, based on locally predetermined student needs. In the second and third chapters, the authors identify biological-psychological and environmental-circumstantial barriers to learning. The authors interestingly present the disorders and their descriptions in the order in which they are most likely to be referred, rather than by prevalence. They suggest that biological-psychological barriers to learning, which are the most common, are often the only barriers considered when students have difficulties because school systems are structured to primarily deal with these particular barriers. The author presents useful examples of environmental-circumstantial and biological-psychological symptoms, making the argument that more attention needs to be given to the former symptoms to protect against misdiagnosis and ineffective treatment. Along with describing inadequate interventions, the fourth chapter lists examples of negative outcomes (bullying, school refusal, addictions, early school leaving, suicide, and youth violence) that occur when students receive inadequate interventions to address barriers to learning. In addition to these outcomes, the authors propose that students who are not facing barriers to learning may experience a negative multi-ripple process whereby their academic progress is also compromised because of inadequately addressing other students' barriers. The fifth chapter of the book includes a brief literature review of present and proposed reforms in the education system, which more recently are driven by student achievement (through school leadership and pedagogy) and the mental health system. …

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