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September 18, 2018
by Patricia Tomasi

‘Paraprofessionals’ An Important Mental Health Resource For U.S. School Children Living In Poverty

September 18, 2018 08:00 by Patricia Tomasi  [About the Author]

According to the National Center for Children in Poverty, 43 per cent of children in the United States live in low-income families. According to Children International, children living in poverty are more likely to suffer from mental health problems.

A new study published in the Journal of Community Psychology, (A qualitative study to explore paraprofessionals’ role in school-based prevention and early intervention mental health services), takes a look at the role of paraprofessionals in high-need communities.

Paraprofessionals act as liaisons between community mental health agencies, families and schools. Although they don’t have the same level of training as mental health workers or teachers, studies have shown that especially in immigrant and low-income communities, paraprofessionals play an important role in helping families navigate the mental health system.

For the current study, researchers looked at how School Family Liaisons (SFLs), paraprofessionals participating in the Partners Achieving Student Success (PASS) Program, perceived their role in high-need communities and how they defined their work in schools. The purpose of the PASS program is to promote positive parenting practices and children's engagement in learning.

“We are interested in how paraprofessionals, or community staff who are not mental health clinicians but are trained in a particular intervention, can help to address the long-standing problem in the U.S. of lack of access to mental health services,” study author, Dana Rusch told us. Rusch is the Assistant Professor of Clinical Psychiatry at the Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago. Angela Walden, Erika Gustafson, Davielle Lakind, and Marc Atkins also authored the study.

“In this study, we wanted to know more about how SFLs' define their role and how they describe their work with children and families living in high-need, low-resource urban communities. We thought this was critical to understanding the utility of a flexible service model, as reflected in the PASS Program services.”

Researchers conducted two focus groups with SFLs in Chicago, Illinois. One focus group included SFLs serving primarily Latino and immigrant communities, the other included SFLs serving primarily African-American communities. While the same questions were used for both groups, an additional question was added to the first group on working with immigrant parents given the makeup of the communities they served.

“First, we explored how SFLs described their role, experiences, and contextual knowledge (e.g., 'How would you describe your experience working with [immigrant] parents?'),” Rusch told us. “Second, we probed for deeper contextual meaning about how they defined their work with families within the school context.”

Researchers identified two themes which described broad perceptions of the paraprofessional role. First, there was a shared understanding of context whereby SFLs reflected the importance of their role in serving high-need communities and provided descriptions of their dedication and commitment to this role. Second, SFLs identified relationship-building as the key to engaging both parents and teachers/school staff in order to maximize their impact in the high-need communities they served.

“Paraprofessionals’ perceptions of ‘why and for whom’ services were needed were rooted in knowledge of both cultural and community factors that were important to meeting family needs,” Rusch explained to us. “According to our participants, being situated as community agency staff within schools positioned them as a resource within this setting. Therefore, they viewed themselves as ‘advocates’ and labeled their tasks and responsibilities in schools accordingly. These results generally confirm finding from our other studies that show how community staff are often uniquely capable of reaching families that professional mental health providers fail to reach.”

Rusch told us she and her colleagues were especially interested in the way the SFLs articulated their flexibility and commitment to working with families from their communities. They found that relationship-building was central to engaging parents in services, which is consistent with the literature on the importance of common factors and relationship-based processes in clinical services.

“We think paraprofessional staff are under-appreciated as bridges to families, especially in underserved communities,” Rusch told us. “We see their role as critical in efforts to transform community mental health services, for example, by facilitating engagement and finding innovative ways to make ‘key ingredients’ more contextually relevant to families.”

Rusch and her colleagues also think it is important that paraprofessionals’ perspectives are documented and represented in the research literature because they have a wealth of knowledge about the communities in which they live and work, and have been key allies for researchers’ work in underserved communities.

“Our results demonstrate the value of flexible service models, like the one we collaboratively developed for the PASS Program,” Rusch told us, “that leverage the unique attributes and skills of a paraprofessional workforce.”


About the Author

Patricia Tomasi

Patricia Tomasi is a mom, maternal mental health advocate, journalist, and speaker. She writes regularly for the Huffington Post Canada, focusing primarily on maternal mental health after suffering from severe postpartum anxiety twice. You can find her Huffington Post biography here. Patricia is also a Patient Expert Advisor for the North American-based, Maternal Mental Health Research Collective and is the founder of the online peer support group - Facebook Postpartum Depression & Anxiety Support Group - with over 1500 members worldwide. Blog:

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