Knowledge Access to Action: Care Extender Models to Promote Youth Mental Health in Under-Resourced Schools

Schools are often the de-facto site of mental health care, despite having inadequate human and fiscal resources to meet the growing need. Care extenders offer promise and opportunity to meet student needs by infusing evidence-based mental health kernels into their student support routines. This dissertation presents an academic-community partnership between university researchers and City Year Miami, the local site of a national education non-profit serving the nation’s fourth-largest school district. Collaboration included trainings (n = 20) for City Year Miami Team Leaders (TLs) and AmeriCorps Members (ACMs) serving the lowest performing students at some of the county’s highest-need schools. Trainings were designed to be mental health promoting and were iteratively revised throughout the years of the partnership. One set of trainings, Teach the Triangle, emphasized the Cognitive Triangle, a tool for understanding the interplay among thoughts, feelings, and behaviors, with the goal of bringing compassion and intentionality to their work. During the second year of the partnership, qualitative interviews were conducted with ACMs (n = 13; ~60 minutes) after the training series to explore, “What will it take to infuse mental health knowledge into routine practice?” Theoretical thematic analysis was informed by the Consolidated Framework for Implementation Research (CFIR), highlighting provider characteristics (self-efficacy, carry-in knowledge, attitudes, stress) and perceptions of mental health knowledge (relative ease and advantage; adaptability; complexity; cultural and contextual alignment with schools and youth served). Results illustrate the interplay between innovation and individual characteristics for infusing knowledge into schools via natural work routines. Implications about the role of care extenders, transportability, and workforce support are discussed.

Major Professor: Dr. Stacy L. Frazier