Influences on Teacher Referral of Children to Mental Health Services

Sixty-four third-, fourth-, and fifth-grade teachers read vignettes describing boys and girls with (1) externalizing and internalizing disorders and (2) externalizing and internalizing problems of less severity. Teachers rated whether the child described in each vignette needed to be referred for mental health treatment and indicated whether they had referred a similar child for treatment. Teachers' ratings of need for referral did not differ for boys and girls, and there was no gender effect on the teachers' reported referral experience. However, teachers reported having referred more children with externalizing problems than with internalizing problems for treatment, even though they did not rate externalizing problems as needing referral more than internalizing problems. Such discrepancies are discussed in terms of the different effect of internalizing and externalizing problems on the classroom environment.