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• The majority (65 percent) of ChalleNGe sites surveyed considered cadets’ mental health disorders (e.g., depression, anxiety) during the application process.
• A significant proportion of cadets are taking medication for mental health disorders while completing ChalleNGe. The percentage of cadets taking medication ranges from 1 percent to 68 percent, with the majority of sites (22 out of 39) reporting at least 20 percent.
• There are substantial variations in counseling services across sites, including different staffing models, different ways for cadets to access counseling services, and different methods of providing services.
• Some counselors reported that counseling was integrated into the day-to-day operations at their sites, and counselors worked collaboratively with cadre and teachers to provide consultation on mental health issues among cadets, versus counselors whose work is a siloed activity.
• Although applicants with very serious mental health disorders are not admitted to ChalleNGe, parents and applicants do not always report a complete mental health history. Because counselors have very little time with cadets (e.g., between classes) and counselors often serve 50 or more cadets per class, counselors do not have the resources to provide long-term psychological counseling.

The National Guard Youth ChalleNGe program is a residential, quasi-military program for youth ages 16 to 18 who are experiencing academic or behavioral difficulties in traditional high school. Mental health disorders are an increasing concern among adolescents, and the youth served by ChalleNGe may be particularly at risk for mental health disorders. To better understand how ChalleNGe can support cadets with mental health disorders, RAND researchers conducted interviews with counselors from six ChalleNGe sites and surveyed 39 ChalleNGe sites about their counseling services and cadets’ mental health needs in 2019.

The survey found that the majority (65 percent) of the sites considered cadets’ mental health disorders (e.g., depression, anxiety) during the application process. In addition, a significant proportion of cadets are taking medication for mental health disorders while completing ChalleNGe. Counselor interviews indicated that there are substantial variations in counseling services across sites, including different staffing models, different ways for cadets to access counseling services, and different ways in which counseling services are integrated into a site’s day-to-day operations.

Based on the findings, the authors made four recommendations: (1) implement flexible staffing models that include at least one licensed counselor to meet the needs of the cadets and the sites, (2) establish an integrated counseling department in which counselors and other staff (e.g., teachers, cadre) work hand-in-hand to support cadets’ mental health, (3) partner with community mental health providers to train and support staff, and (4) use evidence-based counseling practices to ensure high-quality and effective mental health services.

• Chapter One

  Introduction

• Chapter Two

  Method

• Chapter Three

  Literature Review: School-Based Mental Health Services Provide a Public Health Approach to Cadet Mental Health

• Chapter Four

  Survey and Interview Results Suggest Common Cadet Mental Health Needs and Varied Models of Care

• Chapter Five

  Conclusions and Recommendations

• Appendix

  Survey Instrument