CCBD’s Position Executive Summary on School-Based Mental Health Services

Abstract

[Image omitted: See PDF.]This document provides administrative recommendations of the Council for Children with Behavioral Disorders (CCBD) regarding the need for school-based mental health services (SBMHS) in schools ([Kern et al., 2017]). It includes (a) an introduction, (b) key considerations for successful SBMHS, and (c) recommendations regarding local, state, and federal administrative guidelines. Examples of specific recommendations are designated by italics.Consistent and compelling evidence indicates that the mental health needs of our school-age population are not being met and there is a need for SBMHS (e.g., [Forness, Kim, & Walker, 2012]). Although mental health services may be available outside of the school setting, such services are rarely utilized (e.g., [Langer et al., 2015]). The consequences of insufficient mental health services have been chronicled for decades and can be seen in the form of poor educational attainment, juvenile delinquency, compromised physical health, substance abuse, underemployment, and ultimately premature mortality ([Brooks, Harris, Thrall, & Woods, 2002]; [Cicchetti & Rogosch, 2002]; [Ghandour, Kogan, Blumberg, Jones, & Perrin, 2012]). In addition, youth mental illness has been estimated to cost society approximately US$247 million annually when factors such as health care, special education services, juvenile justice services, and decreased productivity are considered ([Centers for Disease Control and Prevention, 2013]).In the last 20 years, media has highlighted instances of school violence ranging from bullying to drug distribution to mass shootings. Comprehensive SBMHS can provide the structure to facilitate early identification, prevention, and intervention to prevent escalation of mental health issues in a timely manner (e.g., [Durlak, Weissberg, Dymnicki, Taylor, & Schellinger, 2011]). SBMHS are effective for families and children from varied cultural backgrounds and result in increases in prosocial behavior, appropriate classroom behavior, and academic achievement of participating students (e.g., [Harry, 2008]).Keys to Effective SBMHSProgrammatic ConsiderationsAdministrative support is necessary to build infrastructure, ensure efficient allocation and use of resources, enhance implementation with fidelity, and facilitate organizational management. The use of evidence-based practices is a critical expectation of SBMHS in that instructional practices should be supported by high quality research that offers empirical demonstration of effectiveness ([Weist et al., 2014]). With a focus on prevention, the initiation or worsening of mental health challenges can be mediated ([Anello et al., 2016]). A preventive approach relies on instructional procedures that teach the skills needed for healthy development and positive social interactions. Curricular components of a tiered intervention delivery system help educators target specific instructional strategies to students at different levels of need. Any instruction or intervention should reflect culturally responsive practices, particularly as racial and ethnic disproportionality have been documented in identification, as well as the types and quality of school-based special education and mental health services for students with emotional disorders ([Clauss-Ehlers, Serpell, & Weist, 2013]). Such practices would include specific teacher training in culturally responsive pedagogy and positive support strategies.Schoolwide PracticesAn essential schoolwide practice is regular and universal screening of all students to identify those with and at-risk for mental health challenges, rather than waiting the estimated 8 to 10 years to provide services after symptoms of mental illness first appear ([Lane, Menzies, Oakes, & Kalberg, 2012]). In addition, it is critical that schools have crisis plans and procedures that (a) define the events that are crises, (b) identify and train a crisis team, (c) determine how to assess trauma levels, (d) delineate how to access resources and support, (e) specify reporting procedures, and (f) include review procedures. …