Improving School Mental Health via National Learning Collaboratives With State and Local Teams: Components, Feasibility, and Initial Impacts.

Stakeholders' Perspectives on the Recommendations of the President's New Freedom Commission on Mental Health

School mental health is increasingly recognized as an effective framework of care for enhancing access to high quality mental health services for school age youth. This article discusses the potential role that school mental health can play in helping to address the mental health needs of children and adolescents in foster care, a group with elevated risk for mental health and educational problems when compared to other children and adolescents living in high risk environments. A full continuum of school mental health services, from prevention to intervention, offers opportunities to reach these youth before academic and emotional-behavioral problems escalate. Benefits and challenges to providing services to youth in foster care through school mental health are discussed and next steps toward developing a training curriculum that addresses core competencies needed for effective school-mental health-foster care integration are addressed.

Teachers and other school staff are increasingly relied on to address student mental health in secondary schools in Ireland. As part of the Wellbeing Policy Statement and Framework for Practice (2019), the Department of Education set out the ambition to place the promotion of wellbeing at the core and ethos of all schools in Ireland by 2023. This study investigates secondary school staff’s experiences of addressing mental health in schools through qualitative analysis of open question data provided by n = 359 school staff. Reflexive thematic analysis was used to analyse the data, resulting in three themes. The themes highlighted the salience of mental health in schools, the wide variety of ways mental health is integrated in Irish secondary schools, and how mental health in schools can be a source of pressure for staff. The findings of this study suggest that staff, while generally positive towards mental health engagement in schools, do not feel adequately prepared to deliver this content to the extent expected of them. Findings are discussed in relation to the Wellbeing Framework as well as the existing international literature on school based mental health content, and implications for policy and practice are proposed.

This review examines the history and contemporary landscape of school mental health, describing evidence that schools are an essential component of the system of child and adolescent care and providing recommendations to advance this vital care delivery system. This literature review of scientific data and shifts to policy and practice in school mental health documents the evolution of collaboration between the education and mental health systems to support student mental health. This review describes best practices and provides examples for achieving the standards of the comprehensive school mental health systems model in states and local communities. Data demonstrate that multitiered systems of mental health support and services in schools, including mental health promotion, prevention, early intervention, and treatment, improve academic and psychosocial functioning and reduce risk of poor outcomes, including mental illness and school failure. Policy and practice shifts in the field reflect a movement toward integrating mental health systems into the education sector, including preparing the education workforce to promote mental health and to support early identification of and intervention to address mental illness. To create a full continuum of mental health supports for students, states and districts can draw on national best practices and state exemplars as they install multitiered systems of mental health supports in all schools, conduct universal student mental health monitoring, and coordinate school and community mental health systems.

Counseling self-efficacy (CSE), defined as one's beliefs about his or her ability to effectively counsel a client, is an important precursor of effective clinical practice. While research has explored the association of CSE with variables such as counselor training, aptitude and level of experience, little attention has been paid to CSE among school mental health (SMH) practitioners. This study examined the influence of quality training (involving quality assessment and improvement, modular evidence-based practices, and family engagement/empowerment) versus peer support and supervision on CSE in SMH practitioners, and the relationship between CSE and practice-related variables. ANCOVA indicated similar mean CSE changes for counselors receiving the quality training versus peer support. Regression analyses indicated that regardless of condition, postintervention CSE scores significantly predicted quality of practice, knowledge of evidence-based practices (EBP) and use of EBP specific to treating depression. Results emphasize the importance of CSE in effective practice and the need to consider mechanisms to enhance CSE among SMH clinicians.Keywords: self-efficacy, school mental health, evidence-based practices, counselor training, depressionThere are major gaps between the mental health needs of children and adolescents and the availability of effective services to meet such needs (Bums et al., 1995; Kataoka, Zhang, & Wells, 2002). This recognition is fueling efforts to improve mental health services for youth in schools (Mellin, 2009; Stephan, Weist, Kataoka, Adelsheim, & Mills, 2007). At least 20% of all youth have significant mental health needs, with roughly 5% experiencing substantial functional impairment (Leaf, Schultz, Kiser, & Pruitt, 2003). Further, less than one third of children with such mental health needs receive any services at all.The President's New Freedom Commission on Mental Health (2003) documented the position of schools as a point of contact and universal natural setting for youth and families, recognizing schools as a key factor in the transformation of child and adolescent mental health services (Stephan et al, 2007). In the past 2 decades, there has been a significant push for full-service schools that expand beyond a sole focus on education, and employ community mental health practitioners to respond to the emotional and behavioral needs of students (Conwill, 2003; Dryfoos, 1993; Kronick, 2000). The education sector is the most common provider of mental health services for children and adolescents (Farmer, Bums, Phillips, Angold, & Costello, 2003), with 70%-80% of youth who receive any mental health services obtaining them at school (Bums et ah, 1995; Rones & Hoagwood, 2000). Therefore, attention must be paid to the quantity, quality and effectiveness of school mental health (SMH) services.School Mental HealthIn recent years, SMH programs, supported by both school staff (e.g., school psychologists, social workers, counselors) and school-based community mental health clinicians, have emerged as a promising approach to the provision of mental health services for students and families (Weist, Evans, & Lever, 2003). The growth of these programs has facilitated investigation of what constitutes high-quality SMH service provision (Nabors, Reynolds, & Weist, 2000; Weist et al., 2005). This work has been supported and furthered by the Center for School Mental Health, a federally funded technical assistance and training program to advance SMH programs within the United States. In collaboration with other SMH centers (e.g., UCLA Center for Mental Health in Schools) and interdisciplinary networks focused on school health, consensus was reached to develop a guiding framework defining best practices in SMH (Weist et al, 2005). These principles call for appropriate service provision for children and families, implementation of interventions to meet school and student needs, and coordination of mental health programs in the school with related community resources, among other things. …

Mental health concerns are on the rise among youth, contributing to a growing need for school-based mental health services. However, challenges to service provision arise due, in part, to workforce shortages, service fragmentation, and inefficient allocation of staff time. The current study describes the professional competencies and time allocation of four school-based mental health professions (i.e., school counselors, school psychologists, school social workers, and school nurses) in order to demonstrate how schools can leverage the skills of their existing staff to coordinate a comprehensive approach to support student mental health. First, we identified the core clinical competencies needed to implement the key features of comprehensive school mental health systems. Then, we crosswalked these clinical competencies with the training standards of the four professions. Finally, we conducted a systematic review of the literature to understand how these professionals’ time is allocated, as well as their responsibilities related to the provision of mental health services. Results demonstrated that, although all four professions receive training in most of the core competencies needed to implement comprehensive school mental health services, their skillsets are often underutilized in day-to-day practice. Thus, we concluded that there are at least two untapped opportunities for school leaders to support student mental health—first, maximize the use of school mental health professionals through task-shifting (i.e., reassigning tasks less central to mental health service delivery to other staff), and second, implement an integrated model of school mental health services to efficiently leverage the mental health training of professionals.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12310-022-09535-0.

School engagement and mental health are frequently linked, but within-person associations over time are largely unstudied. Emerging statistical techniques can better gauge how longitudinal changes in school engagement or mental health influence individual-level outcomes. Two cohorts of students (recruited in 2017 or 2018) in 5 Los Angeles high schools completed baseline surveys at the high school transition and 3 annual follow-up surveys through 11th grade. Random-intercept cross-lagged panel models explored the strength and directionality of associations between school engagement (Student Engagement Instrument) and mental health (Mental Health Inventory). Among 431 participants, we observed between-person and within-person correlations between school engagement and mental health. Autoregressive effects of school engagement and mental health on future levels of these variables were identified, with more consistent effects in late high school. A single cross-lagged effect from mental health to school engagement across the high school transition was identified. Decreased school engagement may signal corresponding cross-sectional changes in mental health, presenting opportunities for monitoring and intervention. Changes in school engagement or mental health may influence later within-person changes in these constructs, but associations are likely weaker and less consistent than previously assumed based on techniques that conflate between-person and within-person effects. This study assesses bidirectional and longitudinal relationships between school engagement and mental health among rising high school students. Both school engagement and mental health impacted future levels of these variables with stronger effects observed in the later high school years. Relationships between school engagement and mental health were less frequently observed than in prior studies, with an effect of mental health on future school engagement seen only across the high school transition. Interventions that promote both school engagement and mental health may be particularly beneficial, and the high school transition may be a promising time to leverage these.

Adolescence is a critical period for the promotion of mental health and the treatment of mental disorders. Schools are well-positioned to address adolescent mental health. This paper describes a school mental health model, “School-based Pathway to Care,” for Canadian secondary schools that links schools to primary care providers, mental health services, and the wider community, enabling them to address youth mental health in a collaborative manner. The model highlights the fundamental role of mental health literacy, gatekeeper training, and education/health system integration in improving adolescent mental health, and enhancing learning environments and academic outcomes.

Mental Health Care Reforms in Latin America: Child and Adolescent Mental Health Services in Mexico

Understanding the Health and Well-Being of Early Adolescents Throughout the World: Findings From the 2017–2018 Survey of Health Behavior in School-Aged Children

What Is Causing the Ongoing Youth MH Crisis?

Teachers are the first line of contact for children for any concerns. They are crucial in identifying all health issues, including mental health issues. However, the teachers may not have adequate knowledge of the concerns with children's and adolescents' mental health in schools. School enrollments have grown in India at every level, from primary to higher secondary, and school dropout rates have steadily declined in recent years. In parallel, from the 2013 fiscal year to 2022, the pupil-teacher ratio consistently improved at all levels. Hence, school teachers play a vital role in students' mental health. The study aims to create a tool teachers may use to screen, identify, refer, and follow-up with adolescents' mental health enrolled in classes. The present study was carried out in four phases: literature search, focused group discussions with teachers, development and validation of SAMAT. The number of teachers is 110. The School Adolescents Mental Health Assessment Tool has ten items derived from the thematic analysis of the literature review, focused group discussions with teachers during the training session about general mental health awareness and adolescents' mental health concerns and inputs from 5 mental health professionals. The instrument displayed a high content validity index (S-CVI = 1) and high item-level content validity index (I-CVI: 1). Reliability was calculated using the Cronbach alpha reliability method. SAMAT has high I-CVI and S-CVI and good Cronbach alpha reliability. This tool will support educators in formally evaluating pupils by assisting with the screening, identification, initial mental health support, referral, and follow-up of adolescents with mental health concerns.

Background: The mental health od school-age children is of growing concern in many countries. School professionals require the competences and methods to intervene effectively to promote mental health in schools. Objective: The objective of this study was to describe school professionals’ perceptions of the competences needed and effective methods to promote mental health in primary schools. Design and setting: Qualitative study conducted in five European countries. Method: Multidisciplinary focus group interviews were conducted with teachers, school nurses, psychologists and social workers in Greece ( n = 2), Lithuania ( n = 3), Slovenia ( n = 2), Bulgaria ( n = 2) and Finland ( n = 2). Data were analysed using qualitative content analysis. Results: Competences perceived as required for mental health promotion in primary schools were related to (1) knowledge of child development and mental health among primary school age children, (2) skills such as communication and empathy and (3) teachers’ self perception as health promoters. Insufficient attention is currently given to the development of these competences in basic teacher education and ongoing professional development. Providing a safe and inclusive school environment for children and families, early intervention and the use of structured models of support were viewed as effective approaches to use. Digital tools, online materials, and online support were seen as having a valuable role to play in children’s mental health promotion. Conclusion: School professionals require multiple competences to undertake mental health promotion in primary schools. The development of these competences is best supported by basic and ongoing education. Teachers, school nurses, psychologists and social workers see mixed methods as likely to be most effective in promoting mental health in primary schools.

Impacts from mental illness are debilitating for children, their families, and their communities. Comprehensive school mental health can provide services for all children, while supporting the school’s broader mission of improving academic outcomes and reducing disruptive behavior and suspensions. Universal mental health screening in schools can be enhanced by allying families in this process and configuring viable mechanisms for evaluation and treatment. Schools can effectively provide comprehensive mental health care with multitiered supports adjusted to fit the frequently changing needs of students and their families. Evaluation of school mental health interventions can illuminate impacts on academic and peer functioning, impairing symptoms, and well-being. Thoughtful evaluation helps refine programming and clarify cost-effectiveness. School mental health sustainability necessitates coordinated funding across multiple systems and payers, including health, mental health, education, special education, and public (Medicaid) and private insurance.

The article reviews the dimensions of capacity-building as applied to the development and growth of effective school mental health (SMH) programs and initiatives. There has been considerable growth of SMH in the US and internationally, and this growth is being fueled by conferences and partnerships at local, regional, national and international levels. However, more comprehensive SMH, involving provision of a full continuum of mental health promotion, prevention, early intervention and intervention services for young people in general and special education is a relatively new and emerging field, and numerous challenges are being confronted as communities attempt to build capacity for it. Ideas for building capacity in SMH, along with opportunities to advance global dialogue and collaboration on the field’s advancement, are presented.