School Mental Health Research Articles

A Qualitative Study of School Mental Health Providers’ Experiences with Chart Notes: Perceived Utility, Burden, and Areas for Growth

A Qualitative Study of School Mental Health Providers’ Experiences with Chart Notes: Perceived Utility, Burden, and Areas for Growth

Implementation Science in School Mental Health: A 10-Year Progress Update and Development of a New Research Agenda

Implementation Science in School Mental Health: A 10-Year Progress Update and Development of a New Research Agenda

Multi-Level Adaptations to Promote Implementation of School Mental Health Literacy Programs: A Synthesis and Case Study

Multi-Level Adaptations to Promote Implementation of School Mental Health Literacy Programs: A Synthesis and Case Study

Teachers’ Experiences of Handling Students with Mental Health Issues: Implications for School Mental Health Programs

Teachers’ Experiences of Handling Students with Mental Health Issues: Implications for School Mental Health Programs

Amplifying School Mental Health Literacy Through Neuroscience Education

Children and adolescents face a wide variety of developmental changes and environmental challenges, and it is estimated that at least one in five children aged 3–17 will experience behavioral or mental health issues. This period of life coincides with major changes in brain structure and function that have profound long-term consequences for learning, decision-making (including risk taking), and emotional processing. For example, continued development of the prefrontal cortex in adolescence is a sensitive period during which individuals are particularly susceptible to risky behaviors, environmental stressors, and substance use. While recent advances in mental health literacy programs have paved the way for increased awareness of the benefits of mental health curricula in schools, these efforts could be greatly bolstered with support in basic neuroscience education in developmentally appropriate and area-specific content. Here, we provide a discussion on the basic structural and functional changes occurring in the brain throughout childhood, how this contributes to changes in cognitive function, and the risk factors posed by early life adversity, stress, and drug use. Finally, we provide a perspective on the benefits of integrating findings from the field of neuroscience and suggestions for tools to better equip students, teachers, administrators, and school mental health staff to provide new directions for addressing the mental health crises faced by millions of children and youth each year.

Potential Harms of Responding to Youth Suicide Risk in Schools.

The potential harms related to interventions for adults with suicide-related risk, particularly hospitalization, have been well documented. Much less work has focused on the potential harms related to interventions with youth struggling with suicidal thoughts and behaviors. Young people are most likely to receive mental health services in schools, which are recognized as meaningful sites for effective suicide prevention work. However, no overviews have conceptualized the potential harms to youth when schools engage in ineffective suicide prevention efforts. In this article, we discuss three prominent overlapping areas of potential harms: (1) privacy-related, (2) relationship-related, and (3) mental health-related. We then discuss key factors thought to influence the development and maintenance of these potential harms. We conclude by noting ways in which school-based mental health providers may attempt to reduce unintentional harms in this area, with an overarching goal of helping support school mental health providers and the youth they serve.

‘They don’t even teach you how to make money!’ What insights can marginalised young people provide into developing inclusive education policy?

Using data from a qualitative study exploring the intersections of school exclusion, mental health, and involvement in criminal behaviour, we explore young people’s experience of schools to inform consideration of how schools might be modified to help improve mental health and engagement, and take a more proactive role in safeguarding young people from contextual risks. We draw on sociological theories considering how inequity and disadvantage may be reproduced. Poor experiences of school create disengagement, perpetuate deep structural inequalities, and can act as a motivating force to gain status and money through the illicit economy. Broadening the focus in schools, away from the narrow pursuit of academia, to include more group-based and project-based learning; placing greater priority on life skills and vocational training; and focussing more on developing a sense of belonging through sports and arts may benefit all students, particularly those most at risk of exclusion. If the education system is to build stronger engagement with the most marginalised students, it must actively support them to achieve their priority to find (legitimate) means of earning money.

The association between teacher distress and student mental health outcomes: a cross-sectional study using data from the school mental health survey

BackgroundFew studies have examined the inter-relationships between teacher and student mental health. We aimed to examine associations between teacher distress and student mental health difficulties and if student perceptions of school safety moderate these associations.MethodData from 23,568 students in grades 6–12 and 1,478 teachers from 268 schools participating in the School Mental Health Surveys in Ontario, Canada, were used. Three-level (student, classroom, school) multivariable linear regression models were fit to examine associations between teacher distress and student internalizing and externalizing symptoms by elementary (grades 6–8) and secondary (grades 9–12) school. Statistical interactions were used to evaluate effect modification.ResultsSmall but statistically significant, positive associations were found between teacher distress and internalizing (b = 0.02; 95% CI [0.01, 0.04], p < 0.05) and externalizing symptoms (b = 0.03; 95% CI [0.01, 0.05], p < 0.001) among elementary students only. Student perceptions of school safety moderated the association between teacher distress and externalizing symptoms among elementary students, whereby the positive association was magnified among students reporting lower school safety.ConclusionsFindings from this study highlight the importance of concurrently addressing the mental health needs of educators and students. School safety represents a modifiable target for prevention and intervention efforts in schools that could serve to promote student mental health and mitigate potential risk factors in schools.

School District Discourse Coalitions and Equity-Focused Policy Innovations in Oakland, California 2020–2021

Purpose: To better understand how district leaders at urban school districts innovate and design policies, this study investigated how actors in one district, Oakland Unified School District, discussed ways to improve their education system at school board meetings during 2020 and 2021. Approach: The research used a case study approach to develop a process of inquiry, drawing on theoretical literature on innovation in social fields, empirical work on urban education reforms, and methodological considerations from critical social analysis techniques. It used a variety of qualitative methods to identify critical policy issues and policy innovations, and examined the way actors in two coalitions, each with a different approach to change, used discourse to convey their ideologies about racial equity and justice. Findings: District actors collaboratively designed and passed five innovative policies: school safety, remote learning, climate change, Black reparations, and mental health. While one group, the incumbent discourse coalition, focused attention on fiscal stability and closing underperforming schools, another, the challenger discourse coalition, conveyed strategies on improving schools and surrounding communities through new education policies. Though unexpected crises expedited innovation, the perspectives of the dominant culture were most privileged in the final designs of resolutions. Implications: By using broad theories and generalizable concepts this study shows how discourse in policymaking can be examined in other settings and illustrates ways similar school districts may innovate in their systems.

Utilizing the CFIR framework for mapping the facilitators and barriers of implementing teachers led school mental health programs - a scoping review.

Ample evidence has been generated regarding the effectiveness of school-based mental health interventions as part of the continuum of care for children and capacity building of teachers to deal with the emotional and behavioral challenges of students. The increasing trend of utilization of teachers as the natural support system of children and the huge financial impact of public health interventions highlights the need to review all available evidence regarding multilevel factors that facilitate or pose a challenge to the provision of School Mental Health Programs (SMHP) using teachers as providers. The current review aims to map extracted evidence under the Consolidated Framework for Implementation Research (CFIR) domains to support future implementation research on school-based mental health services. The scoping review included experimental, qualitative studies, and systematic reviews involving teacher-led mental health programs conducted in the school setting to improve the socio-emotional well-being of children and adolescents irrespective of time and geographical limitations. All (published and unpublished) evidence in English from Pubmed, Cochrane database of systematic reviews and clinical trials, Scopus, and Science Direct was searched using keywords and Boolean combinations and extracted using study designs, place of study, year of publication, sample size, and target population. A qualitative analysis of implementation facilitators and barriers cited by the studies was carried out and mapped on CFIR. This review identified barriers and facilitators of implementation across school-based mental health Programs in 29 studies. The major emerging themes were those related to the inner setting of the organization, the process of implementation, and the characteristics of individuals involved in implementation. These included the availability of structural characteristics, positive school culture, organizational readiness, committed leadership, and beliefs of the providers. Findings highlight the need for early assessment of contextual factors acting as barriers and facilitators and careful execution following realistic planning and stakeholders' engagement to ensure the success of SMHP.

Ways of Social Inclusion and Integration of Children with Autism in Secondary Education, Inside and Outside the School Context, In the Region Thessaly

The aim of this study is to advocate the aggregate development of the future adults with autism, in terms of social integration. Thus, in order to study the autistic people’s course of development through the interaction between primary and secondary education, it focuses on school-based as well as out-of-school activities and interventions used by special education stuff in the Thessaly region. 99 people (mental health providers, trainers and relatives of people with autism) took part is the research, which combines qualitative and quantitative methods aiming to shed light on different perspectives of the issue. Early intervention, customized teaching methods and inclusive education seem to be of great significance, while the need for creating restricted programs and school-mental health services networks, along with a proper resource allocation play a significant role in the socialintegration of autistic people.

The Effect of Screen Time and Positive School Factors in the Pathway to Child and Youth Mental Health Outcomes.

Beyond achievement, educational settings offer informal supports that may be critical for child and youth mental health. However, children's educational environments have experienced significant disruption with the coronavirus pandemic. School settings offer unique opportunities to support children's mental health, but research must identify powerful points of intervention. This study examined school factors (aspirations, perceived competence, sense of belonging, and emotional engagement) as predictors of children's mental health, and the potential consequences of increasing screen time in and outside of school. Participants (N = 707) were parents and their children (6-18 years) from community and clinical settings who completed prospective surveys about children's school experiences and mental health symptoms (November 2020-May 2022). Standardized measures of depression, anxiety, irritability, inattention, and hyperactivity were collected. Structural equation modelling tested longitudinal associations between screen time, school factors, and mental health outcomes. Positive associations between each of the school factors (B = 0.14 [SE = 0.04] to B = 0.43 [SE = 0.04]) suggested they may reinforce one another. Longitudinally, sense of belonging and emotional engagement at school predicted lower severity for symptoms of depression, anxiety, irritability, and inattention (B=-0.14 [SE = 0.07] to B =-0.33 [SE = 0.10]). Greater screen time was associated with lower aspirations and perceived competence (B = - 0.08 [SE = 0.04] to B = - 0.13 [SE = 0.06]). Results suggest that school factors beyond achievement may be key correlates of child and youth mental health. While curriculum expectations emphasize academic achievement, an investment in supporting positive attitudes and aspirations at school is also warranted.

Developing a High School Mental Health Action Checklist in Thailand: insights on perception and communication.

This study aimed to develop a mental health action checklist for high school students that emphasized the importance of readiness, safety, and good hygiene at work to enhance their mental health and prepare them for the workforce. In total, 949 students from public high schools in Bangkok, Thailand voluntarily participated in this study. The 15-item High School Mental Health Action Checklist was developed based on a literature review and a pilot study. We used the index of item-objective congruence (IOC) to verify the content validity of the Checklist and exploratory factor analysis (EFA) to establish its construct validity. The tool's internal consistency was estimated using Cronbach's alpha coefficient. The High School Mental Health Action Checklist had good content (IOC = 0.867) and construct validity. EFA revealed four factors that accounted for 46.5% of the variance. The overall reliability coefficient for the High School Mental Health Action Checklist was 0.788, and the reliability coefficients of the subdomains were 0.783-0.797. The Checklist will allow schools to develop an annual action plan for student mental health promotion activities, in accordance with public health guidelines. Our results indicate the High School Student Mental Health Action Checklist has good psychometric properties.

Training Needs for School Staff Supporting Students Returning to School After a Psychiatric Hospitalization

AbstractSupporting students returning to school after a mental health crisis often involves more training than many school staff members receive. With the increase in youth mental health diagnoses, there has also been an increase in the number of youth requiring psychiatric emergency department visits and hospitalizations. As such, this study employed a basic qualitative design to gather the perspectives of school staff who support students’ mental health about their experiences and training needs related to supporting youth returning to school after psychiatric hospitalization. Semi-structured interviews were conducted with 10 school mental health professionals or administrators. Thematic analysis was used to analyze the data. Three themes were identified: (1) most participants received minimal formal training in graduate school on hospital-to-school transition, (2) most participants learned about hospital-to-school transition on the job, and (3) participants made recommendations and identified specific training needs. Implications for training are discussed including a need for variety (e.g., some practitioners need basic training while others need more advanced training) and different format preferences (in-person may be preferred but online asynchronous is more convenient).

School mental health and psychosocial support practices in congressional District 1 Schools Division of Quezon City: Basis for an intervention measure

School mental health and psychosocial support practices in congressional District 1 Schools Division of Quezon City: Basis for an intervention measure

The Mediating Role of School Adaptation in the Impact of Adolescent Victimization from Bullying on Mental Health: A Gender Differences Perspective.

The primary aim of this study is to investigate the mediating role of school adaptation in the impact of adolescent bullying victimization on mental health, as well as the gender differences therein. These findings offer a novel perspective for parents and educators, aiding bullied adolescents in managing and addressing mental health concerns. The primary data source for this study was the 2020/2021 Adolescent Health Theme Database from the China Population Health Data Center (PHDA). The research sample consisted of high school students from 16 cities in Shandong Province. Descriptive statistics, reliability and validity testing, structural equation modeling, as well as mediation analysis and multiple group analysis were conducted using SPSS 26.0 and AMOS 26.0. School adaptation serves as a mediating variable between adolescent bullying and mental health. The model fit indices are as follows: GFI=0.946, AGFI=0.922, RMSEA=0.070, NFI=0.978, IFI=0.979, CFI=0.97. Even when considering gender, the model still demonstrates good fit. School bullying has significant negative effects on the mental health of both male and female victims (p<0.05). For female victims, the mitigating effect of school adaptation on mental health is slightly lower than that for males (-2.256). Regarding cyberbullying, male victims face a greater threat to mental health (-3.234), with a impact of -0.109 from cyberbullying on male mental health and -0.065 from school bullying on female mental health. The school is found to mediate between school bullying, cyberbullying, and mental health. Schools may play a greater role in improving female mental health than male mental health. The impact of campus bullying on female mental health is greater than that of cyberbullying, whereas the opposite is true for males. Enhancing adolescents' school adaptation levels helps mitigate the adverse effects of school and cyberbullying on adolescent mental health.

The Construction of High-Risk Student Leave and Return-to-School Process from the Perspective of Home-School Collaborative Education

Psychological crisis management is a critical component of school mental health education today. In recent years, psychological crises on campus have become increasingly prominent. However, the existing "home-school collaboration" intervention system is still lacking in comprehensive processes and systems, which can lead to issues such as unclear responsibilities, incomplete systems, vague procedures, and disconnection between home and school education when addressing psychological crises from the perspective of home-school collaboration. Therefore, this paper analyzes a student psychological crisis intervention case at our school and explores in detail the construction of a system for managing the leave and return-to-school process for high-risk students from the perspective of home-school collaborative education. It aims to provide institutional support for frontline teachers dealing with students facing psychological issues and offers suggestions for improving the management of high-risk students in schools.

Grow Your Own School Mental Health Specialists: A Policy Pilot to Address Behavioral Health Workforce Shortages in Schools.

The capacity of schools to address behavioral health concerns presents an emerging challenge, exacerbated by major shortages in the workforce. Schools across the U.S. are struggling to hire licensed behavioral health professionals, with additional barriers encountered when seeking to hire practitioners with experience in educational settings. In 2023, a school district in the suburbs of Columbus, Ohio, partnered with The Ohio State University to launch a "grow your own" policy pilot. The priorities focused on addressing workforce shortages and leveraging the experiences of current teachers/staff to support growing needs related to student mental health and well-being. More specifically, the district utilized COVID-19 relief funds to recruit, train, and transition 25 teachers/staff into school mental health positions by underwriting the costs of each professional's Master of Social Work (MSW) degree. Here, we (a) describe the district-university partnership and the processes guiding the implementation of the "grow your own" model, (b) distill preliminary findings about district needs regarding behavioral health, and (c) explore facilitators, barriers, and outcomes associated with learning among participants in the program. The findings from a district-wide staff survey indicated a high level of need for individual counseling, crisis intervention, and small group interventions. Additionally, qualitative interviews revealed that learning among the program's participants was facilitated by effective classroom strategies and specific learning experiences integral to the program's design. These facilitators supported key learning outcomes, including general social work knowledge, self-awareness, and therapeutic skills that are foundational for engaging with students, parents/families, teachers/staff, and the broader school community. This innovative policy pilot and training model demonstrate how universities and local educational agencies can partner to address workforce development challenges at the intersection of behavioral health and education.

What makes a successful whole-school mental health intervention? A comparison of stakeholders’ perspectives and implications for schools and the future of English education

ABSTRACT This small-scale study compares stakeholders’ perspectives regarding what makes a successful whole-school Mental Health Intervention. Four study groups were included from an all-ability coeducational secondary school in south-east England: Students (n = 8), Teachers (n = 5), School-Leaders (n = 3), and YMCA Youth Workers (n = 3). Students took part in a focus group whereas the adult groups participated in semi-structured interviews. Subsequently, all participants ranked potential aspects of what might make a successful whole school Mental Health Intervention. No theme was mentioned consistently across the four groups, suggesting a diversity of perspectives regarding the benefits of Mental Health Interventions. All participants, except teachers, valued student involvement, a feature confirmed by the literature. Teachers occasionally adopted misinformed perspectives – arguably a result of insufficient training. Generally, participants’ job roles informed their responses. However, a loose trend existed whereby School-Leaders’ results were more aligned to an external charity association – the Young Men’s Christian Association (YMCA) – than Teachers’ despite the fact that the Teachers and School Leaders worked in the same context. Although the single context and small sample sizes for this research compromise generalisability, there are clear recommendations to inform future studies and for those who are leading and providing whole-school Mental Health Interventions. This study is set within the political and policy contexts of a competitive, market drive English education system and can comment on the wider system within which this intervention nests.

Experiences of Young People in Ireland with the Mental Health of Youth Story (MYSTORY) Photovoice Study

ABSTRACT The Mental Health of Youth Story (MYSTORY) study is a community-university partnership study which involved photovoice and consultation with young people. The MYSTORY study aimed to: (1) better understand adolescents’ perspectives on youth and school mental health and suicide prevention, and (2) communicate insights to schools and the wider community. In this article, we explored adolescents’ experiences of engaging with the MYSTORY study. Reflexive thematic analysis supports the MYSTORY study as a youth-centered study, which involved reflection, discussion and sharing of mental health perspectives and experiences within the study and community contexts. Study engagement was associated with feelings of pride, accomplishment, and connection. This study makes a novel contribution to understanding adolescents’ engagement in photovoice research exploring youth and school mental health, from the perspective of adolescents. Findings are relevant to researchers in wider mental health fields and practitioners interested in mental health promotion and suicide prevention in applied settings.