School Mental Health Practice Research Articles

School social workers’ experiences delivering mental health supports amid COVID-19 school reopening

Child and adolescent mental health needs are at unprecedented rates in the continued wake of COVID-19. While prior research has examined school mental health practice during initial COVID-19 school closures, few studies have examined school mental health practice amid COVID-19 school reopening. This exploratory study investigates school social workers’ perceptions of their mental health service and support delivery during COVID-19 school reopening as well as the facilitators and barriers they experienced to delivering these supports. This study also examines school social worker’s perceptions of the mental health supports they wished were offered. Fifteen current school social workers in one southeastern state who practiced during the first full school year amid COVID-19 school reopening (2020–2021) participated in virtual interviews. Interview data were analyzed using a qualitative content analysis approach. Findings suggest crisis intervention and counseling were primary mental health services provided by school social workers during this time, and barriers to service delivery included the virtual format of service delivery, emerging experiences of burnout, and a lack of mental health providers. Facilitators to providing mental health services included collaboration with school and community-based partners and supervisor support. Participants wished schools had offered additional in-person mental health services and supports and expressed a need for additional school mental health professionals to be hired. Implications are offered for school mental health practice and research with the aim of helping to inform ongoing responses to COVID-19, future crisis response planning, and areas for improvement in current school mental health approaches.

Is it Influenced by Research?: A Policy Analysis of a Mental Health Strategy

To provide effective mental health support for students, school policies should be based on current research. This poses a great concern because historically, Canadian mental health policies do not rely on research (Nelson, 2012). This study investigates the mental health strategy (a type of policy) of a large public school board in Canada, to determine if the strategy aligns with current research on school mental health. To analyze the strategy, I collected current research about school mental health practices and tabulated the best practices into a checklist. I utilized the checklist to assess the mental health strategy. Overall, the strategy included 12 out of the 17 practices on the checklist, suggesting that the school board did a satisfactory job of incorporating research-based mental health practices. However, there is still room for improvement; input from students and staff can add value to the evaluation of the strategy.

Supporting School Mental Health Providers: Evidence from a Short-Term Telementoring Model.

BackgroundTo support student mental health, school staff must have knowledge of evidence-based practices and the capacity to implement them. One approach used to address this challenge is a group-based telementoring model called Extension for Community Healthcare Outcomes (ECHO). In other applications (e.g., healthcare settings), ECHO has been shown to increase healthcare professionals’ self-efficacy and knowledge of evidence-based practices leading to improved patient outcomes.ObjectivesThis study examined the potential for ECHO to be used as a method for increasing school staff engagement and knowledge of evidence-based school mental health practices.MethodsUsing a quasi-experimental design, this study compared outcomes across two professional development experiences aimed at promoting school staff ability to provide evidence-based mental health services. School staff from four school districts participated in a school mental health training initiative. All participants (N = 57) had access to asynchronous, online mental health modules. A sub-sample (n = 33) was also offered monthly ECHO sessions.ResultsTests of group difference in outcomes revealed significant increases in engagement with online learning (d = 0.58) and satisfaction (d = 0.82) for those who participated in ECHO as compared to those who did not. Knowledge about evidence-based practices was not significantly different between groups.ConclusionsResults suggest that group-based telementoring may be a promising approach for improving engagement and satisfaction with training initiatives aimed at promoting evidence-based school mental health practices. However, further study of ProjectECHO using experimental designs is needed to make causal inferences about its effect on provider outcomes.

Transforming School Mental Health Services Based on a Culturally Responsible Dual-Factor Model

In this article the authors advocate for a culturally responsible dual-factor model for the delivery of mental health services in the schools. This case is made because too many children are not receiving the mental health care they need in order to succeed in school and life. This is especially true for Black, Indigenous, children of color, and other minoritized youth. This transformative approach will require a dramatic change in how school psychological services are currently being delivered. The culturally responsible dual-factor model places a much greater emphasis on psychological well-being (as opposed to psychopathology), unwavering attention to rectifying discriminatory disparities in school mental health practices, an emphasis on population-based over individually focused mental health services, and a commitment to ensuring access for all children—not just those who are receiving special education services or 504 accommodations. This model is proactive and prevention oriented and focuses on equity. The case is presented that we continue to have a mental health crisis in today’s youth with an increase in anxiety and depression. The authors conclude the article with implications for school psychology training, public policy and advocacy, and school-based practice. Impact Statement The culturally responsible dual-factor mental health framework is a transformative approach to school mental health services that is needed to address the nation’s mental health crisis. It is needed because traditional approaches, models, and practices have been too narrow and, thus, continue to fail for diverse and minoritized children, families, and schools. A culturally responsible dual-factor mental health approach expands traditional approaches by emphasizing well-being, cultural strengths of minoritized communities, accessibility of services, and systems and structures (e.g., racism) that contribute to discrimination and disparities in mental health services.

School racial-ethnic discrimination, rule-breaking behaviors and the mediating role of trauma among Latinx adolescents: Considerations for school mental health practice.

Much of the literature linking adversity to trauma fails to account for racialized experiences, including racial-ethnic discrimination, which is a highly prevalent form of adversity for youth of color in the U.S. Adversity and trauma often result in students experiencing elevated rule-breaking behaviors, exacerbating existing racial-ethnic disparities in disproportionate school discipline. Drawing from race-based trauma theory, the present study explored trauma as a mediator of the longitudinal association between racial-ethnic discrimination from teachers, other adults, and students in schools and rule-breaking behaviors among Latinx youth. Data were from a longitudinal study of 547 Latinx students in a southeastern U.S. state. Across gender and nativity groups, school racial-ethnic discrimination and trauma positively predicted later rule-breaking behaviors. Additionally, for girls only, increased levels of trauma partially explained the association between school racial-ethnic discrimination and rule-breaking behaviors. The study highlights the importance of addressing school racial-ethnic discrimination and trauma in equitable school metal health systems. Indeed, efforts aimed at reducing disproportionate school discipline among Latinx students should focus on reducing their exposure to school racial-ethnic discrimination and increasing access to trauma-informed and restorative justice approaches.

What Happens When Training Goes Virtual? Adapting Training and Technical Assistance for the School Mental Health Workforce in Response to COVID-19.

The Northwest Mental Health Technology Transfer Center (MHTTC) provides workforce training and technical assistance (TA) to support evidence-based school mental health practices. Historically, this support targeted school professionals through in-person and online trainings, workshops, and coaching. However, in response to COVID-19 restrictions, all support moved to online formats, and the Center introduced trainings for families and caregivers. The purpose of this article is to present preliminary process and outcome data that compare the reach and impact of support before and following COVID-19-related restrictions. Results suggest that transition to online support resulted in a wider reach and a more diverse audience, with no decrease in trainee satisfaction and perceived impact. Furthermore, families and caregivers reported positive gains in knowledge and behaviors following participation in a virtual youth suicide prevention training. Together, these findings suggest that online training and TA can provide tangible benefits to professionals and family members who support student mental health.

The promotive effects of peer support and active coping in relation to negative life events and depression in Chinese adolescents at boarding schools

Mental health issues among Chinese adolescents in boarding schools have attracted the attention of researchers in recent years. Our study was to examine the relationship between negative life events and depression experienced by Chinese adolescents at boarding schools, and to study whether peer support and active coping would moderate the relationship between negative life events and depression. Questionnaires were administered in 2015 to a sample of 521 boarding school students (51.1% females) in two counties in Jiangxi Province, central China. The mean age of the sample was 13.47 years (SD = 1.04). The Adolescent Negative Life Event Scale, Peer Support Scale, Simple Active Coping Style Scale, and Children Depression Scale were used for data collection. Latent moderation structural equation (LMS) method was used to test the moderating effect of peer support and active coping on depression. Negative life events were related with more depression among boarding school students. Peer support had a negative effect on depression and active coping moderated the association between negative life events and depression. Peer support and active coping are important to relieve the adverse consequences of negative life events among boarding school students. School mental health practice that focuses on these factors may be helpful for boarding school students.

From evidence to impact: Joining our best school mental health practices with our best implementation strategies.

There is substantial research evidence for the effectiveness of school mental health strategies across problem areas, developmental levels, and the prevention-intervention spectrum. At the same time, it is clear that the education and mental health fields continue to struggle to apply this evidence at any level of scale. This commentary reflects on ways in which education-specific applications of implementation science principles - and explicit consideration of determinants of implementation success - may guide more consistent use of evidence in school mental health. After reviewing implementation determinants and strategies across multiple levels of effect (i.e., the outer setting, inner setting, individual, and intervention levels), the commentary goes on to recommend specific areas of needed attention in school mental health implementation efforts and research. These include a need to adapt interventions to better fit the context of schools, streamlining school mental health programs and practices to make them more implementable, and recognizing the critical role of assessment and selection of evidence-based interventions by school leaders. The commentary concludes by reflecting on the substantial opportunity provided by the education sector to both apply and advance implementation science.

Culturally Responsive Interviewing Practices

As communities and school populations continue to become more culturally, economically, and linguistically diverse, the need for comprehensive training and explicit guidelines for culturally responsive school mental health practices also grows. School Psychologists are both expected and ethically responsible to competently assess and serve diverse student and family populations, regardless of potential language or cultural barriers. The current article is focused on describing background and rationale for culturally responsive interviewing practices as they pertain to the roles and responsibilities of School Psychologists. Building on the guidelines and principles of the Cultural Formulation Interview (CFI), developed by the American Psychiatric Association, authors describe the potential applicability of the interviewing format for use with culturally and linguistically diverse students and families. Practical implications for use of culturally responsive interviewing strategies and culturally competent communication skills are discussed.

Testing the Psychological Wellbeing and Distress Screener with Turkish adolescents

ABSTRACTThis report presents initial psychometrics from testing a cultural adaptation of the Psychological Wellbeing and Distress Screener (PWDS) with a sample of urban adolescents in Turkey (N = 399). Results from confirmatory factor analyses indicated that responses to the Turkish version of the measure (PWDS–T) were characterized by a two-factor measurement model, and findings from latent variable path analyses indicated this same measurement model was predictive of youths’ responses to measures of domain-specific social support (i.e., peer, family, and school) and domain-general emotional functioning (i.e., positive and negative affect). Taken together, findings provide preliminary evidence suggesting the PWDS–T is a technically adequate measure of Turkish adolescents’ psychological wellbeing and distress, and therefore may be useful for school mental health screening purposes. Further research is needed to replicate and generalize these findings as well as to establish the classification utility of PWDS scores in school mental health practice.

Interventions for Young Bereaved Children: A Systematic Review and Implications for School Mental Health Providers

Many young children experience the death of a family member and they may be at risk for developing psychological and behavioral problems, but not much is known about how to help young children cope with such a stressful and painful experience. The purposes of this study are to identify the interventions for bereaved young children and examine the effectiveness of the interventions. A systematic review of the literature was performed to investigate the effects of interventions for preschool-age children (3–5 years) who experience the death of a family member. Seventeen studies that met the inclusion criteria for the purpose of this review were identified. All of the studies involved a small sample, and majority of the studies mixed preschool children with other older children in the sample. Play-based therapies were the most common interventions for grieving young children. Involving parents in the interventions, regardless of their therapeutic orientation, was a critical ingredient. Limited empirical evidence of positive intervention outcomes for preschool-age bereaved children was available. Surviving parents were seen as an important agent to help young children grieve and cope with the experience of loss. Implications for school mental health practice and research are provided.

Best Practices for Teaming and Collaboration in the Interconnected Systems Framework

ABSTRACTThe Interconnected Systems Framework (ISF) blends school mental health practices, systems, and resources into all levels of a multitiered system of supports (e.g., positive behavior interventions and supports). The ISF aims to improve mental health and school performance for all students by emphasizing effective school-wide promotion and prevention; early identification; and social-emotional, behavioral, and mental health intervention. Teaming is 1 of 3 foundational components of quality ISF implementation at school, district, and state levels. After introducing the ISF, the authors highlight the core implementation components (i.e., teaming, data-based decision making, and evidence-based practices) and then elaborate on characteristics of well-functioning ISF teams. The authors provide a case example to illustrate each characteristic and review 5 measures teams may consider using to evaluate their functioning and SF implementation.

Intentional, explicit, systematic: Implementation and scale-up of effective practices for supporting student mental well-being in Ontario schools.

Increasingly, the potential for school mental health programming to enhance the well-being of children and youth is being recognized and realized. When evidence-based practices in mental health promotion and prevention are adopted in a whole school manner, students show positive social emotional and academic benefits. These findings have stimulated a proliferation of mental well-being programming for Canadian schools, with variability across offerings in terms of supporting evidence, costs and ease of implementation. In the absence of coordination and guidance, there has been uneven uptake of high-quality programming, resulting in a patchwork of sometimes competing efforts across our country. In order to build cohesive and sustainable evidence-based programming, intentional, explicit and systematic effort must be afforded to matters of implementation and scale-up. In Canada, School Mental Health ASSIST has been developed to provide leadership, implementation support and embeddable resources to the province of Ontario’s 72 school districts, and 5000 schools, with a view to ensuring long-term sustainability of best-in-class school mental health practices. Key elements for uptake and scale-up are described, with an implementation science lens and an emphasis on aspects that are generalizable across jurisdictions.

The Functionality of Four Bullying Involvement Classification Schemas: Prevalence Rates and Associations with Mental Health and School Outcomes

The present study used the 2009–2010 sample of the Health Behavior in School-Aged Children Survey (N = 12,642) to investigate the incremental validity of four competing bullying involvement classification schemas, which differ as a function of relative rates of endorsing victimization and perpetration behaviors at school: the standard four-group model, an alternative four-group model, a nine-group model, and a sixteen-group model. The prevalence rates and associations with concurrent mental health and school functioning outcomes were explored for each of the four bullying involvement classification schemas, which were derived using a categorical analytic approach that relied on the same two self-report items—one targeting victimization and one targeting perpetration—in the HBSC self-report survey. Results indicated substantially different prevalence rates among the four schemas and that schemas which differentiated between higher frequencies of perpetration and victimization involvement were associated with greater odds of being at risk of psychological distress, psychological well-being, academic performance, and attitudes toward school. Findings also suggested that a continuous approach to deriving bullying involvement classifications may be useful, yet preliminary post hoc analyses indicated that this approach would yield redundant results given the parameters of the present study. Implications for school mental health practice and future research are discussed.

Implementing clinical outcomes assessment in everyday school mental health practice.

Evidence-based assessment (EBA) has been shown to improve clinical outcomes, but this practice is frequently not implemented in school mental health practice. This article reviews potential barriers to implementation and offers practical strategies for addressing these challenges. Several valid and reliable tools for assessment are reviewed, and information is provided on clinical use. Case examples of EBA implementation in school mental health settings are provided to illustrate how these tools can be used in everyday practice by school mental health clinicians.

Exploring best practice teaming strategies among school-based teams: implications for school mental health practice and research

School-based teams are central to referrals, problem solving and decision-making in school mental health (SMH). Although the use of teams in SMH appears commonplace, research on these teams, however, is much more limited in scope. Using best practice teaming principles as a conceptual framework, this exploratory study examined the purpose, structure and function of 41 school-based service-delivery teams from 19 schools. Descriptive analyses revealed wide variations in teaming practices. Challenges related to youth and family members being involved in teams, as well as varied team leadership, were noted. In addition, teams discussed numerous topics as part of meetings. The discussion of data, however, was a topic that a limited number of teams discussed. Implications for SMH practice and research are offered.

Attention Problems and Peer Crowd Affiliation among Adolescents

This preliminary study explored the association between symptoms of attention deficit/hyperactivity disorder (ADHD) and self-identified peer crowd affiliation in a community sample of adolescents. Studying peer crowd affiliation in adolescents with ADHD is important to help clarify the nature of peer relationships and social functioning in this population. Participants were 41 adolescents aged 1117 who completed the lab-based study. ADHD symptoms were assessed using parent and teacher report, and peer crowd affiliation was based on self-report. Results suggested a negative relation between ADHD symptoms and affiliation with the Brains peer crowd, and a positive relation between ADHD symptoms and affiliation with the Jocks crowd. There was inconclusive evidence linking symptoms of ADHD to the Deviants or Populars peer crowds, perhaps because of the small sample size. The results have the potential to inform school mental health practices that seek to identity young people at risk for affiliating with speci...

Parent Involvement with African American Families in Expanded School Mental Health Practice

The positive impact of parental involvement on academic success has been well documented, but less is known about parental involvement with African American families. The studies that do exist often label African American families as uninvolved in their children's education. They often overlook the different aspects of participation that are critical to understanding the involvement of African American families. This article discusses the literature on African American parental involvement. Based on the Multicultural Counseling Competencies framework, an approach for working with African American families is described. Specific implications for practitioners working in expanded school mental health are provided.

Critical Factors and Strategies for Advancing Statewide School Mental Health Policy and Practice

The authors sought to identify factors and strategies critical to statewide advancement of school mental health (SMH) efforts from the perspective of states that have demonstrated innovation, achievement and investment in SMH practice and policy. The School Mental Health-Capacity Building Partnership (SMHCBP) 1 conducted three in-depth focus group discussions in each of four states with representatives from diverse stakeholders. Participants reported successes and challenges in developing and advancing local and state SMH policies, programs, and services. Qualitative analyses led to identification of ten critical factors to advancing SMH at state level. They included developing a vision and shared agenda for SMH, identifying feasible and sustainable funding models, and establishing effective accountability and outcomes monitoring of SMH efforts. Strategies to implement each factor were also identified by discussion group participants and SMH-CBP Steering Committee members. States and districts can employ ...

Readiness and School Improvement: Strategies for Enhancing Dissemination and Implementation of Expanded School Mental Health Practices

The primary purpose of this paper is to describe efforts to promote effective dissemination and adoption of an evidence-based school improvement model that incorporates expanded school mental health practices. A systematic readiness and capacity assessment process was used to identify and select pilot schools and school districts for participation in the Ohio Community Collaboration Model for School Improvement (OCCMSI: Anderson-Butcher et al, 2004, in press). In this paper we describe efforts used to incorporate assessment of readiness into selection, training, and implementation of OCCMSI, an evidence-based school improvement initiative. Assessments were used to ensure that pilot sites were ‘ready’ for adoption of the initiative and to promote attention to readiness and capacity as an integral part of the aims of the intervention. Assessments were based on the A-VICTORY model (Davis & Salasin, 1975; Robbins et al, 2003). Results from each readiness assessment were used to inform delivery of training and...