School Mental Health Services Research Articles

School psychologists' training and experience in providing grief support

AbstractSchool‐based mental health professionals consistently report that they are either not prepared to support grieving students, or do not have time to integrate crisis intervention support into their hectic schedule. Given that inadequate school mental health services can increase a bereaved student's risk of developing emotional problems, it is critical that school psychologists increase their comfort in grief. This study surveyed 75 school psychologists in the Northwestern United States regarding their training and experience in grief support. A reflexive thematic analysis identified four themes related to the challenges and recommendations in grief support: lack of training, limited role of the school psychologist, lack of formalized grief response system, and lack of school and community resources. Furthermore, only 3% of participants reported taking the lead in providing grief support and 64% provide grief support fewer than five times a year. The majority (81%) reported that they had zero courses devoted to grief support during their graduate degree, with more participants (67%) obtaining grief training postdegree. Study limitations, areas for further research, and implications for schools and school psychologists are also discussed.

Embedding social emotional learning from the bottom up in multi‐tiered services and supports frameworks

AbstractStudent mental health needs continue to rise across the United States and many students and families rely on schools to provide services to meet these needs. Yet, an overwhelming number of available frameworks and approaches to school mental health (SMH) and overlapping terminology surrounding SMH supports like trauma‐informed (TI) approaches, social and emotional learning (SEL), and others can lead to confusion and potentially less effective implementation of services and supports for students. In this paper, we aim to mitigate this confusion and offer a solution that integrates several of these approaches into a single complementary model with a special emphasis on the role of SEL. We first present an overview of commonly used SMH frameworks. Next, we present the Trauma‐Informed Multi‐Tiered Systems of Support Model (TI‐SEL MTSS)–an adaptation of the TITI‐SEL MTSS–to include and emphasize the specific role of SEL as a critical foundational layer within a multi‐tiered system of support. The proposed adapted model maintains the key structure of a MTSS while highlighting the importance of embedding SEL pedagogy in daily teaching practices and all aspects of school life. A case study is used to illustrate how the proposed model adaptations can be used in practice and in tandem with TI and SMH services without being conflated as the same service as SEL. Practical implications for implementation are discussed.

Intergenerational Transmission of Mental Health Literacy and Its Mechanism: The Mediating Effect of Parent-Child Relationship and the Moderating Effect of School Mental Health Service.

Adolescents' mental health literacy is a topic ofgrowinginterest and studies have begun to explore thefactors that influenceadolescents' mental health literacy. This study investigated the relationship between parents' mental health literacy and adolescents' mental health literacy,as well asthe mediating roles of parent-child relationship, and the moderating roles of school mental health service. Questionnaires were distributed to adolescents and their parents at two time points with an interval of one month. In the first survey, 835 parents completed a mental health literacy scale and a parent-child relationship scale. In the second, 841 adolescents completed a school mental health service questionnaire and an adolescent mental health literacy assessment questionnaire. A total of 617 paired data points were matched (parents' age: M = 40.47, SD = 5.10; adolescents' age: M = 13.34, SD = 0.99). Bootstrapping results showed that parents' mental health literacy was positively associated with adolescents' mental health literacy. In addition, parent-child intimacy mediated the relationship between parents' mental health literacy and adolescents' mental health literacy. School mental health service moderated therelationship between parents' mental health literacy and parent-child intimacyandadolescents' mental health literacy. Intergenerational transmission of mental health literacy from parents to adolescents and its conditions were revealed. These findings provide new insights for the intervention of adolescents' mental health literacy, and may lead future research to investigate the role of parents within the family context, as well as the influence of home-school cooperation on adolescents' mental health literacy.

A Qualitative Examination of School Principals’ Self-Perceived Role in School Mental Health Service Implementation

A Qualitative Examination of School Principals’ Self-Perceived Role in School Mental Health Service Implementation

Engaging Black youth in depression and suicide prevention treatment within urban schools: study protocol for a randomized controlled pilot

BackgroundDepression continues to be an ongoing threat to adolescent well-being with Black adolescents being particularly vulnerable to greater burdens of depression as well as lower mental health service utilization. Black adolescents are likely to have untreated depression due to social network influences, varied perceptions of services and providers, or self-stigma associated with experiencing depressive symptoms. Furthermore, if or when treatment is initiated, low engagement and early termination are common. To address this gap, a trial is being conducted to preliminarily test the effectiveness of an engagement intervention targeting Black adolescents with depression in school mental health services in New York City.MethodsA total of 60 Black middle and high school adolescents displaying depressive symptoms are equally randomized (based on school site) to the treatment arms. Both trial arms deliver Interpersonal Psychotherapy for Depressed Adolescents (IPT-A), a time-limited, evidence-based treatment for depression. Additionally, one arm pairs IPT-A with a brief, multi-level engagement intervention, the Making Connections Intervention (MCI), involving adolescents, caregivers, and clinicians. Outcomes of interest are group differences in depression and suicide ideation, adolescent and caregiver engagement, and mental health service use.DiscussionThis trial will serve as an efficacy assessment of the MCI among a sample of Black adolescent students with depressive symptoms. Clinical and implementation results will be used to inform future research to further test the MCI intervention in a larger sample.Trial registrationRegistered by ClinicalTrials.gov on May 3, 2019, identifier: NCT03940508.

Applying the extension for community healthcare outcomes (ECHO) model to promote collaborative and effective school mental health services.

Applying the extension for community healthcare outcomes (ECHO) model to promote collaborative and effective school mental health services.

A collaborative, school-based wraparound support intervention for fostering children and youth's mental health

Early mental health interventions are needed in response to a growing mental health crisis among children and youth. Schools are promising sites for early intervention because they have existing infrastructure for engaging with students. Specifically, collaborative initiatives involving community partnerships allow schools to leverage shared resources to deliver mental health support. However, more research is needed to guide the development of early interventions so that they effectively address students' mental health needs. The present study explored the role of collaborative, school mental health services in fostering children and youth's mental health, through All in for Youth, a wraparound model of support in Edmonton, Canada. Three research questions were addressed: What mental health concerns do children and youth experience? What are the factors that impact the use of collaborative school mental health services? Do collaborative school mental health services lead to perceived mental health impacts among children and youth? A multiple methods secondary analysis was conducted on school cohort data across seven elementary and junior high schools (n = 2,073 students), and interview and focus group data (n = 51 students, grades 2–9; n = 18 parents/caregivers). The quantitative findings indicated that 42.7% of students accessed any type of mental health service across the schools, with close to equivalent service use by gender (50.2% male, 49.5% female, 0.3% genderqueer) and grade (kindergarten-grade 9; M = 10%, SD = 1.9%, range = 6.3%−13%). Participants accessed mental health services in primarily individual or combined individual and group settings (72.9%) and as an informal client (75.1%). The interview and focus group findings revealed high mental health needs among students, which were exacerbated by the COVID-19 pandemic. In response to these needs, a supportive school culture, adequate school communication, and a stable and well-resourced mental health workforce promoted access to collaborative school mental health services. Finally, mental health services supported children and youth through the experience of having a supportive relationship with a safe and caring adult, an improved capacity to cope with school and life, and improved family functioning. The findings underscore the importance of developing school mental health services that take an ecological, wraparound approach to addressing students' multi-faceted mental health needs.

MH of teenage girls in Wisconsin has declined twice as much as boys'

According to new data from the Wisconsin Office of Children's Mental Health, 66% of young girls across the state are struggling with anxiety, and 50% feel sad and hopeless nearly every day, Wisconsin Public Radio reported Aug. 18. The report said the mental health of teenage girls has declined twice as much as boys' of the same age. “Girls are having some particularly troubling times right now,” said Linda Hall, director of the state office. Hall said this difference between genders can be explained by early sexualization of women, unhealthy social media use, cyberbullying and regularly seeing content about suicide and eating disorders. These triggers disproportionately affect women of color and LGBTQ teens. According to the report, 95% of people with eating disorders are between the ages of 12 and 25. Reilly said that's because some young girls have a negative internal monologue comparing themselves to others. Gov. Tony Evers' proposed biennial budget had included more than $270 million to expand mental health services in schools. But the Republican‐led budget writing committee cut education‐related items, including the mental health funding. The governor later restored $30 million for mental health spending in schools through the veto process. “What the younger generation is experiencing now is something different than any adults have been through. So we really need to understand how they are viewing the world and what their ideas are about how we address this crisis,” Hall said.

Stakeholder perspectives on the advantages and challenges of expanded school mental health services for publically-insured youth.

Although partnerships between community-based mental health (MH) organizations and school systems to deliver MH services on school grounds (i.e., expanded school mental health, ESMH services) are growing, qualitative research is needed about stakeholders' perspectives on ESMH services. This study collected qualitative data from caregivers, MH providers, and MH administrators recruited from three MH organizations to understand their perspectives regarding potential advantages and challenges associated with ESMH services. The three MH organizations were located in three regions of Georgia and the majority of youth served by the organizations were enrolled in Medicaid. We conducted four focus groups with 33 caregivers and 13 semistructured interviews with MH administrators and providers, and we implemented a thematic content analysis. Caregivers, providers, and MH administrators described how ESMH services could improve MH services by (a) facilitating appointment attendance through the reduction of logistical barriers to care (including geographic barriers, missed class time, and missed work time) and (b) enhancing communication between providers and teachers. However, some participants also described logistical issues with ESMH services including school space constraints and challenges scheduling appointments. In addition, some caregivers expressed concerns about peer stigma if MH services are delivered at school (vs. the clinic). Providers and MH administrators discussed problems with low caregiver engagement and challenges collaborating with school personnel that stem from lack of understanding of MH problems and treatment. Although ESMH services can improve MH treatment among low-income youth, MH providers and MH administrators may consider collaborating with school personnel to proactively develop strategies to address challenges to its success. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The relationship between school mental health service use in high school and educational outcomes of adolescents with psychiatric disorders.

This study aimed to examine the relationship between school mental health service use in high school and educational outcomes of adolescents with psychiatric disorders. The sample included 2617 adolescents who were enrolled in eighth grade in a large urban school district in the United States, were enrolled in Medicaid during eighth grade, and had a mental health diagnosis. Psychiatric hospitalization, school enrollment, school absences, out-of-school suspensions, school dropouts, and school exits for negative reasons were examined as mental health and educational outcomes. Compared with adolescents who used school mental health services for 2 years following eighth grade, adolescents who did not use school mental health service during the high school years had a significantly lower annual number of days enrolled in school and higher rates of exiting school for negative reasons such as school dropout and long-term hospitalization. Our findings support the positive role of school mental health care delivery in high schools in preventing negative educational outcomes for adolescents with psychiatric disorder.

Unveiling the Stigma: Exploring Help-Seeking Attitudes Among Muslim Students in A School with A Dual Education System in Brunei Darussalam

The lack of normalization of mental health as a conversational topic is becoming increasingly evident in certain cultures. The fact that students underutilize mental health services in schools can be attributed to the presence of various barriers that impede their willingness to seek help. Stigma surrounding mental health services continues to be the most prevalent barrier to help-seeking behaviour. Alternative barriers have emerged that are both personal and public in nature and can have a substantial impact on students’ preferences to seek help in schools. A sequential explanatory study was carried out among 256 Muslim students in a school with a dual education system to explore both their self-stigma of seeking help (SSOSH) and mental health help-seeking attitude (MHSA). In addition, 12 students were interviewed in a focus group setting to explore further the phenomenon of help-seeking by students and understand the initial quantitative analysis. Preliminary findings indicated that the students’ level of self-stigma was only moderate, but they had a favourable attitude towards counselling help. There was no significant difference in gender for both variables; however, the lower the self-stigma, the higher the mental help-seeking attitude for this current study, which is a common trend in the relationship between the two variables. The interview revealed that, apart from public stigma, the absence of a qualified counsellor, a lack of ethical principles of counselling, a confidentiality issue, and the emotional openness of the students were identified as other barriers to their help-seeking attitudes. This paper also discussed the recommendations made by students for addressing barriers to counselling and facilitating their counselling needs for the improvement of their mental and academic well-being. Additionally, this research offers the most recent data about mental health in the context of schools with a dual education system in Brunei Darussalam. It is hoped that it will serve as a guide for policymakers to consider the provision of mental health services that are more appealing to the students’ mental and academic well-being.

New report a call to action to address youth MH crisis, improve services

Banding together to address the critical need of tending to the youth mental health crisis in this country, several groups — spearheaded by the National Action Alliance for Suicide Prevention (Action Alliance) — released a new report and embarked on a call to action to ensure federal, national and state support to improve youth mental health services in schools and communities.

Effectiveness of a Brief Engagement, Problem-Solving, and Triage Strategy for High School Students: Results of a Randomized Study

Schools offer an advantageous setting for the prevention, early identification, and treatment of mental health problems for youth. However, school mental health (SMH) services are typically not based on evidence for effectiveness, nor are they efficiently delivered, with SMH practitioners (SMHPs) able to only treat a small number of students in need. The current study evaluated the feasibility, acceptability, efficiency, and outcomes of a four-session assessment, engagement, problem-solving, and triage strategy for SMHPs that aimed to improve efficiency while being based on elements of evidence-based care. The study, conducted in 15 US school districts in three states, used stratified random assignment to assign 49 high schools and their participating SMHP(s) to either the Brief Intervention for School Clinicians (BRISC; N = 259 students) or services as usual (SAU; N = 198 students). SMHPs implemented BRISC elements with adequate to excellent fidelity and reported the strategy was feasible and well-aligned with presenting problems. Students assigned to BRISC reported significantly greater engagement in SMH at 2 months and completion of SMH treatment by 6 months. BRISC-assigned SMHPs reported significantly greater treatment completion after four sessions (53.4%) compared to SAU (15.4%). Students in the BRISC condition also reported significantly greater reduction in problem severity as evaluated by the Youth Top Problems Assessment. No differences were found for anxiety or depression symptoms or overall functioning. Results indicate that BRISC is a feasible early intervention and triage strategy that may aid in more efficient provision of SMH services with no compromise to SMH effectiveness.

Innovations in University-School Partnerships to Provide Mental Health Services

A considerable number of children and adolescents suffer from mental health difficulties, yet a much smaller percentage of these students receive mental health services. Given the amount of time that youth spend at school, being able to offer mental health services at school is a logical solution. In this paper we present an innovative idea for increasing mental health services in schools through partnering with behavioral health training programs, such as social work, counseling, and psychology. The mutually beneficial nature of these partnerships is described and a framework for deciding what services are needed is offered. The article ends with a detailed analysis of logistical challenges and decisions regarding identifying potential clients, supervision, curriculum, scheduling, funding, confidentiality and records, competence, and consent.

Individual and organizational factors as predictors of early evidence-based practice adoption in Michigan high schools: Baseline data from an implementation trial.

Adolescents increasingly access mental health services in schools. School mental health professionals (SPs; school counselors, social workers, etc.) can offer evidence-based mental health practices (EBPs) in schools, which may address access gaps and improve clinical outcomes. Although some studies have assessed factors associated with EBP adoption in schools, additional research focusing on SP- and school-level factors is warranted to support EBP implementation as SPs' mental health delivery grows. Baseline data were collected from SPs at Michigan high schools participating in a statewide trial to implement SP-delivered cognitive behavioral therapy (CBT) to students. Models examined factors associated with attitudes about EBPs, implementation climate, and implementation leadership, and their associations with CBT knowledge, training attendance, and pre-training CBT delivery. One hundred ninety-eight SPs at 107 schools (87%) completed a baseline survey. The mean Evidence-Based Practice Attitude Scale (EBPAS) total score was 2.9, and school-aggregated mean scores of the Implementation Climate Scale (ICS) and Implementation Leadership Scale (ILS) were 1.83 and 1.77, respectively, all on a scale ranging from 0 (low) to 4 (high). ICS and ILS scores were lower than typically reported in clinical settings, while EBPAS scores were higher. School characteristics were not significantly associated with EBPAS, ICS, or ILS scores, but scores did differ by SP role. Higher EBPAS scores were associated with more CBT knowledge (average marginal effect for 1 SD change [AME] = 0.15 points) and a higher probability of training completion (AME = 8 percentage points). Higher ICS scores were associated with a higher probability of pre-training CBT delivery (AME = 6 percentage points), and higher ILS scores were associated with higher probability of training completion (AME = 10 percentage points). Our findings suggest that SPs' attitudes toward EBPs and organizational support were positively associated with early signs of implementation success. As schools increasingly fill the adolescent mental healthcare access gap, efforts to strengthen both provider attitudes toward EBP and strategic organizational factors supporting EBP delivery will be key to encouraging EBP uptake in schools. Schools are an important setting in which adolescents receive mental healthcare. We need to better understand how to implement evidence-based practices (EBPs) in this setting to improve student mental health. This study examined the attitudes and perceptions of school professionals (SPs) as key contributors to the implementation of a particular EBP, the delivery of cognitive behavioral therapy (CBT) in schools. The study found that implementation climate and leadership scores in participating schools were lower than scores typically reported in clinical settings, while scores for SP attitudes about EBP adoption were higher than typical scores in clinical settings. Results further suggest that SPs with more positive attitudes toward EBPs are more knowledgeable of CBT and more likely to complete a 1-day CBT training. We also found that higher implementation climate scores were associated with SPs reporting pre-training CBT delivery (although this association was not statistically significant), and more implementation leadership was associated with SPs completing the CBT training. These findings suggest that SP attitudes toward EBPs and organizational support in schools are positively associated with early signs of implementation success. Early, low-intensity efforts to (1) improve SP attitudes about mental health EBPs, and (2) increase schools' support for implementation may scaffold more intensive implementation efforts in schools down the road.

The Nexus of Family, School, and Society in Adolescent Mental Health

Despite the critical nature of the adolescent period in human growth, mental health among teenagers in China has not received sufficient attention in academic research. This study investigates how the family, school, and community environments can interact to influence the mental health and wellbeing of Chinese teenagers. Using a mixed-methods approach that combines qualitative and quantitative methods, the study gathers both opinion and quantifiable data on how family, school, and societal interventions can work together to support and shape adolescents’ mental stability and wellbeing. Data is collected through surveys and focus groups with parents, instructors, and community leaders. The study reveals that emotional and social problems are prevalent among Chinese teenagers and have various effects on their mental health. The findings suggest that kid-friendly interventions to support teenagers with mental health problems should be developed and distributed through family, school, and community-based mental health services. Schools, in particular, offer a unique setting for the promotion of mental health in teenagers by reducing risk factors and boosting protective elements. Educating families and communities about the warning signs of adolescent mental health problems and how to access local resources when they notice these signs in a loved one is also crucial.

Child Psychiatric Services in the Private Sector: Some Insights

This paper looks at child psychiatric services in the private sector and all that can be done with child psychiatric services in the private sector. The need for public-private partnerships, the role of child psychiatrists in private practice providing integrated services, and the need for school mental health services by private psychiatrists is emphasized. The paper ends by emphasizing the need to focus on adolescent mental health and eradicating the stigma that surrounds child and adolescent mental health.

Okulda Ruh Sağlığı Hizmetleri Kapsamında Mülteci Çocuklar

Schools play an important role in the psychosocial, academic, and professional development of refugee children. Specifically, psychological counselors and guidance (PCG) experts who provide mental health services in schools have a critical role in this process. The way of approach to the problems, areas of difficulty, support needs, and suggestions of PCG experts who have experience working with refugee children can increase the quality of the services to be provided in this direction. In this study based on qualitative design, the experiences of PCG experts who have worked with refugee children were examined. The data were collected from 38 PCG experts. The data were analyzed with the thematic analysis technique. As a result of the analyses, 27 sub-themes related to six themes were determined: the perceptions of the PCG experts about refugee children, their approach to refugee children, the demands of refugee children, the activities carried out for refugee children, the competence to work with refugee children, and effective intervention proposals for refugee children. It has been determined that PCG experts have a realistic perception of refugee children, they carry out various activities towards refugee children in a professional manner in line with their demands, and they develop various coping methods against difficulties in this process. Although working with refugee children contributes to improving the professional skills of PCG experts, PCG experts need training to giving effective services to refugee children such as non-language-based methods, trauma education, refugee rights, psychoeducation and play therapy activities. Based on PCG experts’ experiences, they offer various recommendations for effective interventions for refugee children. In line with the results obtained, it has been evaluated that school counseling services can be the pioneer of activities to increase positive experiences in order to increase the mental health of refugee children.

Streamlined pediatric anxiety program for school mental health services

There needs to be serious transformation of evidence-based interventions (EBIs) into real-world solutions; otherwise, EBIs will never achieve the intended public health impact. In a randomized trial, we reported effects of a redesigned anxiety program. Herein, we described the redesign process that led to the program. Survey data revealed provider preferences for school mental health anxiety services. Focus groups and prototype feedback sessions revealed service barriers to uptake, implementation, and sustainability along with corresponding enabling strategies. Prototype feedback sessions also focused on refinement and fine-tuning of the redesign. In the end, traditional EBI strategies were transformed and packaged into six lessons, lasting 20–30 minutes each, and amenable to delivery in small-group format. The redesign achieved the intended purpose of retaining elements from cognitive and behavior therapy and social skills training for the target population of the intervention (e.g., 3rd to 5th graders with heterogeneous anxiety problems - identified and referred). The streamlined EBI is accessible from PBS LearningMedia™ - a service that hosts public, research-based, and school-ready materials.

The Impact of Implicit Bias on Black and Latinx Students.

The Impact of Implicit Bias on Black and Latinx Students.