Culture of Caring

Mental Health in Schools

Are Your Students Mentally Healthy?

Dear reader, please read this when you have enough time to dive a little deeper into the topic. There are quite a few links embedded in this article. Each of them leads to valuable information that can help improve the way your school or district addresses mental health. I have also included many of them at the end of the article for easy access.

A school’s role in addressing youth mental health

Mental health has surged to the front burner at one of the most critical issues schools must address right now.

It’s time for advocates, parents, and educators to promote awareness and strive for early identification of mental health conditions. And when disorders are identified or diagnosed, schools need to do their part in making mental health services available either on-site or through collaboration with community partners.

  • One in six U.S. youth aged 6-17 experience a mental health disorder each year.
  • Half of all mental health conditions begin by age 14.
  • Attention-deficit/hyperactivity disorder (ADHD), behavior problems, anxiety, and depression are the most commonly diagnosed mental disorders in children.
  • Only about half of youth with mental health conditions received any kind of treatment in the past year.

It is no surprise that undiagnosed and untreated mental illness is likely to interfere with a student’s ability to learn, grow and develop.

Since students spend so much time at school, it’s logical to train teachers and staff to recognize and identify behaviors that may indicate a mental health disorder. There should also be staff members who are trained in prevention and know how to intervene when necessary.

Can schools provide mental health services?

More and more schools are responding to the increase in mental health disorders among students by hiring more site-based mental health professionals. You might think that means more counselors, but the list also includes social workers, psychologists, and nurses. Unfortunately, not only is there a severe shortage of trained mental health professionals for schools to hire, but districts are notoriously underfunded in many states. K-12 COVID stimulus funds may help schools get through the rough spell, but strategic budget planning is required to succeed over time.

Another option is to partner with community providers. Not just hand parents a list of community resources, but actually build partnerships that are sustained over time. Here’s an example of one district that has set the standard and is willing to help others implement a similar model.

With the right level of support, students can receive services during school hours. Students with more severe conditions would receive help from outside providers who will maintain regular communication regarding the child’s status with the school staff.

You can look at the following data in several ways.

  1. Youth are almost as likely to receive mental health services in an education setting as they are to receive treatment from a specialty mental health provider
  2. in 2019, 15% of adolescents aged 12-17 reported receiving mental health services at school, compared to 17% who saw a specialty provider.[i]

You could infer that a lot of kids who should be getting help for mental health conditions are not identified. Or you could decide that 15-17% of adolescents are receiving mental health care, and that’s good. Either way, it seems like we should be addressing the issue more effectively. 

Here’s another thought. As with any other health issue, the earlier the illness is caught, the better the chances of recovery. The more accessible the treatment is, the more likely it will help. But beyond that, prevention through education could be the best strategy of all! Adding mental health to the curriculum K-12 may be the smartest investment of all, along with professional development for staff in identifying and understanding mental health disorders.

Some good news is that legislators in Washington are taking action to address the problem. This bill is just in its initial stages, so who knows how it will turn out. But the fact that it is bipartisan is promising and gives us hope that our representatives are working together to save lives.

Seeing the signs

A truth we might not think about, but rather just assume it is true, is that mentally healthy children are more successful in school and life.

Sometimes teachers notice when a child is struggling and are aware of the signs that point toward a mental illness. 

But how do we know if a child is mentally healthy if we don’t see those warning signs? Just as we test them for academic concerns, if we really want to be thorough, we evaluate their mental health needs.

The Ready, Set, Go, Review: Screening for Behavioral Health Risk in Schools toolkit is designed to guide schools through developing comprehensive screening procedures and provide resources to facilitate the implementation of effective behavioral health screening in schools.

When and how to provide mental health services in school

When students have academic difficulties, teams of teachers and specialists meet to determine what interventions might work and whether a student needs further testing. They monitor progress to determine if interventions are working.

They should be doing the same thing when a child needs mental health support. Providing Mental Health Services within a Multi‐Tiered System of Supports uses an MTSS model to determine appropriate levels of support based on data. 

Not sure how to implement mental health support at your school? Start by looking at what other schools and districts have found to be best practices.

Improving mental health support for students

NASP, the National Association of School Psychologists, recommends several ways to improve mental health support at your school or district.

  1. Schools that follow an MTSS model with fidelity will screen ALL students for mental health problems and provide tiered levels of support for those who need it.
  2. Historically in American schools, it is a common practice to limit mental health supports to students who are eligible for special education services. It doesn’t have to be that way!
  3. Schools need to collaborate with community mental health providers to strengthen support for students being treated by outside providers.  
  4. Build a collaborative relationship with parents so everyone can work together toward the best outcome for children.

A team approach to mental health in schools

Remember that old mantra, TEAM – Together Everyone Achieves More? If your school follows an integrated approach to mental health, it begins with assembling a team that includes district leaders, school-based mental health professionals, community partners, family, and student representatives.

Every project starts with collecting data and identifying target goals. Next, participants develop plans and provide training to participants. It’s essential to monitor progress along the way and evaluate results.

Here’s an example of what that looked like for an urban district in the southwest.

The team identified an increase in the prevalence of students experiencing adverse childhood experiences (ACES) (Felitti et al., 1998). When the team examined community data from their local behavioral health center, they found many students in their school had family members who were incarcerated, addicted to substances, and were either victims or perpetrators of domestic violence.

After carefully reviewing available social-emotional programs, the team, including youth and families, selected one to use with elementary students that emphasized coping skills, emotional literacy, self-control, and interpersonal problem-solving.

For secondary students, they selected a curriculum with evidence of effectiveness to prevent substance use, cope with anxiety, and improve self-regulation and social awareness. After the district team selected curricula, the school teams were provided team training and time to review their school data to select specific lessons that taught coping skills, emotional regulation, or social awareness. [ii]

Changes don’t happen overnight. They take time, perseverance, and commitment.

Given the world we live in, there is no avoiding the hard truth that children are struggling with more significant mental health issues than ever before. Let’s hold our schools accountable for meeting the needs of all children so they can become well-educated, healthy, and productive members of society.

Dive a little deeper

A Culture of Caring: A Suicide Prevention Guide for Schools (K-12) was created as a resource for educators who want to know how to get started and what steps to take to create a suicide prevention plan that will work for their schools and districts. It is written from my perspective as a school principal and survivor of suicide loss, not an expert in psychology or counseling. I hope that any teacher, school counselor, psychologist, principal, or district administrator can pick up this book, flip to a chapter, and easily find helpful answers to the questions they are likely to have about what schools can do to prevent suicide.

Theodora Schiro