Developing healthy mental health is foundational to the ability to thrive. Successful school-based mental health programs improve the quality of life students achieve. The adverse impact of poor mental health undermines educational achievement and frequently pushes adolescents toward unhealthy behaviors that may eventually land them in the health care and criminal justice systems.

Whether a child is suffering from depression, ADHD, obsessive-compulsive disorder (OCD), substance use disorders, Tourette syndrome, behavior disorders, mood and anxiety disorders, and autism spectrum disorders, their mental health is likely to interfere with their success in school, their ability to develop and maintain healthy relationships, compete on the playing field, and their successful transition to adulthood.

Adolescents who suffer from mental health disorders are not isolated. They sit beside healthy students and some of them are disruptive in the classroom, thus reducing the ability of those who are not ill to achieve to their potential. Helping one adolescent, helps their peers, too.

When it comes to student mental health, society can pay now or pay later. The cost of addressing mental health issues sooner rather than later is much lower and it alleviates suffering and increases the future potential for those with mental health challenges and their peers.

 

How is an ideal school-based mental health program structured?

The ideal program is multi-tiered as shown in the pyramid below (see the SAMSHA.gov website for the complete report).

Continuum of School Mental Health Services

The bottom of the pyramid consists of universal screening for all children and preventative skills training. Although some people advocate only providing services to children who are identified as problematic, research has shown that some children will fall between the cracks with that approach. There are well-behaved children who suffer in silence, get good grades, and appear well-adjusted despite having experienced trauma or living in homes where repeated traumatic experiences are occurring.

Programs that teach all children skills that increase resilience and develop their social and emotional skills serve every student better. Foundations that provide universal health promotion skills, not just character building, as the first aspect of their foundation won’t leave the students who suffer in silence without assistance. Also, this approach will at least provide minimal assistance to students who are identified as needing help whose parents don’t support help seeking.

 

How do you identify high-quality screening tools?

The second aspect of the foundation, universal screening, serves to create baselines that will improve future outcomes and identify students who would benefit from referrals to additional resources. Screening tools should be:

  • Evidence-based
  • Simple to administer (not require experts or lengthy training of staff before use)
  • Fast
  • Have good efficacy (few false positives or false negatives)
  • Provide a systematic method of referring students who are identified as needing additional resources
  • Support coordination and continuity of care

A variety of validated, evidence-based screening tools already exist. We provided a list of several that take less than ten minutes to complete in a previous post.

Want to decrease the amount of time required for administering assessments and coordinating student outcomes? Learn more about the eINSIGHT platform for school-based mental health.

How should schools arrange care for at-risk students?

Ideally, schools will provide a combination of options for at-risk students including: on-campus services, referrals to community mental health centers, and private referrals. The more services that are provided on campus, the more effective the program will be at helping at-risk students. Community support from mental health professionals is an important aspect of care at this level.

A large percentage of adolescents with mental illness do not receive treatment. Providing treatment on campus, when possible, increases the odds that their needs will be met.

The most important aspect is being sure they get the care they need.

 

How should schools react when a students’ treatment needs are intensive?

Although schools should continue working with the student and their family, students with intensive needs should be referred to mental health professionals that have the knowledge, time, and resources to assist someone who is at or near a crisis point as well as those who suffer from chronic issues.

If the student is able to attend school, school involvement remains important. Students with mental health challenges often act out. When their behavior is treated as a disciplinary issue instead of evidence of the student’s unmet needs, it can worsen the condition. It’s a lot like kicking someone who is lying on the ground. Schools that are aware of the situation and have information about the unique needs of the student will be more likely to respond humanely.

 

How else can schools help?

Teachers and administrators should know the signs of mental illnesses and the factors that place the student at elevated risk. This information should be shared with parents to the extent possible.

Being aware of signs of mental illnesses and not turning a blind eye to the symptoms can lead to early help and recovery. We tend to see bad behavior as deliberate rule violations when it is more often a call for help or a manifestation of the students lack of self-regulation skills. When a student starts performing below their potential, we see rebellion when we should be asking if they need help.

Even aggression and angry outbursts can be signs that a student needs a referral. Drug and alcohol use are often a form of self medication for someone who doesn’t have healthy coping skills to manage the stress they’re experiencing.

Universal prevention programs help all students and prevent some who would otherwise develop mental health issues from doing so. That frees up important resources to help those who still may manifest problems over time.

Want to decrease the amount of time required for administering assessments and coordinating student outcomes? Learn more about the eINSIGHT platform for school-based mental health.