Teachers are critical partners in expanded school mental health (ESMH) collaborations that aim to bring educators, community mental health professionals and families together to leverage expertise and resources for addressing non-academic barriers to learning. Although teachers are in a unique position to observe the day-to-day mental health needs of students, their roles in ESMH collaborations have been largely ignored leaving little research-based guidance for maximizing this practice strategy. To address this gap, this study explored 384 teachers' experiences with ESMH collaboration including the types of collaborations they are engaged in, what influences those relationships and what they perceive to be the benefits of this practice strategy. The findings support previous conceptual and research contributions focused on collaboration, as well as suggest some specific influences on collaborative relationships between teachers and community mental health professionals. Implications for practice, policy and research are offered.
Schools are a key setting for mental health promotion and the provision of emotional support to students. As teachers and school counsellors are adults with whom adolescents have regular contact, it is likely they would be used as a help source by distressed students however there are few studies on this from an Irish context. A mixed methods design was used to identify the extent of adolescent help-seeking in addition to exploring what influences a young person's decision to seek help in school. Findings generated through surveys (N = 856) and four focus group interviews (N = 35) with adolescents indicate that young people do not regard teachers and school counsellors as a potential help source. Barriers to seeking help include dislike of the dual role of counsellor/teacher and concerns about confidentiality. The provision of independent school counselling and increased mental health education were identified as factors that might increase help-seeking in school.
Some universal behavioural screening processes require classroom teachers to complete a risk assessment measure on each student in their class, leading to a possible, but unexplored, problem: risk assessment scores may be influenced by the teacher completing the measure. The current study investigated whether teacher-reported risk assessment scores systematically differ between teachers and whether they differ across both deficit- and strengths-based risk assessment measures. Results from this study indicated that between 7.7 and 20.5% of the variance in risk assessment scores was attributable to between-teacher differences. These findings underscore the need to account for and control between-teacher differences in teacher-reported risk assessments.
Paraprofessionals and school volunteers increase the number of youth who receive academic and mental health interventions by providing services that were traditionally reserved for professional staff. However, the promise of these low-cost, high-volume non-professional services is tempered by the lack of experimental evidence documenting their effectiveness. In this study, we trained non-professionals to provide a brief school-based Motivational Interviewing (MI) intervention called the Student Check-Up (SCU) to middle school-students. In contrast with previous studies, we found no significant differences between treatment and control groups in post-treatment academic grades. However, following the SCU, participants randomly assigned to the treatment group rated the importance of in-class participation and academic effort self-efficacy significantly higher than those in the control group. Based on these results, we provide recommendations for improving the effectiveness of paraprofessionals' use of the SCU and for improving future research methodology in this area.
Children exposed to disasters are at an increased likelihood for multiple trauma exposure. The objective of our study is to understand the efficacy of post disaster school based services for reducing trauma symptoms of youth exposed to multiple traumatic events. Students (N = 112) age 8-17 that were survivors of Hurricane Katrina received individual treatment for multiple traumas on site at school. We used repeated measures ANOVA to investigate the effectiveness in self-reported trauma symptoms over time. Results indicated significant reduction in overall posttraumatic stress symptoms as well as subscales assessing anxiety, anger, depression, dissociation, overt dissociation, and fantasy dissociation. The school based services for students with multiple traumas were effective at reducing trauma symptoms following disaster.
Supporting students' mental health needs is critical in high-poverty urban school districts where many students are at risk for mental health problems. Although teacher-student relationships are at the core of student mental health promotion in the classroom, many teacher preparation programmes do not adequately prepare pre-service teachers entering into urban teaching for the realities of urban teaching. Miami University's Urban Teaching Cohort (UTC) is an innovative, community-based approach to preparing pre-service teachers for work in the field of urban teacher preparation. In this paper, we review research on the challenges impacting the mental health of urban youth, describe how these challenges connect to the work of urban teachers and discuss how urban teacher preparation can help teachers better support students' mental health. We discuss the elements of the UTC programme and how this preparation approach can help teachers build relationships with urban students and their families, as well as understand their communities from an asset perspective, to create a positive classroom community that supports the mental health of all students. Preliminary qualitative data indicate student and community support for the programme and support the impact of the programme on relationships and teaching practices.
The present study was part of a group randomized controlled trial in which 7th grade students were assigned to a yoga intervention or physical-education-as-usual. Sixteen students were randomly selected from the yoga condition to participate in one-on-one interviews. Qualitative analyses revealed 13 themes that were organized into two categories: Usability (student perceptions of the usefulness, learnability, and convenience of the yoga intervention) and Effect (student perceptions of the direct results of the yoga intervention). Students reported both positive and negative opinions of yoga, especially when making direct comparisons between yoga and physical education. Students had particularly positive opinions regarding the beneficial effects of yoga on stress, sleep, and relaxation. Student opinions regarding the effects of yoga on self-regulation, social interaction, substance use, and academic performance were also generally positive, although somewhat mixed. Results suggest that qualitative research shows promise for providing an in-depth perspective on the impact of mind-body interventions in schools.
The present paper focuses on teachers' experiences of child abuse/neglect cases, teachers' awareness of reporting or discounting, and their ways of responding to a hypothetical disclosure of abuse/neglect. A total of 1877 teachers in Greek public schools participated from a national teacher in-service training across the country; of them, 306 (16.3%) reported that they had experiences with children exposed to forms of abuse in their professional career. The higher level of perceived awareness of reporting responsibility was significantly associated with a lower level of discounting and with more appropriate ways of teachers responding to a child's disclosure. The findings are discussed within the Greek context, highly characterized by its lack of institutional arrangements and adequate child protection services that could facilitate schools to document, examine and share helpful practices for child abuse and neglect.
This issue of Advances in School Mental Health Promotion touches on different levels of school mental health implementation, from district and school considerations for the installation of evidence...
In this paper, we examine the impact of adopting a comprehensive school health (CSH) approach on reducing anxiety and depression of school-age children. We use the data from 245 schools that received government funding support to adopt a CSH approach in order to build health promoting school environments in Alberta. Using a linear multi-level (hierarchical) model, we compare the average percentage of students with anxiety and depression across the schools that are in three different funding stages: pre-funded, actively-funded, and post-funded. Results show that, all else held constant, the schools that are in the actively-funded stage, relative to pre-funded schools have a lower percentage of students who suffer from anxiety and depression.
Associated with complex developmental, personal, and environmental risk factors, adolescent parents have been found to display higher rates of unfavorable parenting practices than adult parents, placing their children at high risk for social, emotional and behavioral concerns. Nevertheless, interventions targeting this group often focus solely on adolescents' personal outcomes. This study evaluated the acceptability and fidelity of a relationship-focused intervention to increase positive parenting among adolescents with young children, adapted from the Parents Interacting with Infants model. The intervention was delivered via groups in high schools that housed daycare centers for children born to adolescents. Multiple-case study data were evaluated for adolescent parents from each group to describe potential effects of the intervention on parenting behaviors. Delivery of the intervention was feasible and acceptable in a high school group context, suggesting this program can be implemented in a highly accessible format. Case study data suggest positive effects on parental affect, responsiveness, verbalizations, and social initiations.
Schools have limited experience and little guidance to identify and install evidence-based and promising programs and practices/interventions (EBPs) within advanced tiers of School-Wide Positive Behavioral Intervention and Supports (SWPBIS). One form of guidance is the Hexagon Tool which can be used to ensure a match between the EBP and student needs. The authors demonstrate how the Hexagon Tool was utilized by an alternative education program already implementing SWPBIS. Data from the Hexagon Tool were used to identify and install EBPs for various student, faculty, and administrative needs. Outcomes related to installation of those EBPs, when applicable, are summarized. Based on these experiences, a hybrid protocol to equally ensure alignment of a given EBP to the developmental, cultural, and linguistic characteristics at the school was created. Schools are encouraged to use the Hexagon Tool or hybrid protocol in the process of implementing advanced tiers of support.
The purpose of this systematic review and meta-analysis was to synthesize the available research on the Skills for Social and Academic Success (SASS) program, a school-based cognitive/behavioural intervention for adolescents with social anxiety disorder. A search of online databases, combined with reference list examination and communication with program implementers/developers, led to the identification of five (5) studies that explored the effects of the SASS program (N = 227). Given the age of target individuals, analyses focused on self-report of anxiety, with effect sizes aggregated according to a random effects model and calculated as differences in scores between time points (e.g. Standardized Mean Gain). This program is unique in that it was developed specifically for implementation within school systems. The preliminary evidence based on existing studies suggests that the program holds promise for assisting teens with social anxiety in an ecologically valid setting. In the contemporary context of evidence-based practice, it demonstrates initial empirical support, though additional trials are needed to bolster the overall sample size of youth served, and additional generalization studies are needed.
Schools are an excellent setting through which to promote mental health and well-being, and teachers are well positioned to provide related instruction and support in the classroom. However, teachers often report that they lack the knowledge, skills and confidence to deliver social emotional learning instruction and to support students who struggle with mental health challenges. Professional learning initiatives that build teacher capacity in this area are increasing in quantity, but not all of the offerings are evidence based, relevant, scalable, and sustainable. This paper explores the approach being implemented in school districts within Ontario, Canada to enhance mental health literacy for educators. A description of the mental health literacy strategy within the Thames Valley District School Board is provided to illustrate how school districts can align with broad directions while at the same time contextualizing efforts to address local priorities and perspectives. The paper offers a synthesis of lessons learned from this early adopter case study, and from the implementation of the broader provincial approach.
By virtue of their day-to-day contact with students, teachers are uniquely positioned to notice and respond to student psychosocial issues, both mental health problems and issues like peer harassment that can contribute to mental health problems. Yet, teachers' opportunities to learn about providing psychosocial support remain scattered. The present study investigates the impact of one teacher education program's efforts to promote productive teacher interactions with students experiencing psychosocial issues. The intervention - a six-week module that comprised part of a master's-level teacher education practicum support course - aimed to increase candidates' ability to recognize and respond to student psychosocial issues in the classroom. This study's pre-test/post-test design asked 72 candidates to respond to vignettes portraying situations of student psychosocial distress, and also gauged candidates' preference for working with populations experiencing psychosocial distress. Pre- to posttest change was gauged first with a rubric and then compared using Wilcoxon signed-rank tests. While candidates' sense of their preferred role responsibilities regarding work with students experiencing psychosocial distress did not change, their demonstrated knowledge and practice skills in specific areas related to student psychosocial issues, particularly consultation and referral, did. Implications for teacher education regarding student support needs, and school-based mental health practice that engages teachers, are discussed.
Teachers play an important role in promoting a positive school climate, which in turns supports academic achievement and positive mental health among students. This study evaluated the impact of a pre-service teacher education course addressing a range of contributors to school climate. Participants included a cohort of 212 pre-service teachers (75.2% female) who were surveyed during the first week of their teacher preparation program. A second cohort of pre-service students (n = 199, 60.8% female) was used as a comparison group. Pre- and post-tests demonstrated positive gains in the knowledge about bullying and self-efficacy in responding and reporting to incidents of students' exposure to violence. Changes in moral disengagement were associated with improvements in knowledge, whereas personal experience with violence predicted changes in self-efficacy. Findings underscore the need for specific instruction in the area of promoting school climate.
Despite innovations being routinely introduced in schools to support the mental health of students, few are successfully maintained over time. This study explores the role of innovation characteristics, individual attitudes and skills, and organizational factors in school providers' decisions to continue use of Centervention, a technology-based tool that supports implementation of evidence-based mental health interventions (EBIs). Data were collected from 44 providers through online surveys following use of Centervention over a one-year period. When considered with individual and organizational factors, experience with Centervention (usability, usefulness, and satisfaction) was found to be the most influential predictor of intent to sustain use. Results reinforce the importance of (1) differentiating between factors that predict initial adoption vs. those that enable sustainability and (2) tailoring sustainability decision models to the nature of the innovation. They also support the need to incorporate strategies to enhance provider experience during implementation of an innovation.
Perhaps the two principal venues for the delivery of mental health services are schools and primary care practices. Unfortunately, these systems of care are poorly connected, which may result in care that is fragmented and suboptimal. This article describes the development and implementation of an electronic health record portal, known as the ADHD Care Assistant, to facilitate the sharing of information between schools and primary care offices to promote the use of evidence-based practices for managing children with behavioral health conditions. A feasibility study was conducted across 19 diverse primary care practices with 105 participating providers. Across the practices, 67% of providers activated the system for at least one patient and 32% activated it for five or more cases. Care Assistant use was lower in practices with a relatively high percentage of Medicaid patients (≥ 25%). The article discusses challenges that have arisen among primary care providers, parents, and schools in using the Care Assistant, potential strategies for addressing the challenges, and directions for future research and practice.
Collaborative care (CC) is an innovative approach to integrated mental health service delivery that focuses on reducing access barriers, improving service quality and lowering health care expenditures. A large body of evidence supports the effectiveness of CC models with adults and, increasingly, for youth. Although existing studies examining these models for youth have focused exclusively on primary care, the education sector is also an appropriate analogue for the accessibility that primary care offers to adults. CC aligns closely with the practical realities of the education sector and may represent a strategy to achieve some of the objectives of increasingly popular multi-tiered systems of supports frameworks. Unfortunately, no resources exist to guide the application of CC models in schools. Based on the existing evidence for CC models, the current paper (1) provides a rationale for the adaptation of CC models to improve mental health service accessibility and effectiveness in the education sector; (2) presents a preliminary CC model for use in schools; and (3) describes avenues for research surrounding school-based CC, including the currently funded Accessible, Collaborative Care for Effective School-based Services project.
