On April 25, readers discussed schools’ role in student mental health with Stacy Skalski, the director of public policy for the National Association of School Psychologists, in Bethesda, Md., and John Kelly, a school psychologist at Commack High School in Commack, N.Y. Below are excerpts from the discussion.
Question: Is there research showing that screening and early intervention work to help adolescents with mental-health issues? If so, what kinds of school-based interventions are most effective?
Read the full transcript of this chat, “Student Mental Health: The School’s Role.”
Skalski: Yes, there is a variety of research examining the benefits of mental-health screening in students and youths. Screening programs need to involve the student, his or her parents, and a variety of school personnel who can provide input on the overall functioning of the student. Further, screenings that occur as part of a comprehensive school mental-health program that addresses prevention and intervention services are generally believed to be the most successful. Research suggests that the earlier we are able to identify mental-health concerns in youths and respond appropriately, the more positive the outcomes. The President’s New Freedom Commission on Mental Health supported this finding and recommended that schools engage in screening for mental-health issues.
There are numerous school-based interventions that have proven effectiveness. The Substance Abuse and Mental Health Services Administration (www.samhsa.gov) has a great online listing of evidence-based, intervention-model programs for children and adolescents that can be used in schools. Perhaps the most promising of these currently is Positive Behavioral Interventions and Supports, or PBIS. Research on it shows that when schools engage in systemwide efforts to provide positive behavior supports, students are more engaged and more successful in school.
Question: Many schools and districts have employed mental-health professionals. How can these school personnel help teachers and administrators be alert to signs of emotional distress in students before tragedies occur?
Kelly: An excellent question. Mental-health professionals in schools have training and experience in working with emotional issues. I am a big advocate of their engaging in preventative work. This includes conducting in-services with faculty and staff members on common signs and symptoms of emotional problems, as well as the warning signs of more serious emotional issues. In such meetings, I often stress the importance of paying attention to these warning signs and how to seek appropriate help. In addition, mental-health professionals can serve as consultants to individual teachers on specific students. It is important to develop collaborative plans on how to support these students, as well as to provide appropriate resources for teachers.
Question: Should we be asking how we can help troubled parents or guardians at our schools, since they play a bigger role in determining the mental health of students or whether they receive treatment?
Kelly: It is always important to involve parents in the process. Many times, they may not know how to access support for their child. So the school can assist them in negotiating the connection with community resources. In addition, as your question suggests, sometimes it is the parents who need support and intervention. Parenting programs, skills development, and connection with community resources for parents is often just as important as direct services to children. A stable home environment is one of the “protective” factors that help children to be resilient during difficult times.
Question: The number of very young children entering preschool with extreme anger, neglect, and attachment disorders is increasing. What resources are available to fund personnel such as psychologists and therapists to deal with these problems?
Skalski: There are a variety of federal grant programs that support the funding of personnel and services to provide school mental-health services. The U.S. Department of Education funds specific grant programs like the Elementary and Secondary School Counseling program and the Safe Schools-Healthy Students Initiative (Safe and Drug-Free Schools programs). In addition, there are many private foundations, such as the Robert Wood Johnson Foundation, that offer grant support. Schools also have the capacity to use Individuals with Disabilities Education Act and No Child Left Behind Act funds to add school mental-health resources and personnel. The amount of funding available for this purpose in schools is directly correlated with whether recognizing and responding to the mental-health needs of students is an established priority.
Question: When a child has a mental-health diagnosis but is not qualified for special education, does the district have any responsibility for monitoring the emotional well-being, and thus the safety, of the student in the school environment?
Kelly: Unfortunately, this depends on how much the district is aware of, in terms of the mental-health diagnosis and to what degree emotional issues are affecting the student’s ability to function in school. Many times, parents choose not to share this information with the school out of fear that their child will be stigmatized, or for confidentiality reasons. This makes the situation hard to monitor. Assuming that the school is aware of the diagnosis, then there is a level of responsibility that is placed upon the district. While the student may not currently qualify for special education services, the emotional issues may be significant enough to warrant other, education-related support services. The school also needs to monitor the student for a deterioration in functioning that may lead to qualification for special education services.
Question: What seems to work with troubled youths to bring them out of a violent or “revenge” mind-set?
Kelly: Early intervention is the key to success. This not only refers to early intervention with the student, but also intervening early in a situation or condition (teasing and bullying, family dysfunction or violence) that tends to generate intense feelings of anger and aggression. We need to recognize the warning signs students are displaying and know how to respond to their needs. We need to have policies and procedures in place to address the kinds of situations that may lead to violence.
In addition, there are many “protective factors” that can be developed within a child’s environment that will help him or her to be resilient. Some of these are a stable home environment, a connection with a caring, supportive adult, involvement in school-based activities, and setting and accomplishing goals.
Direct interventions that have proven to be effective are peer mediation strategies and the concept of “restorative justice.” These strategies seek a resolution of problems or conflicts without violent outcomes.
Question: What needs to happen for schools and community services to share vital information necessary to help students?
Skalski: We need to be better partners with one another and much less territorial. There is plenty of work for all of us. Schools and communities need to build partnerships that are responsive to the special expertise that both school-employed and community-employed mental-health providers have. We need to clearly understand each other’s training, skills, roles, and needs, and work to build relationships that are respectful and collaborative. Comprehensive, thoughtful interagency agreements that reflect more than just the typical facility and financial information, and that also include guidance on the roles, responsibilities, functions, methods for communication, and shared mission and accountability, are essential.
