Many students face mental health concerns—exacerbated by the pandemic—that can impact their learning and relationships. Indicators of youth mental health and suicide problems have shown increasing trends over the past decade, presenting a major challenge for families and schools. For example, according to the U.S. Centers for Disease Control, 42% of high school youth reported persistent feelings of sadness or hopelessness in 2021, compared to 28% in 2011. This trend is particularly stark for female students (CDC, 2023).
Schools are a natural setting for students to receive needed mental health care. However, schools cannot perform this role alone. Internal and external partnerships are needed to address complex student concerns. Comprehensive School Mental Health Systems (CSMHSs) use a team approach and leverage partnerships with community agencies and families to promote student well-being. Educational administrators across the U.S. are considering CSMHSs as models to support early identification and intervention for students with mental health concerns.
The core features of CSMHSs include:
- school and district personnel who are well-trained to support the mental health needs of students;
- collaboration and teaming among students, families, schools, and community partners;
- needs assessments of school and student challenges and strengths combined with resource mapping of school and community assets to inform needed supports and services;
- a multi-tiered system of support to promote mental health, prevent problem behaviors, and provide early identification and treatment;
- mental health screenings and referrals;
- use of evidence-based and emerging best practices;
- data to monitor needs and progress, assess implementation, and evaluate the effectiveness of supports and services; and
- diverse and leveraged funding to support sustainability and equitable access to resources.
Where do schools start in planning for a CSMHS? One way for schools and districts to begin the process is by conducting a needs assessment. The National Center for School Mental Health has developed school and district versions of an initial assessment. The district assessment, shown below, helps track district and community services available for a variety of common mental health concerns. This simple assessment allows schools to inventory programs and practices that are already in place to support student well-being. The assessment also assists in identifying gaps that should be considered in the planning process. For example, a district might fill out the matrix and discover that student anxiety and attention deficits are addressed by its multi-tiered system of support. At the same time, the district might find that it has no supports in place for students grieving the loss of a parent or those struggling with an eating disorder.
Ideally, schools and community partners, such as mental health therapists, come together to form an integrated system that responds to student needs. Successful partnerships often address complementary parts of the CSMHS. For example, using the multi-tiered system of support framework, districts might offer a universal prevention program for all third graders to learn social skills (Tier 1) while bringing in community members to mentor vulnerable youth who need extra support (Tier 2) and referring youth who display signs of traumatic stress to therapists in the community for treatment (Tier 3). As shown below, school districts and community partners can provide specialized expertise to make the CSMHS truly “comprehensive.”
According to data from the National Survey of Children’s Health, over 22% of 3–17-year-olds in Mississippi experienced two or more adverse childhood experiences (ACEs) during the 2020-21 school year (Child and Adolescent Health Measurement Initiative, 2021). ACEs (e.g., violence, abuse, or neglect) are strongly associated with mental illness and future negative education and job outcomes. The Region 7 Comprehensive Center is excited to be partnering with the Mississippi Department of Education to assist districts in developing CSMHSs. This effort aims to build on and support the coordination of existing state and local efforts to address the mental health needs of students. Research shows that attending to student mental health is associated with stronger academic and social outcomes, such as improving attendance, behavior, and graduation rates (Hoover et al., 2019). Subject matter experts from the Mississippi Department of Education and the Region 7 Comprehensive Center will work with 3–4 districts to enhance stakeholder coordination and collaboration in the creation of CSMHSs. Universal materials for all districts will then be developed based on the resources and experiences with initial pilot districts. These systems and materials will ultimately aim to support the mental health and educational outcomes of Mississippi’s students.
Authors: Jack Schwarz and Paul Smokowski
Centers for Disease Control and Prevention. (February 13, 2023). Youth Risk Behavior Survey: Data Summary and Trends Report. https://www.cdc.gov/healthyyouth/data/yrbs/pdf/YRBS_Data-Summary-Trends_Report2023_508.pdf
Child and Adolescent Health Measurement Initiative. (2021). 2020-2021 National Survey of Children’s Health (NSCH) data query. Data Resource Center for Child and Adolescent Health supported by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB).
Hoover, S., Lever, N., Sachdev, N., Bravo, N., Schlitt, J., Acosta Price, O., Sheriff, L. & Cashman, J. (2019). Advancing Comprehensive School Mental Health: Guidance From the Field. National Center for School Mental Health. University of Maryland School of Medicine. www.schoolmentalhealth.org/AdvancingCSMHS