Developing Comprehensive School Safety and Mental Health Programs

An Integrated Approach

Jeffrey C. Roth, Terri A. Erbacher

• Publisher: Routledge
• Year: 2021
• Print ISBN: 9780367713683
• eBook ISBN: 9781000425055
• Edition: 1
• Topic: Pedagogía
• Subtopic: Política educativa

Developing Comprehensive School Safety and Mental Health Programs offers an integrated, long-term plan to create safe and supportive learning environments.

This user-friendly guide illustrates how to develop, implement, evaluate, and sustain multiple evidence-based programs that work. This book informs school mental health professionals, administrators, and teachers about multi-tiered service delivery, organizational development, and facilitating the implementation process. It describes the complementary roles of school administrators, counselors, and school psychologists, providing school staff with time, resources, and ongoing support to strengthen their skills and sustain programs they have embraced. It expresses empathy and appreciation for teachers, advocating for their personal growth, professional collaboration, and stress management.

School leaders, facilitators, and teams are provided the knowledge, skills, and long-term plans to effectively advocate, assess needs, select programs, train and encourage staff, provide resources, and implement, evaluate, and sustain desired goals.

Section IV
School-Wide Programs Promoting Positive Behavior and Mental Health

12
Universal Mental Health Screening

You can only analyze the data you have. Be strategic about what to gather and how to store it.

∼ Marie Curie

Purposes and Planning of Mental Health Screening

Historically, identification of student emotional and behavioral risk has largely been reactive, depending on teacher referral of students suspected of needing special education. Fear of stigma has often contributed to what McGrath (2010) described as the “wait to fail” approach to mental health issues, waiting until students fail socially and emotionally before getting them help. Indicators of mental health problems were often unrecognized, and the opportunity for early intervention was missed (Kamphaus, DiStefano, Dowdy, Eklund, & Dunn, 2010).

Screenings and check-ups for prevention and early intervention of physical health problems is well recognized and increasingly implemented in pediatric medicine. Routine screenings of signs and symptoms for early detection of child behavioral health problems have not been generally recognized and have been implemented slowly or not at all (Bostic & Hoover, 2020).

Traditional approaches such as office discipline referrals (ODRs), suspensions, and teacher referrals are often inefficient, delaying access to needed services (Romer et al., 2019). When opportunities for early intervention are missed, the risk for negative outcomes increases (Tolan & Dodge, 2005). Universal mental health screening within multi-tiered systems to identify students at risk for social-emotional and behavioral (SEB) concerns is more proactive and efficient than traditional approaches.

Universal screening is a preventive procedure designed for use with all students to assess SEB needs and the likelihood of developing a mental health condition. SEB screening is also designed to assess resilience factors and indicators of wellbeing in order that coping skills and assets can be supported. This cost-effective approach provides the opportunity for early identification and services to prevent or mitigate the severity of mental health difficulties and to obtain a baseline for future monitoring and assessment (Humphrey & Wigelsworth, 2016).

Goodman-Scott, Betters-Bubon, and Donohue (2019) summarized some of the benefits of universal mental health screening in schools:

• Prevention of and early intervention for mental and behavioral health problems, thus enhancing readiness for academics
• Use of data to guide mental health interventions
• Comprehensive approach that encourages systemic thinking in schools
• Collaboration among school and community mental health providers
• Greater awareness and normalization of mental health issues in schools

Adapted from Goodman-Scott et al. (2019)

Best Practices in Universal Screening for Social, Emotional, and Behavioral Outcomes: An Implementation Guide, an outstanding resource for developing and implementing mental health screening, reported that schools are increasingly using systematic approaches to support mental health (Romer et al., 2019). The guide pointed out that multi-tiered frameworks are poised to provide proactive and integrated service delivery for student social-emotional and behavioral (SEB) needs, but depend on early identification of SEB strengths and needs.

School Mental Health Quality Guide: Screening is another outstanding screening implementation guide (National Center for School Mental Health, 2020). This document lists purposes of mental health screening:

• Support a Multi-Tiered System of Supports (MTSS). Screening can promote an integrated continuum of mental health strategies across all tiers, including core social-emotional-behavioral skills at school-wide and targeted tiers before problems escalate (Romer et al., 2019)
• Inform prevention and early intervention strategies. Systematic screening of all students for indicators of wellbeing and social-emotional distress gathers valuable information for planning and implementing targeted prevention and early intervention strategies
• Identify concerns specific to certain grades or classrooms. Data can indicate strengths and concerns specific to a subset of the school population, such as a grade or age group, that can be addressed as part of a classroom or group intervention
• Identify students with highest wellbeing. Collecting information about wellbeing and social-emotional strengths as well as indicators of distress can be beneficial in 1) reducing stigma about discussion of mental health, 2) enhancing student feelings of self-esteem, 3) providing useful information about all students, and 4) strengths-based questions being generally more acceptable across cultural groups
• Identify students at risk for mental illness or harm to self or others. Screening can identify students in immediate need of help for such behaviors as suicidal or homicidal thoughts or plans, risk-taking, office discipline referrals, or academic difficulties
• Make economically sound decisions. Early identification and intervention that connects students and families to services is more cost-effective than later care for severe mental health problems
• Improve access to mental health supports. Screening is urgently needed to improve access to mental health services, which are more likely to be initiated and continued in school than in community settings, especially for racial and ethnic minority and low socioeconomic background students

Adapted from National Center for School Mental Health (2020)

The School Mental Health Quality Guide: Screening details action steps for planning and implementing mental health screening:

• Build a foundation. Assemble a core screening team, including leadership from school administration, staff, and the community to plan and implement the screening process and to generate diverse support
• Clarify goals. It is critical to clarify screening goals before selecting screening instruments and communicating with those outside the screening team
• Identify resources and logistics. Includes buy-in and staffing of key personnel such as available school mental health providers for administration and follow-up, teachers and paraprofessionals for classroom administration, and community-based agencies capable of timely intake of new referrals that may be generated. Key resources include data-infrastructure and Student Information Systems to track academic and behavioral data, and individuals trained in data collection and analysis
• Select an appropriate screening tool. The School Health Assessment and Performance Evaluation (SHAPE) System is a free online platform for school and district teams that offers a broad array of screening and assessment tool options for a variety of needs, including evidence-based, cost-effective instruments and measures of social and academic success such as grades, attendance, office discipline referrals, substance use, and family challenges
• Determine consent and assent processes. Plan for the type of consent procedure needed from parents/guardians, considering the strengths and limitations of either active or passive/opt-out, voluntary student assent for participation, and cultural considerations, while consistently communicating in multiple formats the benefits of screening. When determining type of consent, consider state/federal laws and district policies
• Develop data collection processes. Data management and privacy should be consistent with the Federal Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act (HIPAA). School screening teams are increasingly choosing to administer screening using online platforms, but the relative advantages of online versus paper and pencil methods should be considered. Regardless of methodology, there must be immediate scoring and analysis of collected data to facilitate any needed follow-up such as referral, especially when instruments inquire about pressing concerns such as suicidal or homicidal thoughts. The number of students for each specific screening should be documented and data should be collected frequently after screening during the intervention phase to monitor progress
• Develop administration processes. Action steps include:
  1. Who to screen. Consider starting small with a pilot screening administration of one grade level or classroom before making adjustments and assessing feasibility for whole school screening. Consider relative advantages of student, teacher, and/or parent report for components of a selected screener, such as recognizing that adolescents generally are best for reporting internalizing symptoms (e.g., depression, anxiety) (Margherio, Evans, & Owens, 2019)
  2. When to screen. Consider decisions regarding how many time-points will be screened, relative advantages and disadvantages of certain time-points, and the need to consult with teachers and administrators regarding optimal dates, times, or classrooms for screening, including parent–school functions when parent reports can be sought
  3. Staff to support screening. Clear communication during professional development days or faculty meetings can be used to inform staff about specifics of screener administration and the purpose and value of mental health screeners, combined with teacher referrals
  4. Scripts. These should be provided for proctors (typically teachers, paraprofessionals, counselors, school psychologists, or community mental health providers) to ensure standardized administration. Scripts should be translated into primary languages spoken at school, with staff members and cultural liaisons present to read and answer questions about the scripts. Content of the scripts should include 1) introduction to the screening, including its purpose, confidentiality of results, and relation to student wellbeing, 2) step-by-step instructions on how to complete the instrument, and 3) guidelines for returning completed screenings to an appropriate location
• Develop follow-up processes. It is suggested that interventions based upon screening data be implemented at the universal, targeted, and intensiv...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Contents
• About the Authors
• List of Illustrations
• Foreword
• Acknowledgments and Dedications
• Section I Background
• Section II Foundational Practices Supporting School Safety and Mental Health
• Section III Programs and Practices Supporting School and Student Safety
• Section IV School-Wide Programs Promoting Positive Behavior and Mental Health
• Section V Professional Development for School Safety and Mental Health
• Section VI Putting It All Together
• Appendix
• Index