The Academic/Mental Health Connection

ESSA establishes the authority for schools to address students’ well-being, but will funding support those services?

Imagine one out of every five students in your school district has vision difficulties. Some are severe enough to impair the ability to read, to view digital content and to interpret facial expressions, leading to significant academic, social and behavioral problems. Other students’ eyesight difficulties are milder but still undermine the ability to focus.

The students themselves may not understand or report their problem because they don’t know what clear vision looks like. Teachers may attribute their students’ seeming disengagement to a lack of motivation or a learning disability. Such misinterpretation often results in ineffective intervention, missed opportunities to address the actual problem and frustration for everyone.

Health in Focus

The vision scenario is analogous to the imperative schools face regarding students’ mental and behavioral health — only the spectrum is wider and the stakes are higher.

One in five students will have a diagnosable mental health disorder at some point during their school-age years that significantly impacts their ability to be successful. (In reality, fewer than 1 percent of students have a comparable vision disorder.) This constitutes millions of children and youth nationwide and equates to 100 students in a school of 500 students experiencing a serious mental health challenge. Among these students, only a fraction will get the care they need.

Moreover, the 20 percent does not include the mental health needs of students who do not have a diagnosable disorder. Anyone working in K-12 education knows that many youth experience life stressors that increase social, emotional, behavioral and psychological risks. Stressors range from bullying, interpersonal conflicts and family challenges to more chronic adversity such as exposure to violence, addiction, abuse, poverty, homelessness or the incarceration of a parent.

We know that students under stress, whether chronic or acute, have more difficulty focusing, assimilating information, staying on task and controlling behavior. These risk factors can reverberate throughout a school system in the form of academic and behavior problems and a poorer perception of school climate and safety.

Clarifying Roles

An all-too-common instinct is to want to push the responsibility for addressing students’ mental health problems back out to families and community providers, especially in districts without adequate staffing of school mental health professionals. In many cases, these schools may serve communities that are chronically underserved and have the greatest needs.

Certainly, families and communities play a fundamental role in supporting children’s health and well-being. Unfortunately, deflecting all responsibility doesn’t generally work, in large part because community resources can be fragmented and disconnected from educational needs. Further, families often are under-informed and overwhelmed when navigating the mental health system.

Equally important, schools provide an ideal context to support students’ mental health for myriad reasons, not the least of which is that schools are where children and youth are most accessible. The learning environment offers opportunities to promote wellness; build social, emotional and behavioral skills; identify concerns; and provide interventions.

Schools help lower common barriers to seeking mental health care by reducing stigma, providing services at no additional cost, reducing scheduling conflicts and eliminating transportation challenges. The reality is that a majority of students accessing needed mental health services receive that care in schools. This is especially true in chronically underserved or high-needs communities.

Thinking about the eyesight analogy, most school leaders understand that, left unaddressed, the spectrum of vision problems is detrimental to individual student success and overall school performance. This direct link to learning is why, even though schools are not in the optometry business, legislation has long required schools to engage in vision screening and intervention efforts.

For all of these reasons, it is important that educators and policymakers address shortages of school-employed mental health professionals such as school psychologists, school counselors and school social workers to ensure students have access to services that are effective and appropriate to the learning environment.

The new federal education law, the Every Student Succeeds Act, offers hope. ESSA explicitly recognizes the role of comprehensive mental health supports in ensuring students’ positive school and life outcomes. The law authorizes significant funding and provides broad latitude for states and districts to establish the services and systems that best meet the needs of their school communities. (See related story, “The School Mental Health Dilemma: Philosophy vs. Funding”.)

Core Factors

At the heart of this work are three core factors for schoolwide mental health promotion:

• a recognition that mental health is integral to learning and a function of schools;
• a commitment to whole-school engagement that integrates mental and behavioral health into comprehensive learning supports; and
• an intentional effort from administrators that engages school mental and behavioral health personnel in the design, implementation and evaluation of a comprehensive system of supports.

An overlay to these factors is the interaction between special and general education. The majority of mental health services are commonly provided through special education, which can be a costly and intensive mechanism if what a student truly needs is the mental health equivalent of a pair of glasses rather than a braille reader. Rethinking the approach to mental health enables schools to get all students the help they need more effectively and efficiently.

Multitiered Support

This work looks different in every school and district, yet the most effective approach is to integrate services through a multitiered system of supports, or MTSS, which is a framework that helps coordinate delivery of instruction and learning supports through tiers of support that emphasize universal prevention and increase based on need.

MTSS facilitates interaction between special and general education and supports effective school-family-community collaboration. Schools effectively using MTSS have built-in mechanisms to regularly monitor and address student need and implement and evaluate interventions. They also reduce the scope and scale of the severe problems students face.

Schools using an MTSS approach to mental and behavioral health demonstrate better academic, social and behavioral outcomes.

Tactics to Consider

Our work with local schools nationwide contributes to seven considerations for addressing mental and behavioral health in schools.

 Implement universal screening and a needs assessment. Universal screening identifies students at risk and a needs assessment determines the nature and scope of concerns in a district. Consider tapping your school psychologist or others with expertise to support data collection, analysis and interpretation.

 Develop community partnerships. Establish formal relationships with community providers to leverage unique and complementary skill sets of school-employed mental health professionals and community clinicians. Too often districts simply contract with community providers who are not trained to provide services within the learning context and do so without involving school-employed mental health staff.

 Engage families. Improve engagement by running family workshops at school, improving access to information on mental health services or co-sponsoring community events. Extra effort should be made to reach culturally and linguistically diverse families with language barriers or differing expectations for engagement. Ensure families feel connected by reducing communication barriers.

 Use multiple funding streams through ESSA, the Individuals with Disabilities Education Act and Medicaid. Beyond supporting staffing and programming, funding will enable professional development to focus on the mental and behavioral health needs of students.

 Implement social-emotional learning curricula. These skills can be taught as any other content area and are a common component of Tier 1 strategies.

 Consider the district discipline policy. Identify whether the district implements a “punishment” policy rather than a discipline policy. In many cases, students with mental health problems experience the greatest forms of punishment, exacerbating their difficulties.

The Challenge Awaits

The capacity of district leaders to envision and operationalize a comprehensive, cohesive service delivery system is essential to promote student well-being. Though not easy, doing so will lead to the student outcomes we all desire.

Superintendents have a unique opportunity to leverage existing resources at the local, state and national levels, including new legislation and funding streams and evidence-based practices to bolster the mental health and learning of all students.