Supporting Child Student Social Emotional Behavioral Mental Health

Supporting Child and Student Social, Emotional, Behavioral, and
Mental Health Needs

U.S. Department of Education
Dr. Miguel A. Cardona
Secretary of Education
Office of Special Education and Rehabilitative Services
Katherine Neas
Acting Assistant Secretary
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Education and Rehabilitative Services, Supporting Child and Student Social, Emotional, Behavioral, and Mental
Health Needs, Washington, DC, 2021. This report is available on the Department’s website at
https://www2.ed.gov/documents/students/supporting-child-student-social-emotional-behavioral-mental-health.pdf
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DISCLAIMERS
Other than statutory and regulatory requirements included in the document, the contents of this document do not have
the force or effect of law and are not meant to bind the public. This document is intended only to provide clarity to the
public regarding existing requirements under the law or agency policies. This document is intended as a resource on
social, emotional, and behavioral supports and other mental health services for children and students. Further, with the
exception of brief references to students with disabilities as a subgroup, this document does not provide specific
guidance on Federal disability laws, which include requiring schools to provide for the education of students with
disabilities and to take an individualized approach to providing services, consistent with the student’s individualized
education program (IEP) developed under Part B of the Individuals with Disabilities Education Act (IDEA) or plan
developed under Section 504 of the Rehabilitation Act of 1973 (hereafter, Section 504 and 504 plan), as appropriate.
A summary of legislative and policy resources related to the social, emotional, and behavioral supports and mental
health services in the Elementary and Secondary Education Act (ESEA), IDEA, and Section 504 are provided in
Appendix D. For information on these programs, the rights of children and students with disabilities and schools’
obligations under those Federal laws, please refer to information provided by the U.S. Department of Education’s
Office of Safe and Supportive Schools in the Office of Elementary and Secondary Education; Office of Special
Education and Rehabilitative Services; and Office for Civil Rights. Please also refer to the U.S. Department of
Education's COVID-19 Resources for Schools, Students, and Families.
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preference/support for these examples as compared with others that might be available and be presented.
Contents
Executive Summary ........................................................................................................................................................... 1
Introduction ........................................................................................................................................................................ 3
Challenges .......................................................................................................................................................................... 7
1. Rising Mental Health Needs and Disparities Among Children and Student Groups ............................................. 7
2. Perceived Stigma as a Barrier to Accessing Services Even When Available ...................................................... 14
3. Ineffective Implementation of Practices ............................................................................................................... 14
4. Fragmented Delivery Systems .............................................................................................................................. 15
5. Policy and Funding Gaps...................................................................................................................................... 16
6. Gaps in Professional Development and Support .................................................................................................. 17
7. Lack of Access to Usable Data to Guide Implementation Decisions ................................................................... 18
Recommendations ............................................................................................................................................................ 19
1. Prioritize Wellness for Each and Every Child, Student, Educator, and Provider ................................................. 19
2. Enhance Mental Health Literacy and Reduce Stigma and Other Barriers to Access ........................................... 22
3. Implement a Continuum of Evidence-Based Prevention Practices ...................................................................... 23
4. Establish an Integrated Framework of Educational, Social, Emotional, and Behavioral-Health Support
for All ................................................................................................................................................................... 27
5. Leverage Policy and Funding ............................................................................................................................... 29
6. Enhance Workforce Capacity ............................................................................................................................... 31
7. Use Data for Decision Making to Promote Equitable Implementation and Outcomes ........................................ 32
Summary and State Spotlight..................................................................................................................................... 34
References ........................................................................................................................................................................ 37
APPENDIX A. Implementation Examples by Recommendation ................................................................................... 53
APPENDIX B. Federal Technical Assistance Centers Related to Social- Emotional and Mental Health ...................... 73
APPENDIX C. Technical Assistance Resources Related to Social, Emotional and Mental Health ............................... 81
APPENDIX D. Guidance on Existing Programs That Can Support Social- Emotional and Mental Health
Services for Students ................................................................................................................................................. 93
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs iii
Executive Summary
Like physical health, positive mental health Many children and students struggle with mental
promotes success in life. As defined by the health challenges that impact their full access to
Centers for Disease Control and Prevention and participation in learning, and these challenges
(CDC), “[m]ental health includes our emotional, are often misunderstood and can lead to behaviors
psychological, and social well-being. It affects that are inconsistent with school or program
how we think, feel, and act. It also helps determine expectations. The COVID-19 global pandemic
how we handle stress, relate to others, and make intensified these challenges, accelerating the need
healthy choices. Mental health is important at to provide school-based mental health support and
every stage of life, from childhood and leverage our accumulated knowledge about how to
adolescence through adulthood.” In schools, we provide nurturing educational environments to
prioritize three critical and inter-related meet the needs of our nation’s youth.
components of mental health: social (how we
relate to others), emotional (how we feel), and This resource highlights seven key challenges to
behavioral (how we act) supports to promote providing school- or program-based mental health
overall well-being (Chafouleas, 2020). support across early childhood, K–12 schools, and
higher education settings, and presents seven
This resource is intended to supplement the corresponding recommendations. The appendix
information in the ED COVID-19 Handbook, provides additional useful information, including
Volume 1: Strategies for Safely Reopening (a) numerous examples corresponding to the
Elementary and Secondary Schools, Volume 2: recommendations highlighting implementation
Roadmap to Reopening Safely and Meeting All efforts throughout the country; (b) a list of federal
Students’ Needs, and Volume 3: Strategies for resource centers; (c) a list of resources to assist
Safe Operation and Addressing the Impact of educators (teachers, providers, and administrators)
COVID-19 on Higher Education Students, in implementing the recommendations; and
Faculty, and Staff, by providing focused (d) guidance on existing programs that can support
information and resources to enhance the social, emotional and mental health services
promotion of mental health and social and for students.
emotional well-being among students.
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 1
Challenges Recommendations
1. Rising Mental Health Needs and Disparities 1. Prioritize Wellness for Each and Every
Among Children and Student Groups Child, Student, Educator, and Provider
2. Perceived Stigma is a Barrier to Access 2. Enhance Mental Health Literacy and
Reduce Stigma and Other Barriers to
Access
3. Ineffective Implementation of Practices 3. Implement Continuum of Evidence-Based
Prevention Practices
4. Fragmented Delivery Systems 4. Establish an Integrated Framework of
Educational, Social, Emotional, and
Behavioral-Health Support for All
5. Policy and Funding Gaps 5. Leverage Policy and Funding
6. Gaps in Professional Development and 6. Enhance Workforce Capacity
Support
7. Lack of Access to Usable Data to Guide 7. Use Data for Decision Making to Promote
Implementation Decisions Equitable Implementation and Outcomes
Introduction
The mental health crisis for children and youth in and implementing comprehensive prevention
the United States has reached a critical point. The strategies for all students. This resource is
pandemic has exacerbated already alarming trends intended to supplement the information in the ED
in mental health, and, without increasing the COVID-19 Handbook, Volume 1: Strategies for
number of high-quality, evidence-based mental Safely Reopening Elementary and Secondary
health services, the increased need for services for Schools, Volume 2: Roadmap to Reopening
children and youth will not be met. As schools and Safely and Meeting All Students’ Needs, and
programs return to full in-person learning in the Volume 3, Strategies for Safe Operation and
fall, and have new resources in the American Addressing the Impact of COVID-19 on Higher
Rescue Plan's Elementary and Secondary School Education Students, Faculty, and Staff, which
Emergency Relief fund (ARP ESSER), and were released earlier this year, with more
previous rounds of ESSER funding, to support this comprehensive information and resources to
work, there is a unique opportunity to enhance the promotion of mental health, social,
reconceptualize how we prioritize and provide emotional, and behavioral well-being of children
school- and program-based mental health and students.
supports, an essential component of creating
nurturing educational environments for children, Congress has provided significant federal funding
students, families, educators, and providers. This to assist in efforts to return to full in-person
includes dramatically expanding the number of learning, but as stated in Volume 2, “for most
social workers, school counselors, school nurses, schools, returning to the status quo will not
and school psychologists available to support address the full impact of COVID-19 on students’
students. physical and mental health; students’ social,
emotional, behavioral, and educational needs; or
As stated in Executive Order 14000, Supporting the impact on educator and staff well-being.” As
the Reopening and Continuing Operation of President Biden has often stated, we have an
Schools and Early Childhood Education opportunity to “build back better.” One way to
Providers, “every student in America deserves a build back better is to intentionally integrate the
high-quality education in a safe environment.” In current research and evidence on the importance
addition, Volume 1 of the ED COVID-19 of prevention and intervention practices to address
Handbook describes the importance of planning the mental health needs of children and students.
This should be done not just as a reaction to behaviors inconsistent with school or program
COVID-19 but as a deliberate action to fully expectations. In young children mental health
address children and students’ overall well-being refers to the developing capacity of the child to
and their full access to education and form close relationships, manage and express
opportunities. emotions, explore the environment, and learn
(Zero to Three, 2016). Researchers suggest that
This resource highlights seven key challenges to children’s experiences, even in the earliest stages
providing school- or program-based mental health (infancy), affect their social, emotional, and
support across early childhood, K–12 schools, and behavioral development (Dawson et al., 2000;
higher education settings, and also presents seven Malik & Marwaha, 2018; Steele et al., 1999).
corresponding recommendations. The appendix Supporting students’ social, emotional, and
provides additional useful information, including behavioral development at early ages may mitigate
(a) numerous examples corresponding to the the need for long-term services and supports
recommendations highlighting implementation (Yoshikawa et al. 2013; Bierman et al., 2018).
efforts throughout the country; (b) a list of federal
resource centers; (c) a list of resources to assist in Prior to the COVID-19 pandemic, 13–22% of
implementing the recommendations; and (d) a school-aged youth experienced a mental health
summary of legislation and policy addressing the challenge at a level associated with formal
provision of social, emotional, and behavioral diagnoses (NCSMHI, 2016; Maag, & Katsiyannis,
supports to promote mental health and well-being. 2010). Researchers estimate that 80% of those
children and youth have unmet treatment needs
Mental Health Supports (McCance-Katz, & Lynch, 2019). Unmet needs
Like physical health, positive mental health may result in social, emotional, or behavioral
promotes success in life. As defined by challenges. In the absence of effective support,
the Centers for Disease Control and Prevention these children and students may experience
(CDC), “[m]ental health includes our emotional, reactive and exclusionary discipline practices
psychological, and social well-being. It affects (e.g., suspensions, expulsions) that further
how we think, feel, and act. It also helps determine exacerbate mental health concerns, interrupt
how we handle stress, relate to others, and make access to and participation in learning, limit
healthy choices. Mental health is important at opportunities, and negatively affect outcomes.
every stage of life, from childhood and
In addition, early childhood programs that actively
adolescence through adulthood” (Centers for
involve families, serve children in natural contexts
Disease and Control, 2021). In schools, we
where possible, incorporate evidence-based
prioritize three critical and inter-related
interventions, and take a comprehensive approach
components of mental health: social (how we
to treatment are associated with greater
relate to others), emotional (how we feel),
improvements in mental health outcomes
and behavioral (how we act) supports to promote
(Hodgkinson, Godoy, Beers, & Lewin, 2017).
overall well-being (Chafouleas, 2020).
School mental health services (a) broaden the
However, many children and students struggle reach of mental health services and (b) provide an
with mental health challenges that impact their full access point for early and effective intervention in
access to and participation in learning and result in typical, everyday environments. For example,
youth are six times more likely to complete mental  Emergency department visits related to mental
health treatment in schools than in community health increased 24% for 5–11-year-olds and
settings (Jaycox et al., 2010), and mental health 31% for 12–17-year-olds between January and
services are most effective when integrated into October 2020 (Leeb et al., 2020).
students’ academic instruction (Sanchez et al.,
 Between March and June of 2020, more than
2018). In 2018, nearly 3.5 million adolescents
25% of American parents reported that their
received mental health services in education
child experienced declines in mental health
settings. Adolescents with public insurance, from
and 14% reported increases in behavior
low‐income households and from racial/ ethnic
problems (Patrick et al., 2020).
minority groups, were more likely to only access
services in an educational setting, compared with  In a survey conducted in April and May 2020,
services in both educational and other settings or one in four youth (ages 13–19) reported an
in other settings only (private specialty or general increase in sleep loss due to worry, feeling
medical settings) (Ali et al., 2019). unhappy or depressed, feeling constantly under
strain, and loss of confidence in themselves
(Margolius et al., 2020).
 A CDC report found one quarter of
respondents ages 18–24 had contemplated
suicide in the 30 days prior to completing the
survey (Czeisler et al., 2020).
For example, pediatricians in Washington State
are reporting:
 Significant increases in youth with eating
disorders, anxiety, mood disorders and
depression with suicidal thoughts and self-
harm behaviors (nearly twice the rate of adults
over 40).
The COVID-19 pandemic exacerbated this mental
 Families experiencing long wait times and
health crisis, accelerating the need to provide
limited access to mental health services.
school mental health support at an even larger
scale to meet the needs of our nation’s youth.  Lesbian, Gay, Bisexual, Transgender, Queer or
Research on the effects of prior pandemics and Questioning (LGBTQ2+) youth are having
disasters clearly indicates that there will be both specific challenges navigating limited social
immediate and long-term adverse consequences support when affirmation and support are
for many children (Weist et al., 2002; Yoshikawa particularly important, resulting in sleep
et al., 2020). Initial data related to the impact of disturbances, decreased physical activity
the pandemic underscore an unprecedented leading to unhealthy weight gain, and abuse of
magnitude of mental health needs that children, substances.
students, families, and staffs will continue to  A significant number of previously stable
experience for many years to come: youth have experienced new-onset or
exacerbated eating disorders, depression, or
anxiety, with some requiring increased use of create a healthier path forward. We have a wealth
medications, hospitalization, or other higher of accumulated knowledge across prevention and
levels of care. behavioral science to create more nurturing
environments that prioritize prevention and
 Children are experiencing a significant sense
promote wellness (Biglan et al., 2020). This guide
of isolation and loss, which is negatively
acknowledges the challenges inherent in scaling
impacting their learning and grades.
up school mental health services and supports and
These data underscore the need for urgent action. provides key recommendations to improve these
We have the potential to accelerate support to supports and directly address this critical current
meet this notably increased need for effective societal need, based on advances in research on
social, emotional, and behavioral practices and the implementation of evidence-based practices.
Spotlight on Mental Health Crisis in Washington State: Identifying the Challenges
The Washington Department of Health forecasted In February 2021, Governor Inslee declared a
(based on models from disaster response) that State of Emergency across all counties in
“impacts from COVID-19 outbreak and related Washington State stating, “Although we have, for
government actions will likely cause a surge in the time being, averted the crisis of overwhelming
(services needed from the) behavioral health systems hospital capacity related to COVID-19 cases, we
across the state.” Over the course of the year, some are in the midst of another crisis related to the
of those predictions have come to fruition. mental health of many of our children and youth.”
Challenges
This section explores seven current challenges ethnicity, language, or immigration status, sex,
impacting the effective provision of social, LGBTQI+ status,1 religious identity, and disability.
emotional, and behavioral supports to enhance
Early Childhood
children’s and students’ mental health and well-
The American Psychological Association (2021)
being. A discussion of the current evidence base
describes trauma as “an emotional response to a
follows each challenge.
terrible event.” Trauma affects between half and
two‐thirds of all children in the United States.
1. Rising Mental Health Needs and
These Adverse childhood experiences (ACEs),
Disparities Among Children and
such as maltreatment, exposure to violence, and/or
Student Groups
substance abuse have an important impact on
Even before the pandemic, the United States was mental health from childhood to adolescence and
experiencing a mental health crisis: the escalating can predict poor mental health across the lifespan.
mental health needs of children and youth were ACEs can present particular risk when children
largely unmet due to insufficient capacity, experience them during early childhood when
multiple barriers to care, and disparities across brain architecture is still rapidly developing and
populations. The COVID-19 pandemic continues highly sensitive to environmental adversity
to exacerbate this crisis. However, this crisis (Yoshikawa et al. 2020; Lipscomb et al. 2021).
disproportionately affects populations that have
been marginalized, and COVID-19 has Without adequate access to trauma-informed
exacerbated existing inequities and inadequacies practices, some early childhood programs that
across a range of social structures, including our serve infants, toddlers, and preschool children
nation’s education system. As described below, have struggled to systematically promote positive
there are population-specific mental health social, emotional, and behavioral development and
challenges based on school level, socio-economic adequately address manifestations of that trauma
and housing status, race, color, national origin, which are often perceived as challenging behaviors.
1 With the exception of the Washington State example found on individuals, and our use of ‘LGBTQI+’ should be understood to
page eight that is reflective of report, for consistency, throughout include lesbian, gay, bisexual, transgender, queer, questioning,
this document we use the acronym ‘LGBTQI+’ when speaking asexual, intersex, nonbinary, and other sexual orientation or
on behalf of the Department. We recognize that other gender identity communities. The term is meant to be inclusive.
terminology may be used or preferred by certain groups or
This lack of training and support leave of young children is directly tied to the
practitioners ill-equipped to address students’ functioning of their caregivers and the families in
social, emotional, and behavioral needs and overly which they live. Therefore, reducing the stressors
reliant on more punitive and exclusionary forms of affecting children requires addressing the stresses
discipline (e.g., suspensions and expulsions). in the contexts of their families and communities.
Early research on preschool disciplinary practices
by Gilliam (2005) reported that the rate of K–12 Students
expulsion from state-funded pre-K programs is Even before the pandemic, as students entered
three times higher than that for K–12 programs. their K–12 school experience, schools were
Later research and reports bolster these initial reporting earlier onset, increased prevalence, and
findings and further research report suspension greater intensity and complexity of student mental
and expulsion from early education health needs (Geiser et al., 2019; Hertz & Barrios,
disproportionately affects young boys of color 2020). COVID-19 has significantly disrupted
(Gilliam & Reyes, 2018, Malik, 2017; Meek & supports (Stark & Basu, 2020; WHO, 2020) and
Gilliam, 2016). Early childhood and education increased concerns for K–12 students (CDC,
professionals require adequate training and 2020; Mann, Bangar, & Kulkani, 2020). These
ongoing supports, such as behavior specialists or concerns coupled with inadequate counselor
mental health consultation, to support social, staffing ratios, particularly for students of color
emotional, and behavioral development; address and students from low-income families, stand to
behaviors appropriately; and form supportive and exasperate new and existing gaps (The Education
nurturing relationships with all children and Trust, 2019).
their families.
For example, many children in the United States
The COVID-19 pandemic further disrupted early are experiencing increased loneliness, which is
childhood and education supports (Yoshikawa et harming their psychosocial development given the
al., 2020). With many childcare and early critical role of relationships with peers during
education facilities closed nationwide, and childhood and adolescence (Loades et al., 2020).
interactions with extended families limited, Such increased loneliness is related to the loss of
children have been deprived of both social and in-person school for over 223 million children
cognitive stimulation beyond their homes, as well worldwide, with strong evidence for the
as meals and other resources provided by many importance of in-person school on students’
early childhood development programs adjustment (UNESCO, 2021). In addition to being
(Yoshikawa et al., 2020). Children from families unable to attend in-person school, other factors
experiencing poverty (defined as those in families associated with poorer emotional adjustment of
with incomes under $25,000 per year) have adolescents since the pandemic include
experienced the steepest declines in overall COVID-19 worries, having problems with online
participation in center-based preschool programs learning, and having increased conflicts with
and, especially, in-person participation. During the parents (Magson et al., 2021). Now there are
pandemic, only 13% of children in poverty were indications that children who experienced COVID
reported to receive in-person preschool education, were more likely to developmental health conditions
compared to 38% of those above the poverty line and these students may need even more support
(Barnett & Jung, 2021). The emotional well-being upon their return to school (West et al, 2021).
The United States is not alone in these challenges, overwhelming. Students must develop higher
studies from Australia, China, and the United levels of academic and social competencies
Kingdom document increased anxiety and despite varied levels of prior training an increased
depression among adolescents since the pandemic independent study and autonomy, and refinement
(Magson et al., 2021; Xiang, Cheung, & Xiang, of their course of study to address specialization
2021; Dubicka, 2021), and some studies also and career goals.
document alarming increases in self-harm among According to the most recent American College
adolescents (Dubicka, 2021). Without question, Health Association National College Health
for K–12 students and families the pandemic has Assessment (2021), nearly 50% of college
been a traumatic event and a catalyst for further students experience moderate (23.8%) or serious
trauma including social isolation, financial (24%) psychological distress. This is consistent
insecurity, and death of family members and with previous research that found ninety-five
friends. percent of postsecondary school administrators
note that social, emotional, and behavioral health
Young-Adult University and College
Students are significant issues at their institutions
(American Psychological Association, 2013).
The transition from high school to college can be However, most college faculty and staff receive
challenging. The experience reflects dramatic little formal preparation related to addressing what
changes in peer groups, separation from are referred to as non-academic barriers to college
parents/caregivers, immersion within new cultures students’ success. Non-academic barriers are
and lifestyles, and expansive learning factors that extend beyond traditional academic
opportunities. Further, the prevalence and matters that inhibit achievement, such as college
complexity of mental health disorders among students navigating moving, being away from
college students has increased over time (Xiao et home (and their long-term and consistent support),
al., 2017), and few college students seek support developing new friendships, and managing
(Kaprea & Kalkbrenner, 2017). Despite efforts, academic demands with a new level of
students often encounter fragmented and independence. Recent research indicates the
disjointed mental health services (Farrington et al., pandemic has had a significant impact on college
2012; Morningstar et al., 2018). Just prior to student’s mental health, adding considerable stress
typical entry to college, following high school, and resulting in notably elevated mental health
over one in five (22.2%) adolescents experience a challenges during this time of life involving
mental disorder that has a severe impact on daily notable pre-existing developmental challenges
functioning (Merikangas et al., 2010). Examples (see Copeland et al., 2020).
of mental health risk factors impacting college
students include (a) exposure to adverse childhood
experience (e.g., exposure to substance abuse,
such as the current opioid epidemic),
(b) community stress or trauma such as
experiencing or witnessing violence in the
neighborhood, and (c) the presence of mental
illness (Stephan et al., 2015). The challenges
thrust upon students as they enter college can be
Socio-Economic and Housing Status health services (DeFreitas et al., 2018;
Nearly one in five children in the United States Hodgkinson et al., 2017; Kam et al., 2019;
live in poverty, and youth from lower income Whitaker et al., 2018). As stated, unmet mental
households are less likely to access health care health needs may manifest in behaviors
(Cree et al., 2018) and more likely to experience inconsistent with school or program expectations
significant mental health symptoms (e.g., and students of color who exhibit these behaviors
suicidality among boys; Fang 2018). Further, are more likely to experience reactive and
youth experiencing food insecurity (Willis, 2021) exclusionary discipline rather than interventions or
or homelessness (Barnes et al., 2018) are at higher additional supports and lose instructional time.
risk of mental health concerns. These challenges Based on these experiences, children and youth of
are heightened during the COVID-19 pandemic, color often have poorer outcomes than white peers
with children and students losing access to (Losen & Martinez, 2020; Morris & Perry, 2016;
academic, social, emotional, and behavioral Quirk, 2020; U.S. Department of Education,
supports and other mental health services, for 2021). To be clear, racism, not race, is a critical
example, as provided through school-based health risk factor for mental health concerns and poorer
centers, nursing services, and in-person school outcomes. For example, darker-skinned Latino
mental health support (Dooley et al., 2020; children may be at increased risk for more severe
Williamson et al., 2020). Importantly, before the and/or more persistent mental health problems,
pandemic, these programs helped to reduce than fairer-skinned Latino children perhaps due to
inequities in students’ access to support and care, discrimination based on their skin color (Calzada
and in many cases, these connections have been et al., 2019). Underscoring the complexity of this
lost during the pandemic. In addition, the most background literature, there is also evidence that
accessible support for children and students is ethnic identity can be a significant positive
available by attending school in-person, but predictor of mental health, whereas racial status,
families with lower incomes and racial minorities stress, and impostor feelings were negative
have been more hesitant to attend in-person predictors for Black college students (McClain et
schooling during the COVID-19 pandemic (U.S. al., 2016).
Department of Education, 2021).
As briefly reviewed, there is a disproportionate
burden of COVID-19 illness and death among
Race and Ethnicity
racial and ethnic groups in the United States
Based on race and ethnicity, youth experience (CDC, 2020). Increased rates of coronavirus
differences in severity of mental health symptoms. disease, racial discrimination, and hate crimes
Black teens have disproportionately higher rates of against Asian-Americans have been documented
suicide than White teens (Price & Khubchandani, by reporting centers and polls (Margolius et al.,
2019), and the odds of having attempted suicide 2020). According to FBI data, hate crimes
within the past year were significantly greater targeting people of Asian descent in the United
among Asian international and Black college States rose by 70 percent in 2020 compared to the
students than in previous years (Goodwill et al., numbers of such incidents in 2019 (FBI Hate
2020). Further, there are differences among Crime Statistics, 2021). Asian and Latino youth
communities, by race and ethnicity, in the extent were more likely than any other racial/ethnic
to which individuals seek, access, and use mental group to report poorer physical, cognitive, and
mental health since schools closed in March 2020.  Supporting younger siblings in navigating
Non-Hispanic Black, female, and LGBTQI+ remote learning and helping them connect to
students were at highest risk of increases in digital platforms.
depression symptoms (Fruehwirth, et al., 2021).  Finding employment to provide vital income
to help support their family.
 Lack of access to technology, which
disproportionally impacts ELs’ access to
online health services, including mental health
support, creating a gap in accessibility to
intervention supports when in-person services
have been suspended.
Youth with immigrant parents were 34% more

likely to experience poorer physical, cognitive,
and mental health than youth parents born in the
United States (Margolius et al., 2020). In addition,
existing stressors for newcomer or migrant EL
English Learner (EL) or Immigration communities were worsened with the pandemic,
Status including feelings of isolation and disconnection
Latino ELs have been identified as a unique group from the community due to language and cultural
of students who are at an elevated social, barriers. School and program closures removed
emotional, and/or behavioral risk (Castro-Olivo et the very support systems these child and student
al., 2011). However, many screening assessments populations and their families depended upon to
for social, emotional, and behavioral risk have cope with stressors related to learning and living
limited data to support their reliability, validity, in a new country. For example, food, childcare,
and usability with ELs, as screenings are not and mental-health support services offered
usually conducted in students’ native languages through public schools disappeared overnight for
and may not capture student need (e.g., Lambert et many of these families and undocumented families
al., 2018). During the COVID-19 pandemic, in were exempt from stimulus support other
addition to the stress of social isolation, food and American families received.
shelter insecurity, and COVID-19 related health
risk, some ELs had to confront additional Moreover, teachers of migrants, refugees, and
challenges (Uro et al., 2020), such as: newcomers are often the people best positioned to
identify and refer underserved migrant and refugee
 Taking on adult responsibilities, such as learners to mental health services within and
dealing with the landlord, social service outside of school. Teachers and providers can
agencies, and school—if they have more engage in substantial care work that may mitigate
English proficiency than their parents and no the stressors that newcomer children or students
interpretation services are offered. often experience, but their roles in doing this work
have been severely constrained by the pandemic.
Adding to this concern, immigrant families are not
accessing many social safety-net services, like the depression and anxiety symptoms compared with
Women, Infants, and Children (WIC) Nutrition students with cisgender identities. Additionally,
Program (Pelto et al., 2020). Even though the intersection of an individual’s gender identity
immigrant families are eligible for some types of and sexual orientation with other aspects of their
public assistance, some are fearful of accessing identity impacts mental health, such that students
these resources. of color who are also LGBTQI+ have significantly
worse outcomes, such as depression and anxiety,
It is vital that school psychologists, counselors, and compromised educational functioning, than
and other mental health professionals collaborate, students in only one minority identity group
in accordance with applicable law, with (Borgogna et al., 2019).
community agencies that can assist in the
provision of services for their children and During the COVID-19 pandemic, LGBTQI+
students and identify those that can work with students were among those at highest risk of
families who do not speak English (Peterson et al., increases in anxiety symptoms (Fruehwirth et al.,
2021). It is critical that health care providers 2021). Young students who identify as LGBTQI+
communicate in a language that is understood by are exposed to social inequalities, which, in some
ELs and their caregivers, and utilize qualified cases may be worsened by the pandemic,
language service providers when needed. Concrete compounding their stress (Hunt et al., 2021;
guidance about how to serve ELs, as well as other Gonzalez et al., 2020; Salerno et al., 2020).
learners with complex needs, in challenging times According to The Trevor Project polling in August
is still emerging (Reich et al., 2020). of 2020, LGBTQI+ youth were significantly more
likely than straight or cisgender youth to exhibit
LGBTQI+ Status symptoms of depression, anxiety and/or both. In
Prior to the pandemic, youth who identify as addition, loneliness was most acutely felt by
LGBTQI+ experienced unique stressors such as transgender and Black LGBTQI+ youth. Overall,
emotional distress, symptoms of anxiety and LGBTQI+ youth were more likely to report
depression, hopelessness, self-harm, feeling “much more lonely” than straight or
alcohol/substance abuse, suicidal ideation, and cisgender youth. The Trevor Project’s 2021
suicidal behavior at rates higher than heterosexual National Survey on LGBTQI+ Youth Mental
and cisgender youth (Taylor, 2019). Further, Health found 42% of LGBTQI+ youth considered
individuals who identify as LGBTQI+ experience attempting suicide in the past year, with higher
greater physical/sexual violence and bullying percentages for transgender and nonbinary
victimization, making them almost five times respondents. Specifically related to the pandemic,
more likely to experience severe mental health the survey (The Trevor Project, 2021) revealed
symptoms (Heiden et al., 2020). Students who 70% of LGBTQI+ youth reported that their mental
identify as LGBTQI+ may routinely hear anti- health was “poor” most of the time or always
LGBTQI+ language and experience victimization during the time of COVID-19.
and discrimination at school, resulting in worse
educational outcomes and poorer psychological Religion
well-being (Kosciw et al., 2018). College students Prior to the pandemic, studies showed that
with transgender and gender nonconforming religious minority students faced challenges from
identities reported significantly higher rates of bullying. Research shows that more than 16% of
bullying incidents in public schools target students full range of instructional services and supports
because of their religious identity (Schlanger & approved in their Individualized Education
Shaffer, 2017). In one nationally representative Program (IEP) specific to their individual needs.
sample of American families, 42% of Muslims, School closures have also impacted testing and
23% of Jews, and 6% of Catholics reported that at eligibility decisions regarding early identification
least one of their children had been bullied in the of children with disabilities and additional service
past year because of their religion (ISPU, 2017). needs (Cummings & Turner, 2020).
The COVID-19 pandemic disrupted the ability of
religious people to congregate at houses of
worship, which likely further impacted children in
religious minority communities. The challenges
experienced by religious minority students,
whether due to bullying in school, or as a direct
result of the pandemic, potentially raise unique
mental health concerns.
Disability
Compared to children and students without
disabilities, children and students with disabilities
experience (a) higher rates of mental health
challenges; (b) more anxiety, depression, and
academic-related distress; (c) higher rates of Children and students with disabilities may face
suicide ideation and suicide attempts, and non- additional stress during the pandemic related to
suicidal self-injury; and (d) greater peer increased health and social risks. Discussions of
victimization (Coduti et al., 2016; Fleming et al., health care rationing, especially early in the
2016; Salle et al., 2018). Unique barriers to pandemic, contributed to heightened anxiety–for
support include limited availability of resources, example, perceptions among children and students
behaviors inconsistent with school or program with disabilities such as, “[i]f people like me get
expectations, family characteristics and sick, we won’t get care.” (Lund & Gabrielli,
involvement, lack of collaboration between 2021). Furthermore, immunocompromised
partners and need for professional development children/students and kids with other high-risk
(Poppen et al., 2016). Further, the current conditions (e.g., Down Syndrome, Cystic Fibrosis,
approach of assessment and provision of mental asthma, etc.) may experience greater risks due to
health services for children and students with COVID-19 which may result in increased anxiety–
disabilities is poorly conceptualized and especially if school districts are not requiring
fragmented (Carlson et al., 2020; Skaar et al., masks to be worn in the classroom).
2020).
COVID-19 has disproportionately impacted

children and students with disabilities (Pier et al.,
2021). School closures prevented children with
disabilities across most states from accessing the
2. Perceived Stigma as a Barrier to health needs may manifest as behavioral
Accessing Services Even When challenges, resulting in exclusionary discipline
Available (e.g., suspension, expulsion), and further
decreasing the likelihood of students accessing
Many factors, including culture, tradition,
educational, social, emotional, and behavioral
availability of best practices and local advocacy,
support in school.
and access to education and healthcare, can shape
public perceptions of mental health (Seeman, To the extent that unmet mental health needs are
Tang, Brown, & Ing, 2016). Additionally, the related to a disability, schools must be mindful of
profound impact of early experiences on mental their obligations under the IDEA and Section 504,
health warrants increased public awareness. which include providing appropriate supports
Research increasingly suggests that adverse events when addressing behavior that is disability related.
in early childhood are linked to persistent mental Further, where a mental health-related disability
health problems. Childhood maltreatment, for has not been identified, but there is reason to
example, increases the odds of developing believe that a student may have a disability, based,
depression or Post-Traumatic Stress Disorder in at least in part, on a student’s undesirable
adulthood (Weir, 2012). However, perceived behavior, schools are reminded of their obligations
public stigma is (a) one of the major reasons under the IDEA and Section 504, which include
people, including children, adolescents and identifying and evaluating students. Finally,
families do not seek mental health care (Weist et schools are reminded that both the IDEA and
al., 2019a) and (b) significantly associated with Section 504 have requirements with respect to the
greater odds of suicide ideation, planning, and limitation of and prohibition of exclusionary
attempt (Goodwill et al., 2020). A similar stigma discipline.
exists in institutions of higher education as well,
where barriers to mental health access lead to 3. Ineffective Implementation of
increased suicide risks (Horwitz et al, 2020). Practices
Negative perceptions of mental health can be
There are many limitations in the ways mental
reduced through mental health literacy for
health services are traditionally implemented for
educators, children, students, and families, which
children, students, and families. Clinicians
has therapeutic benefits and increases help-
typically provide services in specialty clinics
seeking. Further, there is growing evidence that
outside of the school or program setting, and often
many labels for children and students experiencing
barriers prevent families and children from
challenges in education and mental health systems
effectively and efficiently connecting to care (e.g.,
are highly pejorative 2 (e.g., “disturbed,” “crazy”)
poor knowledge of mental health, perceived
and are associated with negative perceptions,
stigma, long distances to centers, or poor
reduced help-seeking, and ongoing and worsening
communication among agencies). Further, there
self-stigmatization (Weist et al., 2019a).
are questions about the quality of care (see Eklund
Exacerbating these experiences, unmet mental
et al., 2020): some clinical staff continue to
2 Section 504 protects students from disability harassment. Schools at https://www2.ed.gov/about/offices/list/ocr/letters/colleague-

have an obligation to investigate reports of disability-based bullying-201410.pdf.
bullying or harassment. For more information, see the Office for
Civil Rights guidance on Bullying of Students with Disabilities
implement practices that are not supported by least some tier one supports as a part of their core
research evidence and, even when practices are mission to educate students.
evidence-based, clinical staff may have
insufficient training and support to effectively Unmet mental health needs can also be related to a
implement practices (Evans & Weist, 2004; disability. For this reason, when a student engages
Massey & Vroom, 2020). Moreover, some in behaviors inconsistent with school or program
arrangements result in mental health clinicians expectations, schools and programs must be
only being present in a school on a limited basis mindful of their obligations under the IDEA and
(e.g., one or two days per week), without being Section 504, which include identifying and
considered part of the school support team. In evaluating students for a suspected disability,
some cases, some school staff may not know who providing appropriate supports when addressing
the outside clinicians are working with or what behavior that is disability-related, and complying
they are working on (see Barrett et al., 2013). In with requirements imposing limitations and
addition, school personnel often relegate prohibitions pertaining to exclusionary discipline.
addressing all mental health services to more
clinical mental health staff. 4. Fragmented Delivery Systems
The current system is not working for many
More well-trained, experienced clinicians, whether children, students, families, and staff, with notable
school-based staff or community-based problems that existed before the pandemic made
professionals, are critical for children with much worse during the pandemic. Medical and
intensive mental health needs, but all school and mental health care are frequently siloed—provided
program staff should be (a) trained to support and in separate facilities by different providers and
respond to general social, emotional, and with different payment streams—making it
behavioral needs as an integrated part of teaching cumbersome and confusing to obtain needed care
and learning and (b) aware of communication and (Knickman et al., 2016). Similarly, within schools,
collaboration strategies to engage clinicians for those providing direct services to children and
more intensive mental health needs. However, students, including teachers, counselors, school
school environments are busy and complex, and psychologists, and social workers, are often siloed
environmental challenges may inhibit the delivery and work in relative isolation from one another
of evidence-based supports (Eklund et al., 2020). (Adelman & Taylor, 2021b) affecting all children
Therefore, it will be critical that schools consider and students, including those with disabilities
what they should stop doing (or de-implement) (Skaar et al., 2020).
alongside conversations about what to implement.
For example, schools may consider discontinuing For young children, many states are now working
efforts that are not supported by evidence and to strengthen supports for emotional growth and
practices that result in stigma or harm to children mental health. However, great variation exists in
and students (e.g., exclusionary discipline the capacity of state early childhood systems to
practices for behaviors that result from an identify and meet the needs of infants and toddlers
underlying mental health need). Unmet mental who have social, emotional, or behavioral delays;
health needs can be barriers to staying on task or mental health conditions; or circumstances that put
learning new information, schools may consider them at high risk of developing these difficulties
their efforts to ensure all students have access to at (Smith et al., 2020). These challenges include
inconsistencies in practices related to screening; Further, funding streams vary significantly
referral; service provision for mental health or by state.
social, emotional, and behavioral challenges; and
provider standards and competencies. An To date, there is limited guidance on policies that
additional level of both complexity and risk exist will improve and help to implement evidence-
for young children in early education programs based social, emotional, and behavioral health
who are also being served in a variety of different practices in schools and programs (National
mixed delivery settings from home, family child Center for School Mental Health, 2021).
care, center-based child care, and schools which Education law and policy prioritize supports to
impact the types of services that may be available. promote educational benefit with less direct
emphasis on mental health supports. (Bateman &
Current systems focus on individual level needs, Yell, 2019). For example, mental health needs are
leaving out community supports. One important not consistently considered across evaluations for
approach is Asset-Based Community all the eligibility categories under Part B of the
Development which has a long track record of IDEA and thus there may not be an assessment of
bringing communities together to identify their mental health needs “related to the suspected
inherent assets and support collective and self- disability” (Skaar et al., 2020). Section 504
determined solutions to challenges. Also requires the provision of related services to meet
recommended is human-centered design to the individual educational needs of students with
support community development disabilities as adequately as the needs of students
approaches. These and other approaches support a without disabilities are met. As discussed in
more focused understanding of equity and Appendix D’s sections on “How a Student with a
empowerment by including the larger community Disability Can Receive Services
in which schools operate.
5. Policy and Funding Gaps

Meeting the comprehensive mental health needs of
all children and students requires coordinated
policy and multiple funding streams (McCance-
Katz, & Lynch, 2019); however, school, district,
and state staff often lack the knowledge of these
systems to satisfy requirements for funding (Maag
& Katsiyannis, 2010). Local and state
organizations struggle with the ability to provide Under IDEA and Section 504” and “Mental
the full continuum of expanded school mental Health Services,” these related services may
health services, necessitating grants, contracts, and include mental health services to address the
funding from other federal, state, local, and private student’s needs. State guidelines related to
mechanisms (Evans et al., 2003; Weist et al., provision of mental health services vary, with
2003). Gaps in funding between public and private many states having no or vague guidance
sources lead to many children and students (Education Commission of the States, 2020), and
receiving limited or no services for documented there is a lack of focus on fidelity and outcome
mental health needs (Maag & Katsiyannis, 2010). data to drive provision and evaluation of supports.
Additionally, there is a gap in strong and effective (b) employ functional behavioral assessment to
policy that prohibits ineffective disciplinary develop individualized behavioral intervention
practices. Instead, states, districts, schools, and plans for students whose behaviors interfere with
programs may rely on ineffective policy, such as their ability to access and benefit from the
zero tolerance, that often result in disproportionate education program.
and/or inappropriate use of exclusionary discipline
(Skiba & Peterson, 2000). Further, not all states 6. Gaps in Professional
have policies that prohibit inappropriate Development and Support
disciplinary practices, such as corporal Resources to address child and student mental
punishment, seclusion, and restraint 3 that health needs vary across schools, programs, and
disproportionately impact children of color and districts, often focus on crisis management, and
children with disabilities (Children’s Equity rest heavily on reactive responses to individual
Project & Bipartisan Policy Center, 2020). Note child or student issues rather than a
that seclusion and restraint have been found by comprehensive system of support (Geiser et al.,
GAO and congressional investigators to have been 2019). Many school staff have limited mental
connected with a number of cases of alleged abuse health knowledge (Frauenholtz et al., 2017), and
and death, including cases which have resulted in schools rely on community-based mental health
convictions or findings of civil and criminal services to provide or supplement their school
liability. (GAO, 2009) mental health supports. Community-based mental
health supports may be less accessible (Fazel,
Moreover, there is concern that some traditional
Hoagwood, Stephan, & Ford, 2014), available,
special education programs and supports
and coordinated (Frauenholtz et al., 2017),
inadequately address student mental health
presenting particular challenges to under-
concerns (Carlson et al., 2020; Skaar et al., 2020).
resourced, rural communities (Shelton & Owens,
For example, Spiel et al. (2014) assessed goals,
2021).
objectives and plans for 97 middle school students
with Attention-Deficit/Hyperactivity Disorder Often children and students from underserved
with IEPs (62% of the sample) or receiving groups are less likely to be referred for additional
support through Section 504. In general, social, emotional, behavioral support and mental
recommendations in school programs had little or health services (Vincent et al., 2012). Continued
no research to support their effectiveness, and professional development and assistance from
particular evidence-based programs were rarely leadership may be helpful to neutralize potential
mentioned. Instead, to comply with IDEA and bias in decision making regarding the need for
Section 504, individualized programs should additional supports (McIntosh et al., in press).
(a) support children and students in each area of
unique need—including educational, social, Again, this scenario underscores the critical
emotional, behavioral, and related areas—with importance of true education-mental health system
high-quality and evidence-based support and partnerships. For example, one approach hinges on
3The use of restraint and seclusion can result in discrimination https://www2.ed.gov/about/offices/list/ocr/letters/colleague-

against children and students with disabilities, which would be a 201612-504-restraint-seclusion-ps.pdf.
violation of Section 504. For more information, see OCR's
Guidance on the Use of Restraint and Seclusion in Schools at
school mental health working systematically children and students (Murray et al., 2016), may
within a Multi-Tiered System of Supports be more negatively impacted by teacher stress,
(MTSS), articulated by the Positive Behavioral which may heighten the impact of implicit biases
Interventions and Supports (PBIS) framework (see and lead to further inequities in discipline and
Barrett et al., 2013; Eber et al., 2019) and the academic achievement (Girvin et al., 2017).
Pyramid model framework.
7. Lack of Access to Usable Data to
Guide Implementation Decisions
Schools, districts, campuses, and programs
experience significant challenges with collecting
and accessing usable data (accurate, readily
available, and comprehensive) including the high
cost of some proprietary measurement systems,
variability in measures used between
schools/districts, insufficient staffing, insufficient
training and implementation support, and the fast-
paced environment of schools (Arora et al., 2016).
Beyond collecting data (attendance, discipline
records, climate surveys and school satisfaction
ratings), schools, districts, campuses and programs
Further, educators may experience stress or mental struggle with (a) effectively using the data to
health challenges that affect their ability to support guide programming within the MTSS for selection
children and students. Teachers who experience of evidence-based practices; (b) identifying and
high occupational stress tend to demonstrate a lack screening for early risk factors for children,
of emotional support and negative interactions students, and families; (c) implementing programs
with students (Hamre Pianta, 2005; Oberle et al., to prevent problems, address them early, and
2016). Similar findings have been reported in provide more intensive intervention;
early childhood education, with elevated stress a (d) evaluating and improving the fidelity of
common experience among early childhood program delivery; (e) monitoring child or student
teachers and providers. Teacher stress correlates to progress in relation to programs/interventions
unfavorable teaching practices (e.g., less positive received; (f) documenting program impacts on
attention to children, more punitive responses to child or student social, emotional, behavioral, and
children’s behaviors inconsistent with school or academic functioning; and (g) using progress
program expectations, less attention to social, monitoring and outcome data to refine, strengthen
emotional, and behavioral learning), more and scale up programs that are working and move
conflictual teacher-child relationships, and less toward replacing or eliminating programs that are
optimal child outcomes (e.g., less positive not working (Eber et al., 2019; Center on PBIS,
behavior, lower engagement in classroom 2017).
activities; Smith & Lawrence, 2019). Black
Recommendations
To increase the capacity of states, districts, regulatory requirements included in the overall
schools, programs, and institutions of higher document, the contents of this document (i.e.,
education to provide social, emotional, and these recommendations) do not have the force or
behavioral health support and to improve effect of law and are not meant to bind the public.
outcomes for children and students, we The strategies listed are intended only as
recommend the following: recommendations to increase capacity to meet the
social, emotional, and behavioral health needs of
1. Prioritize wellness for each and every child,
children and students.
student, educator, and provider.
2. Enhance mental health literacy and reduce For each strategy, we provide educator action
stigma and other barriers to access. steps and offer implementation tips. Appendix A
includes implementation examples organized by
3. Implement a continuum of evidence-based
recommendation. As described in the opening
prevention practices.
paragraph, these recommendations have
4. Establish an integrated framework of application across early childhood, K–12, and
educational, social, emotional, and behavioral- higher education settings; however, the current
health support for all. evidence base for implementation in higher
5. Leverage policy and funding. education settings is more limited.
6. Enhance workforce capacity. 1. Prioritize Wellness for Each and

7. Use data for decision making to promote Every Child, Student, Educator,
equitable implementation and outcomes. and Provider
Educator wellness is associated with child and
Prioritizing these recommendations can help
student wellness (Harding et al., 2019). Educators
create more nurturing programs and schools,
who provide emotional support and establish
including higher education, and, through them, a
positive relationships influence children’s and
more responsive and inclusive society (see Biglan
students’ health, overall mental wellness, and life
et al., 2020) that promotes mental health and well-
satisfaction (Stewart & Suldo, 2011). Wellness is
being for children, students, educators, and
multidimensional and may include medical,
providers. As a reminder, other than statutory and
emotional, environmental, occupational, physical,
intellectual, spiritual, social, and financial emotional, and behavioral adjustment, including
components (Lever et al., 2017). Educators’ wellness programming for them and for staff. For
wellness is an important component to ensuring a example, prioritize stress reduction, mental and
healthy school climate, and educator wellness physical wellness routines such as daily
programs are associated with greater workplace opportunities for movement, yoga, mindfulness
satisfaction and lower rates of absenteeism (Lever activities, meditation, and any additional calming
et al., 2017). Promoting staff wellness benefits routines to promote self-regulation (e.g., lights off,
staff, children, and students. music, breathing, drawing). These routines
(a) promote resilience and health among children
Action Steps for State, District, School, who have experienced trauma (Sciaraffa et al.,
and Program Leaders 2018) and (b) reduce stress and increase health
Assess well-being. School, district, and program and focus among adults. In the higher education
leadership teams can use data to determine their setting, colleges and universities can distribute
specific wellness needs and areas of focus resources, such as wellness kits, to support
(Alliance for a Healthier Generation, 2016). students.
 Conduct educator well-being assessments Teams may consider the following approaches to
(e.g., Professional Quality of Life promote wellness and de-stress staff.
https://proqol.org/; Hudnall Stamm, 2009) and
universal wellness screening for children and  Eliminate ineffective or redundant efforts such
students (see additional detail in as non-instructional administrative duties and
Recommendation 7). non-critical meetings so educators can direct
their attention and energy toward better and
 Use existing data sources like staff perception sustained implementation of high-quality
of school climate, campus climate surveys, practices for all children or students, especially
staff attendance rates, and focus group those with high risk.
information to gain insight into staff’s
satisfaction and overall impact from the stress  Establish a realistic workload, child or student
of their work. to teacher ratio, and a manageable approach to
teaching an aligned and integrated curriculum
 Consider using universal staff for academics and social-emotional, and
surveys/strengths and needs assessment data to behavioral health instruction. Feeling
strengthen and promote access to existing competent is part of wellness. When educators
Employee Assistance Programs (EAP) for feel like they have the skills, resources, and
educators and additional supports for students supports to do their job well, they feel less
(Recommendation 4). stressed and are able to better meet the needs
of their children, students and families
Emphasize wellness programming for children,
(Grayson & Alvarez, 2008; Shackleton et al.,
students, and staff. While schools and districts
2019).
are faced with a significant educational and
developmental slide for many children and  Provide time for debriefing after stressful days
students associated with the pandemic, there is a (Miller, 2010).Provide quiet space for staff to
need for balanced programming that supports regroup and reset (McIntosh et al., 2018).
learning, while also supporting their social,
 Integrate wellness into professional  Reach out to colleagues in multiple formats to
development approaches by providing model care and emotional support to promote
adequate planning time for staff that includes a mentally healthy work environment.
opportunities for collaboration, training, peer  Consider protecting time in all meeting
coaching, and supportive performance agendas to check in with others as a simple
feedback. way to integrate this into daily work.
 Allow departments focused on health and  Similarly, classroom staff can focus on
wellness to combine efforts and create campus building emotional safety in classroom
wide focus on well-being (NASPA, 2017). conversations and start their instructional day
 Prioritize collaborative planning time for with greetings/check-ins with their children
delivery of instruction. Use Communities of and students.
Practice or Professional Learning

Communities, which provide collaborative We should be discussing how to provide
opportunities to engage in group learning meaningful learning, as well as mental-
focused on a common issue and grade health systems that prioritize
level/core/department team meetings to create belongingness and well-being. We
should focus on creating environments
small systems of support for staff (see
that will welcome students back to a
Cashman et al., 2014).
transformed system.”
 Ensure wages and benefits are competitive, —Kurt Hatch, PhD
including by ensuring those professionals
serving children birth to five are compensated Create, normalize, and prioritize habits of
competitively with kindergarten educator physical and mental wellness for ourselves and
peers, when similarly qualified. others. Consider building habits of positive and
Implementation Tip
proactive practices (e.g., actively engaging
children or students in learning,) using positive
Focus on effectiveness and efficiency, embracing feedback to promote growth), as described in the
the concept that “more is not necessarily better.”
Consider investing in a small number of evidence-
Habits of Effective Classroom Brief.
based practices that are matched explicitly to the  Interact and deepen connections with children
needs of the community and have the potential of
and students and staff across the day.
impacting children and students with identified needs.
 Establish predictable environments throughout
Action Steps for Educators with increased structure and routines, teaching
Promote habits of connection. Ensure daily positive expectations that incorporate a focus
connection with others using a regular schedule of on wellness (e.g., care for others, self,
communication through various platforms. This environment), and celebrate or reinforce
could be as simple as emotional check-ins, or wellness practices for staff and children or
using humor in an appropriate way. Reach out to students.
colleagues in multiple formats to model care and  Build routines within daily schedule for social
emotional support to promote a mentally healthy time, self-care, and program or school wide
work environment. calming strategies.
2. Enhance Mental Health Literacy and improve mental health literacy. Mental health
and Reduce Stigma and Other literacy is defined as “knowledge about mental
Barriers to Access health disorders that is associated with their
recognition, management, and prevention”
Given increased mental health needs associated
(Furnham & Swami, 2018, p.1). Low levels of
with the pandemic and social challenges (e.g.,
mental health literacy contribute to the
racial injustice), there is an urgent need to improve
misperception of mental health needs and access to
access to mental health support by reducing
services (Miles et al., 2020), whereas gains in
barriers, changing attitudes and perceptions about
mental health literacy are associated with increased
mental health, and eliminating discriminatory
help-seeking intentions and potential treatment
practices that harm students with mental health
utilization (McCance-Katz, & Lynch, 2019).
challenges. This will require intentional efforts
including providing information, building skills, Offering a range of mental health literacy
actively engaging learners in intervention, interventions at the community level (e.g.,
empowering individuals with mental health wellness campaigns, embedding services within
challenges, and engaging in structural and policy educational programs, and providing information
change (Nyblade et al., 2019). The goal is to on websites) can empower families and
eliminate stigma associated with seeking mental community members to take action for better
health support. mental health (Jorm, 2012). Mental health literacy
training programs, now widely available, can also
empower school staff and families with skills to
recognize and assist children or students
experiencing mental health needs and better
prepare them to make appropriate referrals.
Increasingly, these mental health literacy
programs are being implemented in schools and
play an important role in Tier 1 MTSS
programming (see Clauss-Ehlers et al., 2020).
Further, offering mental health services in the
school setting may be met with less stigma than in
a traditional, community-based mental health
setting (Hoover et al., 2019). Additionally, there
are fewer barriers to school-based services when
Campaigns to change attitudes and behaviors need the child or student does not have to leave the
to be based on sound evidence (Stuart, 2016), and setting to attend appointments, so children or
inclusive of all children and students (Brock & students may be more willing to receive mental
Brant, 2015). Importantly, there is a critical need health services (Clauss-Ehlers et al., 2020).
to broadly define mental health (e.g., thoughts,
Encouraging the use of or providing the
feelings and actions that promote success in life,
opportunity to receive Telemental health (mental
or developing capacity of the child or student to
healthcare that is provided remotely via electronic
form close relationships, manage and express
device) may also reduce the barrier of stigma
emotions, and explore the environment and learn)
associated with seeking mental health treatment,  Identify a school or program person to manage
especially for college students. College students the request for assistance process from
view this treatment option as convenient, teachers and providers to ensure assistance is
accessible, easy to use and helpful (Hadler et al., provided in a timely manner (e.g., not having
2021). This intervention not only provides to wait for a meeting to identify support).
additional flexibility to students navigating busy
 Consider ways to bundle the request for
class schedules, but offers additional opportunities
assistance process, providing supports for staff
for students who may otherwise be reluctant to
and families.
seek care.
Implementation Tip
Action Steps for Educators
Model understanding and appreciation for Establish processes to actively include and engage
all community members, including children,
mental health and mental health challenges.
students, and parents whose primary language is
School and program leaders, teachers, and staff set not English. Spend time discussing language,
the tone about the acceptance and importance of terms, and acronyms. Host listening sessions and
mental health. A consistent message should be focused community interviews to ensure all
shared by all school and program staff that taking members of the community have a voice and role
in supporting wellness activities.
care of mental health is just as important as caring
for physical health. Challenges are common and
are even more prevalent since the pandemic. 3. Implement a Continuum of
When school and program staff model the ways Evidence-Based Prevention
people have addressed them on a personal level it Practices
helps to reduce stigma and increase supportive Implementing evidence-based practices within a
discussions and actions among staff, children or Multi-Tiered Systems of Support (MTSS)
students and families. framework provides an effective organizing
structure for schools, programs, and districts.
Recognize and respond using a similar process
MTSS is an integrated implementation framework
across social, emotional, behavioral, and
for organizing a continuum of evidence-based
educational supports. Increase mental health
practices to support each child’s and student’s
literacy (e.g., Youth Mental Health First Aid,
educational, social, emotional, and behavioral
programs on Adverse Childhood Experiences) and
needs (see https://mtss.org/overview/ for a detailed
develop marketing campaigns (e.g., Prevent,
description of integrated MTSS).
Recognize, and Respond) to look for signs and
symptoms of social, emotional, and behavioral Within the context of an effective MTSS
needs. framework, it is important to prioritize primary
 Look for behavior and mood changes in prevention (Tier 1) practices that establish
children, students, and staff. positive, predictable, and safe environments and
routines (Center on PBIS, 2020; Office of Special
 Be explicit about how to get help.
Education Programs, 2015). Examples of primary
 Create a positive process for teachers and prevention practices include: (a) creating a
providers to seek assistance. welcoming physical environment for children or
students, staff, and families; (b) intentionally
making connections with children or students individualize support, teams (a) use individual
using simple strategies, like positive greetings, to assessment data to identify specific areas of
set children or students up for success; strength and need and (b) develop an
(c) establishing consistent and predictable individualized plan that promotes educational,
routines; (d) explicitly teaching, prompting, and social, emotional, and behavioral skill
reinforcing a few positive expectations; development and improves overall mental health
(e) delivering effective, engaging, and culturally- or well-being.
relevant academic instruction; (f) using screening
tools to plan, implement, and assess instruction MTSS is a fluid and data-driven framework for
and; (g) providing specific and supportive organizing supports, not children or students. In
feedback. These practices promote wellness and other words, children and students likely have
are associated with desired educational, needs that are met by supports within and across
developmental, social, emotional, and behavioral all tiers. For example, a student may benefit from
outcomes (Allday et al., 2011; Alter & Haydon, Tier 1 support in math, Tier 2 support in reading,
2017; Cook et al., 2017; Cook et al., 2018; and Tier 3 social, emotional, and behavioral
Hancock & Carter, 2016; Kern & Clemens, 2007; support. Further, supports are layered; a student
Simonsen et al., 2008; Simonsen et al., 2021). who receives Tier 3 support should also have
access to relevant Tier 1 and 2 supports. For
In addition to these critical primary prevention example, a child who receives Tier 2 social skills
practices, schools and programs may use their data instruction should also participate in the classroom
to identify universal needs and adopt a Tier 1 Tier 1 social skills instruction. Using a MTSS
mindfulness-based practice to teach resilience and Framework to organize evidence-based practices,
other coping skills to students (Gueldner & educators can effectively and efficiently meet the
Feuerborn, 2015) or other social, emotional, and educational, social, emotional, and behavioral
behavioral learning approaches (Fazel et al., 2014; needs of all children and students.
Hoover et al., 2017). Research shows even greater
improvements in overall mental health and
reductions in externalizing behaviors when
combining Social-emotional Learning (SEL) and
PBIS (Cook et al., 2015).
Beyond primary prevention, secondary

prevention (Tier 2) provides targeted support for
students who continue to experience social,
emotional, and/or behavioral risk. Targeted
support intensifies the core features of universal
support, providing, for example, more frequent
opportunities for connection, reminders, skill
practice, feedback, and acknowledgement. For
students with chronic or intense social, emotional,
or behavioral needs, tertiary prevention (Tier 3)
provides intensive and individualized support. To
Action Steps for Educators  Secondary prevention (Tier 2). Implement
Organize practices into an integrated targeted support for children and students who
continuum. Ensure that all children or students continue to demonstrate social, emotional,
have opportunities to maximize educational, and/or behavioral risk. Select empirically
developmental, social, emotional, behavioral, and based targeted supports such as Check In
physical outcomes. Adjust to ensure that some Check Out (CICO; Hawken et al., 2009);
children or students get whatever additional Check & Connect (Sinclair et al., 2003);
supports they need in a timely manner. See the Check, Connect, and Expect (Cheney et al.,
federal technical assistance centers from Appendix 2009); social skills groups; or similar targeted
B for additional support on organizing practices supports for children and students with
into an integrated continuum (e.g., National emerging needs. With targeted Tier 2 supports
layered on top of universal Tier 1 supports, the
Center for Pyramid Model Innovations, National
majority (~95%) of children and students
Technical Assistance Center on Positive
will benefit.
Behavioral Interventions and Supports).
 Tertiary prevention (Tier 3). Prioritize
 Primary prevention (Tier 1). Emphasize
intensive and individualized support for
universal support and wellness promotion for
children and students who demonstrate chronic
all. At Tier 1, this should include a holistic
or high-intensity social, emotional, and/or
emphasis on wellness for both children or
behavioral need. Tier 3 interventions are
students, families, and staff, emphasizing
typically (a) based on individual student
positive and proactive classroom practices
assessment data (e.g., functional behavioral
(e.g., culturally-relevant and engaging
assessment, psycho-educational evaluation);
instruction, predictable routines, positive
(b) developed by a child- or student-centered
expectations, explicit instruction in key social,
team that includes relevant experts (e.g.,
emotional, and behavioral skills);
behavior coach, school psychologist,
opportunities to connect; and additional self-
clinician), educators, family members, and the
care strategies that include elements of
child or student; and (c) supported by on-going
mindfulness, relaxation and stress
data collected to monitor implementation and
management, problem solving, exercise, sleep,
outcomes. Children and students receiving
and nutrition (George et al., 2014). Integrating
Tier 3 support should continue to access
programs involving culture, the arts, and sports
support in Tiers 1 and 2 (Eber et al., 2019).
provides additional opportunities for staff,
For example, connect work of clinicians at
children, and students to interact in non-
Tier 3 to work of educators in implementing
academic subjects to build deeper
CICO at Tier 2, and include common
relationships. With effective implementation,
emphases on stress management and wellness
most (~80%) individuals will benefit from Tier
at both tiers. In addition, for students with
1 support. To identify children and students
complex needs that require a coordinated
who require additional support, schools should
approach, use a wraparound process, a
engage in universal screening (described in
comprehensive approach to support for a
Recommendation 7) and consider appropriate
student and family, to (a) create partnerships
targeted (Tier 2) or intensive (Tier 3) supports,
between children or students, their families,
as needed, tailored to student needs.
educators, and other community resources to social, emotional, and behavioral skills; and
meet their individual mental health needs; (d) incorporate wellness practices (e.g.,
(b) center supports on student and family connections, self-care breaks, mindful minutes)
strengths and needs; (c) adopt a flexible and into classroom routines. Engage participants in
coordinated approach to supporting needs; and discussion about the benefits and challenges
(d) implement, monitor, and celebrate related to each step of integration (Florida PBIS,
implementation successes (Maag & 2020).
Katsiyannis, 2010).
Address the specific needs of underserved
 Crisis response. Throughout the continuum of children and students. Develop specific
support, ensure there is a process for strategies to support children and students from
developing crisis response plans for children race, ethnicity, socio-economic, and LGBTQI+
and students who may be actively in crisis groups, who are underserved and
(e.g., experiencing suicidal thoughts, disproportionately at higher risk for experiencing
homelessness, or domestic violence) that is harassment, discrimination, mental health
(a) proactive and preventive, (b) aligned with challenges, and barriers to effective mental health
intervention tiers, and (c) guided by evidence care (DeFreitas et al., 2018). Differentiate support
and data. to meet the needs of all children and students,
including those with disabilities (Bradshaw et al.,
2012; Gage et al., 2019; Grasley-Boy et al., 2019;
Loman et al., 2018). In addition, improve the
coordination and collaboration with social service
and community agencies that serve children that
are the most marginalized (e.g., children
experiencing homelessness, substantiated cases of
abuse and neglect).
Engage families and students. Establish two-way
communication between schools, programs, and
families in a genuinely collaborative fashion
(Weist, Garbacz, Lane, & Kincaid, 2017).
• Use simple language and minimize jargon
Focus on integration and alignment of (Owens et al., 2002).
practices. Integrate educational social, emotional,
• Promote engagement with children,
behavioral, and trauma-informed practices to
students, and their families to provide
maximize efficiency. For example, (a) engage in
them a voice in their care and assure that
complementary prevention practices (e.g.,
processes are appropriate for receiving
predictable routines are part of effective instruction
more intensive programs/services
and also considered a trauma-informed approach);
(Adelman & Taylor, 2021a; Maag &
(b) teach and remind students to engage in desired
Katsiyannis, 2010).
social, emotional, and behavioral skills during
academic instruction; (c) provide specific,
positive, and supportive feedback for academic,
Consider supports for specific contexts (e.g., framework that intentionally integrates school
higher education). Protective practices and mental health and PBIS at the school, district, and
strategies to build resiliency in college settings state levels (Barrett et al., 2013; Eber et al., 2019).
(e.g., support systems involving peers and faculty, Integrating systems within an MTSS framework is
ready access to counseling services) are important an incremental process requiring intentional
to help reduce these risk factors and build resiliency investment (time and political will) by people with
to enhance success in college (Knoster, 2020). decision making authority to blend funding,
develop policy, change job descriptions, etc. This
Identify and intervene early. Early interventions process is guided by implementation science and
conducted by comprehensive school mental health data informed improvement cycles. Information
personnel are associated with enhanced educational sharing must be done in a manner that is consistent
or developmental performance, decreased need for with applicable privacy laws, such as the Family
special education, fewer disciplinary encounters, Educational Rights and Privacy Act (FERPA) and
increased engagement with school, and elevated the Confidentiality Provisions of IDEA.
rates of graduation (McCance-Katz, & Lynch,
2019; Weist et al., 2018). Children and students learn more, report feeling
safer, and develop more authentic trusting
Implementation Tip relationship with peers and adults if the learning
Create daily classroom schedules to allow time for and social environments of the school are positive.
explicit instruction on and support for social, Educators foster safe and supportive environments
emotional, and behavioral skill development. by maximizing child and student connections,
arranging engaging and successful learning, and
4. Establish an Integrated being positively constructive in responding to the
Framework of Educational, needs of children and students.
Social, Emotional, and
Implementation Tip
To effectively support the social, emotional, and To implement an integrated MTSS approach, start
by establishing positive, nurturing environments
behavioral needs of all, it is critical to where all children, students, and staff thrive; and
intentionally integrate systems such as education, layer on additional supports to address the unique
health, and mental health within a MTSS needs of some.
framework. Mental health promotion is a critical
part of education, but schools and programs Action Steps for Educators
struggle with how to establish a comprehensive Communicate shared priority. Implementation
system of mental health support. There is support to schools and programs is shared by
increasing recognition of the need to (a) move education and mental health systems, and as
away from co-located programs involving ad-hoc above, ideally with other systems such as child
involvement of mental health system staff in welfare, juvenile justice, and primary care (see
schools or programs and (b) move toward Lever et al., 2003).
approaches that clearly integrate education and
mental health systems, such as the Interconnected  At state and district levels, identify standards
Systems Framework (ISF). ISF is a MTSS to support social, emotional, and behavioral
development and align them with other
initiatives/standards (e.g., those emphasizing • At the school and program level, these
educational support) so that schools and efforts should be led by administration and
programs are not having to do the work of the current school or program (Tier 1)
alignment-that should happen above the level leadership team. Establishing a plan to
of implementation. gather, honor, and reflect voice and choice
 At school and classroom levels, develop within school, district and community
schedules to prioritize time for (a) explicit decision making may require expanding
instruction and support around social, team membership to include broader
emotional, and behavioral health and participant representation and other
(b) careful planning for the integration of community partners that support
social, emotional, and behavioral health wellness efforts.
practices within educational content.  Co-design a comprehensive and contextual
plan focused on strengthening mental health
Implementation Tip
promotion and prevention. Bring on experts to
Alignment of student services and supports from the existing school or program improvement
different agencies is a district responsibility. It team or form a workgroup that has direct
should not fall on the shoulders of school connection to the existing team. With new
administrators or individual educators.
partners at the table, create space for building
trust to co-develop norms and routines, share
Focus on effective teams. Leadership teams are
expertise, and engage in authentic
key to implementing this kind of framework
collaboration.
(Barrett et al., 2019; Splett et al., 2017). However,
having too many teams decreases the system’s Implementation Tip
ability to work efficiently. Look for opportunities
Do not create separate teams and systems for
to expand or merge existing leadership teams (e.g.,
Mental Health and Return to School. Consider
school improvement) with similar goals. bringing on experts to the existing school
 Design a system of support driven by improvement team or forming a workgroup that has
direct connection to the existing team. Schools
community voices, including children,
won’t be able to do this effort alone. Families, child-
students, families, and community partners, serving partners, and community providers will be
and include ways for educators to support one critical. It will be important to have a team focused
another as well as acquire and improve skills on trends and patterns with focus on developing/
to address diverse child or student needs. strengthening Mental Health promotion and
prevention. Hold space to build trust and work
• At the district level, this work should be toward establishing norms and routines together.
led by a team that includes cabinet level
members who can make decisions to Integrate implementation support. District
change budgets, policy, job descriptions, leadership should develop a training and coaching
professional development, and human plan to increase the number of school or program
resources, including but not limited to staff personnel with social, emotional, and behavior
health plans. expertise and to ensure everyone understands their
role within an interconnected system. (See
Recommendation 6 for further information.)
Implementation Tip
those that may be less critical in the current
moment. While the national average remains at a
Commit to integration and alignment of district, 1:464 school counselor staffing ratio, the
school, or program-wide initiatives to organize
recommended best practice is 1:250, with 80% of
resources and supports for staff. The Technical
Guide on Alignment of Initiatives may be a helpful their time working directly with or indirectly for
resource for teams. students (The Education Trust, 2019). For
example, many K–12 school counselors with
5. Leverage Policy and Funding advanced training in mental health spend a
disproportionate amount of time in academic
Policy reviews can help the team examine the
advising, including relatively straightforward tasks
extent to which current policies support an
such as coordinating students’ class schedules,
integrated system and highlight where changes to
that could be assigned to other staff to free
policies could eliminate potential barriers to
counselors up to engage in counseling. In early
integration.
childhood, mental health consultation and access
Despite current fragmentation, districts and states to mental health experts to discuss child and
have been able to improve local policy and family needs, has emerged as an effective
leverage funds to improve mental health support. prevention and intervention strategy. Robust
For example, several states expanded their school- workforce development (training, supervision,
based Medicaid programs since elimination of the mentoring, etc.) and quality assurance systems
free care rule by the Centers for Medicare & must be in place to ensure that mental health
Medicaid Services (CMS) in 2014, allowing states consultants have the needed knowledge and skills.
to receive federal reimbursement for services
provided to any child or student enrolled in
Medicaid and meet other specific requirements,
Implementation Tip
instead of limiting exclusively to those with IEPs.
Build a sustainable funding stream that allows
clinicians to participate in system planning—
moving beyond the restriction of a fee-for-service
delivery model. Flexible funding that is independent
of diagnosis and insurance plans can expedite
delivery of interventions, especially at Tiers 1 and 2.
Work to expand funding options for mental

health. First, leverage federal funds available
through programs and statutes such as IDEA,
Social Security, Children’s Mental Health
Services Program, Medicaid (EPSDT), formula
A critical need for policy/funding efforts is to grants (e.g., grants under the ESEA or
ensure there are sufficient mental health staff in administered by the Office of Juvenile Justice and
educational settings (e.g., psychologists, Delinquency Prevention), grants (e.g., Garrett Lee
counselors, social workers, behavior specialists), Smith Suicide Prevention, Project AWARE,
and that they are working in optimal roles versus
SAMHSA Systems of Care, HRSA Workforce reduce overall or long-term need (Maag &
Development). Katsiyannis, 2010). Identify mental health needs
early to avoid intensive, and more costly programs
In addition, funds to address pandemic recovery and services, such as psychiatric hospitals and
include the Elementary and Secondary School residential treatment programs (SAMHSA, 2020).
Emergency Relief (ESSER) Fund, including the Where available, use mobile crisis team services
American Rescue Plan ESSER (ARP ESSER) to provide more timely and cost-effective access
program, the Governor’s Emergency Education to screening, behavioral health medication
Relief (GEER) Fund, and the Higher Education management, referral, and care (SAMHSA, 2020).
Emergency Relief Fund (HEERF) can be used for
this purpose. Leverage funds to hire additional Implementation Tip
staff and develop a coordinated plan for
Discipline policies should reflect an instructional,
(a) selecting key social, emotional, and behavioral rather than punitive, approach and emphasize
(i.e., mental health) outcomes; (b) aligning proactive evidence-based strategies to support
activities across funding streams that are student social, emotional, and behavioral needs.
consistent with selected outcomes; (c) prioritizing
activities that build local capacity (e.g., team- Share success stories with policymakers.
based leadership, developing expertise among Sharing innovative approaches to providing
school and district leaders) to ensure efforts services and supports may influence more
outlast specific funding sources; and supportive policies and increase needed funding.
(d) developing a comprehensive evaluation plan to For example, consider the following:
monitor and adjust supports based on data.
Form groups to focus on public policy issues
Second, investigate options for financing mental
affecting children and families with the goal of
health services through other sources, such as
advancing promising, evidence-informed public
advocacy groups, foundations, or community
policy (Hill, 2021).
benefit investments (National Academies of
Sciences, Engineering, and Medicine, 2017). The  Suggest policy changes to enhance school
Department has released a Frequently Asked districts’ ability to partner with local health
Questions use of funds document on ESSER and departments to leverage available federal
GEER as well as HEERF that includes additional funding (National Academies of Sciences,
information about how funds may be used to Engineering, and Medicine, 2017).
address social, emotional, and behavioral (i.e.,
mental health) needs. These existing and enhanced Implement policy in districts, schools, and
funding streams related to addressing mental programs to support inclusion and
health needs of children and students address an implementation of effective social, emotional,
array of services and improvements in key areas and behavioral health practices. Ensure equal
and are critical to ensure needed supports are priority for learning outcomes and social,
provided. emotional, and behavioral health are reflected in
local policies, procedures, and funding decisions.
Work to lower costs for providing needed  When reviewing current policies, reflect on the
mental health care. Implement preventive need for mental health informed responses
services such as PBIS and early interventions to
rather than exclusionary responses to mental significantly elevated child and student social,
health needs. emotional, and behavioral concerns as well as
addressing the lost instructional time associated
 Implement standard policy to address how data
with the pandemic.
will be shared to ensure children and students
are linked to appropriate interventions and
have their rights protected.
 Prioritize a healthy workforce as part of the
district vision and mission statements. Support
this priority through consideration of budget
and allocation formula with staff assignment,
workload and context of school or program
needs.
 Articulate new ways of working with
community providers using a memorandum of
understanding process.
 Clearly articulate and communicate new or Funds provided from ARP and ESSR, can be used
revised policies to impacted groups in to hire additional staff such as social workers,
languages they can understand. counselors, mental health and behavioral specialist
and school psychologists to meet the growing
Implementation Tip needs of students. Schools can also identify
current and returning staff with responsibility for
Provide clear guidance on how to implement
policies consistently. Establish two-way
improving school climate, implementing wellness
communication channels to continuously improve programming (as above), coordinating Tier 2
policy based on input from implementers and new programming, and providing additional support
emerging knowledge on evidence-based practices. for Tier 3 services (e.g., to expand family
outreach, case management). Emphasis should be
6. Enhance Workforce Capacity placed on recruiting, training, and providing
There is a critical need for all staff in schools ongoing coaching and implementation support to
(e.g., administrators, educators, school nurses, this expanded workforce (see Gustafson et al.,
community health workers, family advocates, 2021; McQuillin et al., 2019; Reddy, Lekwa, &
family resource developers, school liaisons, Glover, 2020; Rusch et al., 2019).
teacher aides, teacher assistants, student aides,
class aides, behavior coaches, behavior
interventionists, behavior aides) to be trained to Leverage the existing workforce to support
fully support schools’ Tier 1 mental health. Expand or clarify functions of
(promotion/prevention) and Tier 2 (early existing school, program, and district-level staff to
intervention) programming (Gustafson et al., provide mental health support. Use special
2021; McQuillin et al., 2019; Rusch et al., 2019). education teachers or school nurses, for example,
As underscored in this document, schools and to deliver comprehensive mental health support
programs are and will be contending with where their skills align with need (Fazel et al.,
2014). Recruit nurse practitioners to provide Provide ongoing coaching. Implement coaching
mental health support onsite (Fazel et al., 2014). models to further strengthen teachers’ mental
Supplement school mental health staff with health knowledge and capacity (Cappella et al.,
telemedicine for more specialized or intensive 2012).
needs (Fazel et al., 2014). School social workers
can act as conduits between community mental Connect with local community colleges and
health organizations and school staff to provide four-year colleges and universities. An
training and support for mental health important strategy is to map local community
(Frauenholtz et al., 2017). colleges and four-year colleges and universities to
explore connections for college students to work
 Develop processes for assessing current staff in schools. For example, students in associates and
resources and needs, refocusing staff to
undergraduate programs can be placed in
address current child or student needs, and externships in schools to assist in Tier 1 and Tier 2
using data to inform professional development programming, and those in mental health graduate
activities. programs can work in externships focused on
 Partner with community mental health involvement across tiers, and involvement in Tier
providers and expand their role to serve on 3 intervention under supervision. Such
school leadership teams to provide a full arrangements represent a “win-win,” giving
continuum of mental health service across all students training experience, and helping schools
tiers. expand their workforce capacity.
 Ensure school and community mental health
7. Use Data for Decision Making to
clinicians are visible, interact and are
Promote Equitable
accessible to school personnel across settings
Implementation and Outcomes
providing mental health training and
consultation. Regularly collecting, analyzing, and acting on data
is critical to supporting the mental health needs of
 Provide time for planning and collaboration
children, students, and staff. Data can inform
for an aligned educational, social-emotional,
decisions on specific mental health needs (Barrett
and behavioral approach to instruction (e.g.,
et al., 2018) as well as academic needs that are
small professional learning communities meet
impacted by underlying mental health issues
frequently and are supported by district
(Hancock & Carter, 2016). Data can also be used
coaches and community partners).
for more systemic and proactive decisions in
Enhance training. Modify or extend pre- and in- schools and districts (McCance-Katz, & Lynch,
service professional development to include mental 2019). Importantly, school and program staff
health training. Ensure that teacher preservice should use data sources from the school and local
programs include mental health training. Offer educational system but also from the community
blended professional development for teachers and to help guide planning and program
other service providers so evidence-based practices implementation (e.g., foster care placements,
can be implemented effectively and with high psychiatric hospitalizations).
fidelity (Barrett et al., 2019).
 The proportion of families in the community
affected by substance abuse, incarceration, or
domestic abuse,
 Grade retention,
 Learning outcomes, including credit
accumulation,
 Mental health service utilization,
 Community Health Assessments, and
 Other relevant indicators of need (Barrett et al.,
2018; The Steve Fund/JED Foundation, n.d.).
These broader sources of data can (a) identify key
areas of risk and resilience and (b) better position
school and program personnel to identify and
deliver appropriate interventions, and to monitor
their progress with children and students (Barrett
et al., 2018).
Connect data review to goals, outcomes, and

action plans. Similarly, school teams review
relevant school and community data to determine
Action Steps for Leaders and which approaches will meet the needs of all
Educators
children and students. Data should include figures
Review school, program, and community-wide of students referred for and receiving mental
data. States, school districts, and community health services, which interventions are most
partners can evaluate and document outcomes, frequently offered, and outcomes from those
including impact on academic and classroom services (Hoover et al., 2019). In reviewing data,
functioning, using school and community-wide the team should establish measurable goals that
data (McCance-Katz, & Lynch, 2019). For include mental health outcomes. Reviewing data
example, district teams can access community- prior to and throughout the school year helps
level data to determine types and intensities of teams strengthen school-wide prevention efforts.
mental health needs that are present in their school In addition, annually track demographic changes
or program communities. Examples of these data in the composition of the program or school that
include: may have an impact on service needs and
 Chronic absenteeism data, utilization (The Steve Fund/JED Foundation, n.d.).
 School and campus climate survey results, Support teachers, staff, and providers in using
 Student visits to school specialists (e.g., data to document the needs and progress of
counselors, nurses, social workers), children and students. At the classroom level,
teachers, school, and program personnel in early
 Calls to community crisis centers,
childhood and K–12 can use tally sheets or
checklists to determine when students are most This allows leaders and educators to better
likely to demonstrate undesirable behaviors and understand the procedures, allows teams time to
which expectations students have the most course correct, and provides opportunities to build
challenges meeting, for example (Hancock & upon successes.
Carter, 2016). This data collection can better
inform planning instruction and intervention to Promote accountability. Child and student well-
meet identified needs. being is critical to ensure and enhance full access
to educational opportunities. Implementation of
Implement an integrated universal screening data-based interventions is critical to meeting this
process. Districts are encouraged to adopt a obligation and demonstrating progress for students
structured and comprehensive universal screening (Hoover et al., 2019). Thus, in addition to
process to catch internalizing and externalizing monitoring school, program, and community data,
child or student needs. “Internalizing problems are schools and programs should measure, monitor,
described as inner-directed and generating distress and evaluate how effectively programs are
in the individual, while externalizing problems are implemented and if the desired outcomes are
described as outer-directed and generating being achieved (Barrett et al., 2018).
discomfort and conflict in the surrounding
environment” (Forns et al., 2014). An integrated Implementation Tip
screening process looks for early indicators of States, districts, schools, and programs need valid
social, emotional, and behavioral strengths and and reliable data to guide all decisions—from the
concerns. First, train all school or program selection of evidence-based practices to evaluation
of implementation fidelity and outcomes.
personnel to recognize mental health risk factors
and act if they are concerned. Second, educators
administer universal screening for every student Summary and State Spotlight
three times a year in accordance with applicable The mental health crisis in the United States is at a
law. The district oversees (a) selection and use of critical point. The pandemic has exacerbated
a reliable and valid universal screening already alarming trends in mental health needs of
tool/process across all schools, (b) use of universal children and students. There is a unique
screening data to inform universal support, opportunity to reconceptualize the role of schools
(c) identification of strategies to gather additional and programs in creating nurturing environments
information for children and students identified as for children, students, families, and educators to
potentially at-risk, and (d) targeted or intensive address the mental health needs and overall well-
support based on data-indicated need. being of children and students. This resource
highlighted seven key challenges to providing
Schools and districts may consider implementing a school and program mental health supports and
pilot screening with small groups of students prior presented seven corresponding recommendations.
to the comprehensive universal screening process.
Challenges Recommendations
1. Rising Mental Health Needs and Disparities 1. Prioritize Wellness for Each and Every
Among Children and Student Groups Child, Student, Educator, and Provider
2. Perceived Stigma is a Barrier to Access 2. Enhance Mental Health Literacy and
Reduce Stigma and Other Barriers to
Access
3. Ineffective Implementation of Practices 3. Implement Continuum of Evidence-Based
Prevention Practices
4. Fragmented Delivery Systems 4. Establish an Integrated Framework of
Educational, Social, Emotional, and
5. Policy and Funding Gaps 5. Leverage Policy and Funding
6. Gaps in Professional Development and 6. Enhance Workforce Capacity
Support
7. Lack of Access to Usable Data to Guide 7. Use Data for Decision Making to Promote
Implementation Decisions Equitable Implementation and Outcomes
challenges. States, districts, and schools are

The continuing “Spotlight on Supporting Mental
encouraged to use data to guide and contextualize
Health in Washington State” illustrates how
their own approach to implementing these
Washington responded to the challenges,
recommendations. In addition to this example,
described in the first spotlight, by implementing
please see Appendix A for additional examples
these recommendations to address their local
organized by each of these recommendations.
Spotlight on Supporting Mental Health in Washington State: Moving Forward with
Aligning and Implementing
Schools are the most common setting in which children the MTSS framework used in PBIS (Barrett, Eber,
and adolescents receive mental health services and Weist, 2013). Both PBIS and MTSS emphasize the
supports. Shifting to a more integrated and effective need for detecting mental health needs in students at
approach to providing social-emotional, and behavioral the earliest sign of need and responding effectively with
support requires making changes to many of the evidence-based strategies. To address the well
standard approaches to prevention and intervention in documented gap between onset of mental health
schools. In the Northwest, the states of Idaho, Oregon, disorders and treatment, schools must have the
and Washington along with several organizations are structures in place to recognize need in students at the
streamlining and coordinating efforts to enable school- first sign of need and respond rapidly. The ISF provides
aged students to access and benefit from a continuum of systematic steps for building capacity to identify
mental health support in the school environment, problems and intervene early and effectively. The
otherwise known as the Interconnected Systems traditional hand-off to a community mental health
Framework (ISF). Coordination efforts between the practitioner common in most schools today can delay or
groups includes (a) combining and leveraging local, discourage further treatment. Other traditional
state, and federal funding sources, (b) co-sponsoring approaches to school mental health result in mental
professional development resources and events, and health practitioners providing services without feedback
(c) aligning messaging and resources for impacted to the school or systems to monitor progress and
groups. This joint effort aims to more effectively meet the outcomes. In an ISF framework, community and school-
needs of children and youth and to support their well- based clinicians’ partner on leadership teams, review
being by consolidating federal, state, community, and data collectively with school staff, and ensure effective
school resources. system structures at the school level. Regardless of
The University of Washington SMART Center, as part of who facilitates interventions, they are all selected, and
the Northwest Mental Health Technology Transfer progress monitored by the blended teams using both
Center, the Northwest PBIS Network, Idaho’s Project school and community data.
AWARE Washington’s State Education Agency, the Training and Technical Assistance (TA) has increased
Association of Washington School Principals, and the the capacity of districts to install and sustain effective
National Center on PBIS are working together to install systems that support mental wellness of all students.
and improve the implementation of evidence-based The Training and TA providers facilitate the
mental health practices across the region. The strengthening of the district and school teams to ensure
installation of school-based interventions is an extension school mental health services and supports provided by
of the previous regional plans to scale PBIS. both school and community mental health providers, are
The ISF is a structure and process that maximizes data-informed, evidence-based, monitored frequently,
effectiveness and efficiency by blending the strengths of implemented with fidelity and adjusted when outcomes
school and community mental health and strengths of are not realized.
References
Adelman, H., & Taylor, L. (2021a). Embedding mental health as schools change. University of California at
Los Angeles: The Center for Mental Health in Schools & Student/Learning Supports.
http://smhp.psych.ucla.edu/pdfdocs/mh20a.pdf
Adelman, H., & Taylor, L. (2021b). New directions for school counselors, psychologists, & social workers.
University of California at Los Angeles: The Center for Mental Health in Schools &
Student/Learning Supports. http://smhp.psych.ucla.edu/pdfdocs/report/framingnewdir.pdf
Algozzine, B., Wang, C., White, R., Cooke, N., Marr, M. B., Algozzine, K., Helf, S. S., & Duran, G. Z.
(2012). Effects of multi-tier academic and behavior instruction on difficult-to-teach students.
Exceptional Children, 79, 45–64.
Ali, M. M., West, K., Teich, J. L., et al. (2019). Utilization of mental health services in educational setting by
adolescents in the United States. Journal of Science Health, 89, 393–401.
Allday R. A., Bush M., Ticknor N., & Walker L. (2011). Using teacher greetings to increase speed to task
engagement. Journal of Applied Behavior Analysis. 44(2), 393–396.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3120079/
Alliance for a Healthier Generation (2016). Healthy Schools Program: Framework of Best Practices.
https://www.niost.org/pdf/host/HealthySchoolsProgramFramework.pdf
Alter, P., & Haydon, T. (2017). Characteristics of effective classroom rules: A review of the literature.
Teacher Education and Special Education, 40, 114–127. https://doi.org/10.1177/0888406417700962
American College Health Association. (2021). American College Health Association-National College
Health Assessment III: Reference group executive summary Spring 2021. American College Health
Association. https://www.acha.org/documents/ncha/NCHA-III_SPRING-2021_REFERENCE_
GROUP_EXECUTIVE_SUMMARY_updated.pdf
Ansary, N. S. (2021) Religious-Based Bullying: Insights on Research and Evidence-Based Best Practices
from the National Interfaith Anti-Bullying Summit Report. Institute for Social Policy and
Understanding (ISPU). https://www.ispu.org/wp-content/uploads/2018/09/ISPU-AMHP-Religious-
Based-Bullying.pdf
Arora, P., Connors, E.H., George, M.W., Lyon, A.R., Wolk, C.B., & Weist, M.D. (2016). Advancing
evidence-based assessment in school mental health: Key priorities for an applied research agenda.
Clinical Child and Family Psychology Review, 19(4), 271–284.
Barnes, A. J., Gilbertson, J., & Chatterjee, D. (2018). Emotional Health Among Youth Experiencing Family
Homelessness. Pediatrics, 141(1). https://pediatrics.aappublications.org/content/141/4/e20171767
Barrett, S., Eber, L., McIntosh, K., Perales, K., & Romer, N. (2018). Teaching Social-Emotional
Competencies within a PBIS Framework. Washington, DC: National Center on Positive Behavioral
Interventions and Supports (PBIS Center). https://www.pbis.org/resource/teaching-social-emotional-
competencies-within-a-pbis-framework
Barrett, S., Eber, L., Perales, K., & Pohlman, K. (2019). Interconnected Systems Framework 201: When
School Mental Health is Integrated Within a Multi-Tiered System of Support: What’s Different.
Center on Positive Behavioral Interventions and Supports (PBIS Center)/Substance Abuse and
Mental Health Services Administration (SAMHSA). https://www.pbis.org/resource/the-
interconnected-systems-framework-201-when-school-mental-health-is-integrated-within-a-multi-
tiered-system-of-support
Barrett, S., Eber, L., & Weist, M.D. (2013). Advancing education effectiveness: An interconnected systems
framework for Positive Behavioral Interventions and Supports (PBIS) and school mental health.
Center for Positive Behavioral Interventions and Supports (funded by the Office of Special Education
Programs, U.S. Department of Education). Eugene, Oregon, University of Oregon Press.
Bateman, D., & Yell, M. (2019). Free appropriate public education: The essence of special education. In D.
Bateman and M. Yell (Eds.), Current trends and legal issues in special education (pp. 37–52).
Thousand Oaks, CA: Corwin.
Bevilacqua, L., Kelly, Y., Heilmann, A., Priest, N., Lacey, R.E. (2020). Adverse Childhood Experiences and
Trajectories of Internalizing, Externalizing, and Prosocial Behaviors from Childhood to Adolescence.
Child Abuse & Neglect, 112. https://doi.org/10.1016/j.chiabu.2020.104890
Bierman, K. L., Mathis, E. T., & Domitrovich, C. E. (2018). Serving the needs of young children with social,
emotional, and behavioral needs: A commentary. School Mental Health, 10(3), 254–263.
Biglan, A., Elfner, K., Garbacz, S. A., Komro, K., Prinz, R., Weist, M. D., Wilson, D., & Zarling, N. A.
(2020). A strategic plan for strengthening America’s families: A brief from the Coalition of
Behavioral Science Organizations. Clinical Child and Family Psychology Review, 23(2), 153–175.
Bitsko, R. H., Holbrook, J. R., Robinson, L. R., Kaminski, J. W., Ghandour, R., Smith, C., Peacock, G., &
Eds. (2016). Health care, family, and community factors associated with mental, behavioral, and
developmental disorders in early childhood–United States, 2011–2012. MMWR: Morbidity &
Mortality Weekly Report, 65(9), 221–226.
Bradshaw, C. P., Mitchell, M. M., & Leaf, P. J. (2010). Examining the effects of schoolwide positive
behavioral interventions and supports on student outcomes: Results from a randomized controlled
effectiveness trial in elementary schools. Journal of Positive Behavior Interventions, 12, 133–148.
http://www.fixschooldiscipline.org/wp-content/uploads/2020/09/5.Examining_Effects_Schoolwide_
Positive_Behavior_Interv_and_Supps_Student_Outcome.2010.pdf
Bradshaw, C., Waasdorp, T., & Leaf, P. (2012). Effects of school-wide positive behavioral interventions and
supports on child behavior problems. Pediatrics, 130, 1136–1145.
https://pediatrics.aappublications.org/content/130/5/e1136
Brock, S.E., & Brant, H.T. (2015). Four ways to improve student mental-health support. Bethesda, MD:
National Association of School Psychologists (NASP). https://www.nasponline.org/resources-and-
publications/resources-and-podcasts/mental-health/school-psychology-and-mental-health/four-ways-
to-improve-student-mental-health-support
Calzada, E. J., Kim, Y. & O’Gara, J. L. (2019). Skin color as a predictor of mental health in young Latinx
children, Social Science & Medicine, 238, 112467 https://doi.org/10.1016/j.socscimed.2019.112467
Cappella, E., Hamre, B. K., Kim, H. Y., Henry, D. B., Frazier, S. L., Atkins, M. S., & Schoenwald, S. K.
(2012). Teacher consultation and coaching within mental health practice: Classroom and child effects
in urban elementary schools. Journal of Consulting and Clinical Psychology, 80(4), 597–610.
Carlson, R., Hock, R., George, M. Kumpiene, G. Yell, M., McCartney, E., Riddle, D., & Weist, M.D.
(2019). Relational factors influencing parents’ engagement in special education for high school youth
with emotional/behavioral disorders. Behavioral Disorders, 45(2), 103–116.
Cashman, J., Linehan, P., Purcell, L., Rosser, M., Schultz, S., & Skalski, S. (2014). Leading by convening: A
blueprint for authentic engagement. Alexandria, VA: National Association of State Directors of
Special Education.
Centers for Disease Control and Prevention (CDC). (2020). COVID-19 in racial and ethnic minority groups.
Atlanta. https://stacks.cdc.gov/view/cdc/89820/cdc_89820_DS1.pdf
Centers for Disease Control and Prevention (CDC) (2021). Mental Health. National Center for Chronic
Disease Prevention and Health Promotion, Division of Population Health.
https://www.cdc.gov/mentalhealth/index.htm
Center for School Mental Health Assistance (2002). Empirically supported interventions in school mental
health. Center for Mental Health Assistance.
Center on Positive Behavioral Interventions and Supports (PBIS Center) (n.d.). Mental health/social-
emotional well-being. Washington, DC: U.S. Department of Education.
https://www.pbis.org/topics/mental-healthsocial-emotional-well-being
Chafouleas, S. (August 2020). Four questions to ask now in preparing your child for school. Psychology
Today. https://www.psychologytoday.com/us/blog/promoting-student-well-being/202008/4-
questions-ask-now-in-preparing-your-child-school
Cheney, D. A., Stage, S. A., Hawken, L. S., Lynass, L., Mielenz, C., & Waugh, M. (2009). A 2-year
outcome study of the check, connect, and expect intervention for students at risk for severe behavior
problems. Journal of Emotional and Behavioral Disorders, 17(4), 226–243. Children’s Equity
Project & Bipartisan Policy Center, 2020). https://eric.ed.gov/?id=EJ863235
Clauss-Ehlers, C. S., Carpio, M. G., & Weist, M. D. (2020). Mental health literacy: a strategy for global
adolescent mental health promotion. Adolescent Psychiatry, 10(2), 73–83.
Coduti, W. A., Hayes, J. A., Locke, B. D., & Youn, S. J. (2016). Mental health and professional help-seeking
among college students with disabilities. Rehabilitation Psychology, 61(3), 288–296.
https://doi.org/10.1037/rep0000101
Cook, C. R., Fiat, A., Larson, M., Daikos, C., Slemrod, T., Holland, E. A., Thayer, A. J., & Renshaw, T.
(2018). Positive greetings at the door: Evaluation of a low-cost, high-yield proactive classroom
management strategy. Journal of Positive Behavior Interventions, 20, 149–159.
Cook, C. R., Frye, M., Slemrod, T. Lyon, A. R., Renshaw, T. L., & Zhang, Y. (2015). An integrated
approach to universal prevention: independent and combined effects of PBIS and SEL on youths’
mental health. School Psychology Quarterly, 30(2): 166–183. https://doi.org/10.1037/spq0000102
Cook, C. R., Grady, E. A., Long, A. C., Renshaw, T., Codding, R. S., Fiat, A., & Larson, M. (2017).
Evaluating the impact of increasing general education teachers’ ratio of positive to negative
interactions on students’ classroom behavior. Journal of Positive Behavior Interventions, 19(2),
67–77.
Copeland, W. E., McGinnis, E., Bai, Y., Adams, Z., Nardone, H., Devadanam, V., Rerrew, J., Hudziak, J. J.
(2020). Impact of COVID-19 pandemic on college student mental health and wellness. Journal of the
American Academy of Child & Adolescent Psychiatry, 60(1), 134–141.e2.
https://doi.org/10.1016/j.jaac.2020.08.466
Cree R. A., Bitsko R. H., Robinson L. R., et al. (2018). Health care, family, and community factors
associated with mental, behavioral, and developmental disorders and poverty among children aged 2–
8 Years — United States, 2016. MMWR Morbidity and Mortality Weekly Report, 67. 1377–1383.
DOI: http://dx.doi.org/10.15585/mmwr.mm6750a1external icon
Cummings, A., & Turner, M. (2020). COVID-19 and Third-Grade Reading Policies. Education Policy
Innovation Collaborative. https://epicedpolicy.org/wp-content/uploads/2020/10/RBG3-Reading-
Policies-FINAL-10-29-20.pdf
Czeisler, M. E., Lane, R. I., Petrosky, E., Wiley, J. F., Christensen, A., Njai, R., Weaver, M. D., Robbins, R.,
Facer-Childs, E. R., Barger, L. K., Czeisler, C. A., Howard, M. E., & Rajaratnam, A. M. W. (2020).
Mental health, substance use, and suicidal ideation during the COVID-19 pandemic. MMWR
Morbidity and Mortality Weekly Report 69, 1049–1057. http://dx.doi.org/10.15585/mmwr.mm6932a1
Dawson, G., Ashman, S. B., & Carver, L. J. (2000). The role of early experience in shaping behavioral and
brain development and its implications for social policy. Development and Psychopathology, 12(4).
DeFreitas, S.C., Crone, T., DeLeon, M., & Ajayi, A. (2018). Perceived and Personal mental health stigma in
Latino and African American college students. Public Health, 26.
https://doi.org/10.3389/fpubh.2018.00049
Department of Education. (2021). Education in a Pandemic: The Disparate Impacts of COVID-19 on

America’s Students. Office for Civil Rights.
https://www2.ed.gov/about/offices/list/ocr/docs/20210608-impacts-of-covid19.pdf
Dooley, D. G., Bandealy, A., & Tschudy, M. M. (2020). Low-income children and Coronavirus disease 2019
(COVID-19) in the US. JAMA Pediatrics 174(10): 922–923.
Eber, L., Barrett, S., Perales, K., Jeffrey-Pearsall, J., Pohlman, K., Putnam, R., Splett, J., & Weist, M.D.
(2019). Advancing education effectiveness: Interconnecting school mental health and school wide
PBIS, Volume 2: An implementation guide. Center for Positive Behavioral Interventions and Supports
(funded by the Office of Special Education Programs, U.S. Department of Education). Eugene,
Oregon, University of Oregon Press.
Eber, L., Barrett, S., Scheel, N., Flammini, A., & Pohlman, K. (2020). Integrating a trauma-informed
approach within a PBIS framework. Washington, DC: National Center on Positive Behavioral
Interventions and Supports (PBIS Center).
Education Commission of the States. (2020). What are the mental health and trauma training requirements
for K–3 teachers?: 50-State Comparison. Denver, CO. https://files.eric.ed.gov/fulltext/ED608357.pdf
Eklund, K., Meyer, L., Splett, J., & Weist, M. D. (2020). Policies and practices to support school mental health.
In B. Levin, & A. Hanson, K. (Eds.), Foundations of behavioral health (pp. 139–161). New York:
Springer.
Evans, S. W., Glass-Siegel, M., Frank, A., Van Treuren, R., Lever, N. A., & Weist, M. D. (2003).
Overcoming the challenges of funding school mental health programs. In M.D. Weist, S.W. Evans, &
N.A. Lever (Eds.), Handbook of school mental health: Advancing practice and research (pp. 73–86).
New York, NY: Springer.
Evans, S. W., & Weist, M. D. (2004). Implementing empirically supported treatments in schools: What are
we asking? Clinical Child and Family Psychology Review, 7, 263–267.
Fang, M. (2018). School poverty and the risk of attempted suicide among adolescents. Social Psychiatry &
Psychiatric Epidemiology, 53(9), 955–967.
Fazel, M., Hoagwood, K., Stephan, S., & Ford, T. (2014). Mental health interventions in schools 1: Mental
health interventions in schools in high-income countries. Lancet Psychiatry, 1(5): 377–387.
Fleming, A. R., Edwin, M., Hayes, J. A., Locke, B. D., & Lockard, A. J. (2018). Treatment-seeking college
students with disabilities: Presenting concerns, protective factors, and academic distress.
Rehabilitation Psychology, 63(1), 55–67.
Florida PBIS, Florida Center for Inclusive Communities, & the University of South Florida. (2020).
Integrating social and emotional learning into your School-Wide Positive Behavior Interventions and
Supports framework. Presented at the 17th International Virtual Conference on Positive Behavior
Support. https://assets-global.website-files.com/5d3725188825e071f1670246/
60fee55463745c71a95e0705_FLPBIS_SEL_Integration_0712.pdf
Forns, M., Abad, J., & Kirchner, T. (2011). Internalizing and Externalizing Problems. Encyclopedia of
Adolescence. https://doi.org/10.1007/978-1-4419-1695-2_261
Fruehwirth, J. C., Biswas, S., & Perreira, K. M. (2021). The COVID-19 pandemic and mental health of first-
year college students: Examining the effect of COVID-19 stressors using longitudinal data. PLoS
ONE, 16(3), 1–15. https://doi.org/10.1371/journal.pone.0247999
Frauenholtz, S., Mendenhall, A. N., & Moon, J. (2017). Role of school employees’ mental health knowledge
in interdisciplinary collaborations to support the academic success of students experiencing mental
health distress. Children & Schools, 39(2), 71–79. https://doi.org/10.1093/cs/cdx004
Furnham, A., & Swami, V. (2018). Mental health literacy: A review of what it is and why it matters.
International Perspectives in Psychology: Research, Practice, Consultation, 7(4), 240–257.
Gage, N. A., Grasley-Boy, N., George, H. P., Childs, K., & Kincaid, D. (2019). A quasi-experimental design
analysis of the effects of school-wide positive behavior interventions and supports on discipline in
Florida. Journal of Positive Behavior Interventions, 21(1), 50–61.
https://doi.org/10.1177%2F1098300718768208
Geiser, K., Fehrer, K., Pyne, J., Gerstein, A., Harrison, V., Joshi, S., & Stanford University, J. W. G. C. for
Y., and T. C. (JGC). (2019). San Mateo area teen mental health study. Research Brief. John W.
Gardner Center for Youth and Their Communities. https://eric.ed.gov/?id=ED604087
Gilliam, W. S. (2005). Prekindergartners left behind: Expulsion rates in state prekindergarten systems. New
Haven, CT: Yale University Child Study Center. https://medicine.yale.edu/childstudy/zigler/
publications/National%20Prek%20Study_expulsion%20brief_34775_5379_v1.pdf
Gilliam, W. S., & Reyes, C. R. (2018). Teacher decision-making factors that lead to preschool expulsion:
Scale development and preliminary validation of the preschool expulsion risk measure. Infants and
Young Children, 31(2), 93–108.
Gonzales, G., de Mola, E. L., Gavulic, K. A., McKay, T., & Purcell, C. (2020). Mental health needs among
lesbian, gay, bisexual, and transgender college students during the COVID-19 pandemic. Journal of
Adolescent Health, 67(5), 645–648.
Goodwill, J. R., & Zhou, S. (2020). Association between perceived public stigma and suicidal behaviors
among college students of color in the U.S. Journal of Affective Disorders, 262, 1–7.
Grasley-Boy, N., Gage, N. A., & Lombardo, M. (2019). Effect of SWPBIS on disciplinary exclusions for
students with and without disabilities. Exceptional Children, 86, 25–39.
Gueldner, B. A., & Feuerborn, L. L. (2016). Integrating mindfulness-based practices into social and
emotional learning: A case application. Mindfulness, 7:164–175.
Gustafson, E. L., Lakind, D., Walden, A. L., Rusch, D., & Atkins, M. S. (2021). Engaging parents in mental
health services: A qualitative study of community health workers’ strategies in high poverty urban
communities. Administration and Policy in Mental Health and Mental Health Services Research,
1–15.
Hancock, C. L., & Carter, D. R. (2016). Building environments that encourage positive behavior: The
Preschool Behavior Support Self-Assessment. Young Children, 71(1). https://www.naeyc.org/
resources/pubs/yc/mar2016/building-environments-encourage-positive-behavior-preschool
Harding, S., Morris, R., Gunnell, D., Ford, T., Hollingworth, W., Tilling, K., Evans, R., Bell, S., Grey, J.,
Brockman, R., Campbell, R., Araya, R., Murphy, S., & Kidger, J. (2019). Is teachers’ mental health
and well-being associated with students’ mental health and well-being? Journal of Affective
Disorders, 253, 460–466.
Hawken, L. S., Adolphson, S. L., Macleod, K. S., & Schumann, J. (2009). Secondary-tier interventions and
supports. In W. Sailor, G. Dunlap, G. Sugai, & R. Horner (Eds.), Handbook of positive behavior
support (pp. 395–420). New York: Springer.
Heiden, R. K., Salas, J., Moore, R., Hasan, S., & Wilson, L. (2020). Peer victimization and mental health
outcomes for lesbian, gay, bisexual, and heterosexual youth: A latent class analysis. Journal of
School Health, 90(10), 771–778.
Hertz, M. F., & Barrios, L.C. (2021). Adolescent mental health, COVID-19, and the value of school-
community partnerships. Inj Prev 27:85–86.
Hill, T. J. (2021). Enhancing school capacity to support children’s mental health. Washington, DC: National
Conference of State Legislators (NCSL). https://www.ncsl.org/Portals/1/Documents/Health/1-
Mental-Health-in-Schools_v04_web.pdf
Hodgkinson S., Godoy L., Beers L. S., & Lewin, A. (2017). Improving mental health access for low-income
children and families in the primary care setting. Pediatrics, 139(1): e20151175.
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. Baltimore, MD: National
Center for School Mental Health. University of Maryland School of Medicine.
Horner, R. H., Sugai, G., & Lewis, T. J. (2020). Is school-wide positive behavioral interventions and
supports (PBIS) an evidence-based practice? Center on PBIS, University of Oregon.
https://www.pbis.org/resource/is-school-wide-positive-behavior-support-an-evidence-based-practice
Horner, R. H., Sugai, G., Smolkowski, K., Eber, L., Nakasato, J., Todd, A. W., & Esperanza, J. (2009). A
randomized, wait-list controlled effectiveness trial assessing school-wide positive behavior support in
elementary schools. Journal of Positive Behavior Interventions, 11, 133–144.
https://doi.org/10.1177/1098300709332067
Horwitz, A. G., McGuire, T., Busby, D. R., Eisenberg, D., Zheng, K., Pistorello, J., Albucher, R., Coryell,
W., & King, C. A. (2020). Sociodemographic differences in barriers to mental health care among
college students at elevated suicide risk. Journal of Affective Disorders, 271, 123–130.
https://doi.org/10.1016/j.jad.2020.03.115
Jorm, A. F. (2012). Mental health literacy: Empowering the community to take action for better mental
health. American Psychologist, 67(3), 231–243.
Kam, B., Mendoza, H. & Masuda, A. (2019). Mental health help-seeking experience and attitudes in Latina/o
American, Asian American, Black American, and White American college students. International
Journal for the Advancement of Counselling, 41, 492–508.
Kern, L., & Clemens, N. H. (2007). Antecedent strategies to promote appropriate classroom behavior.
Psychology in the Schools, 44, 65–75.
Knickman, J., Krishnan, K. R. R., Pincus, H. A., Blanco, C., Blazer, D. G., Coye, M. J., Krystal, J. H.,
Rauch, S. L., Simon, G. E., & Vitiello, B. (2016). Improving access to effective care for people who
have mental health and substance use disorders: A vital direction for health and health care.
Discussion Paper: National Academy of Medicine. https://nam.edu/wp-content/uploads/2016/09/
Improving-Access-to-Effective-Care-for-People-Who-Have-Mental-Health-and-Sustance-Use-
Disorders.pdf
Kosciw, J. G., Greytak, E. A., Zongrone, A. D., Clark, C. M., & Truong, N. L. (2018). The 2017 National
School Climate Survey: The experiences of lesbian, gay, bisexual, transgender, and queer youth in
our nation’s schools. New York: GLSEN. https://www.glsen.org/sites/default/files/2019-10/GLSEN-
2017-National-School-Climate-Survey-NSCS-Full-Report.pdf
Lambert, M. C., Garcia, A. G., January, S. A., & Epstein, M. H. (2018). The impact of English language
learner status on screening for emotional and behavioral disorders: A differential item functioning
(DIF) study. Psychology in the Schools, 55(3), 229–239.
https://onlinelibrary.wiley.com/doi/pdf/10.1002/pits.22103
Lane, K. L., Oakes, W. P., Buckman, M. M., Sherod, R., & Lane, K. S., (November 2020). Systematic
screening for behavior in current K–12 Settings. Eugene, OR: Center on PBIS, University of Oregon.
https://www.pbis.org/resource/systematic-screening-for-behavior-in-current-k-12-instructional-
settings
Lederer, A. M., Hoban, M. T., Lipson, S. K., Zhou, S., & Eisenberg, D. (2021). More than inconvenienced:
The unique needs of U.S. college students during the COVID-19 pandemic. Health Education &
Behavior, 48(1), 14–19. https://journals.sagepub.com/doi/pdf/10.1177/1090198120969372
Lee, A., & Gage, N. A. (2020). Updating and expanding systematic reviews and meta‐analyses on the effects
of school‐wide positive behavior interventions and supports. Psychology in the Schools, 57, 783–804.
https://onlinelibrary.wiley.com/doi/epdf/10.1002/pits.22336
Leeb, R. T., Bitsko, R. H., Radhakrishnan, L., Martinez, P., Njai, R., & Holland, K. M. (2020). Mental
health–related emergency department visits among children aged <18 years during the COVID-19
pandemic — United States, January 1–October 17, 2020. Morbidity and Mortality Weekly Report,
69(45), 1675–1680. https://www.cdc.gov/mmwr/volumes/69/wr/mm6945a3.htm
Lever, N. A., Adelsheim, S., Prodente, C., Christodulu, K. V., Ambrose, M. G., Schlitt, J., & Weist, M. D.
(2003). System, agency, and stakeholder collaboration to advance mental health programs in schools.
In M. D. Weist, S. W. Evans, & N. A. Lever (Eds.), Handbook of school mental health: Advancing
practice and research (pp. 149–162). New York, NY: Springer.
Lever, N., Mathis, E., & Mayworm, A. (2017). School mental health is not just for students: Why teacher
and school staff wellness matters. Report of Emotional and Behavioral Disorders in Youth, 17(1): 6–
12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6350815/
Lipscomb, S. T., Hatfield, B., Lewis, H., Goka-Dubose, E., & Abshire, C. (2021). Adverse Childhood
Experiences and Children’s Development in Early Care and Education Programs. Journal of Applied
Developmental Psychology, 72. https://doi.org/10.1016/j.appdev.2020.101218
Loman, S. L., Strickland-Cohen, M. K., & Walker, V. L. (2018). Promoting the Accessibility of SWPBIS for
Students with Severe Disabilities. Journal of Positive Behavior Interventions, 20,
https://journals.sagepub.com/doi/10.1177/1098300717733976
Losen, D. J., & Martinez, P. (2020). Is California doing enough to close the school discipline gap? The
Center for Civil Rights Remedies at The Civil Rights Project, University of California Los Angeles.
https://www.civilrightsproject.ucla.edu/research/k-12-education/school-discipline/is-california-doing-
enough-to-close-the-school-discipline-gap
Lund, E. M. (2020). Interpersonal violence against people with disabilities: Additional concerns and
considerations in the COVID-19 pandemic. Rehabilitation Psychology, 65(3), 199–205.
http://dx.doi.org/10.1037/rep0000347
Lund, E. M., & Gabrielli, J. (2021). The role of pediatric psychologists in mitigating disability-specific
barriers among youth during the COVID-19 pandemic. Clinical Practice in Pediatric Psychology,
9(1), 12–23. http://dx.doi.org/10.1037/cpp0000387
Maag, J. W., & Katsiyannis, A. (2010). School-based mental health services: Funding options and issues.
Journal of Disability Policy Studies, 21(3), 173–180. https://www.researchgate.net/publication/
236135037_School-Based_Mental_Health_Services_Funding_Options_and_Issues/link/
0deec5183e3efa0455000000/download
Malik, F., & Marwaha, R. (2018). Developmental stages of social emotional development in children.
StatPearls Publishing. Jan–. PMID: 30521240.
Malik, R. (2017). New data reveal 250 preschoolers are suspended or expelled every
day. https://www.americanprogress.org/issues/early-childhood/news/2017/11/06/442280/new-data-
reveal-250-preschoolers-suspended-expelled-every-day/
Margolius, M., Doyle Lynch, A., Pufall Jones, E. & Hynes, M. (2020). The State of Young People during
COVID-19: Findings from a nationally representative survey of high school youth. America’s
Promise Alliance. https://www.americaspromise.org/sites/default/files/d8/
YouthDuringCOVID_FINAL%20%281%29.pdf
Massey, O., & Vroom, E. (2019). The role of implementation science in behavioral health. In B. Levin, & A.
Hanson, K. (Eds.), Foundations of behavioral health (pp. 101–118). New York: Springer.
McCance-Katz, E., & Lynch, C (2019). Guidance to states and school systems on addressing mental health
and substance use issues in schools. Washington, DC: Substance Abuse and Mental Health Services
Administration (SAMHSA)/Centers for Medicare and Medicaid Services (CMS).
https://store.samhsa.gov/sites/default/files/d7/priv/pep19-school-guide.pdf
McClain, S., Beasley, S. T., Jones, B., Awosogba, O., Jackson, S., & Cokley, K. (2016). An examination of
the impact of racial and ethnic identity, impostor feelings, and minority status stress on the mental
health of black college students. Journal of Multicultural Counseling & Development, 44(2),
101–117.
McIntosh, K., Girvan, E. J., Falcon, S., Santiago-Rosario, M. R., McDaniel, S. C., Izzard, S., Bastable, E.,
Nese, R. N. T., & Baldy, T. S. (in press). An equity focused PBIS approach reduces racial inequities
in school discipline: A randomized controlled trial. School Psychology.
McIntosh, K., Girvan, E. J., Horner, R. H., Smolkowski, K., & Sugai, G. (2018). A 5-point intervention
approach for enhancing equity in school discipline. OSEP Technical Assistance Center on Positive
Behavioral Interventions and Supports.
McLeod, J. D., Uemura, R., & Rohrman, S. (2012). Adolescence Mental Health, Behavior Problems, and
Academic Achievement. Journal of Health and Social Behavior, 53(4), 482–497.
McQuillin, S. D., Lyons, M. D., Becker, K. D., Hart, M. J., & Cohen, K. (2019). Strengthening and
expanding child services in low resource communities: The role of task‐shifting and just‐in‐time
training. American Journal of Community Psychology, 63(3–4), 355–365.
Meek, S. E., & Gilliam, W. S. (2016). Expulsion and suspension in early education as matters of social
justice and health equity. NAM Perspectives. Discussion Paper, National Academy of Medicine,
Washington, DC.
Meleo-Erwin, Z., Kollia, B., Fera, J., Jahren, Al., & Basch, C. (2021). Online support information for
students with disabilities in colleges and universities during the COVID-19 pandemic. Disability and
Health Journal, 14(1). https://doi.org/10.1016/j.dhjo.2020.101013
Miles, R., Rabin, L. Krishnan, A., Grandoit, E., & Kloskowski, K. (2020). Mental health literacy in a diverse
sample of undergraduate students: Demographic, psychological, and academic correlates. BMC
Public Health, 20:1699. https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-020-
09696-0.pdf
Miller, J. (2010). The use of debriefings in schools. Smith College Studies in Social Work, 71(2), 259–270.
https://doi.org/10.1080/00377310109517627
Morris, E. W., & Perry, B. L. (2016). The punishment gap: School suspension and racial disparities in
achievement. Social Problems, 63, 68–86.
National Academies of Sciences, Engineering, and Medicine. (2017). Communities in action: Pathways to
health equity. Washington, DC: The National Academies Press.
National Association of School Psychologists. (2021). Comprehensive School-Based Mental and Behavioral
Health Services and School Psychologists [handout].
National Association of Student Personnel Administrators (NASPA). (2017). A New Model for Campus
Health: Integrating Well-Being into Campus Life. Leadership Exchange, 15(3).
https://www.naspa.org/blog/a-new-model-for-campus-health-integrating-well-being-into-campus-life
National Center for School Mental Health (NCSMH). (2021). Advancing Comprehensive School Mental
Health Systems: Guidance from the Field. University of Maryland School of Medicine,
https://www.schoolmentalhealth.org/Resources/Foundations-of-School-Mental-Health/Advancing-
Comprehensive-School-Mental-Health-Systems--Guidance-from-the-Field
National Technical Assistance Center on Positive Behavioral Interventions and Supports. (2017). Technical
guide for alignment of initiatives, programs, practices in school districts. Eugene, OR:
https://www.pbis.org/resource/technical-guide-for-alignment-of-initiatives-programs-and-practices-
in-school-districts
North Carolina School Mental Health Initiative (NCSMHI). (2016). Current status of mental health in
children and youth. https://www.collectiveimpactforum.org/sites/default/files/initiative-
documnts/SMHI%20EXECUTIVE%20SUMMARY_FINAL.pdf
Office for Civil Rights. (2016). 2013– 2014 Civil Rights Data Collection: A first look. U.S. Department of
Education. https://ocrdata.ed.gov/assets/downloads/2013-14-first-look.pdf
Office of Special Education Programs. (2015). Supporting and Responding to Behavior: Evidence-Based
Classroom Strategies for Teachers. U.S. Department of Education.
https://osepideasthatwork.org/sites/default/files/ClassroomPBIS_508.pdf
Owens, P. L., Hoagwood, K., Horwitz, S. M., Leaf, P. J., Poduska, J. M., Kellam, S. G., & Ialongo, N. S.
(2002). Barriers to children's mental health services. Journal of the American Academy of Child &
Adolescent Psychiatry, 41(6), 731–738.
Patrick, S. W., Henkhaus, L. E., Zickafoose, J. S., Lovell, K., Halvorson, A., Loch, S., Letterie, M., & Davis,
M. M. (2020). Well-being of parents and children during the COVID19 pandemic: A national survey.
Pediatrics, 146(4), 1–8. https://pediatrics.aappublications.org/content/146/4/e2020016824
Pelto, D. J., Ocampo, A., Garduño-Ortega, O., López, C. T. B., Macaluso, F., Ramirez, J., Gonzalez, J., &
Gany, F. (2019). The nutrition benefits participation gap: Barriers to uptake of SNAP and WIC
among Latinx American immigrant families. Journal of Community Health, 45, 488–491.
Peterson, L. S., Pham, S., & Solé, M. (2021). Supporting English learners during virtual learning.
Communique (0164775X), 49(6), 14–17.
Pier, L., Christian, M., Tymeson, H., & Meyer, R. H. (2021). COVID-19 impacts on student learning:
Evidence from interim assessments in California. Policy Analysis for California Education.
https://edpolicyinca.org/publications/covid-19-impacts-student-learning
Poppen, M., Sinclair, J., Hirano, K., Lindstrom, L., & Unruh, D. (2016). Perceptions of mental health
concerns for secondary students with disabilities during transition to adulthood. Education and
Treatment of Children 39(2), 221–246.
Price, J. H., & Khubchandani, J. (2019). The changing characteristics of African-American adolescent
suicides, 2001–2017. Journal of Community Health, 44(4), 756–763.
https://media.tristatehomepage.com/nxsglobal/tristatehomepage/document_dev/2019/05/22/Price-
Khubchandani2019_Article_TheChangingCharacteristicsOfAf_1558536959621_88573150_ver1.0.pdf
Quirk, A. (2020). Mental health supports for students of color during and after the coronavirus pandemic.
Center for American Progress. https://www.americanprogress.org/issues/education-k-
12/news/2020/07/28/488044/mental-health-support-students-color-coronavirus-pandemic/
Reddy, L. A., Lekwa, A. J., & Glover, T. A. (2020). Supporting paraprofessionals in schools: Current
research and practice. Psychology in the Schools, 58(4), 643–647. https://doi.org/10.1002/pits.22457
Rusch, D., Walden, A. L., Gustafson, E., Lakind, D., Atkins, M. S. A qualitative study to explore
paraprofessionals’ role in school‐based prevention and early intervention mental health
services. Journal of Community Psychology. 2019; 47: 272–290.
Salle, T. L., George, H. P., McCoach, D. B., Polk, T., & Evanovich, L. L. (2018). An examination of school
climate, victimization, and mental health problems among middle school students self-identifying
with emotional and behavioral disorders. Behavioral Disorders, 43(3), 383–392.
Schlanger, P., & Shaffer, S. (2018). Protecting Religious Desegregation in Public Schools. Center for
Educational Equity at MAEC. https://maec.org/wp-content/uploads/2017/06/Exploring-Equity-
Protecting-Religious-Desegregation.pdf
Simonsen, B., Goodman, S., Robbie, K., Power, M., Rodriguez, C., & Burns, D. (January 2021). Effective
Instruction as a Protective Factor. Eugene, OR: Center on PBIS, University of Oregon.
https://www.pbis.org/resource/effective-instruction-as-a-protective-factor
Sinclair, M. F., Christenson, S. L., Lehr, C. A., & Anderson, A. R. (2003). Facilitating Student Engagement:
Lessons Learned from Check & Connect Longitudinal Studies. California School Psychologist, 8,
29–41.
Skaar, N. R., Etscheidt, S. L., & Kraayenbrink, A. (August 2020). School-Based Mental Health Services
for Students with Disabilities: Urgent Need, Systemic Barriers, and a Proposal. Exceptionality.
https://doi.org/10.1080/09362835.2020.1801437
Skiba, R. J., & Peterson, R. L. (2000). School discipline at a crossroads: From zero tolerance to early
response. Exceptional Children, 66(3), 335–346. Smith & Lawrence, 2019.
Smith, S., Ferguson, D., Burak, E. W., Granja, M. R., & Ortuzar, C. (2020). Supporting social-emotional and
mental health needs of young children through part c early intervention: Results from a 50-state
survey. National Center for Children in Poverty, Bank Street Graduate School of Education.
Spiel, C. F., Evans, S. W., & Langberg, J. M. (2014). Evaluating the content of Individualized Education
Programs and 504 Plans of young adolescents with attention deficit/hyperactivity disorder. School
Psychology Quarterly, 29(4), 452–468. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4285444/
Splett, J. W., Perales, K., Halliday-Boykins, C. A., Gilchrest, C., Gibson, N. & Weist, M. D. (2017). Best
practices for teaming and collaboration in the Interconnected Systems Framework. Journal of Applied
School Psychology, 33(4), 347–368.
Stark, A. M. & Basu, A. Shifting from survival to supporting resilience in children and families in the
COVID-19 pandemic: Lessons for informing U.S. mental health priorities. Psychological Trauma:
Theory, Research, Practice and Policy, 12(1), 133–135. https://doi.apa.org/fulltext/2020-40856-001.pdf
Steele, H., Steele, M., Croft, C., & Fonagy, P. (1999). Infant‐mother attachment at one year predicts
children’s understanding of mixed emotions at six years. Social Development, 8(2), 161–178.
Stephan, S. H., Weist, M., Kataoka, S., Adelsheim, S., & Mills, C. (2007). Transformation of children's
mental health services: The role of school mental health. Psychiatric Services, 58(10), 1330–1338.
Stuart, H. (2016). Reducing the stigma of mental illness. Global Mental Health, 3.
Substance Abuse and Mental Health Services Administration (SAMSHA). (2020). National guidelines for
behavioral health crisis care best practice toolkit. Rockville, MD: Office of the Chief Medical
Officer, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/
sites/default/files/national-guidelines-for-behavioral-health-crisis-care-02242020.pdf
Substance Abuse and Mental Health Services Administration (SAMSHA). (2019). Ready, Set, Go, Review:
Screening for behavioral health risk in Schools. Rockville, MD: Office of the Chief Medical Officer,
Substance Abuse and Mental Health Services Administration.
https://www.samhsa.gov/sites/default/files/ready_set_go_review_mh_screening_in_schools_508.pdf
Taylor, J. (2019). Mental health in LGBTQ Youth: Review of research and outcomes. Communique, 48(3),
4–6.
The Education Trust, Reach Higher, American School Counselors Association. (2019). School Counselors
Matter. https://www.schoolcounselor.org/getmedia/b079d17d-6265-4166-a120-3b1f56077649/
School-Counselors-Matter.pdf
The Steve Fund/JED Foundation. (n.d.). Equity in mental health framework.

https://equityinmentalhealth.org/wp-content/uploads/2017/11/Equity-in-Mental-Health-Framework-
v17.pdf
The Trevor Project. (2020). How COVID-19 is impacting LGBTQ youth. West Hollywood, CA: The Trevor
Project. https://www.thetrevorproject.org/wp-content/uploads/2020/10/Trevor-Poll_COVID19.pdf
The Trevor Project. (2021). 2021 National Survey on LGBTQ Youth Mental Health. West Hollywood, CA:
The Trevor Project. https://www.thetrevorproject.org/wp-content/uploads/2021/05/The-Trevor-
Project-National-Survey-Results-2021.pdf
Uro, G., Lai, D., Alsace, T., & Council of the Great City Schools. (2020). Supporting English learners in the
COVID-19 crisis. Council of the Great City Schools. https://files.eric.ed.gov/fulltext/ED607280.pdf
U.S. Department of Education. (2021). ED COVID-19 Handbook Volume 2: Roadmap to Reopening Safely
and Meeting All Students’ Needs. https://www2.ed.gov/documents/coronavirus/reopening-
2.pdf?utm_content=&utm_medium=email&utm_name=&utm_source=govdelivery&utm_term=
Vincent, C. G., Tobin, T. J., Hawken, L. S., & Frank, J. L. (2012). Discipline referrals and access to
secondary level support in elementary and middle schools: Patterns across African-American,
Hispanic-American, and white students. Education and Treatment of Children, 35, 431–458.
Weir, K. (2012). The beginning of mental illness. Monitor on Psychology, 43(2), 36.
Weist, M. D., Eber, L., Horner, R., Splett, J., Putnam, R., Barrett, S., Perales, K., Fairchild, A. J., & Hoover,
S. (2018). Improving multitiered systems of support for students with “internalizing”
emotional/behavioral problems. Journal of Positive Behavior Interventions, 20(3), 172–184.
Weist, M. D., Franke, K., Lucio, R., Bass J., Doan, T., & Blalock, D. (in press). Privatization and school
mental health. Journal of Public Mental Health.
Weist, M. D., Garbacz, A., Lane, K., & Kincaid, D. (2017). Enhancing progress for meaningful family
engagement in all aspects of Positive Behavioral Interventions and Supports and Multi-Tiered
Systems of Support. In M. Weist, A. Garbacz, K. Lane, & D. Kincaid (Eds.), Aligning and
integrating family engagement in Positive Behavioral Interventions and Supports (PBIS): Concepts
and strategies for families and schools in key contexts (pp. 1–8). Center for Positive Behavioral
Interventions and Supports (funded by the Office of Special Education Programs, U.S. Department of
Education). Eugene, Oregon, University of Oregon Press.
Weist, M. D., Goldstein, J., Evans, S. W., Lever, N. A., Axelrod, J., Schreters, R., & Pruitt, D. (2003).
Funding a full continuum of mental health promotion and intervention programs in the schools.
Journal of Adolescent Health, 32, 70–78.
Weist, M. D., Mellin, E. A., Garbacz, S. A., & Anderson-Butcher, D. (2019b). Reducing the use of language
that stigmatizes students. Communique, 47(8), 1–22.
Weist, M. D., Shapiro, C. J., Hartley, S. N., Bode, A. A., Miller, E., Huebner, S., Terry, J., Hills, K., &
Osher, D. (2019a). Assuring strengths- and evidence-based approaches in child, adolescent, and
school mental health. In Osher, D., Mayer, M. J., Jagers, R. J., Kendziora, K., & Wood, L. (Eds).
Keeping Students Safe and Helping Them Thrive: A Collaborative Handbook on School Safety,
Mental Health, and Wellness, Volume 2. ABC-CLIO.
West, K. D., Ali, M. M., Schreier, A., & Plourde, E. (2021). Child and Adolescent Mental Health During
COVID-19: Considerations for Schools and Early Childhood Providers. Office of the Assistant
Secretary for Planning and Evaluation Issue Brief.
https://www.aspe.hhs.gov/reports/child-adolescent-mental-health-during-covid-19
Whitaker, K., Nicodimos, S., Pullmann, M. D., Duong, M. T., Bruns, E. J., Wasse, J. K., & Lyon, A. R.
(2018). Predictors of disparities in access and retention in school-based mental health services.
School Mental Health, 10(2), 111–121.
Williamson, S., Hoover, S., & Lever, N. (2020). Addressing students’ immediate mental health needs on re-
engaging for the 2020-21 school year. National Center on Safe Supportive Learning Environments.
https://safesupportivelearning.ed.gov/sites/default/files/BIF%201%20Slides%20Addressing%20Imm
ediate%20MH%20Needs%20August%202020_Final.pdf
Willis, D. E. (2021). Feeding inequality: food insecurity, social status, and college student health. Sociology
of Health & Illness, 43(1), 220–237.
World Health Organization (WHO). (2020a). COVID-19 disrupting mental health services in most countries,
WHO survey. Geneva: World Health Organization.
World Health Organization (WHO). (2020b). Guidelines on mental health promotive and preventive
interventions for adolescents: Helping adolescents thrive. Geneva: World Health Organization.
Xiao, H., Carney, D. M., Youn, S. J., Janis, R. A., Castonguay, L. G., Hayes, J. A., & Locke, B. D. (2017).
Are we in crisis? National mental health and treatment trends in college counseling
centers. Psychological Services, 14(4), 407–415.
Yoshikawa, H., Weiland, C., Brooks-Gunn, J., Burchinal, M. R., Espinoza. L. M., Gormley,
W. T., Ludwig, J., Magnuson, K. A., Phillips, D., Zaslow, M. J. (2013). Investing in our future: The
evidence base on preschool education. New York, NY: Foundation for Child Development.
Yoshikawa, H., Wuermli, A. J., Dreyer, B., Leckman, J. F., Lye, S. J., Britto, P. R., Ponguta, L. A., Richter,
L. M., & Stein, A. (2020). Effects of the global Coronavirus disease-2019 pandemic on early
childhood development: Short- and long-term risks and mitigating program and policy actions. The
Journal of Pediatrics, 223, 188–193. https://doi.org/10.1016/j.jpeds.2020.05.020
APPENDIX A.
Implementation Examples by Recommendation
K–12 Schools, Early Childhood Programs and the planning and development of Central’s
Institutions of Higher Education around the Comprehensive Distance Learning, Limited In-
country are intentionally prioritizing their efforts Person Instruction, and Hybrid Learning models.
to enhance child and student wellness, focusing on From that larger committee, the Interconnected
social, emotional, and mental health strategies and Systems Framework District Community
supports. Here are some examples organized by Leadership Team has solidified its focused work
the seven recommendations discussed earlier. on building District systems that support “mental
health for all” through an MTSS framework. The
1. Prioritize Wellness for Each and leadership team continues to use school and
Every Child, Student, Educator, community data to identify student needs and
and Provider support mental health holistically including
community resources and partnerships to provide
support. Central has maintained a strong focus on

Mental health will always be important,
whether the virus is here or not.” building and maintaining positive relationships
— Bryan Jandres, with students through live class connections,
Youth Panel on Wellness family and student outreach, home visits, and
more. The district continues to focus on Tier 1
Mental Health For ALL: school-wide practices to teach and model healthy
Strengthening Community coping strategies and stress management and
Partnerships expanded their procedures to identify and connect
Using the Interconnected Systems Framework students and families to further support as needed.
(ISF), the Central School District in Oregon has Central has implemented the “Handle with Care”
strengthened and relied upon its community program, met basic needs through food
partnerships to prioritize the social and emotional distribution to students and families, and provided
needs of students, staff, and families during the students access to reliable internet through
Pandemic. A Community Planning Committee partnerships with the cities of Monmouth and
was formed, including representation of key staff, Independence and their local internet provider.
student, family, and community partner voices for Staff wellness has been a high priority for school
and district administrators, along with Central’s populations relative to mental illness and
employee wellness program, Get Fit, and the substance use and seek creative solutions to
Whole Child Program that has supported enhance prevention efforts, reduce wait time for
educators with mental health and wellness therapeutic services, and increase the quality and
resources and weekly virtual staff wellness groups sustainability of school mental health services and
throughout the Pandemic. supports. Through shared learning, collaboration,
and consultation, member districts will actively
engage in efforts to improve the well-being of

Equity has been a key focus of the students in order to support their future success.
Central School District’s Pandemic
response as we have worked to Leveraging the MTSS
consistently include staff, family, and Framework to Support
student voices that truly represent our Wellness
community and work to support every
single student. We are partnering with Clifton Public Schools in New Jersey have
Western Oregon University to embed leveraged their Multi-Tiered Systems of Support
equity into every aspect of our (MTSS) Framework to support their transitions
professional learning”. among in-person, remote, and hybrid learning
— Jennifer Kubista modes. During this time, they have built a strong
Superintendent district leadership team that includes
representation from each school, key areas of
Early Intervention is Key expertise (e.g., mental health/wellness, physical
Infant and Early Childhood Mental education/wellness, special education), and
Health Consultation (IECMHC) is a preventive representation from families. This team
and inclusive intervention for promoting young coordinates with other school and community
children’s social, emotional, and behavioral health partners (e.g., food service, local law enforcement,
in early childhood settings. The cornerstone of child welfare) to proactively support students and
IECMHC is a collaborative relationship between families. Each of their schools uses the MTSS
the Mental Health Consultant (MHC) and the framework to teach, remind, and reinforce positive
adults who care for young children (e.g., parents expectations to support learning and wellness. To
and other family members, early childhood ensure expectations are accessible to most families
educators, home visitors). and students, educators presented expectations in
English, Spanish, and Arabic. Further, staff used
Promotion of Student Well- district-wide data to drive decisions about
Being Through Shared intensifying their universal support (for all),
Learning and Enhanced targeted support (for some), and intensive support
Prevention Efforts
(for individual students identified with significant
The Massachusetts School Mental Health need). And they did all of this while building a
Consortium is comprised of Massachusetts school strong, positive, and vibrant community—
districts committed to improving the mental health celebrating the “Heart of the Mustang.”
services and supports available to students across
the Commonwealth. Consortium member districts
recognize the growing needs of our student
Center on the Social and

Our loss is huge, and we need our
Emotional Foundations for
teachers to help us process our grief. We
Early Learning Pyramid Model
need to have time to talk. They can set
and the Provision of Infant and Early
aside the curriculum and teach us how to
Childhood Mental Health Consultation
breathe, facilitate discussions in class.
This will help relieve the pressure.” In Maryland, the Infant and Early Childhood
Mental Health consultation model can assist with
the implementation of trauma-informed care,
Supporting Families of strategies to enhance children's positive
Preschool Children with IEPs relationships with caregivers and will provide
In North Carolina, preschool teachers consultation related to staff or families
implementing the Pyramid Model focus on the experiencing depression, substance abuse, or other
importance of building relationships with families adversities.
of children with IEPs to assess the children's https://www.mdpyramidmodelsefel.org/iecmh-
social-emotional and mental health needs. consultation
Establishing and building these relationships helps
assess needs and develop support strategies that Cross-System Learning
are relevant and meaningful to the family's unique The Federal National Workgroup on
cultural context, routines, and priorities. Candace School Mental Health Partnership
Land from Floyd L. Knight School Preschool affiliates federal agencies, university centers,
Program in Lee County, NC is one of many NC professional associations, and advocacy groups
teachers who demonstrate this as shown in a video around cross-system learning. With the support of
interview with Ms. Land: the Bainum Family Foundation, the Substance
https://ectacenter.org/topics/disaster/preschoolpan Abuse and Mental Health Services Administration
demic-episode11.asp. (SAMHSA) convened three expert panels in
partnership with the National Center on School
Community-Driven Design Mental Health (NCSMH) and the Federal National
Native American Community Academy School Mental Health Partnership to coalesce
(NACA), in Albuquerque, New Mexico, community members from all sectors around
serves K–12 students with an emphasis on comprehensive school mental health systems. The
community-driven design that centers the concept recommendations of the three panels are
of holistic wellness. NACA has established an summarized in Advancing Comprehensive School
integrated curriculum prioritizing identity and Mental Health Systems: Guidance from the Field.
culture development through culturally relevant
lessons such as land-based learning as a part of a Recognizing that no one group can make the
broader academic and college prep program. changes outlined in their recommendations, the
Workgroup began co-creating Dialogue Guides
with these partners. The guides enable them to
hold conversations within their own networks,
learn about the realities of practice and encourage
partners to come together in action. System
leaders, mental health practitioners, educators and
families participated together in developing Helpful Hint
dialogue starters that will enable conversations,
share perspectives, build understanding, and Universal mental health promotion for all students
and staff in the school community is foundational to
reduce barriers. These collaboratively developed
any implementation framework. This includes
tools are available on the National Center for positive school climate, positive discipline
School Mental Health website. practices, teacher and school staff well-being,
mental health literacy, positive behaviors and
Supporting Mental Health in relationships and social-emotional learning. Social-
Higher Education emotional and behavioral health and well-being
skills are skills that should be taught by all staff
The University of South Carolina across all school settings and embedded in daily
Department of Psychology Student Advisory practices.
Board composed a mental health and department
climate survey in an effort to better understand 2. Enhance Mental Health Literacy
graduate student perceptions and mental health and Reduce Stigma and Other
needs. This information was especially critical to
Barriers to Access
have during the COVID-19 pandemic. The results
of the October 2020 survey revealed that majority Increasing Mental Health
of the graduate students surveyed (27/39) reported Literacy and Reducing Stigma
experiencing 3 or more symptoms of negative with Student-Led Campaign
mental health. In an effort to address these
Beginning in 2014, Fauquier County Public
concerns, the department formed a Mental Health
Schools (FCPS) in Virginia, along with
and Well-Being Committee, composed of program
community partners, the Mental Health
faculty (Experimental, Clinical-Community, and
Association of Fauquier County, and the PATH
School Psychology Ph.D. programs) and graduate
Foundation, successfully implemented community
student representatives to meet twice a month in
training in Youth Mental Health First Aid
an effort to address graduate student mental health
(YMHFA). YMHFA is a training program
needs and overall climate. Throughout the 2020-
supported by the National Council for Behavioral
21 academic year this committee facilitated the
Health designed to educate people in the
setup of graduate student support groups led by
community about mental health issues and how to
recent alumni to provide support and a safe space
guide people experiencing mental health issues
to process the stressors of graduate school. This
towards treatment. To date, over 1,600 adults in
committee also helped advocate for other supports
the Fauquier community have been trained in
(e.g., mentor-mentee contract that provides a
YMHFA. A high percentage of those trained were
number of discussion prompts to facilitate
teachers and other staff within the FCPS. In 2018
communication) and provide feedback to the
at a community safety conference, FCPS pointed
department leadership to increase social
out that they did not know which staff were
responsiveness. In addition, the committee
trained, so they were unsure how to seek help. The
organized a number of socially distanced social
students aptly pointed out the number of adults
activities, including discussion walks, and outside
trained was impressive, but the value was not
lunches.
there if students did not know who to go to when
they needed help, so FCPS provided purple
lanyards to staff who had received training in challenges, this complicates an already difficult
YMHFA. The district worked with students to situation. Each year the MCEC holds a National
develop video messages shown to all students so Training Seminar to help families, and
that they knew who to approach when they needed practitioners and providers world-wide come
help. The Purple Lanyard Project was an together to learn the most about promising
important part of the district’s efforts to build a practices. MCEC, with the support of the United
support network for students experiencing mental States Army Medical Command, the National
health challenges. Given success in implementing Association of State Directors of Special
YMHFA in this community and its schools, the Education and the National Center for Systemic
National Council for Behavioral Health selected Improvement launched a new training session
Fauquier High School to pilot Teen Mental Health designed to help attendees make an impact at their
First Aid (TMHFA), a similar version of mental current duty station and carry best practices when
health training designed for students. During the they move to a new assignment. The Leaving
2019-2020 school year, 260 tenth-grade students Your Footprint Series is a two-part process.
were trained in TMHFA. Plans are underway to During the National Training Seminar,
expand the TMHFA training to our remaining participants work with behavioral health experts
high schools in the 2021-2022 school year. The from the United States Medical Command around
impact of the YMHFA training and the Purple issues of youth mental health, in particular
Lanyard project includes many examples of staff Attention Deficit Hyperactivity Disorder, Anxiety,
using the knowledge acquired through the training and Depression. Then, participants co-create
to help students. Equally important, the effort and infographics to help them share the information
attention focused on the training have increased simply. Based on the infographics, they work
awareness and acceptance in FCPS schools and together onsite and virtually to develop dialogue
the larger community regarding mental health. guides that will help parents and others bring
attention to these issues at their current duty
Web-link for YMHA: https://sites.google.com/ station. As they move to a new duty station, they
fcps1schools.net/ymhfa/home take the infographics and dialogue guides with
them while leaving their ‘footprint’ on the issue
Helpful Hint and an activity at their former assignment with the
Meet as a team after training to determine how to intent to sustain the focus on youth mental health.
apply new content in your setting. Consider using a The Leaving Your Footprint Series of Behavioral
marketing campaign to increase visibility of staff Health Guides are found on the Military Child
who are serving as mental health ambassadors. Education Coalition (MCEC) website.
Provide ongoing coaching and support for staff.
Mental Health Professionals
Supporting Military Families Supporting Educators and
Military Child Education Coalition Caregivers
(MCEC)- Military-connected families Infant and Early Childhood Mental Health
move every 2–3 years, and their children often Consultation is a preventive and inclusive
change schools 6–9 times during their K–12 intervention for promoting young children’s
education, which is three times more than their social, emotional, and behavioral health in early
nonmilitary peers. For students with mental health childhood settings. The cornerstone of Infant and
Early Childhood Mental Health Consultation is a Early Intervention with Social-
collaborative relationship between the Mental Emotional Screening
Health Consultant and the adults who care for In Illinois, 25 local Child and Family
young children (e.g., parents and other family Connections offices serve as the system point of
members, early childhood educators, home entry for families referred to Part C Early
visitors). The Mental Health Consultant helps Intervention. State policy requires that at the initial
caregivers learn to identify, understand, and intake meeting and with the family’s consent, a
address the needs of children at risk for mental service coordinator administers the Ages & Stages
health problems as early as possible (SAMHSA, Questionnaires: Social-Emotional, Second Edition
2014). (ASQ:SE-2), a validated social-emotional-focused
screening tool. The service coordinator uses the
Promoting Young Children’s
results of the ASQ:SE-2, along with information
Social-Emotional Development
gathered during the Routines Based Interview
to Address Undesirable
Behaviors assessment and other sources to determine who
will be on the family’s evaluation/ assessment
Greene County Educational Service Center (ESC) team. A positive screen on the ASQ:SE-2
in Ohio developed the Early Childhood Mental indicates that the evaluation team should consider
Health Consultation (ECMHC) program to including a professional with a background in
promote young children’s social and emotional infant-toddler early childhood mental health and
development, to address undesirable behaviors, social-emotional development. This practice helps
and to assist parents/caregivers of young children ensure that infant and toddler needs in the social-
in the region who have experienced high levels of emotional domain will be identified early in the
trauma or toxic stress. The Greene County ESC family’s involvement with Early Intervention so
ECMHC program has taken a two-prong approach that interventions to address social-emotional
to spread understanding about the foundations of needs can be included in the Individual Family
child social and emotional development while Service Plan (Excepted from Smith, Ferguson,
normalizing the need to seek help for parenting Burak, Granja, & Ortuzar, 2020).
and child behavioral problems. Parents and
caregivers experiencing chronic toxic stress first College Mental Wellness
need help building their own resilience and Ambassadors
protective factors in order to help the children in Utilizing a peer-to-peer model, Foothills
their care. Using this approach, the Greene ESC College in California has strengthened and
early childhood mental health professional augmented its Office of Psychological Services
developed the program and provided consultation
and Personal Counseling by creating a Mental
to the schools and community agencies in Wellness Ambassadors program. The ambassadors
response to the needs of the adults and children.
are the student representatives of Psychological
(Excerpted from Project LAUNCH, Grantee/Filed Services whose aim is to promote mental health
Spotlights, https://healthysafechildren.org/grantee-
services, reduce stigma surrounding mental health
field-spotlight/early-childhood-mental-health-
disorders, create community, and foster an
consultation-ecmhc)
inclusive and non-judgmental campus culture.
This program was created during the COVID-19
pandemic while students were learning remotely, (https://www.miamioh.edu/cas/academics/centers/
not physically active on campus, and experiencing csbmhp/initiatives/geer/index.html), a Miami
traumas associated with the pandemic. University-led project to aid mental health and
substance use supports for Ohio’s K–12 students
3. Implement a Continuum of and staff received $6 million from the Governor’s
Evidence-Based Prevention Emergency Education Relief Fund. The project
Practices aims to explore, implement, and sustain a full
continuum of care for K–12 students within local
Transforming the System districts who adopt student assistance programs,
Requires Educating Staff AND Tier 2/3 supports, and staff wellness frameworks.
Providing Ongoing Support for
Implementation Rooted in Relationships
The Northwest Mental Health Technology Nebraska’s Rooted in Relationships
Transfer Center (MHTTC) utilizes various content initiative guides communities to
from sources such as the National School Mental implement evidence-based practices that enhance
Health Best Practices: Implementation Guidance the social-emotional development of children birth
Modules for States, Districts and Schools and the through age eight. Each community has a
U.S. Department of Education’s Trauma Sensitive multidisciplinary stakeholder team that
Modules to support a systems transformation implements a long-range plan to enhance the early
effort that are a part of targeted technical childhood systems of care and the implementation
assistance that includes team-based training, data of the Pyramid Model.
for decision making, coaching supports, and https://challengingbehavior.cbcs.usf.edu/Pyramid
family engagement and youth involvement. Nation/State/docs/NE_2019_rir_executive_
Pairing content with implementation strategies summary.pdf
increases the likelihood of sustainability and
positive student outcomes. Supporting University Students
at Home
Did You Know? The Ohio State University has leveraged
Thirty-one states are implementing the Pyramid their campus wellness center to support their
Model as a tiered system of evidence-based students experience through the COVID-19
practices that promote social-emotional pandemic with an online webinar series entitled,
competence and prevent undesirable behavior in “Staying Calm and Well in the Midst of the
infants and young children.
COVID-19 Storm.” This series provides evidence-
https://challengingbehavior.cbcs.usf.edu/index.htm;
https://childcareta.acf.hhs.gov/resource/resource- based tactics on topics ranging from managing
guide-developing-integrated-strategies-support- stress to mindfulness to ensuring a good night’s
social-and-emotional-wellness sleep amongst the stressors of the pandemic. The
videos are posted on an easily accessible website
Statewide Wellness Initiative with other wellness tips such as healthy recipes
At the Center for School-Based Mental and additional resources. Having this information
Health Programs in Ohio – Ohio School in one location mitigates any stress from finding
Wellness Initiative resources and allows the students to personalize
their experience with the resources they need the apparent, the collective decision was made to add
most at any given time. ISF to the Strategic Plan as the primary focus for
the remainder of the grant cycle and beyond.
Helpful Hint
Implementing ISF to fidelity required examining
Use the Hexagon Tool to ensure you aren't
responding to the crisis by overwhelming the the MCBH program model and making significant
system. Greater efficiency with teaching will reduce changes to reflect mental health integration at
feelings of being overwhelmed with too many every tier of PBIS intervention, as well as
different instructional tasks that compete for changing the role of the mental health clinicians.
teacher time, energy, and fluency.
While MCBH clinicians were co-located on
school campuses, most were itinerant and
4. Establish an Integrated providing only individual therapy with no
Framework of Educational, coordination with the PBIS teams at the school
Social, Emotional, and sites they were serving. Additionally, the MCBH
Behavioral-Health Support for All Services to Education program was divided into
two separate teams serving students in either
Building an Interconnected general education or special education, which
Systems Framework further reinforced the existing siloed ways of
Monterey County in California began working. As PBIS informs us that relationships
the journey of building an Interconnected Systems and consistency are essential ingredients in
Framework (ISF) in 2016, shortly after learning cultivating a positive climate and culture, critical
about the model at the PBIS National Leadership adjustments to the program model included
Forum in Chicago. As a recipient of a School assigning clinicians to specific school sites and
Climate Transformation Grant to address alarming expanding PBIS teams at the school sites to
levels of trauma and community violence, the include them so that they could become part of the
Monterey County Office of Education (MCOE) decision-making process and share their expertise
had an established Leadership Team to coordinate in identifying mental health interventions for
efforts in PBIS implementation comprised of students. MCBH also established a full continuum
participating school districts and various of mental health services and supports that aligns
community and county members, including with the PBIS framework and allows time for
Monterey County Behavioral Health (MCBH). clinicians to provide Tier 2 groups in collaboration
Given that MCBH had existing memoranda of with school counselors, as well as Tier 1 training
understanding to serve students in both general and consultation that will build capacity of all staff
education and special education with all PBIS for responding to the mental health needs of
school districts along with robust staffing and students.
executive leadership buy-in to support changes
Along with changes to the MCBH program model
needed to implement ISF, this county agency was
and clinician involvement with the PBIS teaming
well positioned to incorporate necessary changes
process that supported ISF implementation,
into their service model for success. As the
MCBH clinicians were also included in district
leadership team’s collaboration and partnerships
PBIS trainings provided by MCOE. Initially,
deepened and the need for mental health
school staff and MCBH clinicians had difficulty
integration into PBIS became increasingly
understanding the purpose of receiving training in of relationships. The abundance of strong working
PBIS and how it related to mental health, and this relationships is the foundation that Monterey
eventually shifted as cultures merged and they County uses to continue the journey of ISF.
began to experience the value of having MCBH
clinicians participate in the PBIS process and Addressing Toxic Stress
share expertise in that helped inform team To address toxic stress among children
decision-making. As MCBH and MCOE worked growing up in poverty, an innovative
with school districts to identify ISF Knowledge collaboration was developed between a
Development Sites, ISF Working Agreements community center, Operation Breakthrough (OB),
were established with each site outlining roles and and a tertiary care children’s hospital, Children’s
responsibilities, in addition to a detailed scope and Mercy Hospital. OB houses the largest Head Start
sequence that provided a clear timeline of how ISF program in Missouri, serving more than 300
would be implemented throughout the school year children each day in its center. It started as a day
and how each agency would be working together care center but has expanded and developed ways
to support implementation to fidelity. to provide shelter, safety, food, employment,
education, and health care. Currently 96% of its
Now that Monterey County is several years into preschool children enter kindergarten ready to
implementation, those involved in this movement learn. Current CLASSTM scores for Emotional
have embraced a new way of working together to Support, Organizational Support, and Instructional
support the mental health and wellness of the Support exceed national averages.
learning communities, an indication of the positive
changes and ripples of meaningful impact can be Creating a Single System of
seen across all child serving systems. The School Delivery
Climate Leadership Team continues to hold ISF as Vermont’s Agency of Education (VT
the guiding framework and philosophy for all AOE) in collaboration with the Department of
training offerings while MCBH has been woven Mental Health have prioritized the Interconnected
into every layer of decision making at county, Systems Framework (ISF) to enhance and expand
district, and site levels. School district staff who School Mental Health. The leadership saw the
were familiar with the former MCBH program need to create a single system of delivery that
model report feeling more connected to the could be consistent across the state, while
clinicians working at their school sites and have a allowing local flexibility. The ISF provides the
better understanding of their role and how to opportunity to assess current resources, strengths
support students presenting with mental health and needs and a process to efficiently and
problems as clear pathways for referrals have been effectively build a continuum of support. As local
created. There has also been increased sense of educational agencies (LEAs) develop their
purpose for MCBH clinicians as many requests to Recovery Plan, districts are well positioned to use
remain at the same sites each new school year so their multi-disciplinary leadership teams to assess
that they can maintain the positive working student need and address three VT AOE identified
relationships they have worked so hard to cultivate priorities: (1) social-emotional functioning, mental
within the learning communities they serve. As health, and well-being;( 2) student engagement;
with any large-scale change that impacts the hearts and (3) academic achievement and success. The
and minds of so many, success lies in the quality 3 LEAs who have been utilizing the ISF are well
positioned to successfully implement their their strategic plan for developing a
Recovery Plans as they have already been working comprehensive and sustainable early childhood
with community partners in an integrated system.
approach to meet student needs. http://www.nysecac.org/application/files/7916/16
79/0961/ECAC_Strategic_Plan_Final_3.26.21.pdf
As part of the ISF work at the school level, school
leaders have been prioritizing youth voice (e.g., Embedding SEL and Trauma
engaging students with data to assess social- into Existing Framework
emotional behavioral well-being strengths and STEAM Academy at Woodrow Wilson
needs). The emphasis on stakeholder engagement is an elementary school in Port Huron, Michigan
to include students, families, and community that has been implementing PBIS for a number of
within the PBIS and ISF framework positions the years. During the last two years, they have worked
LEA to establish two-way communication to embed more social-emotional learning into their
feedback loops and authentic engagement that PBIS framework through the integration of
includes voice and choice. trauma-informed practices. The School Leadership
Team that guides their PBIS work also took the
Using Implementation Science
lead on embedding trauma-informed practices into
to Build State Capacity for
PBIS for their school to ensure that it was not a
Implementation of the Pyramid
separate initiative, but an enhancement of their
Model in North Carolina, Connecticut,
and New York current system that would better meet the needs of
their students.
North Carolina and Connecticut use
implementation science and implementation The School Leadership Team began by looking at
structures to build statewide capacity to adopt the what already existed within their PBIS system that
Pyramid Model. These structures include a state included a trauma-informed lens, then built upon
leadership team, a network of program it. For example, they were able to make small
implementation coaches, implementation sites, changes to many areas of their behavior matrix to
and data decision-making. ensure it was written in a way that would build up
students that have experienced trauma. From
The North Carolina state team develops and
there, the team determined that they needed to add
implements a plan based on implementation stages
a column that really focused on bringing some
and drivers.
social-emotional skills to the forefront of what
https://nceln.fpg.unc.edu/ncppmresources
was being taught. The column for Coping Skills
The Connecticut strategic plan outlines action and was added to the school-wide behavior matrix so
budgeting across implementation stages. they could be more intentional about helping
https://challengingbehavior.cbcs.usf.edu/Pyramid students develop these skills. Additionally, the
Nation/State/docs/CT_strategic_plan.pdf school added a row to the bottom of the matrix
titled “Staff Anchors” which describes how staff
In New York, the New York State Early will model and support students with this skill
Childhood Advisory Council has included equity development. Much of the same language is then
and social-emotional wellness through the mimicked in the classroom matrix, which allows
implementation of the Pyramid Model as part of teachers to add in any nuances for their particular
classroom. The classroom matrix sits right next to more coping skills that students can engage in
teacher workstations so they can easily reference it right at their seats given the pandemic. Recorded
as they model and teach the social-emotional skills interview with Joe Kramer, principal at STEAM
that are identified within it in their interactions Academy.
with students.
Providing Screening and
The team developed a professional development Treatment to All Incoming
plan to ensure teachers had what they needed to be University Students
successful in their work with students around the Free mental health screenings that are available to
integration of trauma-informed practices. The all incoming students and will eventually be made
administrator wanted to make sure staff were available to the entire UCLA community are just
supported in the teaching and modeling of the one part of the UCLA Depression Grand
coping skills that were included in the matrix. Challenge, a campus wide effort to reduce the
Staff were provided professional learning on health and economic impacts of depression by half
trauma and trauma-informed practices, given time globally by the year 2050. The online screening
to develop products for their classroom, and and treatment program are thought to be the first-
received coaching both from a school-level and ever campus wide mental health screening
district-level coach. Given that, they have a program conducted at a university.
greater skill set related to teaching social-
emotional skills in the classroom. The announcement in 2017 signaled a new phase
in the Depression Grand Challenge, which has
STEAM Academy has been using the school-wide brought together more than 100 researchers from
PBIS Tiered Fidelity Inventory (TFI) since 2015 more than 25 academic departments — and
to measure their PBIS implementation fidelity. growing — to develop better methods of
Upon beginning the work of embedding trauma- detecting, evaluating, and treating depression.
informed practices, they decided to use the Researchers also aim to eliminate the stigma
trauma-informed TFI companion guide that associated with depression, which is often a
includes enhancements to the items and barrier to seeking diagnosis and treatment.
walkthrough in order to collect data on their
practices. The team used the data from this tool to 5. Leverage Policy and Funding
determine the needs of the school and develop an
action plan to achieve them. For example, after Statewide Integration Through
they began implementation of their new practices, Legislation
they conducted the walkthrough with the Through legislation, Minnesota has
additional trauma-informed questions and realized concretely linked education and mental health
that the adults had not yet spent enough time on services and established a grant program to build
teaching the coping skills to students. The team capacity of educators and clinicians to serve the
went back and made plans to ensure the staff were social, emotional and behavior needs of students
very intentional with their teaching of these social- in schools. Their goals include:
emotional skills. They continue to alter their
 improving clinical service quality through the
action plan based on their data and the changing
support, training, and provision of evidence-
needs of the students and school, such as including
based treatments;
 increasing the number of mental health more deeply about their complementary roles
clinicians who are trained in and providing in achieving their goals.
Evidence-Based Practices;
Funding to Increase School
 improving capacity and infrastructure
Mental Health Providers and
development to support the expansion and School Nurses
sustainability of services long-term throughout
Michigan passed legislation allocating $31 million
Minnesota;
for hiring school mental health providers for
 developing and strengthening partnerships general education students and also required their
between mental health providers and host state to expand their Medicaid school-based
school districts, and services. The state has been able to use the
 increasing the number of school districts who increased funding to go from 1,738 school-based
have both a School-Linked Mental Health behavioral health providers statewide to 2,975
(SLMH) and PBIS framework. school-based behavioral health providers
statewide and increased school nursing staff from
Two of the features in the Minnesota approach are 253 to 307.
exceptionally promising.
Leveraging Funding with Youth
 First, Minnesota intentionally embeds the
Voice and Decision Making
PBIS framework in a comprehensive approach
to school mental health. Minnesota draws on The 2019 Oregon State Legislature
the behavioral approaches currently in place in dedicated $7.5 million to continue to support
schools developed through PBIS initiatives School-Based Health Center mental health
and integrates that knowledge with the array of capacity during the 2019–2021 biennium. Most of
evidence-based strategies that Mental Health this funding was reserved to support School-Based
partners bring. Health Center (SBHC) mental health capacity by
adding mental health staff and expanding current
• The partnership between Minnesota PBIS mental health staff hours at Oregon School-Based
and SLMH has a history of collaboration Health Center. An additional $700,000 was
spanning over 13 years and have become allocated to support youth-led mental health
increasingly aligned over the years. projects that would reduce mental health stigma
Currently, SLMH services are provided in and promote student resiliency at School-Based
51% of Minnesota schools; 63% of the Health Center SBHC host schools. In the 2019–
PBIS trained schools have SLMH services 2021 biennium, 15 School Based Health Centers
and 46% of all SLMH schools are in a received funding and technical assistance from the
PBIS trained building. Oregon Health Authority to operate Youth
 Additionally, and potentially most important, Advisory / Action Councils. Youth Advisory
Minnesota attends to the relationship building Councils are youth-driven groups that focus on
between school staff and mental health advising, supporting, and advocating for SBHCs
providers. As part of the co-written grant and their services while also providing space for
application, potential partners must identify students to connect with one another, build
what they hope to ‘give’ and ‘get’ in the new relationships with a facilitator who is
relationship. They must commit to learning knowledgeable in youth adult partnerships, and
create change in their schools, School Based  Do individuals who identify as male have a
Health Centers, and communities. healthier body image than students who
identify as female?
During the 2019–2020 school year, student-led
For more information on School-Based Health
projects included:
Centers and Youth Advisory Councils in Oregon
 Food Pantry and hygiene supply closets please visit: www.healthoregon.org/sbhc.
 Stress management resources for students
Removing the Funding Barrier
 Creation of materials promoting SBHCs and
Lake Washington School District is
addressing misconceptions
located in Redmond, Washington east of
 Attendance at State Youth Advisory Council Seattle serving over 32,000 students. As a
Summit strategic priority, Lake Washington School
 Education campaigns about issues identified District has worked with national and local experts
by Youth Advisory Council members to support the implementation of mental health
and well-being supports within a Multi-Tiered
 Celebrate Love tabling event during school
Systems of Support framework throughout 55
lunch promoting love outside of just romantic
schools. Through district directed and local
relationships
dollars, about 1 million dollars, Lake Washington
 Attendance at School Health Advocacy Day at has worked to remove barriers for timely mental
the Oregon State Capital health supports for students and families. By
removing eligibility requirements such as
Youth Advisory Councils that received state insurance and diagnostic assessments, students
funding are asked to do a Youth Participatory and schools can mobilize supports and
Action Research (YPAR) project where the youth interventions earlier than later.
are authentically engaged in a research and
decision-making process around a topic of their The collaborative partnership with community
choice. YPAR is an innovative approach to mental health partners focuses on an integrated
positive youth and community development based approach that embeds the providers so that they
in social justice principles in which young people are part of the school community. Students and
are trained to conduct systematic research to staff see them regularly in the building. Through a
improve their lives, their communities, and the memorandum of understanding the community
institutions intended to serve them. mental health partners also support prevention and
promotion efforts that enhance Tier 1 supports.
During the 2017–2019 biennium some examples Each secondary building has a mental health
of YPAR questions included: provider 20–40 hours a week and their middle
schools are building a framework to support
 What affects student mental health and how do
mental health providers. During COVID-19 they
students deal with stress?
have been able to adjust the mental health
 How do students experience and cope with providers hours to reach more families–something
anxiety while in school? they will continue through and after the pandemic.
Flexible Funding the work and initiatives are integrated into one
California’s early childhood mental system to build a strong capacity for sustainability
health efforts in San Francisco have of successful initiatives.
been built on existing collaboration, spurred by “The Collaboratory” leaders work together to
flexible funding from Temporary Assistance for align the work of each initiative and combine
Needy Families welfare reform. The city has efforts of each grantee in order to “work smarter,
created a network of early childhood mental health not harder.” This process has led to integration of
consultants responsive to different ethnic needs, all grant initiatives into a collaborative effort to
primarily providing prevention and early provide cross training across disciplines in schools
intervention services. The initiative uses a pooled and community agencies/organizations; to align
funding strategy that involves multiple agencies and implement programming in schools; and to
and federal, state, and local funding streams. collect data across systems informing state leaders
of best practices for the work of creating safe and
Using Data and Cost Analyses
to Study the Impact of the violence-free schools. “The Collaboratory”
Pyramid Model worked together to develop and submit legislative
House and Senate bill drafts for the 2017
Wisconsin has successfully used data and cost
Legislative Assembly to consider. The team
analyses to increase resources for the Pyramid
submitted eleven (11) bills of which nine (9) were
Model implementation and scale-up. The
approved for legislation. (Excerpted from Project
Governor's budget also includes a funding increase
LAUNCH, Grantee/Filed Spotlights,
for Pyramid Model coordination, which provides
https://healthysafechildren.org/grantee-field-
professional development and resources focused
spotlight/state-and-community-integration-
on trauma-informed practices for daycare
initiatives-create-safe-and-violence-free)
providers to reduce undesirable behavior in young
children. 6. Enhance Workforce Capacity
Aligning State Grants and
Initiatives Using the Pyramid Model in
Minnesota and Wisconsin
“The Collaboratory” in Nevada
integrates various state grants and initiatives to Minnesota has been implementing the
ensure a climate of collaboration. State leaders Pyramid Model for over ten years and has trained
worked together to develop a State Integration and coached hundreds of practitioners,
Team to include many state initiatives in order to administrators, and families. The evaluation of
align the work across the state. The initiatives training and support efforts are included in the
include: Project AWARE, School Climate following report:
Transformation, Pre-K Development, Systems of https://challengingbehavior.cbcs.usf.edu/Pyramid
Care, Office for a Safe and Respectful Learning Nation/State/docs/MN_pm_executive_summary_2
Environment, OJJDP Comprehensive School 020.pdf
Safety Initiative, and State Youth Treatment
Wisconsin has been building the capacity of early
Planning for Substance Abuse. The State
childhood programs and practitioners to
Integration Team meets monthly to coordinate the
implement the Pyramid Model since 2009. A
work of all Nevada grants, and this team ensures
cross-sector state leadership team works to build
and guide this effort to provide Pyramid Model Virginia Partnership for School
training and support to practitioners and leaders in Mental Health
childcare, public preschool, early childhood
special education, family resource centers, and A new statewide project, the Virginia
Head Start programs. In 2016, an evaluation of the Partnership for School Mental Health, aims to
Pyramid Model work in two Wisconsin strengthen school mental health services through
communities found that children in Pyramid two major pathways: by building a pipeline of
Model programs had better social and emotional graduate student trainees to high-need school
skills and less problematic behavior than children divisions, and by creating an inter-professional
in non-Pyramid Model programs. The positive network of school mental health practitioners.
outcomes achieved through the implementation of
Funded by a five-year, $2.5 million grant from the
the Pyramid Model resulted in a substantial
U.S. Department of Education, the partnership
funding allocation for the work from the State
between the Virginia Department of Education
Department of Children and Families.
and the University of Virginia’s School of
The Greater Watertown Community Health Education and Human Development was
Foundation in Wisconsin is also supporting the announced in 2020.
implementation of the Pyramid Model for
School Behavioral Health
Promoting Social and Emotional Competence in
Community of Practice
Young Children in all early childhood education
programs within a two-county service area The District of Columbia has been
through a phased cohort model approach. working across systems and alongside educational
Committed to ensuring access to high-quality partners to ensure that every school and student
early care and education, the Greater Watertown has access to comprehensive school behavioral
Community Health Foundation has invested to health services and supports. A key factor in its
support program-wide implementation of the success has been connecting with community-
Pyramid Model in 7 sites within a two-county based organizations (CBOs) to supplement the
area. Using a cohort model, the Foundation’s services and support already available through
Early Childhood Learning Innovation Coach school-hired behavioral health providers.
guides program leadership teams and internal
In 2019, school teams, composed of educators,
coaches in five childcare and two school district
school staff, CBO clinicians and other interested
programs. They also support community partners
groups from all DC public and public charter
to provide parent training related to Pyramid
schools, joined the School Behavioral Health
Model practices. For infants and toddler, the
Community of Practice (DC CoP). Along with
training is conducted within playgroups where
other community partners and District agency
parent-child relationships are strengthened, and
leaders, DC CoP members come together monthly
families are guided in their responsive
to learn from each other, solve problems of
interactions. Parent training for parents and
practice and to support the implementation of best
caregivers of preschool children is offered through
practices in school behavioral health to promote
the Positive Solutions for Families workshop
healthy development and well-being for all
series that provides training to families of
students and their families.
preschool children with undesirable behavior.
The DC CoP offers a space for system level mapping. Additional modules will focus on
leaders to interact with on the ground service staff/student wellness and data usage for mental
providers—and learn about the urgent challenges wellness.
facing students, staff and families, and
providers—so all invested partners are empowered Increased Funding to Expand
to respond quickly and use numerous the Workforce in Alabama,
communication channels to carry the learning into Kentucky, and Tennessee
the broader system. Alabama: State Funding for a New Position:
School-Based Mental Health Service Coordinators
CoP members also join Practice Groups and Work
Groups led by volunteers representing different  In 2020, the Alabama State Legislature
roles. Some examples of the Practice Groups and allocated $4.5 million in grants for local
Work Groups include: Trauma-Informed Practices educational agencies to employ School-Based
in Schools, Crisis Response and Intervention, Mental Health Service Coordinators in
Family and Youth Engagement, and Positive 2020-2021.
School Climate and Social and Emotional  Responsibilities:
Learning Implementation, Suicide Prevention and
Teacher Wellness. Over 100 practitioners, • Complete a needs assessment and a
educators and family members engage in shared resource map of school mental health
work through the DC CoP. services for all schools in their jurisdiction
• Coordinate and support student mental
Pennsylvania Department of health services (including Tier 1, Tier 2,
Education (PDE) Released
and Tier 3 services) throughout the school
Creating Equitable School
district
Systems: A Roadmap for Education
Leaders that Addressed Supporting Alabama: State Funding to Expand the
Social and Emotional Wellness for
Workforce: Master’s Level Clinicians
Staff and Students
 Seven years ago, the AL Department of
PDE is set to release a new learning series on
Mental Health and AL Department of
Accelerated Learning, which will provide a
Education placed master’s level mental health
process and system of support for local
clinicians in public schools using local
educational agencies to make key decisions for
dollars.
school reopening. Fostering supportive learning
environments through equitable, trauma-informed  In FY 2019–2021, the Governor and Alabama
principles and focusing on comprehensive mental Legislature appropriated $1.75 million in state
health is a key component of Accelerated funding to expand this workforce in 21
Learning. The modules around supportive learning additional school systems.
environments are set to focus on comprehensive
mental health and utilize portions of the National Kentucky: State Funding to Expand the
Center for School Mental Health/Mental Health Workforce
Technology Transformation Center School mental  HB 352 (enacted April 2020)
health curriculum to support teaming and resource
• Appropriated $7.4 million to fund development, with “booster sessions” (e.g.,
additional school-based mental health coaching, additional workshops, follow-up to
provider full-time equivalent positions in assessments) provided during the school year. In
FY 2020-2021 on a reimbursement basis addition, 100% of children and youth in each Safe
Schools/Healthy Students (SS/HS) Local
• Goals committed to under SB 8, 2020:
Educational Agencies have been screened for
 At least one school counselor per early social, emotional, or developmental delays
public school, 60% allocated to and a follow-up screening process has been
services institutionalized.
 At least one school counselor or
The state developed Michigan Social Emotional
school-based mental health services
Learning Competencies for ages birth to eighteen
provider (statutory definition) for every
and is in the process of working collaboratively
250 students
with a cross representation of diverse partners
Tennessee: State Funding to Expand the including educators on a corresponding
Workforce implementation guide to align curriculum to the
competencies for effective utilization. These
 Governor's budget for FY 2020-2021
competencies are expected to be utilized across
(finalized June 2020)
the SS/HS LEAs post-grant for sustainability of
• Allocated $3 million (recurring) to fund 59 effective practices. (Excerpted from Project
new school-based behavioral health LAUNCH, Grantee/Filed Spotlights,
liaisons https://healthysafechildren.org/grantee-field-
spotlight/promoting-early-childhood-social-and-
• Responsibilities:
emotional-learning-development)
 Assist schools in conducting needs
assessments Personnel Standards for Infant-
Early Childhood Mental Health
 Provide training and education for
Specialists
school personnel on behavioral health
topics Illinois’ Child and Family Connections
Procedure Manual has an extensive set of
 Implement Tier 1, 2, and 3 services
recommended qualifications for the Part C Early
 Foster positive family-school- Intervention program’s social-emotional
community relationships consultants. These include “master’s degree in
child development, special education, psychology,
Screening in Early Childhood social work, or a related field; supervised clinical
and Statewide Social- experience with children and families; training in
Emotional Learning infant development; diagnosis of mental health
Competencies disorders in infancy; impact of stress and trauma
In each of the three Safe Schools/Healthy Students in infancy; assessment of parent/child relationship;
Local Educational Agencies in Michigan, 100% of intervention to support parent/child relationship;
early childhood staff were trained in early and knowledge about and skill in providing
childhood social-emotional learning and reflective supervision and consultation.”
Developing University 7. Use Data for Decision Making to
Telehealth Services Promote Equitable
Prior to the March 2020 shut down of Implementation and Outcomes
Heidelberg University in Tiffin, Ohio, there were
no telehealth services for student’s mental health Listening and Learning from
care. The creation of telehealth services was to the Community
target postsecondary students who were enrolled Recently, Michigan’s Multi-Tiered
at Heidelberg University. The System of Support (MiMTSS) Technical
materials/information accessed to create this Assistance Center paused the training offered on a
service included: Ohio Administrative Code 4757- behavior screening tool. This pause allowed time
5–13, which outlined the legal and ethical steps to to listen and learn from the Michigan community.
provide telehealth services appropriately, The MiMTSS Center wanted to examine how
American Psychological Association’s Office & screening is affected by or addresses concerns of
Technology Checklist For Telepsychological inequities. Through current work, the MiMTSS
Services which offered a checklist of items from Center realized that the use of a valid and reliable
technology to beginning of virtual session to screening tool must be embedded within an
verify engaging in a telehealth in an appropriate efficient screening process that considers multiple
manner, and The Center for Connected Health sources of information. It is important that an
Policy: Current State Laws and Reimbursement effective and equitable multi-tiered system of
Policy which outlined definitions regarding support is in place to (1) prevent possible concerns
Telehealth, defined consent, as well as highlighted and (2) provide intervention and supports when
limitations and restrictions as set forth by the need is identified. All of this is nested within
individual states. Counselors at Heidelberg have educational systems and the community, ensuring
seen an increase in the usage of the telehealth responsiveness to context and culture. (See figure
services as students navigated the pandemic. for illustrating these connections.)
MTSS: Providing a Educational

Community: the
Screening process: continuum of supports Systems: Schools,
people of the region
Information gathering process to matched to student need LEAs, ISDs structures
with regards to context
identify needed supports that can an allocation within a and process for
of social values and
include a screening tool system to allocate providing educational
responsibilities
supports program
The ultimate goal is to provide comprehensive Engaging Students with
guidance, training and resources connecting Information
screening with systems. To achieve this goal, they Providing students with an opportunity
are utilizing a phased process. They released a to be heard can yield important outcomes. As part
brief document with considerations to identify and of ongoing PBIS implementation, Roanoke
support social-emotional-behavior-well-being. A County Public Schools in Virginia engaged youth
more extensive document will be released that with both school-wide climate data and Youth
builds upon the brief. By the end of the 2021– Risk Behavior Survey data. Students were
2022 school year, they will have a comprehensive provided a structure for reviewing those data. The
manual for a screening process that was developed first group of students who were invited to take
with diverse and stakeholder input as well as part in this activity were all secondary students.
usability testing. Each document supports work Students identified behavioral health as a need,
toward technical adequacy, an equity focus, and specifically expressing their concerns about
meaningful outcomes. suicidal ideation. The students made connections
in the data between substance use, unhealthy
Preparing the System for
choices, and high incidence of suicidal
Screening
ideation. Having heard from the initial group of
Battle Ground School District No. 119 secondary students, district leadership visited each
is a public school district in Clark County, of the 27 schools, including elementary schools,
Washington. To set the stage for effective mental and interviewed students, asking students what
health screening for next year, the district team concerned them about their school. The students’
created a 6-week plan emphasizing social- responses enlightened leadership and allowed
emotional learning supports, adjusted previous them to take intentional steps to incorporate
intervention practices to support youth during the social-emotional behavior supports.
COVID-19 climate, as well as supporting staff via
monthly newsletters addressing those social- Connecting Pre-K Students to
emotional behavior topics such as staff wellness, Additional Supports
recognizing and responding to trauma, and The Lamar County Early Learning
practices to use in the transition back into the Collaborative in Mississippi uses the Pyramid
classroom. Model for Promoting the Social and Emotional
Competence of Young Children as a MTSS for
Including Students in Decision
their pre-K students. These procedures include a
Making
flow chart to help determine which children need
Forest Park Middle School, in Forest Tier 2 and Tier 3 interventions and a system for
Park, Illinois, has created equitable, identity linking areas of need with state social-emotional,
affirming, and co-created learning spaces for math, or English Language Arts performance
students. The school's emphasis on circle standards progress monitoring. For children
leadership ensures that decisions are made with receiving Tier 3 non-academic interventions, they
students, not for them, and that students are use the Pyramid Model’s Behavior Incidence
included in every part of the change-making cycle. Report System to help determine the functions of
behavior and to provide individualized supports
such as assisting children develop targeted social- remote learning. Much of the work of embedding
emotional skills. social-emotional learning curricula into lesson
plans has continued this year, with daily lessons
What is Your Call to Action? devoted to social-emotional skills.
Through their review of data, Medical
Lake School District recognized a Additionally, there has been a particular focus
substantial gap of unmet needs for its most during remote learning to revisit routines and
underserved students, and this was their call to schedules multiple times a day and using plenty of
action. By developing protective factors and a visuals. "One of the things making the biggest
robust system of support for their youth, they are difference is remembering that kids have to have
fostering knowledge and promoting the routines and expectations laid out every day all
development of skills that prepare students to be year long… that really impacted us a lot." Over
informed, thoughtful, and productive individuals the years, the school has also made efforts to
and citizens, and teach individuals to recognize increase free playtime for young children,
risk factors and warning signs pertaining to expanding recess from 15 to 30 minutes, and
mental health. shifting from an at times 'academic focus' to
include plenty of free time.
Using the PBS Pyramid Model
in Classrooms The leadership team regularly uses data to help
guide progress. For example, teachers are using
Chelsea Public Schools in
the electronic Behavior Incident Reporting system.
Massachusetts has been engaged in Positive
The leadership team meets monthly to review
Behavior Support Pyramid Model since 2016.
patterns and trends in classrooms, identify school-
Presently, all 45 classrooms across Pre-K to first
wide professional development, and identify
grade are working with the framework. The
individual student needs. Overall, program leaders
district has served children remotely for all of the
suggest that among the general population of
2020–2021 school year, just now shifting back to
students, the Pyramid Model has led to a decrease
in-person instruction.
in behaviors that require intervention outside of
Program leaders note that teachers across the the classroom. As the school returns to in-person
school have embedded principles of Positive instruction, they will continue expanding their use
Behavior Support Pyramid Model into daily of Pyramid Model practices and fidelity to the
routines of classrooms, which has carried over into model.
APPENDIX B.
Federal Technical Assistance Centers Related to Social-
Emotional and Mental Health
resource collection is designed to increase the
Comprehensive Center Network
capacity of state and district leadership to
(CCNetwork)
support their school communities create
Funded by the U.S. Department of trauma-informed approaches for social,
Education emotional, and behavioral learning. The
resources within the collection are also
CCNetwork comprises 19 Regional
targeted to specific needs and contexts, such as
Comprehensive Centers and one National Center
schools in rural communities, or schools that
that provide capacity-building technical assistance
are in the early stages of implementing social
to states, districts and schools in their design and
and emotional learning (SEL) strategies.
implementation of evidence-based policies,
practices, programs, and interventions that  Reimagining Excellence: A Blueprint for
improve instruction and educational outcomes for Integrating Social and Emotional Well-
all students. State educational agencies may Being and Academic Excellence in Schools,
request capacity-building support from their designed with input from in-person and remote
Comprehensive Centers. educators, leaders, researchers, professional
learning providers, and technical assistance
The CCNetwork produces and disseminates providers, details the indicators of learning
research-based tools and resources to build the programs that successfully integrate equity,
capacity of educational leadership in social- well-being, and academics and discusses how
emotional, behavioral learning and mental health to improve student outcomes through a cycle
approaches to better support the well-being of of strong planning, action, and continuous
school staff, students, and families. monitoring.
Select CCNetwork resources include:  Informational Resources on Improving

Social and Emotional Learning and
 The Social, Emotional, and Behavioral
Outcomes provides resources for
Learning and Trauma-Informed Practice
understanding, prioritizing, and measuring  General. The first, general tier is conceived to
students’ SEL competencies and on evidence- serve the broadest audience and consists of a
based SEL programs and interventions. The growing inventory of carefully curated online
document organizes resources and information resources, including evidence-based
about SEL into nine categories listed under professional learning opportunities, videos,
two broad headings: What is SEL? and How is tools, resources, and other publications. This
SEL being implemented? tier also includes reports, tools, and protocols
developed by Center staff.
 Supporting Well-Being and Learning
Through a Concerns-Based Approach  Targeted. The second, targeted tier of
provides guidance to school leaders on technical assistance includes peer-to-peer
supporting teacher well-being through collaborative opportunities for SEAs to work
implementation of the Concerns-Based on a shared problem of practice relevant to the
Adoption Model (CBAM). A series of blogs broader field. The work will yield participant-
opens with an introduction to using the CBAM designed and -tested tools and resources that
framework and includes action steps to apply will then be disseminated more broadly to
three diagnostic tools (i.e., Stages of Concern, the field.
Levels of Use, and Innovation Configuration  Intensive. Finally, the third, intensive tier
Maps) to help maintain a focus on improving supports the SEL and school safety needs of
student learning while simultaneously individual SEAs and LEAs. These one-on-one
supporting teacher well-being. consulting engagements will aim to build their
capacity to lead and sustain the work.
Website: https://compcenternetwork.org/
Website: https://selcenter.wested.org/
Center to Improve Social and
Emotional Learning and School Center of Excellence on Infant and
Safety (CISELSS) Early Childhood Mental Health
Consultation (CoE for IECMHC)
Funded by the U.S. Department of
Education Funded by the U.S. Department of
The purpose of the CISELSS is to provide Health and Human Services
technical assistance to support states and districts The CoE for IECMHC is a national technical
in the implementation of social and emotional assistance center dedicated to the advancement
learning (SEL) evidence-based programs and and impact of the field of IECMHC through
practices. Our charge from the U.S. Department of training, technical assistance, and resource
Education is to build the knowledge and capacity development. The CoE is supported by the U.S.
of (1) state educational agencies (SEAs) to support Department of Health and Human Services’
their local educational agencies (LEAs) and Substance Abuse and Mental Health Services
(2) LEAs to support their schools. Administration in partnership with the
Administration for Children and Families and
Like some other federally funded technical
assistance centers, it provides technical assistance Health Resources and Services Administration.
in three tiers:
IECMH consultants support professionals in early  To provide professional development to
care and education, home visiting, early IECMH consultants nationally.
intervention, and other early childhood settings. Website: https://www.iecmhc.org/
National Technical Assistance

Center for the Education of
Neglected or Delinquent Children
and Youth (NDTAC)
Education
In 2002, the U.S. Department of Education
established the NDTAC, which is overseen by
Longevity Consulting and its partners Child
Trends, BreakFree Education and Cyber Synergy.
NDTAC’s overarching mission is to improve
educational programming for children and youth
who are neglected or delinquent or at risk. Within
this overarching mission, NDTAC focuses on
three key goals:
 Collect and disseminate information and
resources related to the education of children
and youth who are neglected or delinquent
and/or at risk of dropping out of school.
 Foster coordination and collaboration among
The CoE for IECMHC provides technical
neglected or delinquent programs focused on
assistance to programs, communities, states,
the practice of educating children and youth
territories, and tribal communities, and individual
who are neglected or delinquent.
mental health consultants to increase access to
high quality mental health consultation throughout  Synthesize and provide existing evidence-
the country. based research to expand the general
knowledge base about the education of
The CoE for IECMHC has three areas of focus: children and youth who are neglected or
 To serve as a clearinghouse for best practice delinquent.
resources related to developing, implementing,
Website: https://neglected-delinquent.ed.gov/
and maintaining an IECMHC program at a
state, territorial, community or tribal level.
 To provide technical assistance to states,
territories, programs, communities, or tribal
nations in any stage of IECMHC program
development.
National Center on Afterschool and based child development and teaching and
Summer Enrichment (NCASE) learning practices that are culturally and
linguistically responsive and lead to positive child
Funded by the U.S. Department of outcomes across early childhood programs. They
Health and Human Services also support strong professional development
The National Center on Afterschool and Summer systems. NCECDTL is responsive to the unique
Enrichment (NCASE) is part of the Office of needs of dual language learners, American Indian
Child Care (OCC) Technical Assistance network. and Alaskan Native and Migrant and Seasonal
NCASE provides training and technical assistance Head Start programs, in particular, as well as other
to the state, territory, and tribal Child Care and diverse populations. It uses professional
Development Fund lead agencies and their development strategies that support states, tribes,
designated networks, which include the statewide and agencies in serving low-income families. The
afterschool networks, state and local educational Center's work includes, but is not limited to:
agencies, provider associations, and Child Care  Professional development for the infant,
Resource and Referral agencies. The goal of toddler, and preschool workforce
NCASE is to ensure that school-age children in
families of low income have increased access to  Evidence-based curriculum
high-quality afterschool and summer learning  Intentional teaching and home visiting
experiences that contribute to their overall practices
development and academic achievement.
 Effective transitions
Selected NCASE resources include:  Developmental screening instruments and on-
 Social and emotional learning going assessment tools
 Addressing adverse childhood experiences  Practice-based coaching
 Supporting positive social-emotional climates  Culturally, linguistically, and age-appropriate

in out-of-school time practices
 Enhancing teacher-child interactions
Website: https://childcareta.acf.hhs.gov/centers/
national-center-afterschool-summer-enrichment  Supporting children with disabilities and
suspected delays (Part C and Part B)
National Center on Early Childhood  Using data to improve practice
Development, Teaching, and
Learning (NCECDTL) Website: https://eclkc.ohs.acf.hhs.gov/ncecdtl

Health and Human Services
This Center is part of a comprehensive Training
and Technical Assistance System funded by the
Office of Head Start. NCECDTL advances best
practices in the identification, development, and
promotion of the implementation of evidence-
National Center on Health, National Center for Homeless
Behavioral Health, and Safety Education (NCHE)
(NCHBHS)
Funded by the U.S. Department of Education
Health and Human Services This Center operates the U.S Department of
This Center is part of a comprehensive Office of Education's technical assistance center for the
Head Start Training and Technical Assistance federal Education for Homeless Children and
System and works collaboratively with a Youth (EHCY) Program. In this role, NCHE
consortium of partners. NCHBHS designs works with educators, service providers, parents,
evidence-based resources and delivers innovative youth, and other interested groups to ensure that
training and technical assistance to build the children and youth experiencing homelessness can
capacity of Head Start and other early childhood enroll and succeed in school. NCHE, based at the
programs to: University of North Carolina at Greensboro,
creates publications, hosts webinars, and delivers
 Support children’s healthy development and
onsite and virtual presentations in addition to
school success
providing individual assistance via a national
 Promote the safety of children, families, and helpline at 800-308-2145.
staff
Website: https://nche.ed.gov/
 Provide inclusive, culturally, and linguistically
responsive services
National Center on Parent, Family,
 Address disaster preparedness, response, and and Community Engagement
recovery (NCPFCE)
 Mitigate adversity through trauma-informed
care
Health and Human Services
 Advance health equity by improving child and This Center is part of a comprehensive
family well-being Department of Health and Human Services/Office
of Head Start Training and Technical Assistance
NCHBHS is responsive to the unique needs of
System. NCPFCE provides training and technical
children who are dual language learners, children
assistance for Head Start and Early Head Start
in Tribal or Migrant and Seasonal Head Start
staff who work with
programs, children with special health care needs,
families. NCPFCE professional development
and children who are living in foster care or
activities reflect current evidence and lead to
experiencing homelessness.
improved:
Website: https://childcareta.acf.hhs.gov/centers/  Family outreach, recruitment, and attendance
national-center-health-behavioral-health-and-
 Family well-being
safety
 Expanded family engagement in children’s
learning and development
National Center for Pyramid Model
Innovations (NCPMI)
Education
The Center works to improve and support the
capacity of state systems and local programs to
implement an early childhood multi-tiered system
of support to improve the social, emotional, and
behavioral outcomes of young children with, and
at risk for, developmental disabilities or delays.
The goals of the Center are to assist states and
programs in their implementation of sustainable
systems for the implementation of the Pyramid
Model for Supporting Social Emotional
 Enhanced community partnerships that support Competence in Infants and Young Children
families (Pyramid Model) within early intervention and
 Strengthened outcomes for children and early education programs with a focus on
families enrolled in Head Start and Early Head promoting the social, emotional, and behavioral
Start programs outcomes of young children birth to five, reducing
the use of inappropriate discipline practices,
NCPFCE also offers professional development in promoting family engagement, using data for
areas, including but not limited to: decision-making, integrating early childhood and
 Staff-family relationship building that is infant mental health consultation, and fostering
culturally and linguistically responsive inclusion.
 Family employment, career pathways, and Website: https://challengingbehavior.cbcs.usf.edu/

financial stability
National Center on Safe Supportive
 Equity and inclusiveness in family
Learning Environments (NCSSLE)
engagement
 Parent leadership, advocacy, and transitions to Funded by the U.S. Department of
kindergarten Education
NCSSLE is funded by the Department’s Office of
Website: https://eclkc.ohs.acf.hhs.gov/about- Safe and Supportive Schools. The Center offers
us/article/national-center-parent-family- information and technical assistance to states,
community-engagement-ncpfce districts, schools, institutions of higher education,
and communities focused on improving school
climate and conditions for learning. NCSSLE
operates under the premise that, with the right
resources and support, educational partners can
collaborate to sustain safe, engaging, and healthy
school environments that support student
academic success. The website includes
information about the Center’s training and
technical assistance resources, products and tools,
and latest research findings.
NCSSLE’s three main areas of support are:

 Providing training and support to state
administrators, including 27 grantees funded
under the Mental Health Service Professional
Demonstration Grant program, 15 grantees
funded under the Project Prevent Grant
program, 5 grantees funded under the Trauma
Recovery Demonstration Grant program,
school and district administrators, institutions
of higher education, teachers, support staff at The National Center for School
schools, communities and families, and Mental Health (NCSMH)
students.
Funded by the Health Resources and
 Seeking to improve schools’ climate and Services Administration
conditions for learning through measurement
The NCSMH at the University of Maryland
and program implementation, so that all
School of Medicine conducts research, training,
students have the opportunity to realize
policy, and practice to advance school mental
academic success in safe and supportive
health nationally. The NCSMH engages school,
environments.
district, state, and territory leaders in assessing and
 Promoting and managing the U.S. Department improving their comprehensive school systems via
of Education School Climate Surveys a free online portal, The School Health
(EDSCLS) maintenance and help desk hotline. Assessment and Performance Evaluation
(SHAPE) System. The SHAPE System offers
To contact the National Center on Safe Supportive individuals and teams the opportunity to assess
Learning Environments, call 1-800-258-8413 or e- school mental health quality using national
mail [email protected]. performance measures and provides targeted tools
and resources to support quality improvement and
Website: https://safesupportivelearning.ed.gov
strategic action planning. Through facilitation of
School Mental Health Collaboratives on
Improvement and Innovation Networks, national
communities of practice, state coalitions, and other
learning collaboratives at local, district, state,
regional, and national levels, the NCSMH
analyzes diverse sources of information, develops
and disseminates practical tools, issue and policy
briefs, and promotes the utilization of knowledge
and actions to advance successful, innovative, and National Technical Assistance
sustainable school mental health policies, Center on Positive Behavioral
practices, and programs. Interventions and Supports (PBIS)
Website: http://www.schoolmentalhealth.org/ Funded by the U.S. Department of
Education
National Training and Technical The PBIS Center has been funded since 1998. The
Assistance Center for Child, Youth, purpose of the Center is to improve the capacity of
and Family Mental Health (NTTAC) state educational agencies, local educational
Funded by the Substance Abuse and agencies, and schools to establish, scale-up, and
Mental Health Services Administration sustain the PBIS framework to (a) scale up tiered
systems of support to improve outcomes for
NTTAC provides states, tribes, and communities
students with or at-risk for disabilities, (b) enhance
with training and technical assistance on
school climate and school safety, and (c) improve
children’s behavioral health, with a focus on
conditions for learning to promote the well-being
systems of care. NTTAC is funded to increase
of all students.
access to, effectiveness of, and dissemination of
evidence-based mental health services for young The Center on PBIS (a) provides the technical
people (birth to age 21) and their families, assistance to encourage large-scale
including young people experiencing serious implementation of multi-tiered systems of support
mental illness or serious emotional disturbance. (MTSS) to address social-emotional, behavioral,
NTTAC supports a system of care that is trauma- and mental health needs; (b) provides the
informed and person-centered. NTTAC is organizational models, demonstrations,
committed to equity, inclusion, and diversity, and dissemination, and evaluation tools needed to
promotes authentic partnership with youth and comprehensively and effectively implement
families. NTTAC supports Children’s Mental MTSS across an extended array of contexts; and
Health Initiative grantees and provides an array of (c) extends the lessons learned from PBIS
trainings, technical assistance, and resources to implementation to the broader agenda of
providers, organizations, and agencies from across educational reform. The Center also provides
the system of care. support to the School Climate Transformation
District and State grants.
Website: https://nttacmentalhealth.org/
The website includes resources, tools, and
trainings to enhance district and state efforts to
build capacity and systemically integrate social,
emotional, behavioral, and mental health strategies
and supports in schools.
Website: www.pbis.org
APPENDIX C.
Technical Assistance Resources Related to Social,
Emotional and Mental Health
Link: https://nieer.org/wp-content/uploads/2021/
Assessment
02/NIEER_Seven_Impacts_of_the_Pandemic_on_
Title: Using Student Achievement Data to Young_Children_and_their_Parents.pdf
Support Instructional Decision Making Description: This study highlights seven impacts
Link: https://ies.ed.gov/ncee/wwc/ the pandemic has had on children and their
PracticeGuide/12 parents. The research was conducted by the
National Institute for Early Education Research
Description: This guide offers five (NIEER) at the Graduate School of Education,
recommendations to help educators effectively use Rutgers University, New Brunswick, NJ, where
data to monitor students’ academic progress and they conduct and disseminate independent
evaluate instructional practices. The guide research and analysis to inform early childhood
recommends that schools set a clear vision for education policy.
schoolwide data use, develop a data-driven
culture, and make data part of an ongoing cycle of Title: Checklist of Early Childhood Practices
instructional improvement. The guide also that Support Social-Emotional
recommends teaching students how to use their Development and Trauma-Informed
own data to set learning goals. Care (NCPMI)
Link: https://challengingbehavior.cbcs.usf.edu/
Early Childhood
docs/Informed-Care-Checklist.pdf
Title: Seven Impacts of the Pandemic on Young Description: This checklist is a list of practices
Children and their Parents: Initial that will help guide your thinking about how to
Findings from NIEER’s December 2020 support the social-emotional development of
Preschool Learning Activities Survey. young children who have experienced trauma.
New Brunswick, NJ: National Institute This list of practices is not exhaustive nor is it
for Early Education Research meant to be a substitute for treatment or
counseling for children and families. Many of Mental Health
these practices are part of the Pyramid Model (i.e.,
the Teaching Pyramid Observation Tool), while Title: Advancing Comprehensive School
other practices may not be explicitly described in Mental Health Systems: Guidance from
the Pyramid Model practices yet they align well the Field
with Pyramid Model practices that you may Link: http://www.schoolmentalhealth.org/
already be using. Resources/Foundations-of-School-Mental-
Health/Advancing-Comprehensive-School-
Families
Mental-Health-Systems--Guidance-from-the-
Field/
Title: National Federation of Families:
Education and Mental Health During Description: This resource synthesizes school
COVID-19 mental health knowledge and guidance of over 75
experts nationally. This resource is a
Link: https://www.ffcmh.org/crisis-hotlines
foundational document in the field to help guide
Description: The link offers free, national local, state, and national efforts to strengthen
hotlines and helplines that can assist parents, school mental health efforts and to start to
caregivers, families, and youth. understand and bring consensus to the quality
domains of school mental health. A partnership of
Title: Supporting Students with Disabilities at
national school mental health leaders and
School and Home: A Guide for Teachers
organizations contributed to the development of
to Support Families and Students
the guidance.
Link: https://www.pbis.org/resource/supporting-
students-with-disabilities-at-school-and-home-a- Title: National School Mental Health Best
guide-for-teachers-to-support-families-and- Practices: Implementation Guidance
students Modules for States, Districts, and Schools
Description: This guide highlights five key Link: https://mhttcnetwork.org/centers/global-

practices for teachers and families to support all mhttc/national-school-mental-health-best-practices
students, including students with disabilities, at Description: The Guidance was co-developed by
school and home. For each practice, the guide the Mental Health Technology Transfer Center
provides (a) tips for teachers to support students Network Coordinating Office and the National
with disabilities during instruction; (b) tips for Center for School Mental Health to help states,
families that educators can share to support or districts, and schools across the United States
enhance learning at home, especially during understand the core components of comprehensive
periods of remote instruction; and (c) free-access school mental health and engage in a planning
resources that include strategies shown to be process around implementation of services. The
effective by research (e.g., informational guides, modules are intended to be used with school and
downloadable materials, research-based district teams that can influence, develop, and
programs). oversee school mental health systems at the school
district and building levels.
Title: Classroom WISE (Well-Being Title: School Connectedness Tip Sheets—
Information and Strategies for School Mental Health Quality
Educators) Guide Series
Link: https://mhttcnetwork.org/free-smh-course Link: https://www.cdc.gov/healthyyouth/
protective/school_connectedness.htm
Description: Educators and school personnel play
a vital role in promoting mental health and well- Description: Data shows that students who say
being and identifying and responding to emerging that they feel connected to their school (that their
mental illness in children and adolescents. teachers care about them, that they feel like they
However, they often have not received the belong, that they feel safe there) are less likely to
education, training, and/or ongoing support engage in many risk behaviors, including early
needed to respond in the classroom. To address sexual initiation, alcohol, tobacco, and other drug
this need, the Mental Health Technology Transfer use, and violence and gang involvement, less
Center Network, in partnership with the National likely to report symptoms of anxiety or
Center for School Mental Health at the depression, and are more likely to report higher
University of Maryland School of Medicine, has grades and test scores, have better school
developed a FREE self-guided online course, a attendance, and stay in school longer. This
video library + resource collection and a website webpage contains links to resources for school
focused on educator mental health literacy. The 3- administrators and parents, and other
part training package is informed by and co- interested groups.
developed with educators from across the nation.
These resources will present concrete, universal
approaches to promoting student mental health
and creating safe and supportive classroom
environments, describe student behaviors that may
indicate a mental health concern, and provide
specific skills and strategies to engage and support
students with mental health concerns.
Title: CDC’s Division of Adolescent and School

Health (DASH) School Mental Health
Quality Guide Series
Link: https://www.cdc.gov/healthyyouth/mental-
health/index.htm
Description: CDC’s DASH promotes the health
and well-being of adolescents through schools,
enabling these adolescents to become healthy and
productive adults. DASH provides funding and
technical assistance to local educational agencies
and supports surveillance and research to promote
student and staff well-being.
Title: Social and Emotional Climate resource on classroom management approaches that
foster school connectedness to our safe supportive
Link: https://www.cdc.gov/healthyschools/
environments website, linked here:
sec.htm
https://www.cdc.gov/healthyyouth/whatworks/
Description: The Social and Emotional Climate what-works-safe-and-supportive-environments.htm.
webpage contains information about why a
positive social-emotional climate is important, Positive Behavioral Interventions
ways to foster a positive climate, and links to other and Supports
resources, including a resource on the relationship
between nutrition and social-emotional climate. Title: Teaching Social-Emotional Competencies
Within a PBIS Framework
Title: How to Cope with Stress and Anxiety
Link: https://www.pbis.org/resource/teaching-
Link: https://www.cdc.gov/coronavirus/2019- social-emotional-competencies-within-a-pbis-
ncov/daily-life-coping/managing-stress- framework
anxiety.html
Description: Positive behavioral interventions and
Description: The COVID-19 pandemic has had a supports (PBIS) provides an ideal framework for
major effect on our lives. Many of us are facing promoting social-emotional competencies to
challenges that can be stressful, overwhelming, improve outcomes for the whole child. The
and cause strong emotions in adults and children. purpose of this brief is to describe how school
Public health actions, such as social distancing, personnel can teach social-emotional
are necessary to reduce the spread of COVID-19, competencies within a PBIS framework to support
but they can make us feel isolated and lonely and systematic, school-wide implementation through
can increase stress and anxiety. This webpage one system, rather than trying to improve student
contains suggestions about how to cope with stress outcomes through separate, competing initiatives.
in a healthy way will make you, the people you
care about, and those around you become more School Climate
resilient.
Title: Strategies for Trauma-Informed Distance
Title: CDC Mental Health Tools and Resources Learning
Link: https://www.cdc.gov/mentalhealth/tools- Link: https://selcenter.wested.org/wp-
resources/index.htm content/uploads/sites/3/2020/05/SEL_Center_
Description: The series developed by the National Strategies_for_Trauma_Informed_Distance_
Center for School Mental Health provides Learning_Brief.pdf
guidance to school mental health leaders to Description: To help educators use trauma-
advance the quality of their services and supports. informed teaching practices in distance learning
The guides contain background information on contexts, this brief offers some general strategies,
each domain, best practices, possible action steps, with specific examples, for how to recognize and
examples from the field, and resource guidance. respond to students’ social and emotional needs
In addition, the Division of Adolescent and School while teaching remotely. The strategies are
Health will also be adding a research-informed organized by Perry’s 3 Rs: Regulate, Relate, and
Reason.
Social-Emotional Learning Title: NCPMI Resources: Helping Young
Children Understand Emotions When
Title: NCPMI Resources: Practical Strategies Wearing Masks
to Promote Social-Emotional Skill
Development and Mental Health in
docs/Wearing-Masks_Tipsheet.pdf
Young Children- Back to School:
Promoting Social-Emotional Skills and Description: Here are tips and ideas for helping
Preventing Challenging Behavior children identify emotions when your face, your
most expressive feature, is covered by a mask. Use
Link: (Downloadable, Captioned)
these strategies to let children know that behind
https://challengingbehavior.cbcs.usf.edu/videos/
the mask, a kind and warm expression is
Back-to-School_CC.mp4
still there!
Description: Brief video (9 min) that describes
the strategies that might be used by early Title: NCPMI Resources: Practical Strategies
childhood programs and educators to promote to Promote Social-Emotional Skill
social and emotional skills and prevent Development and Mental Health in
challenging behavior. The video provides Young Children—Tucker Turtle
information on universal and targeted practices Takes Time to Tuck and Think
and materials that might be used by classroom Link: https://challengingbehavior.cbcs.usf.edu/
teachers. docs/TuckerTurtle_Story.pdf
Title: NCPMI Resources: The Leadership Description: Tucker the Turtle provides a scripted
Team’s Guide for Re-Opening Programs story to teach young children how to calm down
when they have strong feelings by tucking into
their shell and taking deep breaths. The story also
docs/Leadership_ReOpening_Guide.pdf
includes visuals to help children learn how to use
Description: This document is designed to guide the self-regulation strategy. A home version is
the Program Leadership Team around offered so that caregivers can partner with the
considerations for supporting children, families, classroom in teaching this important self-
and staff as they return to the program. The regulation skill.
guidance provides 29 links to practical strategies
Spanish school version:
and encourages you to think about those strategies
https://challengingbehavior.cbcs.usf.edu/docs/
from a trauma-informed perspective. While the
TuckerTurtle_Story_sp.pdf
leadership team may not know who among
children, families, and staff have or are Home version:
experiencing trauma, a trauma-informed approach https://challengingbehavior.cbcs.usf.edu/docs/
guides programs in providing a safe and nurturing TuckerTurtle_Story_Home.pdf
environment where children, families, and staff Spanish home version:
can build resilience, feel safe, and recover. https://challengingbehavior.cbcs.usf.edu/docs/
TuckerTurtle_Story_Home_SP.pdf
Title: Self-Care Strategies for Educators
During the Coronavirus Crisis:
Supporting Social and Emotional Well-
Being—Resources Related to Social,
Emotional, and Mental Health for
Teachers, Providers, and Leaders—
Developed by the Center to Improve
School Safety (CISELSS)
Link: https://selcenter.wested.org/wp-
content/uploads/sites/3/2020/05/Self_Care_
Strategies_for_Educators_During_the_Coronavirus
_Crisis.pdf
Description: The brief offers practical
information and guidance on self-care in these
challenging times. In this rapidly changing
context, teachers are called upon to continue
Title: We Can Be Problem Solvers! educating their students, often teaching from home
Link: https://challengingbehavior.cbcs.usf.edu/ while also supporting families and communities in
docs/ProblemSolving_Story.pdf new ways. But in order to support others,
educators must support themselves first. In fact,
Description: This scripted story helps children
across helping professions generally, self-care is
understand the steps to social problem solving.
considered an ethical imperative.
The story includes problem scenario cards and a
solution kit to help young children practice finding Title: Community-Care Strategies for Schools
a solution to common social problems. A home During the Coronavirus Crisis—
version is offered so that caregivers can partner Resources Related to Social, Emotional,
with the classroom in teaching these important and Mental Health for Teachers,
skills. Providers, and Leaders—Developed by
Spanish school version: the Center to Improve Social and
https://challengingbehavior.cbcs.usf.edu/docs/ Emotional Learning and School Safety
ProblemSolving_Story_SP.pdf (CISELSS)
Home version: Link: https://selcenter.wested.org/wp-

https://challengingbehavior.cbcs.usf.edu/docs/ content/uploads/sites/3/2020/05/Brief_Community
ProblemSolving_Story_Home_EN.pdf _Care_Strategies.pdf
Spanish home version: Description: This brief offers practical guidance

https://challengingbehavior.cbcs.usf.edu/docs/ for educators and other school staff, and for
ProblemSolving_Story_Home_SP.pdf administrators and other leaders, to help you ensure
that school communities are effective, cohesive,
collaborative, healthy, and sustainable while coping
with the stresses of social isolation, school closures, State Guide:
and changes to how services are provided. https://www.pbis.org/resource/a-state-guide-for-
returning-to-school-during-and-after-crisis
Title: Connecting Teacher Practice with Social
District Guide:
and Emotional Learning—Resources
Related to Social, Emotional, and Mental https://www.pbis.org/resource/a-district-guide-for-
returning-to-school-during-and-after-crisis
Health for Teachers, Providers, and
Leaders—Developed by the Center to School Guide:
Improve Social and Emotional Learning https://www.pbis.org/resource/a-school-guide-for-
and School Safety (CISELSS) returning-to-school-during-and-after-crisis
Link: https://selcenter.wested.org/resource/ Description: This guide describes the use of a
connecting-teacher-practice-with-social-and- multi-tiered systems of support framework to
emotional-learning/ support students, families, and educators during
the transitions back to school during and following
Description: Promoting teacher social and
the global pandemic in a manner that prioritizes
emotional learning (SEL) benefits the entire
their health and safety, social and emotional
school community. Not only does it support
needs, and behavioral and academic growth. The
teacher effectiveness and help make the work
comprehensive guide provides information to
sustainable for teachers; it also supports student
support implementation at the state, district,
well-being, higher achievement, and a healthy
school, and classroom levels. To learn more about
school climate and culture. In this interview,
how to use this resource, please view the video
listeners will learn about: (1) the unique ways that
Guide to the Guide. For more streamlined
mentoring programs can help develop teacher
guidance, please view the state, district, and
SEL, strengthen school-based relationships, and
school guides.
support effective instruction and (2) the
importance of teacher SEL (and well-being) to Title: Center on Positive Behavioral
school and classroom culture. Interventions and Supports (PBIS)—
Guidance to Support States, Districts,
Title: Center on PBIS—Guidance to Support
and Schools During and After Pandemic:
States, Districts, and Schools During and
Supporting PBIS Implementation
After Pandemic: Returning to School
Through Phases of Crisis Recovery
During and After Crisis: A Guide to
Supporting States, Districts, Schools, Link: https://www.pbis.org/resource/supporting-
Educators, and Students through a Multi- pbis-implementation-through-phases-of-crisis-
Tiered Systems of Support Framework recovery
Links: Description: As school and district communities
consider options for effectively supporting
Main Guide:
students, educators, and families during and after a
https://www.pbis.org/resource/returning-to-
crisis, it can be difficult to identify critical
school-during-and-after-crisis
impactful actions. The PBIS framework can serve
as a road map to meeting this challenge. This
practice brief provides strategies to guide
implementation efforts through the various phases Supporting and Responding to
of crisis recovery for schools and districts that are Behavior
(a) getting started or (b) strengthening and
Title: Returning to School: Considerations for
maintaining current implementation.
Students with the Most Intensive
Title: How the Pandemic is Reshaping Behavioral Needs, A Guide to Supporting
Education Students with Disabilities, Their
Families, and Educators During the
Link: https://www.washingtonpost.com/education/
2020–21 School Year
2021/03/15/pandemic-school-year-
changes/?arc404=true Link: https://www.pbis.org/resource/returning-to-
school-considerations-for-students-with-the-most-
Description: This article features topics that cover
intensive-behavioral-needs-a-guide-to-supporting-
the changes schools had to make during the
students-with-disabilities-their-families-and-
pandemic. The third topic is on Mental Health and
educators-during-the-2020-21-school-year
includes comments from Sharron Hoover, one of
the Directors of the School Mental Health Description: This document is a set of strategies
Technical Assistance Center. and key practices to restart classrooms and schools
in a manner that students, their families, and
Title: Connecting Teacher Practice with Social educators can use effectively, efficiently, and
and Emotional Learning relevantly in the current climate.
Link: https://selcenter.wested.org/resource/
Title: What Works Clearinghouse
connecting-teacher-practice-with-social-and-
emotional-learning/ Link: https://ies.ed.gov/ncee/wwc/FWW/
Results?filters=,Behavior
Description: Promoting teacher social and
emotional learning (SEL) benefits the entire school Description: The What Works Clearinghouse
community. Not only does it support teacher (WWC) reviews the existing research on different
effectiveness and help make the work sustainable programs, products, practices, and policies in
for teachers; it also supports student well-being, education. The goal is to provide educators with
higher achievement, and a healthy school climate the information they need to make evidence-based
and culture. In this interview, listeners will learn decisions. WWC focuses on the results from high-
about: (1) the unique ways that mentoring programs quality research to answer the question “What
can help develop teacher SEL, strengthen school- works in education?” This direct link includes a
based relationships, and support effective filter to review topics related to behavior.
instruction and (2) the importance of teacher SEL
(and well-being) to school and classroom culture.
Teachers and Providers and tools for coaches guiding the ISF process in
districts/communities and schools are included.
Title: Building a Culture of Staff Wellness
Through Multi-Tiered System of Title: Installing an Interconnected Systems
Supports Framework at the School Level:
Recommendations and Strategies for
Link: https://www.pbis.org/resource/building-a-
School Leadership Teams, Practitioners
culture-of-staff-wellness-through-multi-tiered-
and Coaches
system-of-supports
Link: https://www.pbis.org/resource/installing-an-
Description: The purpose of this brief is to
interconnected-systems-framework-at-the-school-
provide recommendations to district and school
level-recommendations-and-examples-to-guide-
leadership teams on how the components of
school-leadership-teams-practitioners-and-coaches
Positive Behavioral Interventions and Supports
can be used to prioritize staff health and well- Description: This Practice Guide describes and
being. illustrates how schools, with support from coaches
and district/community leaders, can benefit from
Title: Installing an Interconnected Systems the integration of mental health supports within
Framework at the District/Community the Positive Behavioral Interventions and Supports
Level: Recommendations and Strategies (PBIS) Framework. District/school leaders and
for Coaches and District Leaders coaches can use this information to support their
Link: https://www.pbis.org/resource/installing-an- efforts building an Interconnected Systems
interconnected-systems-framework-at-the-district- Framework (ISF) of mental health and PBIS. This
community-level-recommendations-and- Guide highlights practical strategies from one
strategies-for-coaches-and-district-leaders school’s successful experiences, including
indications of the impact on students’ success
Description: The Interconnected Systems while building strong partnerships with families
Framework (ISF) is a process to create a more and community partners. Suggested Technical
stream-lined approach to school mental health and Assistance strategies for coaches are provided.
wellness by connecting all social-emotional-
behavioral (SEB) efforts through one system, Title: Advancing Education Effectiveness:
while eliminating barriers inherent in systems that Interconnecting School Mental Health
previously have operated separately. This Practice and School-Wide Positive Behavioral
Guide describes and illustrate how Interventions and Supports, Volume 2:
district/community leaders can embed mental An Implementation Guide
health supports within the Positive Behavioral
Link: https://www.pbis.org/resource/
Interventions and Supports framework to create a
interconnecting-school-mental-health-and-pbis-
unified and comprehensive system of SEB
volume-2
supports in schools. One district’s experience
building such an ISF is portrayed including how Description: This implementation guide provides
they engaged community partners, families, and a step by step process with examples, activities,
school personnel. Technical assistance strategies and resources for district and school teams to
install and implement an Interconnected Systems
Framework.
Title: Community-Care Strategies for Schools discussed how collective trauma may affect staff
During the Coronavirus Crisis and students.
Link: https://selcenter.wested.org/wp-
Title: Integrating a Trauma-Informed
content/uploads/sites/3/2020/05/Brief_Community
Approach within a Positive Behavioral
_Care_Strategies.pdf Interventions and Supports (PBIS)
Description: This brief offers practical guidance Framework
for educators and other school staff, and for Link: https://www.pbis.org/resource/integrating-
administrators and other leaders, to help you a-trauma-informed-approach-within-a-pbis-
ensure that school communities are effective, framework
cohesive, collaborative, healthy, and sustainable
while coping with the stresses of social isolation, Description: As educators have become
school closures, and changes to how services are increasingly aware of the impact of trauma on the
provided. school success of children and youth, they have
been investing in professional development about
Trauma how to address childhood trauma in schools.
However, evaluation to support evidence of
Title: Addressing Trauma in Educational
impact are lacking. This Guide describes how to
Settings, Module 3: School Systems,
integrate trauma-informed approaches into the
Policies, and Procedures to Support
PBIS framework to ensure efforts are linked to
Students Experiencing Trauma (Regional
student outcomes. Strategies and tools to ensure
Educational Laboratory Appalachia)
effectiveness are included.
Link: https://ies.ed.gov/ncee/edlabs/regions/
appalachia/events/event_12-21-20_addressing- Technical Assistance
trauma-in-educational-settings_module-2.asp
Title: Comprehensive Center Network
Description: Regional Educational Laboratory (CCNetwork)
Appalachia staff held a total of three webinars, in
which they shared research, resources, and Link: https://compcenternetwork.org/
strategies to support students and educators in the Description: The Comprehensive Center Network
context of trauma. (CCNetwork) is comprised of 19 Regional
Comprehensive Centers and 1 National Center that
Title: Addressing Collective Trauma and provide capacity-building technical assistance to
Supporting the Well-Being of Students states, districts and schools in their design and
and School Staff (Regional Educational implementation of evidence-based policies,
Laboratory Southwest) practices, programs, and interventions that
Link: https://ies.ed.gov/ncee/edlabs/regions/ improve instruction and educational outcomes for
southwest/events/2021/webinar-012121.aspx all students. State educational agencies may
request capacity-building support from their
Description: This was a free virtual event that
Comprehensive Centers.
addressed collective trauma in the current context
of COVID-19 and social injustice. Presenters The CCNetwork produces and disseminates
research-based tools and resources to build the
capacity of educational leadership in social- Title: Reimagining Excellence: A Blueprint for
emotional, behavioral learning and mental health Integrating Social and Emotional Well-
approaches to better support the well-being of Being and Academic Excellence in School
school staff, students, and families. (CCNetwork)
Link: https://selcenter.wested.org/resource/
Title: Social, Emotional, and Behavioral
Learning and Trauma-Informed Practice reimagining-excellence-a-blueprint-for-
(CCNetwork) integrating-social-and-emotional-well-being-and-
academic-excellence-in-schools/
Link: https://compcenternetwork.org/national-
Description: Reimagining Excellence: A
center/our-work/collection/6278
Blueprint for Integrating Social and Emotional
Description: The Social, Emotional, and Well-Being and Academic Excellence in Schools,
Behavioral Learning and Trauma-Informed designed with input from in-person and remote
Practice resource collection is designed to educators, leaders, researchers, professional
increase the capacity of state and district learning providers, and technical assistance
leadership to support their school communities providers, details the indicators of learning
create trauma-informed approaches for social, programs that successfully integrate equity, well-
emotional, and behavioral learning. The resources being, and academics and discusses how to
within the collection are also targeted to specific improve student outcomes through a cycle of
needs and contexts, such as schools in rural strong planning, action, and continuous
communities, or schools that are in the early monitoring.
stages of implementing social and emotional
learning strategies. Title: Informational Resources on Improving
Outcomes (CCNetwork)
Link: https://compcenternetwork.org/sites/default/
files/R6CC%20SEL_InformationalResources.pdf
Description: Informational Resources on
Improving Social and Emotional Learning and
Outcomes provides resources for understanding,
prioritizing, and measuring students’ social and
emotional learning (SEL) competencies and on
evidence-based SEL programs and interventions.
The document organizes resources and
information about SEL into nine categories listed
under two broad headings: What is SEL? and How
is SEL being implemented?
Title: How Are You Doing? Supporting Well- Title: Better Together: A Coordinated
Being and Learning Through a Response for Principals and District
Concerns-Based Approach (CCNetwork) Leaders (CCNetwork)
Link: https://region12cc.org/how-are-you-doing- Link: https://compcenternetwork.org/sites/default/
supporting-well-being-and-learning-through-a- files/Better_Together.pdf
concerns-based-approach/ Description: This brief published by the National
Description: Supporting Well-Being and Comprehensive Center for school and district
Learning Through a Concerns-Based leadership presents strategies, research and a
Approach provides guidance to school leaders on structured approach to manage and support the
supporting teacher well-being through social-emotional well-being of adults in the school
implementation of the Concerns-Based Adoption building as well as the families and students they
Model (CBAM). A series of blogs opens with an serve post COVID-19 closures.
introduction to using the CBAM framework and
includes action steps to apply three diagnostic Title: Student Engagement in Online Classes:
tools (i.e., Stages of Concern, Levels of Use, and Tips for Teachers Based on Trauma-
Innovation Configuration Maps) to help maintain Informed Approaches and Social and
a focus on improving student learning while Emotional Learning (SEL) Strategies
simultaneously supporting teacher well-being. (CCNetwork)
Link: https://compcenternetwork.org/sites/default/
Title: Trauma-Informed Practices Resource files/Tip%20sheet%20for%20online%20teaching.pdf
List Dashboard (CCNetwork)
Description: This fact sheet compiled by the
Link: https://app.smartsheet.com/b/publish? National Comprehensive Center provides
EQBCT=f250258487f7488594d1a0327ace297b concrete strategies that middle and high school
Description: This dashboard by the National teachers can incorporate into their online teaching
Comprehensive Center contains curated to increase engagement with students. The authors
collections of resources in four Trauma-Informed present a framework based on trauma-informed
Practices Topics: Distance Learning, Addressing approaches and social and emotional learning
Grief, Historical Trauma and Self-Care for strategies to ensure students feel safe, connected,
Educators. The collections are updated regularly. engaged, and ready to learn.
APPENDIX D.
Guidance on Existing Programs That Can Support Social-
Emotional and Mental Health Services for Students
students, educators, and families. 5 Funds may be
American Rescue Plan (ARP)
used to implement actionable strategies to meet
In March 2021, the President signed the American the urgent needs of students and educators as
Rescue Plan (ARP) Act into law, which allocated LEAs and schools work to return to and safely
substantial funding to States (as well as the sustain in-person instruction, address the
Commonwealth of Puerto Rico and the District of educational inequities that have been exacerbated
Columbia), districts, schools, educators, students, by the COVID-19 pandemic, and address
and families as the country continues to recover students’ social, emotional, mental health, and
from the COVID-19 pandemic. The ARP funds academic needs. 6 ARP specifically allows the use
may be used to address the many impacts of of funds to support the mental health of children
COVID-19, including the provision of mental and staff through the provision of evidence-based
health services and supports. 4 interventions and critical services. 7 This includes
dramatically expanding the number of social
American Rescue Plan Elementary and workers, school counselors, school nurses, and
Secondary School Emergency Relief school psychologists available to support students.
(ARP ESSER) Fund
The ARP ESSR funds provide support to States, The Higher Education Emergency
LEAs, and schools as they work to reopen schools Relief Fund III (HEERF III)
safely, maximize in-person instructional time, and The Higher Education Emergency Relief Fund III
address the impact of the COVID-19 pandemic on (HEERF III) provides funding to support
4 Secretary of Education Letter, American Rescue Plan (ARP) Act announces-american-rescue-plan-funds-all-50-states-puerto-rico-

of 2021 (March 2021), https://oese.ed.gov/files/2021/03/ and-district-columbia-help-schools-reopen
ARP_Letter_Sec_to_Chiefs_FINAL.pdf 6 Fact Sheet: American Rescue Plan Act of 2021, Elementary and
5 Press Release, Department of Education Announces American
Secondary School Emergency Relief Fund (ARP ESSER) (2021),
Rescue Plan Funds for all 50 States, Puerto Rico, and the District https://oese.ed.gov/files/2021/03/FINAL_ARP-ESSER-FACT-
of Columbia to Help Schools Reopen (March 2021), SHEET.pdf
https://www.ed.gov/news/press-releases/department-education- 7 Id.
institutions of higher education to serve students competitive grant programs that address the need
and ensure learning continues during the for mental health services in schools.
COVID-19 pandemic. 8 This includes emergency
financial aid grants for mental health support at Title IV, Part A of the ESEA—SSAE
the student and institutional level. 9 Program
Under the SSAE program, the Department
Individuals with Disabilities Education allocates funds to state educational agencies
Act (IDEA) American Rescue Plan (SEAs) based on a formula, and SEAs in turn
Funds allocate funds to local educational agencies
ARP also provided additional funding through (LEAs). LEAs must use the funds in three content
IDEA for state educational agencies and IDEA areas, one of which is safe and healthy students. 14
Part C Early Intervention state lead agencies to Among the allowable activities in the content area
help recover from the impact of the coronavirus of safe and healthy students are services
pandemic and to safely re-open schools and addressing mental health. These include
sustain safe operations. 10 ARP supplemental (1) school-based mental health services, which
IDEA funds extend the capacity of states to may be provided by school-based mental health
provide early intervention and special education services providers; and (2) school-based mental
supports and services, including psychosocial health services partnership programs, conducted in
services, to children and adolescents eligible for partnership with a public or private mental health
IDEA services. 11 entity or health care entity, that provide
comprehensive school-based mental health
Elementary and Secondary services and staff development for school and
Education Act—Programs community personnel working in the school.
Supporting Mental Health Services Allowable activities in the area of safe and healthy
The Elementary and Secondary Education Act students also include schoolwide positive
(ESEA) makes available funds that may be used to behavioral interventions and supports (PBIS),
develop and provide mental health services to including through coordination with similar
support students in grades Pre-K–12. There are activities carried out under the Individuals with
two primary sources of funds for mental health Disabilities Education Act (IDEA). These
services under the ESEA. The first is a formula specifically identified mental health services are
grant program–Title IV, Part A, the Student illustrative and not exclusive, so LEAs also have
Support and Academic Enrichment Grants considerable flexibility to use their SSAE funds to
program (SSAE). 12 The second is the School develop and provide other kinds of mental health
Safety National Activities (SSNA) authority, 13 services, consistent with program and
under which the Department funds several administrative requirements for the use of funds.
8 Office of Postsecondary Education, ARP: American Rescue Plan 11 Id.

(HEERF III) (September 2021), 12 Sections 4101–4112 of the Elementary and Secondary Education
https://www2.ed.gov/about/offices/list/ope/arp.html Act (ESEA), as amended, 20 U.S.C. 7111, et seq.
9 Frequently Asked Questions, Higher Education Emergency Relief 13 Section 4631 of the ESEA, 20 U.S.C. 7281.
Fund III (May 2021), 14 Section 4108 of the ESEA, 20 U.S.C. 7118.
https://www2.ed.gov/about/offices/list/ope/arpfaq.pdf
10 Materials Page, IDEA American Rescue Plan Funds (July 2021),
https://www2.ed.gov/policy/speced/leg/arp/index.html
In fact, under a second SSAE content area, well- SEAs and LEAs must obtain prior written,
rounded educational opportunities, 15 LEAs may informed consent from the parent of each child
use funds for a broad category described as who is under 18 years of age before they
activities that support student access to, and participate in any SSAE-funded mental-health
success in, a variety of well-rounded education assessment or service. 17 Additionally, services
experiences. Such activities could include mental provided under SSAE may not include medical
health services and activities that promote social- services or drug treatment or rehabilitation, except
emotional learning (SEL). for integrated student supports, specialized
instructional support services, or referral to
Of note, the flexibility that LEAs have under the treatment for impacted students. 18
SSAE program also means that they are not
required to use their SSAE funds for mental health The Department’s non-regulatory guidance for the
services. LEAs are required to conduct a needs SSAE program 19 acknowledges the connection that
assessment every three years, and the SSAE can exist between students’ unaddressed mental
program contemplates that they will use funds health issues and poor academic achievement. It
consistent with the results of their needs emphasizes that SSAE program activities can
assessments. Therefore, to the extent that mental positively impact safe and supportive learning
health services are indicated as a result of its needs environments and student mental health. The
assessment, an LEA might choose to use a portion guidance includes examples describing how LEAs
of its SSAE funds to develop programs and may use funds to address student mental health,
activities to meet those needs. including PBIS and SEL activities.
Under SSAE, SEAs reserve a portion of their

allocation to carry out state-level activities. 16
These activities may include supporting LEAs in
implementing evidence-based mental health
awareness training programs and in expanding
access to, or coordinating resources for, school-
based counseling and mental health programs,
such as through school-based mental health
services partnership programs. Again, these
identified activities are illustrative and not
exhaustive, and similar to LEAs, SEAs have
flexibility in developing SSAE-funded programs
that support LEAs in delivering needed mental
health services to students.
15 Section 4107 of the ESEA, 20 U.S.C. 7117. 19 Non-Regulatory Guidance, Student Support and Academic
16 Section 4104 of the ESEA, 20 U.S.C. 7114. Enrichment Grants (October 2016), https://www2.ed.gov/policy/
17 Section 4001(a) of the ESEA, 20 U.S.C. 7101(a). elsec/leg/essa/essassaegrantguid10212016.pdf
18 Section 4001(b) of the ESEA, 20 U.S.C. 7101(b).
SSNA Programs School-Based Mental Health Services
Grants
Under the SSNA authority, the Department
reserves funds to support activities that improve This program focuses on increasing the number of
students’ safety and well-being, during and after qualified (i.e., licensed, certified, well- trained, or
the school day. The Department has used the credentialed) mental health service providers that
flexibility that it has under this authority to provide school-based mental health services to
develop and fund several competitive grant students in LEAs with demonstrated need. Grants
programs that address the critical area of student are awarded to SEAs.
mental health, including programs focused on School Climate Transformation Grants
expanding school capacity to provide mental (SCTG)
health services and programs focused on This program assists grantees in developing,
improving systems for providing those services. enhancing, or expanding systems of support for,
These programs are described below. and technical assistance to, schools implementing
Mental Health Service Professional an evidence-based multi-tiered behavioral
Demonstration Grants framework for improving behavioral outcomes
This grant program supports innovative and learning conditions for all students. The
partnerships to train and deploy school-based Department funds two SCTG programs, one for
mental health service providers in schools. The SEAs and one for LEAs.
purpose is to expand the pipeline of high-quality, Grants to States for School Emergency
trained professionals to address shortages of Management
mental health services in high-need schools and to The purpose of these grants is to expand the
provide supports that encompass social and capacity of SEAs to provide training and technical
emotional learning, mental wellness, resilience, assistance to LEAs for the development and
and positive connections between students and implementation of high-quality school emergency
adults. Eligible entities are high-need LEAs and operations plans (EOPs). Grant programs include
SEAs on behalf of one or more high-need LEAs. mental health integration into EOPs.
Project Prevent Grants
Summary of Federal Disability Laws
These grants focus on increasing LEA capacity to
identify, assess, and serve students exposed to Federal disability laws support the ability of
pervasive violence, helping to ensure that affected children and students with disabilities to access
students are offered mental health services for and receive mental-health related services when
trauma or anxiety; support conflict resolution needed in the context of their education and also
programs; and implement other school–based to protect these children and students from
violence prevention strategies in order to reduce discrimination on the basis of disability. These
the likelihood that these students will later commit laws are Part B of IDEA, Section 504, and Title II
violent acts. LEAs are eligible entities under this of the Americans with Disabilities Act of 1990
program. (Title II). IDEA is the Federal law that, among
other things, provides Federal funds to states, and,
through them, to eligible local educational
agencies (LEAs) to assist in providing a free
appropriate public education (FAPE) to eligible
children and students with disabilities in the least and related needs, including, if appropriate, the
restrictive environment. Section 504 prohibits child’s social and emotional status.
discrimination on the basis of disability by
recipients of Federal financial assistance and also Under IDEA, eligible students are entitled to
has a FAPE requirement for public elementary and FAPE, 21 which includes special education and
secondary school students with disabilities. Title II related services provided at no cost to the parents,
prohibits discrimination on the basis of disability in conformity with an IEP. Depending on state law
by state and local governmental entities, or practice, a child’s entitlement to FAPE can
regardless of receipt of Federal funds. 20 begin at the child’s third birthday (i.e., preschool)
and could last until the child’s 22nd birthday.
How and Which Children and
The vehicle for determining the program of
Students with Disabilities Can
special education and related services to be
Receive Services Under IDEA and
provided to a child with a disability is the IEP.
Section 504
The IEP is a written document that contains a
IDEA requires states and school districts to ensure statement of the student’s annual goals, including
that all children with disabilities residing in the academic and functional goals, and the special
state, regardless of the severity of their disability, education and related services and other supports
who need special education and related services to be provided to the child to enable the child to be
are identified, located, and evaluated. This involved and make progress in the general
responsibility is known as child find. Similarly, education curriculum, i.e., the same curriculum as
Section 504 requires that schools evaluate a child for nondisabled students and to participate with
who because of disability needs or is believed to other children with disabilities and nondisabled
need special education or related services. A children in extracurricular and other nonacademic
school district must obtain the consent of the activities. The IEP is developed at a meeting of the
parent or guardian to conduct the evaluation. Each IEP Team, which includes: the child’s parents; at
child’s evaluation must be individualized and least one of the child’s regular education teachers
comprehensive in order to assess the nature and if the child is, or may be, participating in the
extent of the student’s disability and educational regular educational environment; at least one
20 The Office of Special Education Programs (OSEP) in the U.S. OCR also enforces laws that prohibit discrimination based on
Department of Education (Department) administers IDEA. See race, color, or national origin and sex by recipients of Federal
20 U.S.C. § 1400 et seq. and 34 C.F.R. Part 300. For general financial assistance
information about IDEA, please see: http://idea.ed.gov. The 21 Under IDEA, children with disabilities placed by their parents in
Department’s Office for Civil Rights (OCR) enforces Section private schools are not entitled to FAPE, but are eligible to be
504 as applied to recipients of Federal financial assistance from considered for equitable services in accordance with the
the U.S. Department of Education. See 29 U.S.C. § 794 and 34 requirements in 34 C.F.R. §§ 300.130-300.144. Parentally-
C.F.R. Part 104. For more information about Section 504, please placed private school children with disabilities do not have an
see: https://www2.ed.gov/about/offices/list/ocr/docs/504- individual entitlement to receive some or all of the services they
resource-guide-201612.pdf. In the education context, OCR would receive if enrolled in a public school. However, if a school
shares responsibility for compliance with Title II with the U.S. district or other public agency is unable to educate a child with a
Department of Justice. See 42 U.S.C. §§ 12131-12134 and 28 disability in a program it operates, it may place that child in a
C.F.R. Part 35. The information about elementary and secondary private school or facility as a means of providing special
education in this document focuses on IDEA and Section 504. education and related services to the child in accordance with an
For more information about Title II, please see: www.ada.gov. IEP at no cost to the parents. A publicly-placed child with a
For more information about OCR, please see: disability has all of the rights of a child with a disability who is
https://www.ed.gov/ocr; For more information about how to file served by a school district or other public agency. 34 C.F.R. §
a complaint alleging discrimination with OCR, please see: 300.146.
https://www2.ed.gov/about/offices/list/ocr/docs/howto.html.
special education teacher or provider for the child; who are IDEA-eligible is through the
a public agency representative who is qualified to implementation of an IEP developed under the
provide or supervise the provision of specially IDEA. 24 In general, Section 504 students who are
designed instruction to meet the unique needs of not IDEA-eligible have plans developed under
children with disabilities and is knowledgeable Section 504, commonly called Section 504 plans,
about the general curriculum and agency that reflect the services and supports the school
resources; an individual who can interpret will provide to the student. Placement decisions
evaluation results; the child whenever appropriate; under Section 504, including decisions about the
and, at the discretion of the parent or public student’s program and services, must be made by
agency, other individuals who have knowledge or a group of persons knowledgeable about the child,
special expertise regarding the child, including the meaning of evaluation data, and placement
related services personnel. Disagreements about options. Disputes about the content of a student’s
the child’s evaluation, placement, and content of evaluation, Section 504 plan, and placement can
the child’s IEP can be resolved through IDEA’s be resolved through Section 504 due process
dispute resolution procedures, which include procedures including impartial hearing procedures.
mediation, due process complaint and hearing
Mental Health Services
procedures, or state complaints.
It is not necessary for a preschool, elementary
Under Section 504, a public early childhood,
school, or secondary school child or student under
elementary or secondary child or student with a
IDEA or an elementary or secondary school
disability is entitled to protection against
student under Section 504 to be identified as
disability-based discrimination. As part of this
having a specific emotional or mental impairment
protection, public elementary and secondary
in order for the student to receive mental health-
schools must provide FAPE to all qualified public
related services. Under IDEA, children and
elementary and secondary school students with
students with disabilities, regardless of disability
disabilities. 22
classification, must receive a range of support
All students with disabilities who are eligible for services known as related services, if the supports
services under IDEA are also protected under are required for them to benefit from special
Section 504. FAPE under Section 504 consists of education services. Under Section 504, students
regular or special education and related aids and with disabilities must receive mental health
services designed to meet a student’s individual support services if these services are needed to
educational needs as adequately as the needs of ensure that their educational needs are met as
students without disabilities are met and that adequately as those of students without
satisfy certain procedural requirements related to disabilities. These determinations are made by the
educational setting, evaluation and placement, and student’s IEP Team or the group that develops the
procedural safeguards. 23 One means of meeting student’s Section 504 plan, as appropriate. Under
the Section 504 FAPE requirements for students IDEA, a number of related services, which could
22 Section 504 does not require FAPE for students with disabilities school districts and public schools in educating students with
in public preschool programs. 34 C.F.R. § 104.38. disabilities. Information about the requirements that apply to
23 Note that private schools that receive Federal financial assistance private school recipients is in 34 C.F.R. § 104.39 of the Section
from the U.S. Department of Education are not required to meet 504 regulation.
the same requirements described in this document that apply to 24 34 C.F.R. § 104.33(b)(2).
address mental-health and disability-related Under Section 504, covered institutions of higher
educational needs are referenced and include education may not, on the basis of disability,
psychological services, school health and school exclude a qualified student with a disability from,
nurse services, social work services in schools, or otherwise subject to discrimination under, any
counseling services, parent counseling and part of its programs or activities. An institution of
training, and medical services provided by a higher education must provide program
licensed physician for diagnostic and evaluation modifications, which can include appropriate
purposes only. Also, in developing an IEP or 504 academic adjustments, to ensure that it does not
plan, a factor to be considered is whether the discriminate on the basis of disability. Academic
student needs positive behavioral interventions adjustments may include, for example, changes in
and supports and other strategies to address the length of time permitted for the completion of
behavior if the student’s behavior impedes the degree requirements and substitution of specific
student’s learning or that of others. courses required for the completion of degree
Federal disability laws can provide a vehicle to requirements. Institutions of higher education are
assist students in acquiring the skills they need to not required to modify essential academic
overcome mental health challenges, both as a requirements. Generally, in addition to providing
result of conditions predating the COVID-19 reasonable modifications to policies, practices,
pandemic and the circumstances resulting from the and procedures, institutions of higher education
pandemic, such as the transition to remote may need to provide auxiliary aids and services,
learning, social isolation, and severe illness or such as accessible electronic and information
death of close family members as a result of technology, qualified interpreters, qualified
COVID-19. Providing mental health services to readers, and note takers, to ensure effective
students with disabilities who require them in communication and so that students with
order to receive FAPE can help to ensure that disabilities may have an equal opportunity to
these students have the opportunity to acquire the participate. Institutions of higher education are not
social and emotional skills they need to pursue required to provide modifications or auxiliary aids
college and careers and lead meaningful and or services where doing so would impose an
productive adult lives. undue burden or cause a fundamental alteration to
a service, program, or activity. If a student with a
Application of Section 504 to disability requests a modification, an institution
Institutions of Higher Education may ask the student to provide reasonable
While IDEA and Section 504 FAPE requirements documentation of disability and the need for the
do not apply to public or private institutions of modification. Students with disabilities who have
higher education, these institutions have certain mental health needs can request modifications
obligations to students with disabilities under from institutions of higher education.
Section 504. 25
25 In addition, Title II prohibits discrimination on the basis of 12189 and 28 CFR Part 36. The U.S. Department of Justice
disability by public institutions of higher education. Title III of interprets and enforces Titles II and III. For more information on
the Americans with Disabilities Act prohibits discrimination on the ADA, please visit https://www.ada.gov/
the basis of disability by certain private entities, including certain
private institutions of higher education. See 42 U.S.C. §§ 12181-

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What federal laws are discussed regarding supporting students' mental health needs?

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Supporting Child and Student Social, Emotional, Behavioral, and

Mental Health Needs

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APPENDIX A. Implementation Examples by Recommendation ................................................................................... 53

Spotlight on Mental Health Crisis in Washington State: Identifying the Challenges

Youth with immigrant parents were 34% more

COVID-19 has disproportionately impacted

2 Section 504 protects students from disability harassment. Schools at https://www2.ed.gov/about/offices/list/ocr/letters/colleague-

5. Policy and Funding Gaps

3The use of restraint and seclusion can result in discrimination https://www2.ed.gov/about/offices/list/ocr/letters/colleague-

6. Enhance workforce capacity. 1. Prioritize Wellness for Each and

Beyond primary prevention, secondary

Work to expand funding options for mental

Connect data review to goals, outcomes, and

challenges. States, districts, and schools are

Department of Education. (2021). Education in a Pandemic: The Disparate Impacts of COVID-19 on

The Steve Fund/JED Foundation. (n.d.). Equity in mental health framework.

MTSS: Providing a Educational

Select CCNetwork resources include:  Informational Resources on Improving

National Technical Assistance

 Addressing adverse childhood experiences  Practice-based coaching

 Supporting positive social-emotional climates  Culturally, linguistically, and age-appropriate

Funded by the U.S. Department of

 Family employment, career pathways, and Website: https://challengingbehavior.cbcs.usf.edu/

NCSSLE’s three main areas of support are:

Description: This guide highlights five key Link: https://mhttcnetwork.org/centers/global-

Title: CDC’s Division of Adolescent and School

Home version: Link: https://selcenter.wested.org/wp-

Spanish home version: Description: This brief offers practical guidance

4 Secretary of Education Letter, American Rescue Plan (ARP) Act announces-american-rescue-plan-funds-all-50-states-puerto-rico-

8 Office of Postsecondary Education, ARP: American Rescue Plan 11 Id.

Under SSAE, SEAs reserve a portion of their

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