As students around the country return to in-person instruction, school-based mental health services are more crucial than ever. Before the global pandemic, schools already struggled to offer these critical services to students in crisis—and without question, adding COVID-19 to the equation quickly exacerbated this demand.
According to the National Center for Disease Control and Prevention, the number of children taken to emergency departments (EDs) for mental health-related visits rapidly increased and stayed elevated during the pandemic. Not surprisingly, many require mental health intervention after a year and a half of adapting to an unprecedentedly chaotic world–coupled with the heightened pressure to “catch up” academically.
As educators, we face the tremendous challenge of providing adequate mental health services while simultaneously balancing academic instruction. However, if we are to make progress with the academic component, addressing students’ mental health is highly essential. Many studies indicate that students who receive social, emotional, behavioral, and mental health support can demonstrate academic achievement and appropriate school engagement much more readily than those who are not offered these services.
Administrators and school staff must remain vigilant to identify students experiencing anxiety, depression, inability to cope, and other warning signs of mental illness. Additionally, students affected by mental health issues before the pandemic may encounter even more severe difficulties readjusting to an in-person school environment.
What Is Mental Health?
First, we cannot define mental health simply as “someone who possesses a mental illness.” Instead, the term can also encompass behavioral and social wellness and the ability to cope effectively with life’s challenges. An article published by the National Association of School Psychologists (NASP) validates that the number of students suffering from mental health issues is overwhelming.
Developing a Comprehensive Mental Health Program
As a Pupil Services and Special Education Director, I was charged by my Superintendent to develop a comprehensive mental health program for the students within our district. This was no small task and required extensive planning and research, which involved many stakeholders: students, staff, administrators, parents, and community resources.
Early in the process, I recognized that this program would not be a one-size-fits-all project but rather one administering services along a spectrum based on the students’ level of need. Essentially, I was responsible for developing a multi-tiered support system to meet all my students’ individualized needs. From beginning to end, all stakeholders assisted in the tasks of data collection to program development.
Here are the steps we took to implement such a program.
STEP ONE: Review & Access
- Review counseling and RTI (Response to Intervention) referrals
- Review discipline records for frequency and behavior types
- Conduct climate surveys
- Mental health and behavior staff development
- Interview staff, administrators, and parents
- What were the most common discipline issues, specific student needs, applied consequences, and their outcomes?
- How are students referred for discipline and mental health concerns?
- Currently, what is the follow-up process utilized by the school staff for implemented interventions to guarantee skill generalization and progress rate?
- What is your vision about which supports the program needs?
STEP TWO: Categorize Through Data Analysis
- Classify student behavior according to type (e.g., aggressive, lack of social skills, drug-related, defiant, severe mental illness, etc.)
- Identify multiple offenders and behaviors
- Classify behaviors based on intensity levels (mild, moderate, or severe) and which district staff each level utilizes
- Determine whether students received aid from outside agencies and if they were Medicaid-eligible
- Identify students diagnosed with mental health disorders
- Determine school-based interventions employed at each intensity level and success rates
- Review current social-emotional curriculum in place (if any) to determine if it addresses the data analysis results
- Determine how many students are Medicaid-eligible but have not applied for the program
- Determine which district resources are already in place (e.g., counselor, school psychologist, behavior specialist, etc.)
- Identify resources
- District budget available for service delivery
- SEA (State Education Agency) supports
- Grants and special funding availability
- Community-level resources (e.g., Department of Human Services, mental health agencies, Juvenile Justice, drug and alcohol programs, etc.)
Mental Health and Behavior Intervention: Electing for A Proactive Approach
As a special education administrator with over thirty years of professional experience, I want to offer practical ways to proactively infuse mental health and behavior intervention into your curriculum.
- At a School Level:
- Implement social-emotional programs to foster a positive school environment (e.g., socialized recess, effective communication, positive reinforcement activities, etc.)
- Provide staff development opportunities in response to identified needs
- Train parents on how to recognize and address mental health issues
- For Students Identified with Mild Needs:
Provide student opportunities to participate in school activities focusing on:
- Stress management
- Coping skills
- Social and relational skill development
- Identifying and communicating feelings
- Making responsible decisions
- For Students Identified with Moderate to Severe Needs:
- Behavioral and mental health assessments by appropriate staff
- Behavior plans
- Consultation with BCBA
- Referrals for special education evaluations
- Individualized counseling services by certified mental health staff
- Group therapy involvement
- Structured school environment
- Transition plan for students returning from outside placements
- Additional Considerations:
- A one-to-one aide, if concerns continue to escalate to the severe category
- Intermediate Unit or Education Support Commission personnel and program utilization, if available
- Referral to SAP (Student Assistance Program) team for secondary school students
- Referral to county agencies for attendance, drug, or alcohol issues
- Referral to RTF (Residential Treatment Facility) supported by mental health recommendations
- Help parents to apply for Medicaid, if eligible
- Using psychiatric services for evaluations and treatment recommendations
- Outside agency staff collaboration
- Developing an in-school mental health therapy or partial hospitalization program supported by community mental health
Financial Support to Offset Costs
Associated costs come with developing a comprehensive mental health program. In many cases, schools lack the necessary revenue to fully support a mental health program. Thankfully, funding is available for administrators willing to conduct research and be creative in program development. For example, administrators may want to consider:
- Using COVID-19 funding
- Alternative education grants
- Positive behavior support initiatives
- Partnerships with mental health agencies
- Piloting company-provided social-emotional programs
- Participating in community partnerships
Mental Health Services Is A Priority, Not a Consideration
As the new academic year approaches, more and more students will return to an in-person environment. It remains essential to recognize that staff and students will encounter challenges despite unforeseen trials and obstacles—and keeping this in mind, we must be ready to provide the necessary support to all individuals affected.
Ann Marie Geissel, M.Ed., ABD
Therapy Source National Special Education Director
Ann Marie has 30+ years of special education experience, as a teacher, principal, special education supervisor, and special education director within urban, suburban school districts and charter schools. Her background and qualifications make her well-positioned to assist Therapy Source’s education clients with compliance monitoring and daily operation. Ann Marie holds a Bachelor of Arts in Special Education from LaSalle University, and a Master of Education in Special Education from Arcadia University. Additionally, she has been certified as a principal and special education advisor – and possesses a Letter of Eligibility for Superintendent – through Temple University’s and Widener University’s Doctoral Programs in Educational Administration.