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Best Practices for School Mental Health Screenings

The Association of California School Administrators is the largest umbrella organization for school leaders in the United States, serving more than 17,000 California educators.

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© 2019 Hanover Research 2 Traditionally, school-based mental health screenings are administered based on referrals. While this individualized, reactive approach "is well-intentioned, it is unlikely that focusing on assessment and symptom reduction on an individual basis will yield meaningful improvement within a population." 5 To focus on supporting the mental health of the entire student population, schools should consider implementing a universal, or Tier I, mental health screening approach as a preventative measure for all students within a broader multi-tiered systems of support (MTSS) framework, as described in the figure below. 6 The MTSS Framework Source: Wisconsin Department of Public Instruction and Positive Behavioral Interventions and Supports Technical Assistance Center 7 Universal mental health screenings can be conducted for entire populations (e.g., individual classrooms, specific grade-levels, whole schools) at a time. Identification and risk assessment tools administered universally allow schools to direct supports to students with identified needs, just as they would in a school where students are referred on a more selective basis for mental health screening. A universal preventative approach improves outcomes for all students, however, by determining the existence of mental health problems early across the whole student population and providing schools with the information needed to provide students with the appropriate services or treatments for their specific needs. 8 Preparing for Implementation In their School Mental Health Screening Playbook, the national Center for School Mental Health (CSMH) – a technical assistance and training center at the University of Maryland School of Medicine focused on mental health in schools 9 – presents six action steps schools should take to implement a school mental health screening process. As described in the figure below and on the following page, schools should begin by building a strong foundation to prepare for implementation by generating support, clarifying goals, and considering logistics and resource allocation. Additionally, schools must decide on appropriate screening instruments, consent processes, and data collection systems. Action Steps for School Mental Health Screenings Step Sub-Steps Build a Foundation -Assemble a team of stakeholders to plan and implement the screening process -Utilize data and other strategies to justify mental health screenings -Consider how mental health screenings fit with other initiatives or goals -Review how students are currently being identified for mental health services -Consider whether current practices may contribute to over- or under- identification of mental health problems Clarify Goals -Decide how mental health screening will improve system issues and/or student outcomes at the grade, school, or district levels Identify Resources and Logistics -Ensure staff and community familiarity with in-school and community-based mental health services to refer students to who are identified via screening -Create a timeline for the process, including the frequency of screenings -Identify needed staffing levels and budgetary resources -Develop administrative policies and practices including: materials to communicate the screening process to stakeholders; consent procedures; data collection processes; and follow-up procedures for all students Select an Appropriate Screening Tool -Identify reliable, valid, and evidence- based options for screening -Determine costs for instruments -Investigate the requirements for successful administration (e.g., timing) -Determine access to training and technical support for staff -Evaluate quality and type of data generated to determine applicability to your needs Determine Consent and Assent Processes -Decide whether you will use active or passive consent and opt-out procedures for mental health screenings -Deliver a consistent message about the purpose and importance of mental health screening in advance of all screenings -Share information on screening procedures in multiple formats (e.g., phone, website, written notifications) Tier 3 Intensive Tier 2 Targeted Tier 1 Universal Individualized, ongoing, interventions to support those with significant needs Targeted supports for students identified as having or at risk of developing mild mental health challenges Preventative strategies to promote the well-being of all students

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