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Best Practices for School Mental Health Screenings

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RESEARCH PRIORITY BRIEF— BEST PRACTICES FOR MENTAL HEALTH SCREENINGS IN SCHOOLS © 2018 Hanover Research 1 Introduction As schools continue to adopt multi-tiered systems of support (MTSS) to guide the implementation of student supports and services, increasing attention has focused on universal screenings for academic and non-academic concerns, including mental health concerns. Universal mental health screenings support schools to identify students who have developed, or are at risk of developing, mental and behavioral health issues. Despite research indicating the need for universal mental health screenings, however, schools remain slow to implement such screenings, in part, due to ethical concerns about their ability to respond effectively to identified mental health needs. 1 In this research brief, Hanover Research (Hanover) provides an overview of best practices in administering universal mental health screenings in schools, identifies recommended mental health screening tools, and discusses districts' and schools' obligations related to supporting students with identified mental health concerns. Key Findings • Universal, Tier I mental health screenings allow schools to adopt a preventative approach to supporting students' mental health. Universal screeners are administered to entire student populations, allowing districts and schools to form a comprehensive view of student needs and detect mental health risks in students who may not yet display symptoms. Early detection prepares districts and schools to offer supports to mitigate the effects of mental health challenges and maintain a positive school environment. • Prioritizing consistent, clear, and early communication of mental health screening procedures can promote the school community's participation and lead to a successful screening process. Clear communication helps schools generate buy-in from their community as community members are more likely to participate in the screening process when they understand and value its importance. Communications should describe the administration plan for mental health screenings and policies regarding parent and student consent (e.g., an opt-out policy). • Tools to screen students for mental health concerns may be administered to students, teachers, and/or parents. Evidence indicates that teachers are typically more reliable respondents than parents, although each respondent group has its advantages and disadvantages. Student- administered measures, which can take less than five minutes to complete, appear to be the most common. When choosing a specific screening tool, districts should consider the needs of their students; the validity, reliability, and accuracy of the tool; ease of implementation; and whether the assessment will cause students harm. • Experts recommend screening all students for mental health concerns, ideally three times per year. As universal screenings across grade levels may not be feasible, districts and schools should consider implementing screenings around transition years (e.g., from elementary to middle school). If using a student-administered screening tool, schools should consider administering screenings during established advisory or homeroom periods. Why Screen Students at School? Schools are natural settings for mental health screenings and interventions as education professionals have distinct opportunities for "periods of prolonged engagement with [students,] during which effective intervention strategies can be implemented." 2 Indeed, children spend most of their waking hours in schools, which means that the education professionals that interact with and educate students every day are uniquely positioned to assess and monitor any cognitive, behavioral, and emotional challenges a student might be having. 3 Generally, mental health screenings aim to: 4 • Identify students at risk for poor outcomes; • Identify students who may need monitoring or intervention; • Inform decisions about needed services; • Identify personal strengths, weaknesses, risk factors, and emotional distress; and • Assess effectiveness of universal social, emotional, and behavioral curricula.

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