By Robert Jordan

Introduction

Recognizing the crucial role of mental health in academic success and overall well-being, many K-12 schools are taking proactive steps to establish comprehensive mental health departments ¹. This SITE|SAFETYNET℠ report provides a detailed guide for school districts looking to establish such a department, covering key aspects like the importance of mental health in schools, successful program examples, funding sources, staffing needs, legal considerations, best practices for implementation, and program evaluation strategies.

Importance of Mental Health in K-12 Schools

Mental health is integral to the overall well-being and academic success of K-12 students. Students facing mental health challenges may experience difficulties with learning, social interaction, and overall quality of life ¹. Addressing these challenges early on is crucial, as untreated mental health disorders can have long-term consequences, including poor academic performance, compromised physical health, substance abuse, and even premature mortality ¹.

Schools are critical in supporting student mental health because children and youth spend most of their time in school. Schools offer a safe and supportive environment for delivering mental health services, helping to reduce stigma and improve access to care ². Schools prioritizing mental health contribute to a positive school climate where students feel safe, supported, and connected ². This, in turn, can lead to improved academic performance, reduced truancy and discipline rates, and increased high school graduation rates ².

Examples of Successful Mental Health Programs in K-12 Schools

Several schools have successfully implemented mental health programs that demonstrate the positive impact of such initiatives. Here are a few examples:

• Comprehensive School-Based Mental Health Programs: These programs offer various services, including prevention, early intervention, and treatment, through a team of licensed behavioral health professionals providing on-site therapy services. These services may be supplemented by telehealth as defined in s. 456.47(1) to address mental health needs without disrupting the learning environment ⁴.
• Care & Connection Campaign: This campaign, launched by the Department of Education, focuses on fostering connections between students and adults in the school environment ⁶. Strategies include greeting students individually, creating opportunities for students and teachers to interact, and allowing students to express themselves through various mediums like art and music.
• Integration of Mental Health into Curricula: The Child Mind Institute works with schools to integrate mental health lessons into the curriculum, covering topics like understanding emotions, managing stress, and developing coping strategies ⁶. This approach normalizes conversations about mental health and equips students with essential life skills.
• Use of Technology: Smartphone apps can help students learn about things like mindfulness and relaxation, monitor their mood, and be reminded of skills they can use during stressful times ⁶.
• Multi-Tiered System of Support (MTSS): Schools with well-developed MTSS programs demonstrate positive outcomes in addressing student mental health needs ⁷. This framework provides tiered support based on individual student needs, ranging from universal prevention strategies to intensive interventions.

Funding Sources for Mental Health Programs in K-12 Schools

Securing adequate funding is crucial for establishing and sustaining a comprehensive mental health department. It is essential to use multiple and diverse funding sources from different levels (e.g., school, local, district, state, federal), types of… sources to ensure the sustainability of school mental health services and supports ⁸. Schools can explore various funding sources, including:

• Federal Grants:
  • Project AWARE (Advancing Wellness and Resiliency in Education): This SAMHSA grant supports school-based mental health services and programs, promoting awareness, prevention, intervention, and access to care ⁹.
  • School-Based Mental Health Services Grant Program: This grant aims to increase the number of qualified mental health service providers in schools, supporting telehealth services, loan repayment for providers, and cross-state licensing reciprocity ¹⁰.
  • Trauma Recovery Demonstration Grant Program: This grant provides funding for programs that expand access to mental health services for students from low-income families who have experienced trauma ¹⁰.
  • Mental Health Service Professional Demonstration Grant Program: This grant supports the recruitment and retention of mental health professionals in schools ¹⁰.
  • DOE mental health grants: The Department of Education (DOE) offers several school mental health services grants. DOE grants can support hiring mental health professionals, training school counselors, employing social workers, and funding initiatives promoting mental health awareness and education efforts ⁹.
• State Funding: Many states offer school mental health programs funding through specific appropriations, school funding models, and earmarked tax revenue ¹⁰. For example, in 2019, the Centers for Medicare & Medicaid Services (CMS) approved a state plan amendment in Florida that allows districts to be reimbursed for school-based mental health services to Medicaid-eligible students, regardless of whether those services were included in an Individualized Education Program (IEP). The state plan amendment also included school social workers and psychologists as providers for which Medicaid reimbursement was allowed ¹⁰. Schools should regularly check their state education or health department websites for funding opportunities.
• Medicaid: States can use Medicaid funding to support student mental health services by reimbursing districts for eligible services, supporting school-based health centers, or encouraging partnerships with Medicaid-eligible providers ¹⁰.
• Private Grants: Foundations and nonprofit organizations offer grants to support mental health initiatives in schools. Resources like the Foundation Directory Online can help schools identify potential funding opportunities ⁸.
• Public-Private Partnerships: Collaborating with community organizations and businesses can provide additional funding and resources for school mental health programs.
• Innovative Funding Models: Schools can explore alternative funding models, such as reducing outside therapeutic placements and establishing permanent funding entitlement streams for mental health initiatives ¹¹.

Staffing Needs for a K-12 Mental Health Department

Adequate staffing is essential for providing effective mental health services. Key considerations include:

• Staffing Ratios: Schools nationwide are falling short of recommended mental health professional-to-student ratios. Schools do not have the staff to address the rising demand for mental health services, and many also lack the capability to monitor and assess student behavior in one of the most common places they interact—online ¹².

| Professional | Recommended Ratio | Current National Ratio | |—|—|—| | School Psychologist | 1:500 | 1:1,211 | | School Counselor | 1:250 | 1:415 |

• Key Personnel: A comprehensive mental health department should include school psychologists, counselors, social workers, and licensed mental health professionals ¹³. It’s also crucial to have a district-level coordinator to oversee and coordinate mental health services ¹³.
• Recruitment and Retention: Schools should implement strategies to attract and retain qualified mental health professionals, such as offering competitive salaries, providing professional development opportunities, and creating supportive work environments ¹⁴.
• Roles and Responsibilities: Clearly define the roles and responsibilities of each staff member, ensuring efficient service delivery and collaboration among team members.

Role of School-Based Mental Health Coordinators

School-based mental health coordinators play a vital role in facilitating the integration of mental health services within the school environment. These coordinators typically have a master’s degree in administration, counseling, psychology, social work, or a related field ¹⁵. While they don’t need to be licensed behavioral health specialists, they possess a strong understanding of multi-tiered interventions and the resources available to support student mental health.

The responsibilities of a school-based mental health coordinator include:

• Empowering school faculty to talk with parents or caregivers about student mental health and well-being.
• Sharing information about school and community-based wellness and mental health resources with students, parents, faculty, and staff.
• Working with school counselors to care for students with mental health concerns.
• Connecting students and families to appropriate mental health services and supports.

Relevant Laws and Regulations

Schools must comply with relevant laws and regulations related to student mental health. Key legal considerations include:

• Federal Laws:
  • Elementary and Secondary Education Act (ESSA) allows schools to use federal funds to support student mental health services ¹⁰.
  • Individuals with Disabilities Education Act (IDEA): This law ensures that students with disabilities access appropriate mental health services as part of their Individualized Education Program (IEP) ¹⁰.
• State Laws: Many states have enacted laws specific to mental health in schools, covering areas like mental health days, crisis response policies, and mental health training for staff ¹⁶. Schools should consult their state education agencies for specific legal requirements.
• Confidentiality: Schools must adhere to federal and state laws regarding student privacy and confidentiality, such as the Family Educational Rights and Privacy Act (FERPA). Under FERPA, parents or eligible students have the right to inspect and review the student’s education records maintained by the school. Schools are responsible for protecting the privacy of student records and must obtain written consent from the parent or eligible student before disclosing any personally identifiable information from a student’s education records, except under certain limited circumstances ⁵.
• Consent: Obtain informed consent from parents or guardians before providing mental health services to students.

Best Practices for Implementing Mental Health Programs

Implementing mental health programs effectively requires careful planning and consideration. Here are some best practices:

• Comprehensive Approach: Provide a continuum of services that address prevention, early intervention, and treatment needs ⁴. The Ohio School Wellness Initiative (OSWI) provides a good example of this approach, offering best practice standards for student assistance programs and staff wellness frameworks ¹⁷.
• Positive School Climate: Create a safe, supportive, and inclusive school environment where students feel connected and respected ⁴.
• Parent and Family Engagement: Involve parents and families in the planning and implementation, ensuring their perspectives are considered and their needs are met ⁴.
• Mental Health Literacy: Provide training for school staff to recognize and respond to students experiencing mental health challenges ⁴.
• Cultural Context: It is crucial to prioritize cultural context when designing and implementing mental health programs. Schools should consider their students’ cultural backgrounds and ensure that programs are culturally relevant and sensitive ⁶.
• Collaboration and Teaming: Establish clear communication channels and collaboration structures among school staff, mental health professionals, and community partners ¹⁸.
• Alignment with Academic Programming: Align mental health initiatives with academic programming to enhance administrator buy-in and support. This integration can demonstrate the connection between mental health and academic success, making it more likely for administrators to prioritize and invest in these programs ¹⁸.
• Data-Driven Decision Making: Use data to inform program planning, implementation, and evaluation, ensuring services are effective and aligned with student needs ¹⁸.

Evaluating the Effectiveness of a Mental Health Program

Regular evaluation is crucial to ensure the effectiveness and sustainability of a mental health program. Key evaluation strategies include:

• Mental Health Screening: Use systematic tools or processes to identify students’ mental health strengths and needs ¹⁹.
• Data Collection and Analysis: Collect data on program outcomes, such as student attendance, academic performance, and social-emotional well-being. Analyze the data to identify program strengths and areas for improvement.
• Feedback and Input: Gather feedback from students, parents, and staff to assess program satisfaction and identify areas for improvement.
• Process Evaluation: Evaluate the implementation process, including program fidelity, staff training, and resource allocation.
• Outcome Evaluation: Assess the program’s impact on student mental health, academic achievement, and overall well-being.

Conclusion

Establishing a comprehensive mental health department in a K-12 school requires a multifaceted approach that considers the unique needs of the school community. By prioritizing mental health, schools can create a supportive environment where students thrive academically, socially, and emotionally. This report provides a roadmap for school districts to establish and sustain effective mental health programs, ensuring that all students have the opportunity to reach their full potential. School districts should use the information in this report to conduct a needs assessment, develop a comprehensive plan, and secure funding for their mental health departments. Investing in student mental health can have long-term benefits, such as improved academic achievement, reduced behavioral problems, and increased graduation rates.

Works Cited

1. Significance of Mental Health Education in Schools, accessed January 25, 2025, https://www.alisbh.com/blog/importance-of-mental-health-education-in-schools
2. School Based Mental Health | Youth.gov, accessed January 25, 2025, https://youth.gov/youth-topics/youth-mental-health/school-based
3. Student Safety and Mental Health Resources at K12, accessed January 25, 2025, https://www.k12.com/student-safety/mental-health/
4. SCHOOLSAFETY.GOV – Mental Health Resources for K-12 Schools, accessed January 25, 2025, https://www.schoolsafety.gov/sites/default/files/2023-05/SchoolSafety.gov%20Mental%20Health%20Resource%20Infographic_May%202023.pdf
5. The 2024 Florida Statutes – Online Sunshine, accessed January 25, 2025, http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String&URL=1000-1099/1006/Sections/1006.041.html
6. 9 essential mental health supports for school-based programs | K-12 Dive, accessed January 25, 2025, https://www.k12dive.com/news/mental-health-supports-school-based-programs/638691/
7. The best mental health programs start with all students, accessed January 25, 2025, http://healthystudentspromisingfutures.org/wp-content/uploads/2019/07/The-best-mental-health-programs-start-with-all-students.pdf
8. Funding and Sustainability – School Mental Health Quality Guide, accessed January 25, 2025, https://www.schoolmentalhealth.org/media/som/microsites/ncsmh/documents/quality-guides/Funding-&-Sustainability.pdf
9. 6 Grants to help address mental health in schools – Talkspace for Business, accessed January 25, 2025, https://business.talkspace.com/articles/grants-for-mental-health-in-schools
10. State Funding for Student Mental Health, accessed January 25, 2025, https://www.ecs.org/wp-content/uploads/State-Funding-for-Student-Mental-Health.pdf
11. Step 5: Navigating School-Based Mental Health Funding – Effective School Solutions, accessed January 25, 2025, https://effectiveschoolsolutions.com/mental-health-funding-schools/
12. Can’t Hire Enough Mental Health Staff? Get Help with Edtech – Lightspeed Systems, accessed January 25, 2025, https://www.lightspeedsystems.com/blog/mental-health-staff-shortage/
13. Counseling, Psychological, and Social Services Staffing: Policies in U.S. School Districts, accessed January 25, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC7075633/
14. Recruiting and Retaining School-Based Mental Health Professionals, accessed January 25, 2025, https://www.ecs.org/recruiting-and-retaining-school-based-mental-health-professionals/
15. FACT SHEET: School-Based Mental Health Coordinators | First Focus on Children, accessed January 25, 2025, https://firstfocus.org/resource/fact-sheet-school-based-mental-health-coordinators/
16. States Take Action to Address Children’s Mental Health in Schools – NASHP, accessed January 25, 2025, https://nashp.org/states-take-action-to-address-childrens-mental-health-in-schools/
17. School-based Mental Health | Ohio Department of Education and Workforce, accessed January 25, 2025, https://education.ohio.gov/Topics/Student-Supports/School-Wellness/School-based-Mental-Health
18. Implementing School Mental Health Supports: Best Practices in Action, accessed January 25, 2025, https://safesupportivelearning.ed.gov/sites/default/files/13-ImpSchMnHlthSprtBtPrt-508_0.pdf
19. Screening – School Mental Health Quality Guide, accessed January 25, 2025, https://www.schoolmentalhealth.org/media/som/microsites/ncsmh/documents/quality-guides/Screening.pdf