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14 ways for school boards to improve school mental health

School mental health

Kentucky School Advocate
September 2020

By Jennifer Ulie-Wells

1. Prioritize SMH as a district goal
A student cannot learn if their brain is not functioning well. It is a basic need, just like food or clothing. Every district strategic goal is benefited by prioritizing school mental health (SMH) as a goal. The first step to a strong and sustainable SMH system is developing a district action team including representation from educators, administrators, parents/ guardians, students, mental health professionals and school board members.

2. Create comprehensive school mental health systems
There cannot be enough emphasis on the importance of creating sustainable school mental health systems versus training only. Training in isolation is not sustainable. Even train the trainer models have potential dangers recognizing the trainer may not have any mental health or trauma expertise. Be wary of commercial outlets selling a product or training that claims to solve all of the district's problems. Without a sustainable system, inspired educators and administrators return to their duties with ideas but lacking a strategic system to implement and maintain. There are many free resources out there to help strengthen the work of your district in developing a sustainable school mental health system, including theshapesystem.com from the National Center for School Mental Health and the mhttcnetwork.org Mental Health Technology Transfer Center Network.

3. Recognize how schools impact mental health in marginalized populations
SMH needs to address how school systems can impact the mental wellness of marginalized populations. LGBT youth that come from highly rejecting families are 8.4 times more likely to attempt suicide. Suicide rates for African-American youth ages 5-12 are double that of the same aged white children. There is an abundance of literature and research that discusses the inequities created by school systems. 82% of educators are white, which creates a cultural mismatch for the over 50% of students of color attending American schools. Cultural mismatch refers to the norms of the institution, not matching the norms of the cultures represented within the school which result in inequitable disciplinary decision making towards students of color. An example includes a student that is told not to use their cultural dialect in class because to the teacher it sounds like slang, then forcing students to engage in code-switching, using a home dialect and having to use a different dialect at school. Students have to face ongoing microaggressions in schools that harm student mental health. They create distrust of schools and educators and resulting in further traumatic responses. Similarly, when adults tell LGBTQ students that their identity is not legitimate or accepted, this creates traumas for students. Federal law protects LGBTQ clubs, yet many are frequently having to jump through additional hoops to be established and recognized. A trans student commonly takes on a new name during the transition process leaving behind a “dead name.” Adults using a person's dead name can traumatize a student and negatively impact the young person’s mental health.

School mental health cannot improve without including devoting time and professional development to implicit bias, critical reflection, and system equity as part of the implementation. System equity work includes evaluating policies, equity audits, disciplinary data, achievement data, and student surveys with a racial, cultural, and gender lens to understand better the experience and barriers facing students.

4. Align discipline policies to actually improve behavior
A child should not have to fail before they get the support that they need. As a district, the goal should be to reduce undesired behaviors by any means necessary, not by following antiquated tradition. Research is clear that get tough, and zero-tolerance responses to behavior are not only ineffective, but they increase negative social and academic impact, especially for male students of color. There is an abundance of research and evidence that explicitly identifies how to change behavior, yet policies often reflect historical practices rather than research. Policies need to reflect brain development, neural responses to toxic stress on the brain, mental illness, behavioral research, with attention to increasing racial/cultural equity, and restorative practices. School districts benefit from policies that include high levels of prevention to reduce behaviors as well as restorative practices that allow students to get the help that they need, such as mental health and substance abuse treatment. In 2016, Michigan enacted law requiring all school districts to use restorative practices in policy and practice. This language should be in all of our discipline policies.

5. Individualized Education Program (IEP) and 504 Plans for mental health
Occasionally I get asked if students should have a 504 Plan if they aren’t visibly struggling, and my response is, do you wait for a student to have an asthma attack to create a plan? A child with asthma needs a plan and accommodations prior to a health crisis. Mental health needs the same diligence, urgency, and prevention. Both IEP's and 504 plans are legal documents made in the best interest of the child. Mental illness is an invisible disability but it is still real. Educators and administrators choosing not to follow a 504 plan or IEP are breaking federal law.

6. Manifestation Determination meetings & behavioral health
If a child with an IEP is being excluded from school, whether as a suspension or an expulsion, a manifestation determination meeting must be held within ten days to determine if the undesired behaviors were a manifestation of the student’s disability. Given the complexities of behavioral health disabilities, if the IEP team is missing mental health expertise, such as a school psychologist, psychiatrist, clinical social worker, or mental health therapist, that becomes a slippery slope. Symptoms of trauma and mental illness can feel frustrating and be easily misunderstood leading to false determinations that a student's behaviors are not manifested by their disability. Also of concern is a school disregarding the feedback of a student's mental health professional. There is increasing attention towards manifestation determination process given the high levels of subjectivity being used to execute manifestation determination meetings, particularly for students of color with behavioral health disabilities.

7. Educator mental wellness
After the tragedy in Parkland, Florida, I had educators calling me crying exhausted from a field they once loved, “What do I tell a student when they ask me if I will take a bullet for them?” Parkland wasn’t the start of an entire field of professionals burning out rather an additional reminder that education is tough. The expectations are higher than ever, yet time and resources are fewer. Even the most amazing educators under challenging conditions will start to see an erosion of their mental health. Some of the most common indicators of burn out are arriving late to work, increased absences, poor work follow-through, struggle to concentrate, depressed, less patient, and low-self worth. Using a punitive approach may take a struggling educator to the point of collapse. Educators working with higher need higher levels of support, self-care, and access to mental health support. Peel Community School District in Canada has included the following in their vision, “Create places to learn and work where staff and students are happy, recognized, and fulfilled.” How do you show your educators that they are valued? Hint that it has to be far more frequent and explicit than contract negotiation benefits. School boards need to be a model of prioritizing school mental health. If building morale and increasing mental health of educators is a priority, consider embedding mental health days as sick days for educators, encourage staff social committees to shift into staff wellness committees, provide onsite therapy for educators in the evening, give time at staff meetings for educators to engage in self-care with each other, and most of all provide opportunities for educators to provide feedback and have voice within the district.

8. Rural districts
Rural school districts are facing a more severe epidemic than suburban and urban areas with scarce to no community mental health resources. To maximize resources, engage in collaboration with other local districts, agencies, and funders. Rural districts benefit when state agencies collaborate with education agencies to develop school mental health available resources to reduce the legwork for schools. Data collection is critical to help state education leaders and legislators understand the story of school mental health across the state.

9. Advocating strongly for SMH legislation
Most legislators heavily rely on feedback from school board members in their district. To assume that legislators have the same dedication to school mental health and even a basic understanding of mental illness and trauma would be ill-informed and dangerous. Every year in my advocacy, I encounter legislators that say they will not support mental health legislation because “the real problem is just bad parenting.” You are a critical member of this work to change and save lives, so please take the time to encourage your legislators to support wellinformed work. Encourage your legislators to make funding school mental health a priority. In Iowa 2019, a group of hundreds of stakeholders from countless capacities launched the Iowa School Mental Health Alliance community of practice. Many states have similar collaborations that should be used to advance school mental health legislation.

10. School counselors versus mental health therapists
School counselors are often time the first line of prevention and intervention with student's social, emotional, and mental health, but they are not therapists. While some may be certified to do mental health therapy, school counselors have a responsibility to serve all students with school counseling programs, groups, prevention, referrals, and crisis intervention hence their role is not to do individual therapy. Districts would benefit from knowing how their counselor to student ratio compares to the National School Counselor Association recommendation of one counselor to 250 students. It is unfortunate when schools over schedule counselors into overseeing study halls, learning labs, lunch and recess duties, which ultimately reduces their time to engage in critical prevention with students. When schools struggle with undesired student behaviors, one consideration is to increase school counselor to student time. School-based therapists are outside agencies contracted with a school or a mental health professional hired by a district. Some of the biggest barriers to getting student therapy are transportation, time, and cost, so creating a school-based therapy program reduces barriers. Some agencies do sliding scales or work with community partners such as the United Way to reduce insurance co-pays. To be used effectively, school-based therapists need private and quiet space during the day rather than in the corner of a hallway.

11. School safety
When I was in school decades ago, we did not lock our school building doors. Visitors only stopped at the office if they needed directions to a classroom, and the concept of school safety had more to do with aging buildings than violence. While the risk of mass violence in a school is rare, it is reasonable that any school board would go to great lengths to make sure that all students, staff, and family members within district buildings are safe. All districts need a comprehensive school safety plan in place that includes consultation with local law enforcement using prevention and response protocols. School districts are best served to utilize local, state, and federal law enforcement expertise and programming. There is building financial momentum being made with commercialized school safety programs, so thoroughly research before committing to a costly program.

12. Screeners
There are a multitude of screeners available. Some evaluate suicidal thoughts, others measure the risk of suicide, some evaluate social-emotional health, while some assess a variety of other mental health disorders and substance abuse. A couple of important thoughts on screeners: 1. A screener alone does not solve a problem, there needs to be a comprehensive system in place and 2. Whoever is administering the screener needs to be highly trained, because even the best screener can be ineffective if being administered by untrained staff. Screeners can provide critical data and identify a problem before it becomes a crisis. School counselors and administrators have the “duty to warn,” an obligation to inform parents of any suicidal ideation.

13. Reduce the stigma of mental illness
One of the driving forces that prevent people from getting help is the stigma associated with mental illness. At board meetings, remind your superintendent, administrators, educators, and students to engage in high levels of self-care and that their mental health is important. Talk about mental illness as a matter of fact, as you would discuss any other medical condition. The more we talk about mental health, the more we normalize it. Encourage your district to make it a priority.

14. Don’t wait for a suicide to take action
One of the most eye-opening insights I've ever heard came from my superintendent, "When it comes to a crisis, it isn’t a matter of “if” rather a matter of 'when.'” Please do not wait until a suicide completion to make mental health a priority. I get many calls from districts after a student or staff has died by suicide, and the pain, chaos, and confusion can leave them paralyzed and dysfunctional for weeks and months. It is heartbreaking, stressful, and makes high-level functioning impossible. The return on investment for creating comprehensive school mental health systems is endless. It impacts every district goal area, improves academic achievement, decreases discipline referrals, benefits student and staff morale, and mental wellness, and the list goes on.

About the author
Jennifer Ulie-Wells, Ph.D., executive director, Please Pass the Love, a school mental health organization and a West Des Moines school board member.
Twitter: @Jenniferwells23
Web: pleasepassthelove.org

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