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It is imperative that educators take a positive and preventive approach to support students and promote school safety. This article addresses the importance of identifying students who need additional mental health support and providing the highest quality support. These include best practices of emphasizing strength-based approaches, working with students and families as collaborators, integrating strategies into schools' multi-tiered systems of support, using data for decision making, implementing and refining evidence-based practices, and conducting ongoing evaluation. This article reviews specific examples of positive approaches to promoting student mental health funded by the National Institute of Justice Comprehensive School Safety Initiative. These real-world research initiatives provide examples of how multi-tiered systems of support for student mental health can serve as a mechanism to promote school safety. [ABSTRACT FROM AUTHOR]

In this article, we present an introduction and overview for a two‐part special issue series focused on embedding equity into school mental health through theory, research, and practice. The papers in Part 1 of the special issue series cover critical topics for advancing equitable school mental health, including the centering of community and youth perspectives; a focus on reducing disproportionality in discipline practices; and details on equity‐focused interventions. In Part 2, papers focus on integrating race and racial equity into school mental health frameworks; integrating a racial equity lens into trauma‐informed school practices; addressing outcomes that have disproportionate impacts on youth of color; and exploring domains of injustice and oppression beyond racial inequity. We hope that the topics discussed in this special issue series move us towards providing equitable and just school mental health services for all children and youth. [ABSTRACT FROM AUTHOR]

Schools and research partners are increasingly implementing complex, multicomponent interventions and school‐wide frameworks to better meet students' social, emotional, behavioral, and academic needs; however, in the research and real‐world contexts, implementation is often fraught with many challenges and barriers to success. This study explores implementation barriers encountered during a randomized controlled trial testing effects of one complex intervention strategy—the Interconnected Systems Framework—from the lens of a practical model for conceptualizing organizational readiness—the Interactive Systems Framework for Dissemination and Implementation. Implementation of the Interconnected Systems Framework was explored via focus group and key informant interviews with school and mental health professionals, and research team members responsible for implementing the intervention in randomly assigned study schools. Results from inductive thematic analysis of verbatim transcripts identified three primary implementation challenges: staff turnover, inadequate leadership buy‐in, and insufficient time for training/planning. Each challenge is explored from interview participants' perspectives and the extant literature, then connected to recommendations from implementation science to help others avoid similar challenges in their well‐intentioned efforts to address the mounting concern for students' wellbeing. [ABSTRACT FROM AUTHOR]

Schools are encouraged to take a proactive approach to mental health through the use of a tiered system of supports facilitated by universal mental health screening. However, schools may experience difficulty implementing universal screening and large‐scale systems change. The purpose of this study was to explore multilevel implementation determinants, identify strategies that aided implementation, and examine how implementation determinants and strategies impacted implementation reach for two schools adopting and initially implementing universal screening within a tiered mental health system. We used a mixed‐methods case study design where qualitative analysis of focus groups identified themes related to implementation determinants and strategies, and quantitative data compared implementation reach before and after the initial implementation of universal screening. Focus groups identified themes of broader influence, structures, school climate, personnel, and resources that enabled and obstructed the implementation process. To aid the tiered system, schools used implementation strategies of outreach and systems, screening, and intervention planning. Integrative mixed‐methods analysis identified influences of these determinants and strategies on changes in implementation reach at Tier 1; however, only minimal changes occurred at Tiers 2 and 3. Results highlight the importance of attending to implementation factors when adopting and initially implementing a tiered mental health system. [ABSTRACT FROM AUTHOR]

Given the important role that teachers play in supporting student mental health, it is critical teachers feel confident in their ability to fill such roles. To inform strategies intended to improve teacher confidence in supporting student mental health, a psychometrically sound tool assessing teacher school mental health self-efficacy is needed. The current article details the initial development and psychometric functioning of the school mental health self-efficacy teacher survey (SMH-SETS). A component of the development included Rasch analysis of pilot data to provide a psychometric appraisal of the SMH-SETS functioning and initial psychometric evidence. Results suggest the SMH-SETS exhibits strong psychometric properties and can be used to measure school mental health self-efficacy, track self-efficacy over time, and inform training and professional development. [ABSTRACT FROM AUTHOR]

Tiered response models encourage a proactive approach to identification of social-emotional needs and intervention. However, schools experience barriers to adopting and implementing such models that use data to allocate interventions. The current study examines the utility of a universal social-emotional learning (SEL) screening system embedded in an empowerment evaluation framework to improve intervention receipt. Teachers at two primary elementary schools rated all students with an SEL screening system in a tiered response model. The intervention school received screening results with empowerment evaluation supports while the comparison school did not receive screening results and proceeded with intervention decision-making as usual. Intervention receipt results were analyzed with chi-square tests and descriptive comparisons. The intervention school served a greater number of students with interventions, was more likely to intervene for students with SEL need, and implemented a greater number of small-group interventions than the comparison school. Limitations and future directions are discussed. [ABSTRACT FROM AUTHOR]

Identifying youth with mental health concerns and connecting them to effective intervention is important because poor mental health is related to lower educational achievements, substance abuse, violence, compromised health, and reduced life satisfaction. This study examined the ability of teachers (n = 153) to accurately identify mental health concerns among elementary children using vignettes scenarios depicting children with severe and moderate externalizing or internalizing behavior problems. Teachers were asked to rate the seriousness of the problem, their concern for the child's well-being, and whether they felt the student needed school-based or community mental health services. Findings indicated that teachers can accurately identify students with severe externalizing and internalizing problems. However, they were less accurate and less likely to think students with moderate or subclinical symptoms needed services. Additionally, teachers perceived externalizing problems to be more serious and more concerning, than internalizing problems. In most cases, teachers' concern for the child's well-being, but not their perceived seriousness of the problem, predicted endorsement of referral to school and/or community-based mental health professionals, even when controlling for the child's gender. Implications for practice and future research areas are discussed. [ABSTRACT FROM AUTHOR]

The success of universal screening for effective school mental health programs is dependent on the availability of usable measures as well as empirically based recommendations for use. The current study examined the long-term stability of a strengths-based social-emotional screening tool, the Devereux Student Strengths Assessment-Mini (DESSA-Mini). Elementary teachers rated students (N = 273; kindergarten and first grade at Time 1) 3 times per year over 2 years to identify students for early intervention. Stability coefficients were moderate to large for continuous and categorical data but lower between years, and a transition matrix demonstrated greater movement across categories compared with prior research. A latent profile analysis with all six time-point T-Scores indicated four stability profiles. Three patterns were stable across all times while one profile improved over time. Profile results were compared with covariates of free and reduced-price lunch, special education, and intervention status as well as outcomes of reading achievement and behavior referrals. Practice implications and areas for future research are discussed. [ABSTRACT FROM AUTHOR]

There is an urgency to improve accessibility of behavioral health services for children and families given both an increasing need and decreasing support. This special issue aims to advance our understanding of what works to make behavioral health services for children accessible through a collection of articles that examine the issue from research, policy, and practice perspectives. The five research articles included in this special issue examine the organizational and contextual features necessary to improve the accessibility of children’s behavioral health services, thus building upon the growing literature that can inform practice and policy. In addition, the special issue also includes three articles describing the practices and outcomes of innovative state and local community partnerships, with the goal of using practice to inform research and policy. The interconnectedness of research, policy, and practice—coupled with the need for ongoing communication in the arena of children’s behavioral health services—is further examined in the commentary that concludes this special issue. Taken together, the collection advances our understanding of how children’s behavioral health services can be more accessible to all, and provides a model for future integration across research, policy, and practice efforts. [ABSTRACT FROM AUTHOR]

Although it is known some youth access mental health services more readily than others, most service use studies used variable-centric approaches that produced heterogeneous groups and results that require parents and educators to understand diagnostic categories. Person-centered approaches group youth with similar patterns of behavioral and mental health concerns and thus are more homogenous and comparable to the presentation of behavioral and mental health problems noticed by parents and educators, who most typically facilitate access to care for those youth in need. We examined the behavioral and mental health symptom profiles, demographic characteristics and service use histories of youth referred for intervention in a multi-state, randomized controlled trial intervening in severe emotional/behavioral problems (n = 647; Kern et al. in Educ Treat Child 34(4):593-617, 2011). Latent profile analysis of parent-reported hyperactivity, aggression, and conduct, and adolescent-reported anxiety and depression on a broadband measure of student emotional and behavioral functioning was conducted. Model fit indices and theoretical interpretation supported five latent profiles; Class 1 showed severe externalizing behavior problems (7.18%, n = 45), Class 2 showed normative behaviors (37.78%, n = 237), Class 3 showed elevated internalizing behavior problems (12.76%, n = 80), Class 4 showed elevated externalizing behavior problems (33.01%, n = 207), and Class 5 showed elevated internalizing and externalizing behavior problems (9.25%, n = 58). We detected demographic and service use history difference between these profiles using multinomial logistic regression. Findings are discussed in relation to improving children’s mental health services, including universal screening, training emphasizing recognition and concern for internalizing behavior problems, and increased availability of mental health professionals in school settings. [ABSTRACT FROM AUTHOR]

The Interconnected Systems Framework (ISF) blends school mental health practices, systems, and resources into all levels of a multitiered system of supports (e.g., positive behavior interventions and supports). The ISF aims to improve mental health and school performance for all students by emphasizing effective school-wide promotion and prevention; early identification; and social-emotional, behavioral, and mental health intervention. Teaming is 1 of 3 foundational components of quality ISF implementation at school, district, and state levels. After introducing the ISF, the authors highlight the core implementation components (i.e., teaming, data-based decision making, and evidence-based practices) and then elaborate on characteristics of well-functioning ISF teams. The authors provide a case example to illustrate each characteristic and review 5 measures teams may consider using to evaluate their functioning and SF implementation. [ABSTRACT FROM PUBLISHER]

Accurate assessment and effective treatment of mood disorders, particularly depression, is critically important for the millions of youth who are experiencing such symptomatology and who are at risk for a multitude of deleterious outcomes. Although the extant empirical literature provides substantial guidance for the assessment and treatment of depression, real-life complexities necessitate the inclusion of sound clinical judgment throughout the diagnostic, treatment planning and intervention phases. The purpose of this article is to present an example of a real-life case study reliant on evidence-based practices and sound clinical judgment in the assessment and treatment of depression. We first review the extant diagnostic, epidemiological, assessment, and treatment literature. The case study is intended to highlight the therapist's use of evidence-based treatment (i.e., Cognitive Behavioral Therapy), while also considering points during treatment at which the therapist was required to use clinical judgment. Outcomes of the case are described and limitations reviewed. [ABSTRACT FROM AUTHOR]

With collaborative interprofessional teams integral to school mental health (SMH) service delivery, pre-service educational strategies are needed to promote interprofessional collaboration among SMH trainees. The current study evaluated the effectiveness, feasibility, and acceptability of a pre-service, interprofessional SMH educational intervention focused on promoting the cross-disciplinary competencies essential for SMH practice. Eight SMH trainees participated in the study. Using a mixed-method design, quantitative pre/post competency data were collected via trainee self-report. Qualitative data were collected through a focus group and reflection journals. Results indicate that the intervention promoted competency in all areas, with significant growth in the provision of learning supports to youth. Key factors influencing intervention feasibility included time/scheduling, changing school team composition, and project coordination. Trainees' perceptions of the educational intervention were related to buy-in, clinical experience, and role flexibility. Implications for the design of pre-service interprofessional SMH education strategies are discussed. [ABSTRACT FROM AUTHOR]