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Along with increased attention to universal screening for identifying social, emotional, and behavioral (SEB) concerns is the need to ensure the psychometric adequacy of tools available. Nearly all extant tests of universal SEB screening validity focus on traditional inferential forms with little to no study of the consequences of actions following those inferences, or consequential validity proposed under Messick's unified validity theory. This study examines one facet of consequential validity (i.e., utility) of results from one popular screening tool in six elementary schools in one large U.S. district. The schools identified students who were receiving SEB supports on a monthly form throughout one school year. Screening identified 991 students with SEB risk, of which 91 (9%) were receiving intervention prior to screening. After screening, schools provided intervention to an additional 66 students (7%). Unaddressed SEB risk remained after screening for 84% of screener-identified students. Latent profile analyses detected five patterns of risk with those students demonstrating the most risk and predominately externalizing concerns being most likely to receive intervention after screening. Study schools also provided intervention to students with elevated low risk after screening, but this profile was the largest group leaving 708 students with unaddressed SEB risk after screening. Results provide evidence of universal SEB screening interpretation to identify unaddressed SEB risk but insufficient use to provide intervention services at a rate that substantially reduced unaddressed SEB risk. Future research and practice directions for advancing the consequential validity of universal SEB screening are recommended and measurement limitations discussed.

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.

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.

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.

Peer victimization is a widespread and heterogeneous phenomenon, especially during the transition to middle school, and is associated with numerous negative consequences. However, previous research is limited by variable-centric analyses and data manipulations that either fail to capture or mask the complexity of peer victimization many students experience. We used person-centered analyses with continuous variables to detect patterns of peer victimization in a longitudinal sample from Grades 4 (n = 1,349), 5 (n = 1,352), and 6 (n = 1,098). We found five distinct profiles varying by victimization severity (i.e., none, some, pervasive) and form (i.e., relational, verbal, and physical) in each grade level. Female students and Black/African American students experience greater relational victimization during the middle school transition than their male or White peers, respectively, while students with disabilities experience all forms of victimization at greater levels than their non-disabled peers. Study limitations, future research, and practice implications are discussed, including the need for culturally responsive and victimization form-specific prevention and intervention strategies.

As schools increasingly implement multitiered systems of support, there is a pressing need to develop psychometrically sound implementation fidelity measures. The interconnected systems framework (ISF) is a multitiered model blending systems of positive behavioral interventions and supports with promotion, prevention, and intervention strategies of school mental health. The ISF is being implemented in communities across the United States with ongoing evaluation in several randomized controlled trials. The ISF-Implementation Inventory (ISF-II) was developed to measure fidelity of the ISF within a school building. We conducted a national validation study including completion of the ISF-II by 398 educators in 49 schools, 16 school districts, and 9 states. Results indicate the ISF-II produces scores that are internally consistent and structurally valid when items are organized into a three-tiered model. Additionally, the ISF-II was rated as feasible, acceptable, and beneficial. Limitations of the study, including the need for additional psychometric testing, are discussed in light of these results that suggest educators and researchers, alike, should feel confident in using the ISF-II as a measure of ISF implementation quality.

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.

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.

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.

The current study examined between-teacher variance in teacher ratings of student behavioral and emotional risk to identify student, teacher and classroom characteristics that predict such differences and can be considered in future research and practice. Data were taken from seven elementary schools in one school district implementing universal screening, including 1,241 students rated by 68 teachers. Students were mostly African America (68.5%) with equal gender (female 50.1%) and grade-level distributions. Teachers, mostly White (76.5%) and female (89.7%), completed both a background survey regarding their professional experiences and demographic characteristics and the Behavior Assessment System for Children (Second Edition) Behavioral and Emotional Screening System--Teacher Form for all students in their class, rating an average of 17.69 students each. Extant student data were provided by the district. Analyses followed multilevel linear model stepwise model-building procedures. We detected a significant amount of variance in teachers' ratings of students' behavioral and emotional risk at both student and teacher/classroom levels with student predictors explaining about 39% of student-level variance and teacher/classroom predictors explaining about 20% of between-teacher differences. The final model fit the data (Akaike information criterion = 8,687.709; pseudo-R[superscript 2] = 0.544) significantly better than the null model (Akaike information criterion = 9,457.160). Significant predictors included student gender, race ethnicity, academic performance and disciplinary incidents, teacher gender, student-teacher gender interaction, teacher professional development in behavior screening, and classroom academic performance. Future research and practice should interpret teacher-rated universal screening of students' behavioral and emotional risk with consideration of the between-teacher variance unrelated to student behavior detected.

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.

Despite schools increasingly adopting multitiered systems of support (MTSS) for prevention and intervention of mental health concerns, many are slow to adopt universal mental health screening (UMHS), a core MTSS feature, due to concerns about their limited capacity to meet the needs of all identified. In this study, we examined differences in the number and characteristics of students who would be identified for intervention services when UMHS in an MTSS were added to those students already receiving social, emotional, and behavioral supports. In a sample of 3,744 students in Grades 1 to 5 from six schools, 679 (18.1%) additional students were identified by screening, representing a 180.1% increase in students identified with behavioral risk or need for mental health interventions. Using a series of stepwise logistic regression analyses, we identified significant predictors of newly identified students including gender, number of office discipline referrals, and externalizing, internalizing, and adaptive behavior ratings. Findings are discussed in relation to opportunities for prevention and the systems needed in an MTSS to meet the needs of newly identified students.

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.

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.

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]