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Schools are well positioned to facilitate early identification and intervention for youth with emerging mental health needs through universal mental health screening. Early identification of mental health concerns via screening can improve long-term student development and success, but schools face logistical challenges and lack of pragmatic guidance to develop local screening policies and practices. This study summarizes mental health screening practices tested by six school districts participating in a 15-month learning collaborative. Qualitative analysis of 42 Plan-Do-Study-Act cycles revealed that districts tested quality improvement changes across seven screening practice areas, with all teams conducting at least one test to: 1) build a foundation; and 2) identify resources, logistics and administration processes. Quantitative data indicated that the average percentage of total students screened increased from 0% to 22% (range = 270 – 4,850 students screened at follow-up). Together, these results demonstrate how school districts not currently engaged in mental health screening can apply small, specific tests of change to develop a locally-tailored, practical and scalable process to screen for student mental health concerns. Lessons learned are provided to inform future directions for school-based teams.

There are racial and ethnic disparities in use of out-of-school suspensions within the United States. The present study assessed for the presence of disproportionate suspension by race, special edu...

Multidisciplinary teams of school- and community-employed mental health, health, and educational staff work together in schools to offer a full continuum of mental health promotion, prevention, early intervention, and treatment services and supports. Intentional teaming structures and practices are essential to ensure teams deliver effective, coordinated services and supports. The current study investigated the extent to which continuous quality improvement strategies improved school mental health team performance during a 15-month national learning collaborative for 24 school district teams. All teams significantly improved their average teaming performance from baseline to the end of the collaborative (t(20) = −5.20, p < .001). Plan-Do-Study-Act (PDSA) cycles allowed teams to rapidly evaluate specific quality improvement changes to improve their performance. Teams with the most improvement focused on increasing multidisciplinary team membership, avoiding duplication and promoting efficiency, and connecting to community mental health providers/resources.

Learning collaboratives (LCs) have often been used to improve somatic health care quality in hospitals and other medical settings, and to some extent to improve social services and behavioral health care. This initiative is the first demonstration of a national, systematic LC to advance comprehensive school mental health system quality among school district teams. Twenty-four districts representing urban, rural, and suburban communities in 14 states participated in one of two 15-month LCs. Call attendance (M = 73%) and monthly data submission (M = 98% for PDSA cycles and M = 65% for progress measures) indicated active engagement in and feasibility of this approach. Participants reported that LC methods, particularly data submission, helped them identify, monitor and improve school mental health quality in their district. Qualitative feedback expands quantitative findings by detailing specific benefits and challenges reported by participants and informs recommendations for future research on school mental health LCs. Rapid-cycle tests of improvement allowed teams to pursue challenging and meaningful school mental health quality efforts, including mental health screening in schools, tracking the number of students receiving early intervention (Tier 2) and treatment (Tier 3) services, and monitoring psychosocial and academic improvement for students served.

Education and primary care sectors have been called upon to attend to shortages in access to mental health services among children and adolescents. In response, these settings have increasingly attempted to address this need, though research exploring such collaborative efforts remains limited. The current special issue features research examining collaborations between school and paediatric primary care settings, bringing original research and clinical examples to bear on partnerships which leverage opportunities to improve access to high-quality mental health care. Articles in this special issue underscore the positive youth outcomes associated with effective collaboration across these systems and augment the literature describing innovative and successful approaches to this work. Further, articles in this issue identify barriers to collaborative efforts and present opportunities for future research and practice.

School nurses play a critical role in the provision of mental health services in the school environment and are valuable members of the coordinated student mental health team. They possess expertise to navigate in today's complicated educational and health care systems, and it is estimated that school nurses spend 33% of their time addressing student mental health issues. Despite their role and expertise, school nurses are often not recognized as part of the school mental health team and, thus, their role in student mental health care and the full collaboration and coordination with other education and mental health professionals in the school has yet to be fully realized. This article reviews school nurse mental health expertise, models of mental health service provision, and current mental health practices as reported by national stakeholders. In addition, it highlights school nurse barriers and additional training needs related to student mental health care and provides concrete recommendations for building strong collaborations between school nurses and other education and mental health professionals to support student mental health.

This study investigated the perceived feasibility and pattern of implementation following an online training for teachers delivering an integrated intervention encompassing two school-based universal preventive interventions: Promoting Alternative THinking Strategies (PATHS) curriculum and the PAX Good Behavior Game (GBG). Forty-five teachers from three urban elementary schools completed an online training consisting of didactics and video demonstration and received in-person coaching across a 31-week implementation period. Data from 65 teachers from three schools who received in-person training and coaching provided a benchmark for comparison. Most teachers in the online training + in-person coaching (OLT + IPC) condition reported that the technology was easy to use and that the course was as effective as an in-person workshop. Teachers in the OLT + IPC group reported positive attitudes regarding PATHS and the PAX GBG that generally were not significantly different from attitudes reported by teachers who received in-person training + in-person coaching (IPT + IPC). Importantly, teachers in the OLT + IPC condition achieved a high level of implementation quality similar to that demonstrated by teachers in the IPT + IPC condition. The frequency of intervention delivery by OLT + IPC teachers was also not significantly different than that of IPT + IPC teachers. These findings provide evidence that the internet is a promising component in a training sequence designed to teach teachers to deliver evidence-based preventive interventions.