A research review reported in the July 2019 issue of the Journal of Adolescence found that "Greater density of same race/ethnic peers led to better mental health for all youth" and that ".No overall mental health advantage in schools with increased diversity was found."A range of mental health outcomes were assessed (e.g., internalizing behaviors, psychotic symptoms) in order to broadly capture the relationship between school context on mental health and psychological wellbeing. Methods: A search across six databases from 1990 to 2018 resulted in 13 articles from three countries (United States, United Kingdom, and the Netherlands) that met inclusion criteria following a two step review of titles/abstracts and full-text."  Read more....

Comprehensive School Guidance programs enable counsellors and schools to address health and social issues in a holistic, integrated way. An article in Issue #1m 2919 of Professional School Counseling describes how the CSG approach can be used to prevent suicide. The researchers propose "a common standard for the development of an effective, comprehensive school suicide prevention program using a five-step process and frame these approaches within the American School Counselor Association National Model. Read more...

The articles in Issue #3, 2016 of Canadian Journal of School Psychology present a provincial/territorial snapshot of the practice of school psychology across Canada. The introduction notes that "Some provinces also report on the rise of a decentralized clinical administration where the provision of public sector health and social welfare services are increasingly linked to the education system, by recognizing that children are best served in their natural environments. Fundamentally, bridging the gap between “Education” and “Health” is an emerging theme in the present issue given that it represents the most challenging barrier to the implementation of prevention and early intervention programs. The “Global School Health Statement,” (a global dialogue promoted by ASCD, EI and ISHN) which for all intent and purposes, aims for the Integration of Health and Education and recognizes that schools have always “played an important role in promoting the health, safety, welfare, and social development of children.” Similarly, as suggested by Louise Bradley, the Mental Health Commission of Canada CEO, “in order to give today’s young people the best chance, we need to build a bridge—a bridge supported by an integrated, accessible and responsive system.” To date, there is little comprehensive mapping available in Canada of the amount of resources required for the implementation of mental health service provision in schools or of how they should be expended. Efforts to advance mental health in schools have been hampered by the existing gap between Health and Education. As such, by adhering to the “Global School Health Statement” guiding frameworks, school psychologists now seek to find innovative means to integrate health and social programs, which includes mental health, within the education system."  Read more  >>  (This item is among the 5-10 highlights posted for ISHN members each week from the ISHN Member information service. Click on the web link to join this service and to support ISHN)

(An item from the ISHN Member information service)  Many of the national and provincial mental health strategies announced in recent years have included schools as a primary component, with teachers being critical, especially their "mental health literacy". An article in Issue #3, 2015 of School Mental Health reports on a small scale study that describes teacher perceptions of their role(s). It is noteworthy that teacher competence in MH is only one of the six factors identified as barriers by teachers. "This paper explores the teacher role in inter-professional collaboration in mental health promotion and identifies teachers’ perceived challenges to collaborative work in this field. Data are derived from a mixed method design, with three focus group interviews (n = 15) and survey research (n = 771) conducted with Norwegian K-12 teachers. The findings show that teachers perceive their gatekeeping role to be prominent, in that they are front line professionals to identify students’ mental health problems and, if necessary, make referrals to mental health services. However, teachers realize that mental health promotion encompasses more than the assessment of difficulties, and they call for more support and information through inter-professional collaboration in order to extend their engagement in student mental health beyond the gatekeeping role. Based on this, six main challenges to inter-professional collaboration are identified. These are the challenges of: (1) communication and confidentiality, (2) time constraints, (3) contextual presence and understanding, (4) cross-systems contact, (5) school leadership and (6) teacher competence in mental health."  Read more>>

(An item from the ISHN Member information service)  Several of the articles in Issue #7, 2015 of Psychology in the Schools examine the role that school nurses play with other school personnel. The introduction to the speacial issue notes the lack of cooperation between nurses and mental health personnel. "The impetus for this special issue was the lack of research focused on the collaboration of school personnel (i.e., school psychologists and special education teachers) and school nurses. It is surprising that highly recognized professions working within schools, and who often work with same children, rarely collaborate with the goal of enhancing student learning. Although it is common for school psychologists to request vision and hearing examinations or to consult with school nurses regarding medication, active involvement of school nurses during the evaluation and classification process appears limited. In addition, school nurses appear to have limited input during the development and implementation of interventions. The primary aim of this special issue is to demonstrate how school personnel and school nurses can collaborate when developing prevention programs, addressing chronic health needs, and addressing the health needs of children with special needs. Another unique aspect of this special issue is that several of the articles were co-authored by a school nurse or nurse and a school psychologist." The articles in the special issue deal with topics such as continuum of care, identification and evaluation of autistic students, bullying prevention and response, students with disabilities, diabetes and other chronic diseases, responding to crises and roles within comprehensive school mental health promotion programs. Read more>>

(An item from the ISHN Member information service)  A special issue (Issue 2-3, 2015) of Journal of Educational and Psychological Consultation examines the use of school psychologists as systems-level consultants as a strategy to deal with the complexities of the multi-level changes required to introduce and sustain comprehensive approaches to school mental health promotion. An interdisciplinary perspective is used to select the articles which cover topics such as Interdisciplinary Collaboration Supporting Social-Emotional Learning, Ecologically Based Organizational Consultations, the Competencies for Systems-Level Consultants, Multi-Tiered Systems of Support, Collaboration Between School Psychologists and Administrators and Critical Features and Lessons Learned for Implementation. Read more>> Readers may also be interested in a similar ISHN description of a systems-based approach to SMH that is based on capacity and capacity-building at this web page.

(From the ISHN Member information service) Regular readers of this blog will know that we have lamented the confusing presentations and ensuing studies about resilience that have emerged over recent years. Finally, an article and commentary in in the January 2015 Issue of Journal of Child Psychology and Psychiatry present a definition that does not lose the necessary, direct connection with adversity and presents both individual and environmental factors as well as their complex interactions. " This article presents diagnostic criteria for assessing childhood resilience in a way that is sensitive to the systemic factors that influence a child's wellbeing.A multidimensional assessment of resilience is presented that examines, first, the severity, chronicity, ecological level, children's attributions of causality, and cultural and contextual relevance of experiences of adversity. Second, promotive and protective factors related to resilience are assessed with sensitivity to the differential impact these have on outcomes depending on a child's level of exposure to adversity. These factors include individual qualities like temperament, personality, and cognitions, as well as contextual dimensions of positive functioning related to the available and accessibility of resources, their strategic use, positive reinforcement by a child's significant others, and the adaptive capacity of the environment itself. Third, an assessment of resilience includes temporal and cultural factors that increase or decrease the influence of protective factors. A decision tree for the diagnosis of resilience is presented, followed by a case study and diagnosis of a 15-year-old boy who required treatment for a number of mental health challenges." The commentary in the same issue notes: "Yet resilience approaches have been limited by a lack of conceptual clarity and ongoing questions about how to assess and measure it. In this context, Michael Ungar's Practitioner Review is an important contribution to practice". Read more>> 

(From UCLA School Mental Health Project) A new book in January 2015 by the UCLA School Mental Health Project makes a cogent argument for transforming the fragmented delivery of various support services so that they truly support student learning and equitable educational opportunity. The authors begin with this " external and internal barriers to learning and teaching have continued to pose some of the most pervasive and entrenched challenges to educators across the country, particularly in chronically low performing schools. Failure to directly address these barriers ensures that (a) too many children and youth will continue to struggle in school, and (b) teachers will continue to divert precious instructional time to dealing with behavior and other problems...Transforming student and learning supports is key to school improvement. To this end, this book incorporates years of research and prototype development and a variety of examples from trailblazing efforts"  They go on to say "Mapping a school district’s existing efforts to address problems yields a consistent picture of many practices and fragmented, piecemeal, and usually disorganized activity (as illustrated below). The range of such learning and student supports generally is extensive and expensive".  They also go on to describe the cause and this is where we might disagree: "Underlying the fragmentation is a fundamental policy problem, namely the long-standing marginalization of student and learning supports in school improvement policy and practice. Thus, most efforts to directly use student and learning supports to address barriers to learning and teaching and re-engage disconnected students are not a primary focus in school improvement planning. " In our view, a major cause of the fragmentation is that the mandates and funding of the various health, social and other services is done in a sporadic, competitive and disjointed manner. Part of the transformation will require that health and other ministries re-organize their work so that they are accountable for providing consistent support for students most at risk, rather than always worrying about the optimal health of all students in universal programs. There have often been attempts to insert health outputs and outcomes into school system accountability. In our view, this should be a two-way street, with health and other systems being accountable for a reasonable number of educational outputs, particularly for more vulnerable students. Read more>>

(From the ISHN Member information service)   As with many other health issues, mental health advocates often focus on teachers as the key agent in school-based and school-linked mental health promotion. Their "mental health literacy", their willingness to care for their students and their roles in identifying, referring, managing students with problems, which are often presented as disruptive classroom behaviours, are added to their responsibilities to teach all students about mental health, social and emotional learning skills as well as promote mindfulness and resilience, encourage or discourage student friendships and inform, involve ,educate and support parents as well as involve community partners and work with self-help groups. An article in Issue #1, 2015 of Advances in School Mental Health investigated teacher perceptions about their roles and self-efficacy. The researchers note that "Interviews were conducted with 21 teachers from Canberra, Australia. Teachers viewed supporting student mental health as part of their role, though perceived a lack of knowledge and skills in mental health-related areas. They clearly emphasized the need to work within a well-coordinated pastoral care (or secular care) system". The researchers suggest that "Additional training in mental health and clear role delineation within the school may assist teachers to feel better prepared to effectively and appropriately support student mental health." Read more>>

(From the ISHN Member information service)  The US Department of Education announced the winners of their research granting program on educational innovations this week. The focus of these large grants (1.5 million + for each) was on mental health issues, including resilience, social emotional learning, integrated mental health services and many more topics. The extent to which these grants are coordinated with the efforts of non-educational sectors will help to determine their ultimate impact on education and other systems. Read more>>

(From the UCLA School Mental Health Project)  A part of the ASCD-ISHN global dialogue on integrating health & social programs more effectively within education systems has focused on the need for better coordinated among the various student support services. A recent UCLA planning guide takes this coordination a major step forward and connects it to student learning and success. The guide suggests that "New directions for student and learning supports are key to systemically addressing barriers to learning and teaching. The aim is to unify and then develop a comprehensive and equitable system of student/learning supports at every school.This guide incorporates years of research and prototype development and a variety of examples from trailblazing efforts at local, district, regional, and state levels. The prototypes and examples can be adopted/adapted to design and plan ways to transform the role schools play." 

The UCLA analysis of the causes of this fragmentation is revealing. They suggest that "  While the range of student and learning supports at schools varies; some have few, some have many. In some instances, community services (e.g.,health and social services, after-school programs) are connected to a school. However, given their sparsity, agencies endeavoring to bring community services to schools usually must limit their activities to enhancing supports at a couple of school campuses in a neighborhood. Moreover, there often is not a good connection between community services and the work of the many school and district-based student support staff whose roles include preventing, intervening early, and treating students with learning, behavior, and emotional problems. Such school employed personnel include psychologists, counselors, social workers, nurses, dropout/graduation support staff, special educators, and others. When school and community efforts are poorly connected, community and school personnel tend to work
with the same students and families with little shared planning or ongoing communication. Ironically, some education policy makers have developed the false impression that community resources are ready and able to meet all the support needs of students and their families. This impression already has contributed to serious cuts related to student supports (e.g ., districts laying off student support personnel) in the struggle to balance tight school budgets.An outgrowth of all this has been increased fragmentation, as well ascounterproductive competition for sparse resources related to student and learning supports. Underlying the fragmentation is a fundamental policy problem. That problem is the long-standing and continuing marginalization in school improvement policy and practice of most efforts to directly use student and learning supports to address barriers to learning and teaching and re-engage disconnected students. "

The UCLA research and planning guide calls for a transformative change student support services that is based on these four principles:
1) Expand the policy framework for school improvement to fully integrate, as primary and essential, a component that brings together the supports for addressing barriers to learning and teaching and re-engaging disconnected students.
(2) Reframe student and learning support interventions to create a unified and comprehensive system of learning supports in classrooms and school-wide.
(3) Rework the operational infrastructure to ensure effective daily implementation and ongoing development of a unified and comprehensive system for addressing barriers to learning and teaching.
(4) Enhance approaches for systemic change in ways that ensure effective implementation, replication toscale, and sustainability

Read more>>