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- Screen all students for mental health issues including trauma, depression, anxiety, and other disorders as appropriate.
- Consider also screening for families, with attention to relevant privacy considerations, who have experienced COVID-19 during the pandemic, as it may contribute to traumatic responses.
- Work with the district to understand which students and families have experienced increased distress during the pandemic via screens. For example, vulnerable populations may include: students or families who had COVID-19, LGBTQ students, housing insecure. Note: it may be worth incorporating a trauma screen specifically for these populations, and others.
- Ensure screeners are developmentally appropriate.
- Where appropriate, use screeners to understand social determinants of health; home is not always the safest place for children and youth and understanding housing, food insecurity, and exposure to issues including domestic violence is important in understanding students’ recovery needs.
- Communicate with families and guardians which screeners will be used, the rationale behind each screener, and if significant, feedback about their child’s screening results.
- Screeners should not be used for diagnostic purposes, rather to understand which students may need more support. Examples of Screeners include:
- PHQ9- depressive symptoms for teens.
- Universal screeners.
- Guidance for Trauma Screening in Schools.
- Utilize applications that allow students, particularly middle and high-school age, to report concerns about mental health issues and suicidality related to other students anonymously. Research supports these applications as interventive for suicidality and other mental health issues. Example: Sandy Hook Say Something
- Plan for distress around the return to in-person instruction. Organize conversations focused on returning to the classroom and adjustment to in-person learning which can be woven into school-level academic plans.
- Encourage mental health staff to participate in returning to school meetings to help process issues as they arise.
- Host optional educational sessions for parents around services offered within the building and encouraging families to contact the school directly if there are concerns for student mental health.
- Provide families with an outline and understanding of the resources and services available in the realm of mental and behavioral health.
Prevention and Intervention
- Ensure there are appropriate ratios of counselors, school psychologists, etc.
- At minimum, ensure ratios established pre-pandemic. Lower ratios may be needed based on screening outcomes.
- 250:1 school counselors to students.
- 500:1 school psychologists per student.
- 750:1 school nurses per student.
- Implement a standing plan to consent for treatment and update parents regularly on interventions with children.
- Create processes for parents to have regular check-ins with mental health staff to best understand treatment, as recommended in pediatric evidence-based treatments.
- Increase intervention resources, especially in the first six months of return to in-person instruction and in the 2021-2022 school year.
- When students are referred via screening, implement a strategy for mental health professionals to further assess and identify which services are appropriate.
- Encourage continued use of guidance counselors and school psychologists for individual counseling as appropriate.
- Create and implement evidence-based interventions such as CBITS (Cognitive Based Intervention for Trauma in Schools) and/or Bounce Back into intervention repertoire. Also consider Coping Cat for non-traumatic anxiety. Other interventions should have a strong evidence base in pediatric mental health.
- Train counselors, school psychologists, and other staff who have not previously trained in CBITs.
- More resources for trainings can be found here.
- Consult local licensed psychologists and child psychologists to assist with training and collaborative consultation as needed.
- Implement a plan for office hours/check in hours for families who have students involved in intervention services at the treatment level.
- If not already in place, implement a crisis intervention team. Crisis teams formed around empirically based models should be able to evaluate and activate in case of major concerns such as suicidality.
- Make efforts to relieve counselors and school psychologists from no-core duties (i.e. car line, lunch duty) in order to maximize time they have to implement interventions with students.
- Collaborate with the district to understand which empirically-based services are recommended.
- Consider optional screening for teachers upon return to understand need and promote mental health services.
- Update or create employee assistance programs intended to help school staff deal with personal problems that might adversely impact their work performance, health, and well-being, where possible.
- Offer support groups as teachers return and adjust to in-person instruction and kick-off the 2021-2022 school year, understanding that educators may also have experienced trauma, grief, and mental health difficulties during the pandemic.
- To the extent possible, provide teacher training in mental health, such as Youth-Mental Health First Aid or Psychological First Aid.
Trauma-Informed Disciplinary Practices
- Ensure discipline practices are trauma informed.
- Focus should be on a positive, reward-based system with the avoidance of expulsion and suspension that forces to digress from in-person instruction unless entirely unavoidable.
- Teachers and mental health professionals should expect that some amount of difficult behavior and adjustment back to in-person instruction will occur. Protocols should be in place to address this in a tiered discipline manner.
- Refer to the National Association of School Psychologists resources for appropriate discipline.