Mental Health

Essential actions that ensure that every student’s mental and behavioral health needs are met in order to enable learning.


  • 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.

Supporting Teachers

  • 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.