A Flexible Approach for Improving Mental Health Care In Schools

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A Flexible Approach for Improving Mental Health Care In Schools

I’ve worked with children since I was old enough to do so, either as a babysitter, tutor, mentor, or camp counselor, and have focused my psychology major on child development and mental health. The biggest takeaway from my experience with children and study of their psychological development has been the crucial role of teachers in a child’s mental health.

Teachers are in the unique position of witnessing the intersection of a child’s academic and social growth, and as such have the opportunity to intervene or arrange for intervention if a child is struggling in any way.

This important role is often overlooked, which leads to a number of barriers that impede teachers’ ability to fulfill their position as an intermediary between students and the outside resources they may need. Major contributing factors include:

  • Lack of specified training for teachers: Studies have indicated that while many teachers are by no means oblivious to students’ struggles, they often are unsure of how connect them with services. In a 2004 study, Mark Weist and Kathleen Albus found that mental health training for teachers often takes place over the course of a day, or less than a day.
  • Overcrowded classrooms for teachers.
  • Overwhelmed caseloads for in-school mental health service providers.

One approach designed to compensate for these barriers is the Expanded School Mental Health (ESMH) approach. This approach, according to Weist and Albus, refers to programs that strengthen existing school mental health services and fill gaps in collaboration between teachers and mental health professionals. ESMH programs aim to build interdisciplinary support teams for students so that each professional’s role can be fully utilized. These programs look beyond current school mental health initiatives that are usually either school-wide, generalized prevention programs or narrower, disorder-specific interventions.

While the current research on ESMH collaborations leaves much room for further study, many early findings are encouraging. A number of studies in the late 90s and early 2000s found links between ESMH program implementation and improved learning and behavioral outcomes. Nabors and Reynolds (2000) found an association between ESMH collaboration and increased family engagement and access to services, as well as improvement in the quality of services and supports for both students and teachers.

More recent research has focused on fine-tuning these programs. A 2016 study led by Elizabeth Mellin of Binghamton University surveyed 384 teachers within ESMH programs to evaluate strengths and gaps of the collaborative system. Mellin et al used a self-report method to examine teachers’ methods for seeking support for their students.

One important finding from the survey was that most teachers reported first reaching out to colleagues within the school rather than community mental health professionals. This, according to Mellin et al, indicates that collaboration regarding students’ mental health care is in at least some part fueled by trust and close social bonds between teachers and their colleagues.

Based on their overall findings, researched suggested a number of ways to improve ESMH collaborative efforts:

  1. Better engage teachers: Engagement of teachers in ESMH strategy development would ideally facilitate students’ access to services by streamlining the process.
  1. Increased training: Including teachers in training sessions for in-school mental health professionals would allow both groups to learn from each other’s expertise. This would bridge knowledge gaps and strengthen overlapping skills.
  1. Increase number of mental health professionals in schools: Increasing the number of mental health professionals within a school could strengthen a child’s support team by providing teachers a more solid base from which to seek counsel.

The flexible and collaborative core of the ESMH approach lends ESMH programs a compassionate nature; they recognize not only the individuality of students and therefore their diverse needs, but also the necessity of strengthening professional bonds such that teachers and counselors have support systems of their own.

A student’s mental health challenges left unaddressed in elementary school can have a lasting impact beyond high school. The crucial role of teachers in addressing these challenges early on has been well documented, but the task should not fall entirely to them. Research on ESMH programs demonstrates that school mental health initiatives are strongest when they include collaboration between professionals within the school but also in the community.

For more information about the ESMH approach visit: https://gucchd.georgetown.edu/75393.html.


Mellin, A., Ball, A., Iachini, A., Togno, N., & Rodriguez, M. (2016). Teachers’ experiences collaborating in expanded school mental health: implications for practice, policy and research. Advances in School Mental Health Promotion, 1–14. https://doi.org/10.1080/1754730X.2016.1246194

Nabors, L. A., & Reynolds, M. W. (2000). Program evaluation activities: Outcomes related to treatment for adolescents receiving school-based mental health services. Children’s Services: Social Policy, Research, and Practice, 3, 175-189.

Weist, M. D., & Albus, K. E. (2004). Expanded School Mental Health: Exploring Program Details and Developing the Research Base.

By |2019-04-24T14:30:50-07:00February 14th, 2017|Blogger Intros, Community Voices, Featured Posts, Gen Bold|1 Comment

About the Author:

Clare Rock
Clare is a senior at UC Berkeley, where she majors in Psychology with a focus on youth mental health. She intends to pursue a master’s degree in social work and a career as a high school counselor. She is excited to be given the opportunity to contribute to the Generation Bold initiative, and looks forward to learning more about mental health policy and advocacy in her time with Young Minds.