Definitions of the Components of a Comprehensive Mental Health System
Building skills related to managing emotions, establishing and maintaining positive relationships, and responsible decision-making
Programs listed below help students develop the skills necessary to support student academic success. Skill-building lessons included in these programs help students gain the ability to understand and manage emotions, set and achieve goals, feel and show empathy for others, establish and maintain positive relationships, and make responsible decisions. Programs and practices on this list help educators to boost conditions for learning in a school. The list includes additional registries for deeper learning about evidence-based resources and practices. Schools can help students build important personal-interpersonal-emotional-behavioral and responsible decision-making-related competencies through targeted classroom lessons or by developing schoolwide policies and practices infused into every part of the student’s daily school experience. Measures are available to help students and educators gauge progress. Children’s emotions in school are connected to their learning and academic achievement. There is a large and growing body of evidence as well as available programs to integrate into classrooms to teach these competencies.
Early mental health prevention and intervention
Early mental health prevention and intervention encompass both mental health promotion and early mental health interventions. Mental health promotion is a public health concept of primary prevention. It seeks to foster individual competencies, resources, and psychological strengths, and to strengthen community assets to prevent mental disorder and enhance well-being and quality of life for people and communities. Mental health awareness promotion is designed to increase knowledge and skills of mental health risk factors, warning signs and provide connections to support services. Mental health promotion activities also seek to reduce stigma regarding seeking help for mental health challenges. Studies around the country prove that we can prevent or mitigate the effects of mental illness with early intervention that allows individuals to live fulfilling, productive lives. From the influence of genetics and prenatal health all the way through adolescence and into early adulthood, we are learning more about the critical points in brain development and life experiences that increase the risk for or provide protection against the development of mental health disorders.
Early Mental Health Interventions are programs and services offered to children when they first exhibit signs that support may be needed. Such interventions can prevent or mitigate the effects of mental illness and positively affect a child’s long-term development. The use of early mental health interventions in schools requires school staff to be trained to recognize risk factors and warning signs of emotional or behavioral challenges and for schools to have a referral process and resources in place that allow students timely access to appropriate intervention.
Grief and trauma informed practices
Studies now show that nearly every school has children who have been exposed to overwhelming experiences, such as witnessing violence between their caretakers, being the direct targets of abuse, and other kinds of adversity that considerably impact learning. The landmark Adverse Childhood Experiences (ACE) study found higher levels of traumatic experiences in the general population than previously imagined. Recent neurobiological, epigenetics and psychological studies have shown that traumatic experiences in childhood can diminish concentration, memory, and the organizational and language abilities children need to succeed in school. As students get older, exposure to traumatic experiences can also lead to the adoption of high-risk, self-medicating behaviors such as substance abuse, smoking, and overeating. Schools serve as a critical system of support for children and adolescents who have experienced trauma. Schools can create trauma-informed environments that mitigate against the impacts of trauma and grief. Administrators, teachers, and school staff can help reduce the effects of trauma and grief on children by recognizing trauma responses, accommodating and responding to traumatized students within the classroom, and referring students to mental health professionals when necessary.
Positive behavior intervention and support
Positive Behavior Interventions and Supports are strategies employed by schools to effectively teach, encourage, and reinforce pro-social behavior in and out of the classroom. A positive approach to working with students includes a focus on prevention and early intervention; teamwork between all adults; meeting students’ needs; and building a positive school climate.
Positive youth development
Positive youth development (PYD) refers to intentional efforts to provide meaningful opportunities for youth to enhance their interests, skills, and abilities. Using PYD strategies, schools can give students the chance to build skills, choose healthy lifestyles, exercise leadership, and participate in their communities to optimize developmental progress and promote academic achievement.
Safe, supportive, and positive school climate
School Climate means the quality and character of school life, including interpersonal relationships, teaching and learning practices, and organizational structures, as experienced by students enrolled in the school district, parents of those students, and personnel employed by the district. Establishing a Positive, Safe and Supportive School Climate represents two of the mental health components in TEC Section 38.351 for which LEAs must develop practices and procedures.
Substance use prevention and intervention
Substance abuse prevention involves helping individuals develop the knowledge, attitudes, and skills needed to make good choices. The use of drugs during childhood and adolescence has more potential to disrupt brain function in areas critical to motivation, memory, learning, judgment, and behavior control, because the brain is still developing during these periods. Substance use prevention programs in schools foster protective factors, such as school connectedness and positive peer relationships, which can help students avoid engaging in risky behaviors and help students learn skills important to promoting healthy choices, such as decision making, goal setting, self-management, and bystander intervention.
Substance use intervention involves helping individuals who are exhibiting signs of substance use or misuse. In schools, these interventions may include screening for substance use, motivational interviewing to enhance readiness for change, brief interventions to reduce risky or problematic substance use, and referral to specialized treatment. Specialized treatment may be provided in residential or outpatient settings, including in community-based settings like schools. Substance use interventions can include programs or supports intended to support students to enhance or maintain their recovery from substance misuse.
Suicide prevention, intervention, postvention
Suicide prevention, intervention, and postvention resources and programs help school staff recognize students at risk of suicide and intervene effectively by providing referrals or access to effective interventions to a parent or guardian as well as after an event that may increase suicide risk for students (e.g., a suicide attempt or death of a peer). Resources regarding suicide postvention are critical for school staff to know what to do following a suicide death to help students and staff cope with the loss and prevent additional tragedies that may occur.
Suicide prevention, intervention, and postvention is reinforced by the following school mental health domains: mental health promotion, prevention, early intervention; substance use prevention and intervention; positive, safe, and supportive school climate; and building skills related to emotions, positive relationships, and decision-making.
Evidence Rating Definitions
Each program/practice on the best practice list has been rated based on studies of the effectiveness of the practice/program on intended outcomes. The criteria below defines how the evidence rating for each program/practice is determined.
This category includes practices and programs with strong research support. To qualify as well-supported, a systematic review of two or more randomized controlled trials will demonstrate a significant positive effect on one or more primary outcomes. At least one trial will demonstrate sustained effects at one year.
This category includes practices and programs that have support from a well-designed randomized controlled trial. To qualify as supported, at least one randomized controlled trial exists demonstrating a positive effect on one or more primary outcomes. At least one randomized controlled trial demonstrates sustained effects at six months.
This category includes practices and programs that have garnered some research support, but the research design lacks complete rigor. To qualify as promising, the practice/program must have at least one well-designed, controlled study (without randomization) demonstrating a positive effect on one or more primary outcomes or a randomized controlled trial demonstrating comparable effects to a supported or well-supported practice/program.
This category includes practices and programs where there is no controlled research to establish the benefit, but it is generally accepted as appropriate and there is no data suggesting potential harm. The practice/program should be developed in alignment with existing research evidence and clearly communicate a theory of change aligned with research.
Other Categories of Evidence
Practices and programs may also have research data to indicate there is no demonstrable positive effect or that the practice/program has a negative effect on participants. Practices/programs within these categories were not included on the list.