MTSS and School Mental Health in Practice: Exemplary Resources

Online Resource 3.1 The Mental Health Technology Transfer Center School Mental Health Initiative

Online Resource 3.2 National School Mental Health Curriculum: Guidance and Best Practices for States, Districts, and Schools

Online Resource 3.3 The University of Maryland l National Center for School Mental Health  

Online Resource 3.4 Orange County Department of Education MTSS Framework and Guides

Online Resource 3.5 Madison Metropolitan School District MTSS Toolkit

Online Resource 3.6 My School: School Climate and Culture Matters Starting Discussion Guide

“School-Based Mental Health” is not an action or an end in itself, accomplished within a framework or through screening.  Nor is it something that should only be accessible to the students who are struggling.  The following questions are useful conversation guides for you and your colleagues to discuss together to create an environment where mental health is inexorably part of your compassionate school culture, to get a variety of perspectives, and to foster discussion:

• What is your school and classroom culture around mental health and screening?  How is that fostered or impeded by school or district leadership?
• How does your school culture include and lend visibility to disabilities, mental health, and mental health problems?  How can you deepen that inclusion?
• Are school personnel educated about screening goals and logistics?  Which school personnel are included, and can you find ways to include all members of your staff?
• How do all members of the school community (teachers, staff, children, parents, other stakeholders) understand the expectations around screening?
  
  • Understanding what screening does do, and what it doesn’t
  • Cultural ideas about mental health and screening
  • Reducing stigma around mental health problems
  • Increasing compassion for different kinds of diversity, including in disability, behavior, expectations, culture
  • Increasing education on the facts of mental health myths vs facts
  • Being educated and aware of language and implicit bias
  • Privacy and issues with labelling children
• How can you incorporate facts/concepts/topics about mental health disorders into other aspects of your curriculum and culture, rather than just as a stand-alone topic?
• How can you add mindful practices and strategies for improving student resiliency into your school climate?  What resources can you draw on to do that?

If you could go to school tomorrow, and find a culture that is supportive of school based mental health, and students with diverse experiences and needs, what would that look like?

Online Resource 3.7 Choosing the right screening tool

Here is a list of some of the most widely used tools that school leaders have found useful (NCTSN, n.d.):

• Teacher’s Report Form (TRF) (Achenbach & Rescorla, 2001)
  • Measures physical concerns and strengths as well as internalizing and externalizing behaviors
  • Versions available for youth aged 1.5-5 and 6-18
  • 15 minutes
  • It should be noted that the TRF is a part of the Achenbach System of Empirically Based Assessments that includes the TRF, Child Behavior Checklist (CBC), and the Youth Self Report (YSR) and is sometimes colloquially referred to as the CBC.
• Behavior Assessment System for Children, Third Edition (BASC-3)  (Reynolds & Kamphaus, 2015)
  • Measures adaptive and problem behaviors as well as thoughts and emotions
  • Normed for ages 2-21
  • 10-50 minutes depending on which scales are included
• Beck Youth Inventory (BYI) (Beck, Beck, Jolly, & Steer, 2005)
  • Five separate inventories can be used together or separately to measure depression, anxiety, anger, classroom disruption, and self-concept
  • Normed for ages 7-18
  • 20 minutes per inventory
• Behavioral Intervention Monitoring and Assessment System (BIMAS). McDougal, Bardos, & Meier, 2011
  • The BIMAS-2 is a brief, repeatable multi-informant (teachers, parents, clinicians, self) measure
  • Useful for universal behavioral screening, progress monitoring, outcome assessment, and program evaluation.
  • Features an online Data Management System with dynamic analysis, graphing, and reporting options.
  • Assessors are able to manipulate data in a variety of ways in real time to assist in evidence-based decision-making within a Response to Intervention (RTI) or Multi-Tiered System of Supports (MTSS) framework.
• UCLA Post-traumatic Stress Disorder (PTSD) Reaction Index (Steinberg, Brymer, Decker, et al., 2004)
  • Measures exposure to traumatic events and symptoms of PTSD
  • Normed for ages 6-18, with a version for children younger than 6 available
  • 20 minutes

Online Resource 3.8 Using Screening Data

What is the point of collecting data if the data doesn’t inform practices? Do not fall into the trap of spending so much time and energy planning a comprehensive, universal screening procedure only to let the results sit and collect dust. Before screening, make a plan for what to do immediately following the screening when suspected risks become even more certain.

• First, determine the in-school resources that are available to support student mental health, including their capacity to address student needs.
• Outline how additional support will be solicited if needed, what trainings are needed, and how you can support existing staff.
• Outline the process for students who screen positive.
• Plan for how to support students who become distressed by the screening.
• Consider how you can support students who have a negative screening result, but who may still need ongoing support.
• Clarify resources that are available for students to receive special education services or advanced assessment.
• Identify and form relationships with mental health resources that are available in the community. Clarify whether they are available to your students, accepting new referrals, and whether they have expertise in the mental health issues for which you are screening.
• Create a resource list for assistance and support beyond community referrals, including for expanded education, crisis support, etc.
• Communicate to parents about follow up steps and the support available to them, including concrete ways school staff are available to help (or not).
• Clarify how follow up assessment and care will be paid for and communicate this in a transparent way to parents. 
• Establish pathways for coordination between the community and school mental health resources, including identifying how students will access those resources, and how resources will communicate with one another.
• Plan for when students leave your school for school breaks, the next level of schooling, or if they re-location to another school