Professional Documents
Culture Documents
SCHOOLS 1
Matthew J. Samocki
Abstract
MENTAL HEALTH 2
This paper analyzes mental health interventions for all students in K-12 schools such as Social
and Emotional Learning (SEL), Positive Behavioral Intervention Systems (PBIS), and
politics. Additionally, this paper includes an analysis of the Every Student Succeeds Act (ESSA)
as a funding approach for mental health interventions for all students in K-12 schools. The
findings will result in recommendations made to school leaders in order to improve K-12 school
Keywords: mental health, all students, K-12 schools, social and emotional learning,
positive behavioral intervention systems, multitiered systems of support, and the every
realize their general welfare, handle stress, work efficiently, and contribute to society (as cited in
Mental illness surveillance, 2011). Mental illness surveillance (2011) further states that in
the United States only 17% of adults are fully mentally healthy and that mental illness carries an
economic cost of more than 300 billion dollars per year. Thus, mental health issues affect the
K-12 schools across the United States deal with the same mental health issues society
faces, according to the Michigan Department of Education, who created a Mental Health Toolkit
to help educators deal with K-12 mental health issues (Mental health toolkit, 2016). To help
schools recognize mental health issues, the following are common mental health ailments
students may face: depression, anxiety, emotional, obsessive, schizophrenia, addiction, and
personality and conduct disorders (Rossen & Cowan, 2014). When people become addicted,
depressed, or anxious they do things that are not safe for themselves or for others and this is
could lead to catastrophic events like school shootings (Community Mental Health School
difficulty of finding resources for families and students with mental health issues while staff and
January 25, 2016). Therefore, to help schools manage mental health issues, mental health
resources for K-12 schools will be examined through policy research and contemporary politics
Policy Research
Mental health issues can prevent students from being successful in an academic setting
(Mental health toolkit, 2016). According to Mental health toolkit (2016) the promotion of
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positive mental health and prevention activities can help improve academic success. Gall (2000)
finds truancy decreases with mental health interventions while Corrigan (2004) recognizes the
perception that society shames those who seek mental health treatment and thus individuals are
reluctant to get help (as cited in Mental health toolkit, 2016). Despite this societal perception,
mental health services are still a necessity to help all students in need and it is imperative to
The earlier an individual receives mental health services, the greater the results (Mental
Treating students early can prevent further disability and additional (co-occurring) mental
illness, among other challenges. Early intervention activities include strategies for
building skills (e.g. coping strategies, conflict resolution) that not only address social and
emotional problems, but also decrease risk factors and improve protective factors in
Early intervention is not the only key to mental health programs, but involving all systems in an
Greenberg, Domitrovich, and Bumbarger (2001) explain that successful mental health
programs involve the home, school, and community and conclude that schools must collaborate
with community resources for continual treatment and monitoring throughout a students
education (as cited in Mental health toolkit, 2016). Therefore, to benefit K-12 schools, an
analysis follows regarding the subsequent three mental health approaches in terms of their
philosophies, costs, benefits, and abilities to handle problems equitably: Social and Emotional
Learning (SEL), Positive Behavior Intervention System (PBIS), and Multitiered System of
Supports (MTSS).
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SEL attempts to serve diverse students with multiple abilities and drives for learning. Durlak et
al. (2011) defines SEL as the process of acquiring core competencies to recognize and manage
emotions, set and achieve positive goals, appreciate the perspectives of others, establish and
maintain positive relationships, make responsible decisions, and handle interpersonal situations
constructively (p. 406). Application of a SEL model in a school involves creating safe learning
environments, involving friend and family supports, improved behavioral techniques, and school
the Collaborative for Academic, Social and Emotional Learning organization found the following
positive effects a SEL model can have in school: grade improvement, higher standardized test
scores, improvements for minority students, improved social and emotional skills, and reduced
To validate SEL findings, Durlak et al. (2011) studied 270,034 K-12 student participants
in SEL programs. Durlak et al. found that, Compared to controls, SEL participants
demonstrated significantly improved social and emotional skills, attitudes, behavior, and
academic performance (p. 405). However, the authors also discovered that under funded
programs, ineffective leadership, poorly run assessment, and lack of accountability programs
sabotage SEL models. Based on the findings, the philosophy and application of SEL fits the
needs of mental health programs, the benefits outweigh the costs, but inequity in available
A PBIS model seeks to promote positive changes in staff first, thus helping student
behavior, including early intervention and continuous monitoring (Bradshaw, Pas, Bloom,
Morrison, and Shander-Reynolds (2015) a PBIS model is not a one-size-fits-all curriculum but
analysis. Furthermore, a PBIS model can allow for access to community resources such as
universities (Cressey et al., 2015). To understand the ability of school districts to implement
programs such as PBIS, Bradshaw et al. (2012) conducted research using meta-analysis
techniques.
Maryland by collecting 12 years of data from 800 schools. The majority of Bradshaw et al.s
research focuses on the implementation of PBIS within each school district in Maryland.
Bradshaw et al. (2012) found that in successfully implemented PBIS schools, student discipline
incidents, bullying and peer rejection decreased. However, much of Bradshaws findings detail
the difficulties for schools to garner staff buy-in for a PBIS model and funding difficulties related
to training staff. PBIS shows the benefits of improving mental health for students, but the lack
of equity in resources for schools continues be the largest hurdle to implementing positive mental
health interventions.
A MTSS model addresses short-term, chronic stressors and serious mental illness for all
students (Rossen & Cowan, 2014). According to Rossen and Cowan (2014), schools can assist
as prevention, wellness promotion, identification, with early and intense interventions (Appendix
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A). In order to act as an intervention MTSS uses three tiers of support: universal wellness
promotion and primary prevention, targeted prevention and intervention, and individual/tertiary
Cowan (2014), universal wellness promotion and primary prevention includes, promoting
resilience, positive behavior and safety, developing a supportive school environment where all
students feel valued, connected, and respected, and identifying students who may be at risk for or
experiencing a mental health problem (p. 10). Universal wellness promotion and primary
prevention are attainable through MTTS by using PBIS and SEL interventions along with
positive discipline policies, universal screening, and staff training, according to the authors.
targeting school or classroom specific issues with groups of students, which can include group
counseling, according Rossen and Cowan (2014). The authors explain that for a situation such as
this, mental health professionals would assess students on their at-risk areas in order to provide
the most effective intervention along with working with classroom teachers.
and therapeutic interventions from mental health professionals including working with
community agencies and physicians who can provide intensive interventions (Rossen & Cowan,
2014). This allows for agencies outside of the school to provide continuous ongoing support,
according to the authors. Despite the positive effects of the three tiers of support, MTSS faces
implementation issues.
Forman and Crystal (2015) find that in order for to implement MTSS requires the
following:
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effective leadership, the need for the use of data-based decision making, and the necessity
of taking action in five domains: (a) intervention selection that focuses on efficacy and
(d) development of a supportive organizational context, and (e) facilitation from external
Therefore, MTSS shows the benefits of improving mental health for students, but also requires
Mental health issues are rising while school districts have fewer resources. SEL, PBIS,
and MTSS are expensive schoolwide initiatives centered on improving the students mental
health. K-12 schools should have equitable access to mental health resources despite funding
concerns. Mental health is a basic, foundational need of each child that comes into a K-12
building (Anonymous personal communication, February 1, 2016). To help all K-12 students
within mental health interventions, it is necessary for further analysis of mental health policies in
Contemporary Politics
The United States currently incarcerates roughly 350,000 adults with mental illness,
while only 35,000 beds are available within psychiatric institutions (Carey, 2014). Schools are a
vital environment to help provide early interventions to prevent an increase the number of
incarcerated adults who suffer from mental illness. According to the World Health Organization
(2003) untreated mental health issues only become worse with age. In the short term, students
suffer which can lead to long term social issues such as unemployment, civil disengagement,
incarceration, substance, abuse, lost productivity and poor health (as cited in Rossen & Cowen,
MENTAL HEALTH 9
2014, p. 8). Unfortunately, students suffering from mental illness can also lead to violence in K-
12 schools.
Within contemporary politics, focus on mental health issues within K-12 schools occurs
due to recent school shootings. On April 20, 1999, the Columbine shooting killed 13 students
while wounding 20 others (Columbine High, 2009). It is the worst high school shooting in
U.S. history and tragedies have continued at all levels of education including elementary schools
and higher education institutions (Zauzmer, 2015). These shootings highlight the recent
National Center for Education Statistics (2014), 10 million students need professional help in
the K-12 public schools nationwide (as cited in Rossen & Cowen, 2014, p. 9). The authors
estimate that of 150 students with mental health issues, 100 will graduate without receiving
adequate service. Therefore, schools are an ideal institution to begin mental health screening for
all students.
As stated by Foy and Perrin (2010), in many communities, schools are the central hub or
de facto provider of mental health services (as cited in Rossen & Cowen, 2014, p. 9).
However, schools are limited in the interventions and funding to help all students. Currently,
Individuals with Disabilities Education Act (IDEA) primarily helps students with disabilities,
according to the authors. Meaning, the majority of students have not benefited from IDEA. In
fact, the U.S. National Institute for Mental Health (NIMH) estimates that 1 in 5 children will
have suffered from a serious mental issue before becoming an adult and only 50% of those
students will seek help for those issues (Any disorder among children, n.d.; Use of mental
health services, n.d.). Meaning, unless the school is aware of a mental disorder through an
Individualized Education Program (IEP), the vast majority of students will not receive
MENTAL HEALTH 10
interventions. Despite the clear need for increased mental health interventions for all students,
an analysis of the major actors opposing different mental health solutions for all students follows.
Major Actors
(MacPherson, 2005). Kennedy (2014) recognizes that concerns exist for mental health mass
student screenings because they could uncover mental health issues, which could be untreatable
in schools. Additionally, mass student screenings could lead to misdiagnosis or over diagnosis of
students, which could lead to unnecessary labelling throughout their formative years. The
negative stigmas related to mental health treatment for all students are the foundation to
opposition for mental health interventions for all students as shown through the following major
actors in contemporary public policy formation: Republican Party, citizens, and the Bazelon
Republican Party. According MacPherson (2005) President Bush formed a 2003 federal
commission, New Freedom Commission on Mental Health, to improve mental health programs
in schools with early intervention screenings for all students in order to prevent violence. This
commission intended to prevent violence and disruption in schools, according to the authors.
Macpherson found the commission created an 86-page report to help improve mental health
interventions within schools and the United States as a whole. The report was highly disregarded
lives, according to the author. Thus, in this instance, the Republican Party was a major actor in
The Republican Party was once again a major actor in suppressing mental health
interventions for all students in 2013. Senator Al Franken co-sponsored a bill, Justice and
MENTAL HEALTH 11
Mental Health Collaboration Act, which set to authorize $40 million for United States mental
health interventions for all citizens (McEnroe, 2014). The bill faced Republican Party opposition
due to the belief that mental health interventions should be a state issue and not a federal issue
and thus a violation of the constitution, according to McEnroe (2014). The bill eventually died
Assessments for Children, mandating mental health screening of all students in their state
(Concepcion, 2013). The driving force behind the bill was the Newtown tragedy in which an
armed gunman killed 20 children and 6 staff members at Sandy Hook Elementary on December
14, 2012 (Concepcion 2013; Candiotti, Botelho, & Watkins, 2013). According to Concepcion
(2013) the bill proposed confidential screening of which the results will include reporting to
guardians. The author further stated that severe opposition for the bill, which ultimately caused
it to die, stemmed from privacy law violations (Concepcion, 2013). In this instance, no
particular group, but citizens as a whole, banded together as a major actor in order to kill a bill to
The Bazelon Center for Mental Health Law. The Bazelon Center for Mental Health
Law opposes the Helping Families in Mental Health Crisis Act that intends to overhaul mental
health care in the United States (Carey, 2014). The major reason for opposition is language
within the bill that includes involuntary treatment, such as a court-ordered therapy, according to
Carey (2014). Despite the intent of acts such as this, involuntary treatment programs have led
thousands of former psychiatric patients to become fierce critics of the mental health system
(Carey, 2014). Furthermore, Carey states Dr. Bernstein of the Bazelon Center and Dr. Nikkel
said that extending such programs would eviscerate civil right protections and further erode
MENTAL HEALTH 12
trust between patient and provider (para. 18). This bill is currently only in the introduction
become a major actor in thwarting policy formation in regards to mental health interventions for
all citizens.
In contemporary politics, the Republican Party, voting citizens, and the Bazelon Center
for Mental Health Law are three recent examples of major actors halting mental health
interventions for all students. However, opportunities still exist for mental health policies. To
grasp the complex world of political policy in relationship to mental health interventions, an
The previously analyzed pieces of opposition to mental health policies are only a few
examples ranging from concerns of citizens rights violations, federal versus states rights
arguments, privacy law violations, and involuntary treatment. Reading between the lines, once
policies extend beyond providing mental interventions to citizens with disabilities to include the
general population, opposition exists. For example, a student with an IEP may receive benefits
based on their disability such as immediate mental health help from a school social worker.
General education students rarely have the same opportunity. Due to the negative stigma related
to mental health interventions, it seems once special education and general education students are
lumped together, it makes politicians, citizens and special interest groups nervous. Political
barriers will continue to exist and cause debate during the creation of legislation to provide
mental health interventions for all students. Fortunately, the following currently existing policies
and organizations exist that will provide opportunities to continue to debate these issues and shed
light on the necessity for mental health interventions through regulated government policies:
MENTAL HEALTH 13
Affordable Care Act (ACA), Mental Health First Aid, NIMH, U.S. Department of Education, and
ESSA.
ACA. The ACA became law in March of 2010 and within the legislation, many different
aspects address mental health interventions (Lehman, 2015). Within the law, mental health
services are essential pieces of health insurance, no citizen can be denied access to insurance due
to pre-existing conditions, children can continue to be covered until age 26, home and
community based mental health services were continued and further home options are available
for those with chronic mental health issues, according to Lehman (2015). Lehman is hopeful
that the ACA expansion of insurance coverage and will allow more help for those affected by
mental health issues. Meaning, the ACA is an opportunity to help all citizens and not just those
Mental Health First Aid. Mental Health First Aid is an organization that is spreading
worldwide including the United States. The intent behind the organization is to train citizens,
physicians, and public servants how to handle situations such as an individual who reports they
are suicidal (Monette, 2012). The U.S. congress is behind the movement and recently
appropriated $15 million in funding (Mental health first aid, 2013.) Since 2008, more than
500,000 citizens received training in the awareness and intervention program, according to
Mental health first aid (2013). Mental Health First Aid seeks to help all individuals in need,
NIMH. The NIMH receives funds from congress in order to research mental disorders as
a part of the U.S. Department of Health and Human Services (About NIMH, n.d.). The
organization approves grants for communities to provide further mental health interventions
education system within the United States with a yearly budget of $68 million (U.S.
Department, 2013). In 2013, the department decided to grant $12.3 million between 35 school
districts in order to hire and train counselors, along with increasing family and community
relationships in hopes to helps schools ensure safety (U.S. Department, 2013). Hence, U.S.
Department of Education fund grants to help all in need of mental health interventions.
ESSA. On December 10, 2015, President Barack Obama signed the passage of the ESSA
into law, which replaced No Child Left Behind (NCLB) as the laws, policies, guidelines, and
regulations that educators must follow within the United States (McGrew, 2015). Due to the
newness of the legislation, much is still yet to be determined about the application and
enforcement of the policies, guidelines and regulations within the law (Anonymous, personal
communication, January 25, 2016). However, it is important to highlight the possible funding of
mental health interventions that may stem from ESSA in the years to come.
Within the legislation, there are many positive mentions of interventions and resources to
available to schools to help mental health issues (Strobach, 2015). For example, To
reauthorize (2015) recognizes mental health as a way to help the needs of all children in school.
Additionally, To reauthorize states that ESSA will help schools who qualify for sub-grants to
develop in-school programs along with creating partnerships with public or private mental health
organizations. Furthermore, the law reads that states will receive an allotment of funds to in
order to distribute to local agencies to implement mental health awareness programs and that
grants will be available to school districts to implement needs assessments, which include mental
health supports (To reauthorize, 2015). For the 2017 fiscal year, $1.65 billion is earmarked
within ESSA for the implementation of the Title IV category, 21st Century Schools, which
MENTAL HEALTH 15
communication, January 26, 2016). The drawback to ESSA thus far is the undetermined grant
2016). Despite opposition, mental health interventions continue to receive support via funding
by various groups and organizations creating opportunities for all students to benefit.
Mental health interventions within schools receive attention due to recent school
shootings and the subsequent blame on a lack of mental health interventions for the individuals
who commit the crimes. Policies related to mental health interventions in schools, not yet
including the ESSA, tend help a minority of the school population based on the specific language
within the laws. Fortunately, ESSA will allow for more flexibility at the local and state level
thus allowing for more choice when implementing all types of programs, such as mental health
policies to help address all students meets opposition due to citizens rights violations, federal
versus states rights arguments, privacy law violations and involuntary treatment. Despite recent
opposition to mental health policies, organizations continue to push the envelope for more
inclusive mental health interventions in the form of funding for already existing interventions.
Mental health will continue to be a controversial topic, thus a clear research based
recommendation follows with suggestions for an approach, support, possible criticism, and
implementation steps.
To help K-12 schools, an implementation of the MTSS model along with ESSA funding
will provide a fully comprehensive mental health intervention to help all students. MTSS is the
most inclusive mental health model as it includes SEL or PBIS interventions, as appropriate, for
all students along with tiers of interventions per each individual intervention. Dullaney, Hallam
and Wall (2013) find that in order to properly implement MTSS the following must occur: the
use of a common language regarding MTSS between buildings in school districts, district wide
collaboration and continuous monitoring of the of the implementation at all levels. The authors
also stress the importance of flexibility within MTSSs structure, which allows MTSS to be more
adoptable across more schools who seek to implement it as a mental health model. Rossen and
Cowan (2014) recognize that, schools must have effective policies and funding before they can
fully implement comprehensive mental health services, and educators should advocate for these
supports at all levels of government (p. 12). Fortunately, educators may begin implementing
MTSS models prior to full funding by using the following five methods: making optimal use of
collaboratively, tapping all potential funding sources, and engaging families (Rossen & Cowan,
2014). In order to acquire full MTSS funding, it is necessary to pursue grants from the ESSA.
Within the ESSA, it states the purpose of the grants offered, provide all students with
access to well-round education and improve school conditions for student learning (Summary
community-based services and programs, and can be partnerships with higher education
entities (p. 9). Activities within these programs will include counseling programs, conflict
resolution, evidence-based drug and violence prevention programs, mental health services,
MENTAL HEALTH 17
supporting a healthy and active lifestyle, helping to prevent bullying and harassment, relationship
building skills, child sexual abuse awareness, site resource coordinators, and technological
As MTSS is the chosen approach to address K-12 mental health interventions for all
students, through ESSA funding, the following policy implementation instruments will provide
to highest opportunity for success: inducements, capacity building, and hortatory policy.
Chosen Approach
instruments as a way to understand the intended goals of the proposed policies: mandates,
inducements, capacity building, system changing, and hortatory policy. More specifically, the
instruments analyze the conditions under which these instruments are most likely to produce
their intended effects (p. 223). To implement MTSS through ESSA, inducements, capacity
building and hortatory policies are a key policy instruments for K-12 school districts.
transfer of money (or in-kind grants) to individuals or agencies in return for the production of
goods or services (as cited in Fowler, 2013, p. 225). The ESSA will award grants in order for
K-12 school districts to implement MTSS in order to provide mental health interventions for
schools.
Capacity building. Capacity building will also work well as a policy implementation
tool for MTSS due to the necessary training involved for K-12 staff, public agencies, parents,
and students. Capacity building works well with K-12 mental health interventions because by
definition, capacity buildings goal is to train, people and institutions, capable of implementing
desirable new programs and policies (Fowler, 2013, p. 227). Training will then help serve the
MENTAL HEALTH 18
needs of all parties involved in the implementation process, which will ultimately benefit all
Hortatory policy. Hortatory policy, as a form of persuasion, is the last McDonnell and
Elmore policy implementation tool, which is appropriate for the implementation of MTSS
through ESSA (Fowler, 2013). Hortatory policy helps persuade K-12 students, parents, and
community that mental health interventions are necessary and should be available without a
negative stigma as a way to help all students, not just those with disabilities. A slogan such as
everyone needs a little MTSS can help spread the message that MTSS is an all-inclusive
mental health model focused on helping all students. Regardless, the implementation of MTSS
will not be without criticism because of the opposition that exists for legislation meant to address
Criticism
As state earlier, mental health opposition ranges from concerns of citizens rights
violations, federal versus states rights arguments, privacy law violations, and involuntary
treatment. However, the distribution of funds through grants related to currently existing
legislation receives little resistance once the law exists. Additionally, a group or organization
may provide funds to help support mental health interventions, which again, garners little
resistance as the group or organization can decide to distribute their money as they see fit.
Therefore, because the ESSA is a new law and enacting the law requires gaps to be filled,
I recommend using the ESSAs language which states, providing all students with a well-
rounded education as a catalyst to acquire funds to implement mental health interventions for all
K-12 students (Summary of Every, 2016, p. 8). Unfortunately, the issue of equitable
distribution of mental health interventions will still exist due to the yet undetermined qualifying
MENTAL HEALTH 19
nature of the grants and the limited budget the U.S. Department of Education has to fund the
ESSA.
Implementation
K-12 schools are not medical facilities, but the use of MTSS allows schools to improve
collaboration and make the best use of the expertise of both community providers and of mental
health professionals on staff (Rossen & Cowan, 2014, p. 8). Our schools and communities will
be a safer place when mental health issues are addressed (Anonymous, personal communication,
February 1, 2016). Therefore, the ESSA should fund MTSS models in K-12 schools to help
provide mental health interventions for all students. The following are my recommendations for
policy formation, implementation, and evaluation of mental health interventions for K-12
Schools:
2. Using data from the surveys, apply for ESSA grants to implement MTSS.
5. Use assessment and identification tools to identify students at-risk and in need of mental
health interventions.
6. Take into account the unique culture of the school and each student prior to interventions.
7. Work with the community agencies, families, and school staff as apart of continuous
observations.
8. Be aware of the unique aspects of each school to avoid interference with instruction
and/or violation of school law prior to the implementation of MTSS as a K-12 mental
health intervention.
MENTAL HEALTH 20
9. Evaluate the effectiveness of the policy through data collection methods such as office
referrals, incident reports, truancy, grades, and surveys to staff, students, parents and
10. If necessary, adjust the MTSS model based on the evaluation of its implementation.
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Appendix A
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