Mental Health Toolkit: 

A Guide for Students on Mental Health in Schools 

 
 
 
 

 
 
Chapman University 
Marleen Castillo, Brittany Diaz, Kassondra Heacock, Hayleigh 
Herrera, Ashley Ho & Nancy Nguyen  
 

Table of Contents    
Introduction​………………………………………………………………………………. 2
What is mental health? ​………………………………………………………………. 2 
What is positive psychology? ​…………………………………………………………. 2 
What is wellness? ​………………………………………………………………….... 3 
What is a systems approach to mental health? ​…………………………………………... 3-4 
Statistics​ ​…………………………………………………………………………….... 5-6 
Common Diagnoses and COncerns​ ​………………………………………………………. 6-7 
Risk Factors ​…………………………………………………………………………… 8-9 
How do schools play a role? ​…………………………………………………………….. 9 
What are specific roles of individuals in the school? ​………………………………………. ​ 0 
1
Student Rights ​…………………………………………………………………………. 11-14 
Steps in Addressing School-Wide Mental Health ​……………………………………….….. 14-15 
School Policy ​…………………………………………………………………………... 15 
What is a mental health Screening?​ ​………………………………………………………. 15-16 
Progress Monitoring ​…………………………………………………………………….. 16-17 
Multi-Tiered Systems Support ​……………………………………………………….…. 17-18 
Tools and Resources ​…………………………………………………………………... 19 
Frequently Asked Questions ​……………………………………………………………. 20-21 
Appendices​ ​……………………………………………………………………………. 22-27 

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Introduction: 
As a high-school student, you are going through many changes and are developing both physically and 
mentally. There are going to be things in life that are stressful or challenging, and these obstacles can 
sometimes be tough to overcome without some support from the people around you. As your school 
counselors and school psychologists, we have created this Mental Health Toolkit for you as a 
reference to learn more about mental health. This toolkit provides definitions, explanations, examples, 
and resources that can help you gain a better understanding of your own mental health, and how you 
can help promote it in and outside of school.  

What is Mental Health? 

Mental health encompasses what it means to be emotionally healthy (or emotionally unhealthy). This
includes what we think about ourselves, how we cope with unpleasant experiences, and how we feel day
to day. It is important to know that if you are occasionally sad, stressed or anxious, there is nothing
wrong with feeling this way. If, however, these feelings become overwhelming, consider talking to
someone you trust.

What is Positive Psychology? 

Positive Psychology is about taking a strength based approach to psychology. It moves away from the
deficit model (i.e. identifying and treating problems) and focuses on what is going well (i.e. Identifying
things that are good and fostering them). Positive psychology encourages us to be proactive in our goal
of being mentally healthy, instead of just ‘treating’ our mental health concerns with drugs or medication.
Positive psychology says that being free from disease is not the same as living well. In order to be the
best version of ourselves, we need to do more than manage the bad; we need to promote the good!

 
 

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What is wellness? 
Wellness refers to general well-being. It goes beyond being emotionally healthy and enters the territory
of “thriving.” Wellness is a conscious process of doing things that help you to be a better version of
yourself. There are many ways that someone can be “well,” whether it’s fostering a certain hobby,
engaging in positive relationships, or finding what gives your life a sense of purpose.

What is a systems approach to mental health? 

A systems health approach looks at all the different aspects that can impact a student. Picture 
yourself as the middle piece of a giant puzzle; a systems health approach looks at all the surrounding 
pieces of the puzzle that have the ability to influence you in both small or big ways. Using the image 
below, try and think about the things that influence your life right now. 

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Below are the definitions of these systems to help you come up with examples.

● Microsystem:​ your small, immediate environment. Example = your school or immediate family.
● Mesosystem:​ the interactions between the parts in the microsystem. Example = your teacher has a
conference with your parents.
● Exosystem:​ other places and people. Example = your extended family or or parents’ workplace
● Macrosystem​:​ social and cultural values. Example =
the government, war

What is a ​system-of-care​? It is a philosophy of how care

should be addressed and delivered.

● A system of care is also a coordinated network of

community-based services and supports that are
organized to meet the challenges of children and
youth with serious mental health needs and their
families.
○ To the right, you can see just what kind of
different services can affect you and your
environment.

In the table below are examples of the types of services

seen in the image to the right.

Transportation Services the buses that pick up and drop off students to and from school.

Mental Health Services an available school psychologist or counselor on campus for

students to talk to about an issue.

Social Services a school psychologist that works with a student’s family.

Recreational Services adaptive physical education (APE) in addition to general physical

education.

Educational Services available on campus tutoring before and after school.

Vocational Services a school that promotes their students to participate in recreational

occupational program courses that are offered.

Substance Abuse Services a school that engages in ​school-wide prevention projects and
provides classroom lessons to teach about substance abuse.

Health Services health clinics in schools that offer students regular health care
assessments.

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 ● The three “C”s for success​: communication, collaboration and coordination.

● Why is this important?

○ When your school uses a systems approach when promoting adolescent health, they are
making sure that you succeed not only in school, but also at home and in your community
as well.

(Sources:
https://csmh.umaryland.edu/media/SOM/Microsites/CSMH/docs/Resources/Briefs/SystemOfCareBrief.pdf

​www.naesp.org/communicator-april-2011/ed-s-perspective-systems-approach​)
 

Statistics 
It is important for schools to address mental health concerns as early as possible. Typically, schools 
have certain programs and protocols in place that help address and support students with mental 
health needs. Mental health issues are more common than you may realize. It is also not something to 
be embarrassed of, but rather to be aware of. The following are some statistics that will give you a 
better idea on how common mental health issues are.

Prevalence  
● 1 in 5 children, ages 13-18, suffer from a
mental health condition.
○ Only 50% of those children receive
the treatment they need.
● Conduct or behavior disorders affect 10% of
youth.
● 9% of youth have Attention Deficit
Hyperactivity Disorder.
● 8% of youth have an anxiety disorder.
● 11% of youth have a mood disorder, such as
major depression.

Impact 
● Suicide is the 3rd leading cause of death for
youth aged 10-24.
○ In 90% of suicide cases, there was
an underlying mental health issue.
● About 50% of students with a mental illness, 14 years or older, end up dropping out of school
● 70% of youth in the juvenile justice system have a mental health issue

What can you do? 

Speak to someone! Your school counselors, psychologists,
teachers, and parents are all there to help you. Connecting with
someone can result in getting the help you need.
● If you see warning signs in a friend or a classmate that
you’re worried about, or even in yourself, don’t be afraid to tell
someone.

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 Warning signs can include:
● Drastic changes in behavior such as severe mood swings (going from very happy to very angry
quickly), worry to the point where it’s hard to concentrate in school, suddenly becoming scared or
paranoid for no reason.
● Risk-taking behavior such as using drugs and alcohol
● Feeling sad or withdrawn such as not interacting with your peers or teachers for more than 2
weeks
● Not eating which results in significant weight loss, or gaining a large amount of weight

(Source: https://www.nami.org/getattachment/Learn-More/Mental-Health-by-the-Numbers/childrenmhfacts.pdf)

Common Diagnoses & Concerns  

There are several common diagnoses that doctors and 
mental-health professionals have for children and 
adolescents; this is because many symptoms start to 
appear as children transition to adolescence. Below is a 
list of some of the most common diagnoses. However, 
these are just signs, and you should talk to your doctor 
about any symptoms you are experiencing.  

Inattention 
The common diagnosis: Attention Deficit/Hyperactivity
Disorder (ADHD)
● Symptoms of inattention are often first observed by
teachers and parents.
● They may notice a student who is unusually easily distracted, is often daydreaming, and has
difficulty completing homework assignments and following directions.
● While all children, especially those who are very young, tend to have shorter attention spans than
adults, some children have much more trouble focusing than others.
● Inattention that is outside the typical range is one of the three key symptoms of ADHD, along with
impulsivity, and hyperactivity. Impulsivity is doing something without thinking about the
consequences, like running across the street without looking both ways. Hyperactivity is when
you are really excited to do something, so you can’t sit or stand still.
● So, when students are unusually distracted, ADHD tends to be the first thing parents and doctors
suspect. However, there are many other possibilities that can be contributing to inattention.
Other possible diagnoses: Obsessive Compulsive Disorder (OCD), Post-Traumatic Stress Disorder
(PTSD), Learning Disorder

Sadness, Fatigue, and Difficulties Thinking Clearly 

The common diagnosis: Depression
● Symptoms of depression include feelings of sadness, decreased interest in usual pleasurable
activities, fatigue, weight changes, and difficulty concentrating.
● While it is normal for everyone to feel “down in the dumps” sometimes, students experiencing
sadness or moodiness that lasts for more than two weeks and it weakens their ability to function
in daily activities may be experiencing depression.
Other possible diagnoses: Hypothyroidism, Anxiety Disorder

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Restricted Speech/Social Interaction  
The common diagnosis: Autism
● Autism is a developmental disorder that causes a child to have impairments in communication.
Children with autism may have a delay in (or complete lack of) the development of spoken
language.
● Autism may first be noticed by school professionals, who become aware that the child is not
interacting socially with his/her peers in an appropriate way.
● Signs of autism are usually noticed between 2 ​to ​3 years of age. Although many children on the
spectrum do speak, they may use language in unusual ways, avoid eye contact, and spend a lot
of time alone.
● Autism includes a wide range of symptoms, which is why it’s called Autism Spectrum Disorder.
So, not everyone who has autism has the same, exact symptoms.
Other possible diagnoses: Selective Mutism

Disruptive Behavior 
The common diagnosis: Oppositional Defiant Disorder (ODD)
● Disruptive behavior is more than the occasional temper tantrums or outbursts
● When kids repeatedly lash out, are defiant, or can’t control their tempers, it can seriously impair
their functioning in school and cause significant family turmoil. Often, these children are thought
to have oppositional defiant disorder (ODD)
● ODD is characterized by a pattern of negative, hostile, or defiant behavior. Symptoms of ODD
include a child losing his temper, arguing with adults, becoming easily annoyed, or actively
disobeying requests or rules.
● In order to be diagnosed with ODD, the child’s disruptive behavior must be occurring for at least
six months and be negatively affecting his life at school or at home.
Other possible diagnoses: ADHD, Anxiety Disorder, Learning Disorder

As you can see, there are many symptoms that overlap. To get the right diagnosis and proper 
intervention, seek a mental health professional for help. The resources listed at the end of this 
Toolkit can help you and your parents find a mental health professional near you.  
 
(Source: Spiro, L. (2016). ​The Most Common Misdiagnoses in Children​. Retrieved from
http://childmind.org/article/the-most-common-misdiagnoses-in-children/)

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Risk Factors
A risk factor is something that can increase the likelihood of 
developing a disorder or condition. Risk factors can come from 
many sources. Biological factors, such as genetics, social factors 
such as your relationships with friends, and psychological factors, 
such as your level of self-esteem are all examples of potential risk 
factors. Please note that just because you have one or more of 
these risk factors, it does not mean that you definitely have one 
of these disorders.  

ADHD (Attention Deficit/Hyperactivity Disorder) 

● If your parents or siblings have ADHD, you are 3 to 5
times more likely to have it as well.
● If you had a low birth weight as a baby.
● If your mother smoked, or was exposed to toxins during
pregnancy
● If you had an injury to your brain from trauma, brain tumors, strokes or diseases
(Source: ​http://adhd-adduce.org/page/view/54/Risk+factors+and+causes+of+ADHD​)

Depression 
● If an immediate family member with depression or mood disorders can increase your risk for
developing depression.
● If were exposed to early childhood trauma such as: abuse, neglect and poverty
● If you have a history of substance abuse with drugs and/or alcohol
● If you have other mental health disorders such as anxiety, eating disorder or post traumatic stress
disorder.
● If you have low self-esteem, and you think of yourself in a negative way (you will find a
self-esteem quiz in the tools section of this toolkit)
● Depression can also be a side effect of some medications you may be taking
(Source:http://www.healthline.com/health/depression/risk-factors#Social3)

Autism 
● If your mother was over 35, or your father was over 40 years old when they had you.
● If you had a low birth weight as a baby.
● Boys have a higher chance of being diagnosed with autism because X chromosome differences.
● If you are a twin, you are 37-90% more likely to have autism.
● If you have older siblings with autism, there is a 1 in 5 chance you may develop ASD.
(Source: https://www.autismspeaks.org/site-wide/autism-risk-factors) 

ODD (Oppositional Defiant Disorder) 

● If the parent(s) has a history of attention-deficit/ hyperactivity disorder (ADHD), ODD, or conduct
disorder (CD)
● Brain-chemical imbalance: Either a lack of or too much of certain chemicals
● If you had a mother who smoked during pregnancy or was exposed to toxins
● Parents that are too harsh or inconsistent with their discipline or even neglectful
● Coming from poverty
(Source:https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/odd/odd_resource_center_odd_guide
.pdf)

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Again, if you have any of these risk factors, it is important not to stress out and diagnose yourself 
with having a mental health condition. Your best bet is to speak to your parents and your doctor 
about the risk factors you have, and get a proper explanation and accurate diagnosis that way.  

How do schools play a role?  

Promoting positive mental health 
To prevent mental health issues from occurring, schools can do their part in creating a positive school
climate. According to the National School Climate Council the following work together to create a positive
school climate:
● Having norms, values, and expectations that promote social, emotional, and physical safety.
● People are respected (i.e. students, parents, teachers, and school staff).
● Everyone in the school works together to develop a the school’s vision.
● Everyone contributes to the carrying out the school’s vision

When schools create a positive school climate, researchers have found that many problems that face our
schools, such as absenteeism, substance abuse, and bullying are reduced. Furthermore, a positive
school climate promotes students’ academic achievement, motivation to learn, and overall psychological
well-being.

Identifying mental health issues 

Because students spend much of their day in school, school personnel play a pivotal role in identifying
warning signs of a mental health condition. Teachers can identify those students who are having a
difficult time adjusting, recess monitors could identify students who are bullying and being bullied, and
counselors can create school-wide action plans to address the common needs of these students.

Treating identified mental health conditions 

School staff can help students by linking them to resources, creating support teams on their behalf, and
giving them short term counseling (and referring out for any longer term counseling). They can work with
students, parents, and teachers to give the students the support they need to be successful in school
and in life.

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What are specific roles of individuals in the school?  
All school staff should be working to promote positive mental health and awareness, but there are some
individuals within the school who have more specific roles in supporting students.
 
Note: These descriptions are meant to give the reader a general sense of what the role entails and 
to raise awareness. It is not meant to be fully representative of all responsibilities and duties of 
these positions, as school districts all vary. However, all of these roles work together with parents, 
students and administration in order to effectively provide the support and resources necessary to 
promote student success. 
 
● School counselors​ ​generally work directly with the students in both mental health and academic
aspects. This includes career development, college applications, financial aid, class scheduling
as well as counseling for both academic and mental health issues, crisis intervention, and
referrals for students to outside services.
● School psychologists ​support students’ ability to learn through assessments and testing to
determine any potential disabilities for special education services. Additionally, they also may
counsel students, deal with crisis interventions, and provide referrals for students. Although this
role in most schools generally involves working with the special education population to improve
learning in the classroom, others can also provide mental health support.
● Social Workers​ help provide mental health services to families and work with students to get the
support and services they need. They act as the liaison between the community, family, and
school by providing access to community resources that can alleviate financial or family stress.
● Nurses​ are responsible for health education and services such as administering medication and
dealing with physical symptoms. Along with providing a safe space to deal with medical issues,
they can provide education for parents and students on their conditions. Nurses also conduct
screening for problems in vision, hearing, etc. as well as document allegations or evidence of
abuse.
● Community-based Mental Health Providers ​deliver direct services such as one-on-one or
group therapy and support groups that teach coping and social skills. Furthermore, they can also
provide referrals to other community services and help educate school staff with workshops and
professional development regarding mental health.
● Teachers​ spend the most amount of time with students. As a result, they are often the first to
notice warning signs. Teachers can also incorporate lessons on mental health into their
curriculum.

(Source: ​www.units.miamioh.edu/csbmhp/network/toolkit.pdf) 

 
 
 
 
 
 
 

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Student Rights 
Confidentiality​:​ Confidentiality is the right to privacy of conversation between a counselor and a client.
● Rights of Confidentiality 
○ As a minor, you have the right to private conversations with your counselor or your mental
health worker.
○ Teachers and school administrators may not be bound to confidentiality: they may have to
share information that you share with them to principals, counselors, and parents about
your school performance, etc.
○ As a student, you have the right to know the when (times when it applies) and who (the
people who these rules apply to) confidentiality includes.

● Breaking Confidentiality 
○ There are times when mental health workers will need to speak to others to make sure
you are being safe and receiving the best treatment, but your counselor or school
psychologist will go over the what the next steps would be.
■ Harm to self:​ When you threaten to hurt yourself. This can be suicidal threats and
planning
■ Harm to others:​ When you are threatening to seriously hurt someone else, the
counselor must warn that person and tell the appropriate people of your threat.
■ Mandatory Reporting:
● When you report abuse of yourself or of another child, the school staff you
tell must report it to Children Protective Services (CPS) in order to make
sure you are safe.
○ Other times confidentiality would need to be broken is when a counselor needs to speak
to your parents, teachers, or other mental health providers. Sometimes, a counselor will
■ If your counselor needs to speak with these individuals, then the counselor is
required to inform you before contacting these people. Your counselor should
review what information he or she will be sharing. Any sharing of information will
be on a need to know basis: information will be shared only if it needs to be shared
with that particular party.
● Protection of Pupil Rights Act (PPRA) 
○ Schools will need your parents’ consent before they can share information about personal
practices, and evaluations to outside parties
● Family Educational Right to Privacy Act (FERPA) 
○ Both legal parents have rights, even when separated or divorced, to view educational
records of their child until the students becomes the age of 18
○ This means that the your parents have access to all your educational records, including
grades, disciplinary actions, and classes you are taking.
○ When you are 18 or older, you have the right to view your records and the right to withhold
educational records or information
● The Health Insurance Portability and Accountability Act (HIPAA) 
○ Parents have the same rights as the underage patient to access medical records. In
schools, any medical records must be held confidential unless written consent is given by
parents. Nurses and those involved with your medical care do have access to medical
records, but are unable to share any information with outside parties (this includes
teachers and counselors) unless given consent.

Consent: ​Consent is the formal and voluntary permission given to mental health workers and
organizations for providing services to patient or a client. If you are under the age of 18, consent is given

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by parents or legal guardians. Before giving consent, parents have the right to be fully informed about the
scope of practice, services, and their rights as parents.

If you are underage, you have a the right called ​“assent”​: this is your given permission to participate in
services. As a minor, you have the right to be fully informed about the scope of services and your rights
receiving these services. Providers should do this in a way in which you can easily understand your
rights. If not, you have the right to ask questions! Feel free to ask your mental health worker to explain
things if you don’t understand it.

**In California, minors have the right to consent to services without the need of parental consent. 
Below are the services and ages when a minor can give consent. 

● Abortion:​ You do not need parents’ consent for an abortion. No one will be able to inform your
parents without your consent. You have the right to keep your abortion private from your parents.

● Birth Control: ​You ​do not​ need parents’ consent for birth control (except for sterilization). No
one will be able to inform your parents without ​your consent​. You have the right to keep access to
birth control private from your parents.

● Pregnancy:​ You ​do no​t​ need parents’ consent for services for prenatal services. This means
you do not need parents’ consent to get medical help related to your pregnancy. No one will be
able to inform your parents without ​your consent​. You have the right to keep your pregnancy
services private from your parents.

● STDs:​ If you are ​12 years or older​, you ​do not​ ​need parents’ consent for medical treatment for
Sexually transmitted diseases (STDs). No one will be able to inform your parents without ​your
consent​. You have the right to keep the treatment of STDs private from your parents.

● HIV Testing: ​If you are ​12 years or older​,​ ​you ​do not​ need parents’ consent for to receive
testing for HIV. If you are ​under the age of 12​, then you will have to take some tests to make
sure you are competent (able to make sound and reliable decisions) before testing. No one will
be able to inform your parents without ​your consent.​ You have the right to keep your HIV testing
private from your parents.

● Outpatient Mental Health Treatment: ​If you are ​12 years or older​, you can consent to
outpatient mental health treatment without parent’s consent. Even though you give initial consent
to services, parents will need to give consent for further services. For example, if you see a
therapist outside of school about feelings of anxiety and school performance, you can give
consent for the initial meeting. Any further counseling will need the consent of your parents.
Mental health workers will try to notify parents about mental health services you are receiving, but
may withhold information if the professional believes it is inappropriate to share with parents.

● Alcohol/Substance abuse Treatment​ If you are ​12 years or older​, you ​do not​ ​need parents’
consent for medical treatment Alcohol/Substance abuse treatment. No one will be able to inform
your parents without ​your consent​. You have the right to keep the treatment of alcohol and
substance abuse treatment private from your parents.

● Rape:​ If you are ​12 years or older​, you ​do not​ ​need parents’ consent for medical treatment for
Rape. No one will be able to inform your parents without ​your consent​. You have the right to
keep your rape treatment private from your parents.

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 ● Sexual Assault: ​You ​do not​ ​need parents’ consent for medical treatment for sexual assault. A
mental health worker must try to call parents about the incident, unless the mental health worker
suspects the parent or guardian to be responsible for the assault.

Rights within Mental Health Services

The right to be informed:​ As a participant in mental health services, you have the right to be fully
informed about your rights, the scope of practice, and any changes that may happen in services. If you
have any questions, you have the right to get them answered! If you are unsure of something at any
point in the service, you have the right to get further explanations from your provider.

The right to participate in services:​ As a minor and a student, you have the right to participate in the
mental health services provided by your school. You also have the right to know what other services are
provided to you in your community if your school cannot provide the services you may need. At the
same time, you have the right to de or to stop services at any time (unless the services are mandatory or
required by law (refer to breaks in confidentiality above)).

If you have a disability, you have certain rights as a student. Here are the rights of students with
disabilities under national law:

● Individuals with Disabilities Education Act (IDEA)​: This law provides the right for students to
be evaluated for special education services. This does not mean that if you have a disability you
automatically qualify for services nor does it mean if you have a disability you will automatically
be placed in special education. This law means you have the right to access services if your
disability significantly interferes with your education. To qualify, school staff will evaluate your
performance in school through several different ways: possibly through tests, your records,
observation, and interviews with those involved with your education. If you qualify for services,

13
 then the school’s ​Individualized Education Program (IEP) team will create a plan to best suit your
educational needs​. If you are a minor, parents or guardians will usually be the one to request
services, give consent to services or request changes to services on your behalf. Teachers may
also request that you be evaluated for services. If you are competent (the law deems that you are
capable to make your own decisions) and 18 or older, you have the right to to decide what special
education services you receive and the right to accept or decline the plan from the IEP team. In
special education, you have the right to free and appropriate education (FAPE: not having to pay
for these required services and to be placed in the classes and services that you best benefit
from), and be held in the least restrictive environment (have the most class time with your peers
outside of special education services as appropriate for your education). Also, if there are any
conflicts with your special education plan, your parents or you have the right to dispute. For
further explanations, you can refer here:
https://www.understood.org/en/school-learning/your-childs-rights/basics-about-childs-rights/at-a-g
lance-which-laws-do-what
● Section 504: ​Students with disabilities have the right to accommodations in their education and
the right for freedom from discrimination. For example, if you have a disability, schools cannot
deny your participation in school activities like sport tryouts, dances, or field trips because of your
disability. This also means you have the right to accommodations within your education.
Accommodation are adjustments to your education, like extended test times or a special room to
take a test, that do not need special education services. These accommodations will be decided
by the Student Success Team (SST) which could include your counselor, teacher, school
administrators and/or parents.
● Americans with Disabilities Act (ADA):​ Under this law, you have the right to be free from
discrimination in school due to your disability. This is similar to the rights under Section 504
above.
 

Steps in addressing school-wide mental health 

When we talk about how to incorporate mental health education and awareness in schools, one of the best 
ways to get students and staff involved is to have a school-wide plan. This means that everyone in the school 
should learn the steps to addressing mental health, so that we can support each other through difficult times 
and know exactly what to do in a crisis.  
 
Step 1: Get to Know Your School  
● Find out if your school has a committee that allows students, like yourself, to join. You are an
expert on what happens at school every day, so your opinions about programs or services can
help schools change for the better.
● If your school counselor asks you and your classmates to complete a survey about your thoughts
on the mental health services on campus, be honest in your answers. This is your chance to
improve the school, so if something needs to be changed or added let the school know.
Step 2: Become Familiar with Mental Health 
● Take opportunities at school and in your community to learn about mental health. Ask teachers,
staff or counselors how you can learn more. Being knowledgeable about this topic can help you
understand that mental health concerns are common, and that there are people you can talk to
who want to help.
Step 3: Be an Advocate  
● Stand up for yourself and your peers if you see that they are struggling with something personal
or mental health related.
● Respect the privacy of others, but if you feel that you or a peer need to speak with a mental
health professional, visit your school counselor or school psychologist.

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Step 4: Know What Resources are Available to You 
● Most schools have mental health related lessons that all students participate in, such as bullying
awareness or anxiety counseling.
● Know that if you need more help than what is provide to all students, there are additional ways
you can get help. All you have to do is ask your school counselor or psychologist.

School Policy 
What is a policy? 
A school district policy represents the goals of a school community. It is how the school district promotes 
student health and wellness. Policies also help everyone understand how to “operate” or act on a daily basis. 
They guide everyone in the school and specify who is responsible for what goes on. They also make sure to 
involve the surrounding community and work with them to make sure all students needs are met. Schools have 
policies on all kinds of topics such as harassment, threats, crisis response, substance abuse, and many more.

What does a policy look like?  

A school district policy that addresses mental health would be outlined in the following 8 steps.
1. Rationale:​ This is the “why” part of the policy. This tells why it is important.
2. Definitions:​ this describes the definitions of the terms used in the policy.
3. Authority: ​the tells who is in charge when certain things happen.
4. Delegation of responsibility for prevention of unsafe or unlawful behavior:​ this​ ​section tells
people in school who is responsible for making sure everyone is doing what they are supposed to
be doing.
5. Procedural guidelines that outline the actions that are taken by staff once a policy is
violated:​ this sections describes what needs to be done to keep schools a safe learning
environment and also identifies who to go to when problems happen.
6. Intervention: ​this tells us what behaviors are and are not acceptable in school and gives plans of
how to support and help kids with mental health disorders.
7. Identification:​ tells the staff in a school the “when and where” problems may or may not come up
with students.
8. Assistance and referral: ​gives the school staff resources to better help students with issues that
they cannot assist with.

What is a Mental Health Screening?

As a student, you spend a large amount of your day at school, and should feel like 
you can speak to a mental health professional one-on-one in a private setting. 
However, school professionals may conduct a mental health screening for all 
students. A mental health screening is like a check-up for all students at a school, 
and helps school counselors and school psychologists identify students who may be 
in need of mental health services. This is similar to how pediatricians and physicians 
screen children for symptoms of a physical condition. You can see an example of a 
mental health screening in Appendix B. 

Mental health screenings allow school-based mental health 

professionals to: 
● Enhance outreach and help to all youth in need
● Provide early treatment

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 ● Connect students to effective mental health services
● P​romote student mental health while encouraging learning

Why do school-based mental health programs work? 

● Programs are sensitive to students’ and family culture
● Easy access for mental health services in communities where services are not widely available
● Removes the negativity students may feel about mental health services
● Having programs at school lets teachers spend more time teaching
● Fewer behavior problems school-wide

**Early ​treatment may lessen long-term disability and prevent years of suffering. Health care 
screenings are common in the US, and mental health screenings should be no exception. If you are 
curious to learn more about whether your school provides mental health screenings, ask your school 
counselor or psychologist for more information.  
 
(Source: http://schools.nyc.gov/Offices/Health/SBHC/MentalHealth.htm)
 

 
Progress Monitoring 
 
What is Progress Monitoring? 
Progress monitoring is a way schools can
keep track how students and teachers are
performing. This can be done on an
individual, on a classroom, to an entire
school level. If there is a new program in
place at your school, administrators would
want to know know how effective it is. This
is where progress monitoring comes in:
using various assessments, the school can
see whether the program is meeting the
intended goals. Think of progress monitoring as a report card for the different programs in place at your
school. From this progress report, the school can determine areas of improvement or if the program is
doing what it is intending to do. For mental health, progress monitoring focuses on social factors and
behaviors and how interventions are changing the rates of certain behaviors and perceptions.

How do schools establish progress monitoring? 

Schools use data from the beginning of the year or from previous years before program implementation.
These data can come from the screening process, teacher ratings, parent reports, and various other
sources to establish a “base point” (You can see an example of a student progress monitoring form in
Appendix C). From there, teachers and staff can use the same tools as before to know whether
interventions are working or what areas need more time and care throughout the year. Depending on
the program, this can be done weekly, monthly, quarterly, and so-on. Then from these results, teachers
and staff can determine what areas need to be changed, focused on, or improved. Schools could also
graph this information to visually show the progression of students.

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During mental health interventions, your mental health worker may ask you to take multiple assessments
during treatment. Your counselor will send out rating forms to teachers and parents asking them to rate
you behaviors throughout treatment. This gives the counselor a better idea of what aspects of the
intervention work and what aspects in your school life that may need changing. Progress monitoring can
be handled by your school counselor or another mental health worker.

Sometimes, mental health professionals may ask you to do your own self-monitoring. This is usually
done when you have a more individual intervention. This helps you create habits of checking in on your
own behaviors and helping you take control of your own behaviors.

How does Progress Monitoring 

help the schools? 
Progress Monitoring gives schools the
data to determine what parts of
intervention, teaching, and policies are
working or need improvements. The
ultimate goal of the programs in place
for the school is to ensure overall
well-being of students. Progress
monitoring ensures that whatever
program is in place at the moment, that
it is helping to make students meet
goals of overall wellness.

 
Multi-Tiered Support System 
This triangle is created as a visual to help meet the needs of all students. Tier 1 is the biggest 
because the whole school is included in this part of the triangle. Tier 3 is the smallest because fewer 
students need individual help for their mental health challenges. Please remember that you do not 
stay in one tier throughout your time in school, you may move through the pyramid. This is a way for 
teachers/school counselors/school psychologists to use specific strategies to help students in each 
tier.  

Tier 3-​ ​Individual support for students with

identified mental health challenges that limit
their participation throughout the school day.
The level of individual support is based on the
specific mental health challenge and formal
diagnosis that the student receives from a
doctor. For example, a student named Rebecca
is formally diagnosed with Autism, and she
specifically has trouble writing and controlling
her emotions. Her aid attends classes with her
to help Rebecca write her papers and use
strategies she is learning to control her
emotions. Rebecca needs individual support to
get her through the school day, which qualifies
her for individual tier 3 support.

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Tier 2-​ ​Students are carefully selected because they are at risk for mental health or behavior
challenges. Small group gatherings and weekly meetings are common in this tier. An example would be
a group that meets once a week during lunch for students who have anxiety. The facilitator teaches ways
to cope with anxiety, while the students learn from each others’ ways of handling stress and anxiety as
well.

Tier 1-​ ​The entire school receives these services, even if some students do not demonstrate behavioral
or mental challenges. The purpose of tier 1 support is to educate the whole school about mental health
and the stigma it brings. An example would be a counselor speaking in each health class about the
general forms of anxiety, and strategies on to how to handle stressful situations. Another example would
be programs for drug and alcohol education or sexual education in the school that is accessible to every
student.

(Source: everymomentcounts.org)

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Helpful Resources (to learn more!) 
We know that this is a ton of information and can be a little overwhelming. That’s why in this section 
of our toolkit, we have provided some resources for you to explore and learn about mental health in 
your own free time. We suggest that you look over these resources with a parent or guardian, in 
case you have questions or aren’t sure what something means. Remember, learning about mental 
health helps you help others! 
 
Learn More about Mental Health 
Mental health overview →​ http://teenmentalhealth.org
This website provides you with an overview of mental health. Using the tabs at the top of the homepage,
you can explore and learn more about a ton of cool mental health topics. Some topics included under the
LEARN tab explain the different mental health conditions, the importance of sleep for teenagers, and
how a teenager’s brain works. The LIVE tab explains what the word “stigma” means, how it relates to
mental health, and provides stories of other teenagers who have overcome their mental health concerns.
Take some time to browse the other tabs like CARE, EXPLORE, and TOOLBOX for more great (and
free!) resources available to you on this website.

Learn More about Yourself 

Where to get help →​ ​https://www.mentalhealth.gov/talk/young-people/
This website offers ways you can ask for help if you are experiencing symptoms of a mental health
condition. It provides interesting facts about mental health, hotline phone numbers to call if you need
help, and tips for helping others. We hope this Toolkit helps you understand that there is nothing to be
ashamed of if you have a mental health concern. In fact, this website features a video of the famous
singer and actress Demi Lovato speaking about her own mental health concerns, and how she works to
overcome them. Please remember that the most important and best thing you can do is talk to your
parents or a trusted adult.

National Alliance on Mental Health →

http://www.nami.org/Find-Support/Teens-and-Young-Adults
This website provides advice on how to get the right start on getting help if you feel you have a mental
illness. It also gives you tips on how to take charge of how you are feeling when talking to a doctor about
your symptoms. The website also provides you with things you can do, what you should look for, and
how to help if you think your friend has a mental illness. Lastly, it offers advice on how to manage your
mental health condition in college and adulthood. NAMI also has a helpline where you can call, text or
email any questions you may have.

Mental Health Resources For Adolescents and Young Adults →

http://www.adolescenthealth.org/Clinical-Care-Resources/Topics-in-Adolescent-Health/Mental-He
alth/Mental-Health-Resources-For-Adolesc.aspx
As teenagers, you are among the most tech-savvy people, and likely use social media and smartphone
apps on a daily basis. This website is a great tool because it provides you with links to apps and tech
services that promote mental health and wellbeing. One example is ​Mood 24/7: A text messaging system
that provides an easy way to record how you’re feeling and tracks your daily moods to share with friends,
family, or a health professional. This way, learning about and monitoring your mental health can be fun!

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Frequently Asked Questions 
 
What does it mean to have a mental health issue? 
Everybody gets sick sometimes. When you have a sore throat, you might take medicine and
sleep a lot. If you have a broken arm, you get a cast. Even teachers and parents can get sick,
and they have to take medicine and rest to get better. Just like physical illness, people can
experience a mental illness anytime. If you or someone you know has a mental health issue, it
can change the way you or that person thinks, feels or acts. ​Mental illness has nothing to do with
how smart you are. We all have different challenges that we face. ​Both your mental health and
physical health are key components in your overall health as a student. It is also important to
remember that everyone has good days and bad days. Just because someone has a bad day
does not mean that he or she has a mental illness.

Can you ever recover from a mental illness? 

Yes, you can get better and recovery is possible! With the help from support systems like family,
friends and mental health professionals, people experiencing a mental illness can get better.
People don’t choose to have a mental illness, but they can choose to admit if they’re having a
hard time. That way, they can get help and start feeling better. The earlier someone gets help, the
better chance they have of either coping or recovering from the illness.

Where can I go for help?

Talk to a trusted adult. This is the first step to helping yourself or someone get better. Just like
when your body is sick and you go to a doctor, someone with a mental illness can go to a mental
health professional. Only a mental health professional can say if someone has a mental illness.
A mental health professional will be able to tell if you have a mental illness based on your
feelings, how often you have them, and how they affect your life. If your mental health
professional thinks you have a mental illness, he or she will give what you are experiencing a
name, such as depression or anxiety, and this is called a diagnosis.

Who do mental health issues affect?  

All kinds of people can experience a mental illness, including kids. It doesn’t matter where you
live or what kind of family you have. No one knows for sure what causes a mental illness.
Researchers think it’s a mix of what’s going on in your body and what’s happening around you.
Mental health challenges are not caused by doing something wrong. You can’t catch a mental
illness from somebody else. Anyone can have a mental illness, and anyone can get better, too. It
is also common to know people who have mental illnesses. It doesn’t mean they are crazy, it just
means that life is different in their shoes.

What is it like to live with a mental illness? 

You may not realize it, but you probably know someone who has a mental illness. It could be
someone like a friend, a family member, a classmate, teacher or neighbor. Even famous people
can struggle with mental health, like Beethoven and President Abraham Lincoln. Everyone has
different likes and dislikes, talents, thoughts, and bodies. A mental illness is not the only thing to
know about a person.

How can I help someone?

● Be Aware: Ask people how they are doing or feeling that day.
● Listen: If someone needs to talk, listen to them. Let them know you are there for them.

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 ● Initiate: Invite someone to do something fun with you!
● Include: Try to include others or even someone new.

(Source: walkinourshoes.org)

Where can I go to learn more? 

First and foremost, we suggest that you talk to your school counselor, psychologist, teacher or
parent(s) to learn more about mental health in general, and how it relates to you. Second, the
websites listed under the Tools & Resources section of this Toolkit are a great starting point to
learn more about mental health. Consider browsing the websites with a trusted adult so you can
ask each other questions as you explore the various topics together.

 
 

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Appendix A 

22
(Source: www.edu.gov.mb.ca/ks4/specedu/fas/pdf/3.pdf)

23
 Appendix B 
Mental Health Screening 
Mental Health Screening Form–III (MHSF–III)
CO-OCCURRING DISORDERS PROGRAM: SCREENING AND ASSESSMENT

Instructions: In this program, we help people with all their problems, not just their addictions. This
commitment includes helping people with emotional problems. Our staff is ready to help you to deal with
any emotional problems you may have, but we can do this only if we are aware of the problems. Any
information you provide to us on this form will be kept in strict confidence. It will not be released to any
outside person or agency without your permission. If you do not know how to answer these questions,
ask the staff member giving you this form for guidance. Please note, each item refers to your entire life
history, not just your current situation. This is why each question begins, “Have you ever . . . ”
Please circle “yes” or “no” for each question.

1. Have you ever talked to a psychiatrist, psychologist, therapist, social worker, or counselor
about an emotional problem? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes
No
2. Have you ever felt you needed help with your emotional problems, or have you had people
tell you that you should get help for your emotional problems?. . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
3. Have you ever been advised to take medication for anxiety, depression, hearing voices,
or for any other emotional problem? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes
No
4. Have you ever been seen in a psychiatric emergency room or been hospitalized for
psychiatric reasons?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes
No
5. Have you ever heard voices no one else could hear or seen objects or things which others
could not see?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
6. (a) Have you ever been depressed for weeks at a time, lost interest or pleasure in most
activities, had trouble concentrating and making decisions, or thought about killing yourself? . . . . .Yes
No
(b) Did you ever attempt to kill yourself?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
7. Have you ever had nightmares or flashbacks as a result of being involved in some
traumatic/terrible event? For example, warfare, gang fights, fire, domestic violence, rape,
incest, car accident, being shot or stabbed?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
8. Have you ever experienced any strong fears? For example, of heights, insects, animals,
dirt, attending social events, being in a crowd, being alone, being in places where it may be
hard to escape or get help? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes
No
9. Have you ever given in to an aggressive urge or impulse, on more than one occasion, that
resulted in serious harm to others or led to the destruction of property? . . . . . . . . . . . . . . . . . . . . . Yes No
10. Have you ever felt that people had something against you, without them necessarily saying
so, or that someone or some group may be trying to influence your thoughts or behavior?. . . . . . . Yes
No
11. Have you ever experienced any emotional problems associated with your sexual interests,
your sexual activities, or your choice of sexual partner? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes
No
12. Was there ever a period in your life when you spent a lot of time thinking and worrying about
gaining weight, becoming fat, or controlling your eating? For example, by repeatedly dieting
or fasting, engaging in much exercise to compensate for binge eating, taking enemas, or

24
forcing yourself to throw up? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
continued on other side
13. Have you ever had a period of time when you were so full of energy and your ideas came
very rapidly, when you talked nearly nonstop, when you moved quickly from one activity to
another, when you needed little sleep, and when you believed you could do almost anything? . . . .Yes
No
14. Have you ever had spells or attacks when you suddenly felt anxious, frightened, or uneasy to
the extent that you began sweating, your heart began to beat rapidly, you were shaking or
trembling, your stomach was upset, or you felt dizzy or unsteady, as if you would faint? . . . . . . . . Yes
No
15. Have you ever had a persistent, lasting thought or impulse to do something over and over
that caused you considerable distress and interfered with normal routines, work, or social
relations? Examples would include repeatedly counting things, checking and rechecking
on things you had done, washing and rewashing your hands, praying, or maintaining a very
rigid schedule of daily activities from which you could not deviate. . . . . . . . . . . . . . . . . . . . . . . . . . Yes
No
16. Have you ever lost considerable sums of money through gambling or had problems at work,
in school, or with your family and friends as a result of your gambling? . . . . . . . . . . . . . . . . . . . . . .Yes No
17. Have you ever been told by teachers, guidance counselors, or others that you have a
special learning problem? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes
No
Print client’s name:
___________________________________________________________________________________
Program to which client will be assigned:
___________________________________________________________________________
Name of admissions counselor: ______________________________________________________
Date: _________________
Reviewer’s comments:

Document is in the public domain. Duplicating this material for personal or group use is permissible.
(Source: www.bhevolution.org/public/document/mhsf-iii.pdf)

25
Appendix C 

26
 Student Progress Monitoring

 
V1.4 DBR Standard Form was created by Sandra M. Chafouleas, T. Chris Riley-Tillman, Theodore J. Christ, and Dr. George
Sugai. Copyright © 2009 by the University of Connecticut. All rights reserved. Permission granted to photocopy for personal
and educational use as long as the names of the creators and the full copyright notice are included in all copies. Downloadable
from ​www.directbehaviorratings.org​.

27
 Student Self-monitoring example 

(Source:
http://www.interventioncentral.org/sites/default/files/pdfs/pdfs_blog/self_management_self_monitoring_1.pdf)

28