Thinking Ahead to Implement – Part Three

An Emerging Best Practice – Universal Mental Health Screening

By Shelley Seslar, Managing Director, Behavioral Health Services, NCESD
Published October 25, 2022

Overview

In the previous two installments, we introduced Universal Mental Health Screening (UMHS) and how to get started developing support for UMHS at your school. In this third post, we will go deeper into the important preparation for success – developing your school’s WHY, the rationale for UMHS in your community. We will describe informative lessons learned by your colleagues in the field who have implemented and sustained a UMHS program in their school.

In order to clarify the goal of Universal Mental Health Screening (UMHS) at your school, work on your explanation for “Why”. Refine your rationale and goal in order to engage a broader multi-disciplinary team of collaborative partners. You may benefit from having research and guidelines to offer your partners when you set out to build support for UMHS and the work to prepare for implementing it.

We have collected some of those resources below. Please reach out to Shelley Seslar at NCESD for partnership as well.

Existing Research

Quantitative

  • Internalizing problems (Weist et al., 2018)
  • Truancy rates (Wroblewski et al., 2019)
  • Depression (Erickson & Abel, 2013)

Qualitative or Mixed Methods

  • Briesch et al. (2021) interviewed school leadership o understand their perceived benefits and challenges of UMHS
  • Brann et al. (2021), UMHS implementation is based on the systems in place in the school (e.g., teams, organization) as well as the climate surrounding screening (e.g., consistency, communication, leadership)

Existing Recommendations

  • National Association of School Psychologists (2009)
  • Institute of Medicine (2009)
  • National Research Council (2009)
  • “A Framework for Safe & Successful Schools”, NASP (2013)
  • American Academy of Pediatrics (for adolescent depression) (2018)

New Recommendations

New recommendations (April 2022) for screening by US Preventive Services Task Force (USPSTF)

A recent qualitative study of UMHS implementation in varying K-12 schools around the U.S found the following benefits experience by school staff involved

(Not yet published – Dr. Jennifer Betters-Bubon, Lead author, Assoc Prof, Univ of Wisconsin – Whitewater, College of Education and Professional Studies, Dept of Counselor Education, presented at the Advancing School Mental Health conference, October 2022)

What they told us about the benefits of UMHS that they experienced at their schools (graphic):

  • Prioritized prevention of problems
  • Increased collaboration
  • Data-based identification and decisions
  • Gained a whole-child perspective
  • Reduced stigma
  • Increased perceived value of school counseling supports
    • “[UMHS] helped us [school counselors] build and grow…that accountability piece, and what the data has allowed us to do, and advocate for this [school counseling] position has been really significant.”
    • “[UMHS] helped us bring in another counselor to our building which is really helpful.”

The advice of school personnel from the study described above follows:

  • They told us to consider and prepare to overcome the most commonly encountered roadblocks to UMHS:
    • Concerns over liability
    • Challenges with screener tool
      • Is it normed, equitable, reliable, fit the time we have, biased?
    • Lack of time scheduled to plan together and implement wisely
    • Resistance by others to new concept
    • Impact on student support staff of high student need initially
      • Time to coordinate response
      • Time to support those students
      • Compassion fatigue/secondary trauma
  • They described the pathways they found to a successful implementation:
    • Connect UMHS to school’s goals and observed student needs
    • Use social capital of our role, of our partners, of UMHS advocates
    • Ensure social equity of planning, process, access, and outcomes
    • All voices represented in planning
    • Multidisciplinary collaboration is critical
      • School counselors, school social workers, school psychologists, school nurses
      • Community mental health providers
      • School and district administrators, PBIS/MTSS coordinators, Special Education directors
      • Parents
      • Teachers

In our next installment, we will discuss the logistics of a successful UMHS event, requiring strong planning for the screening event and, importantly, a robust plan for post-screening follow-up.