Supporting Child and Student Social, Emotional, Behavioral, and 

Mental Health Needs
U.S. Department of Education

Dr. Miguel A. Cardona 

Secretary of Education 

Office of Special Education and Rehabilitative Services

Katherine Neas 

Acting Assistant Secretary

This report is in the public domain. Authorization to reproduce it in whole or in part is granted. While permission to 

reprint this publication is not necessary, the citation should U.S. Department of Education, Office of Special 

Education and Rehabilitative Services, Supporting Child and Student Social, Emotional, Behavioral, and Mental 

Health Needs, Washington, DC, 2021. This report is available on the Department’s website at 

https://www2.ed.gov/documents/students/supporting-child-student-social-emotional-behavioral-mental-health.pdf

Availability of Alternate Formats 

On request, this publication is available in alternate formats, such as Braille or large print. For more information, 

please contact the Department’s Alternate Format Center at 202-260-0818 or via e-mail at 

alternateformatcenter@ed.gov. 

Notice to Limited English-Proficient Persons 

If you have difficulty understanding English, you may request language assistance services for Department 

information that is available to the public. These language assistance services are available free of charge. If you need 

more information about interpretation or translation services, please call 1-800-USA-LEARN (1-800-872-5327) 

(TTY: 1-800-877-8339), email us at Ed.Language.Assistance@ed.gov, or write to U.S. Department of Education,

Information Resource Center, 400 Maryland Ave., SW, Washington, DC 20202. 

DISCLAIMERS 

Other than statutory and regulatory requirements included in the document, the contents of this document do not have 

the force or effect of law and are not meant to bind the public. This document is intended only to provide clarity to the 

public regarding existing requirements under the law or agency policies. This document is intended as a resource on 

social, emotional, and behavioral supports and other mental health services for children and students. Further, with the 

exception of brief references to students with disabilities as a subgroup, this document does not provide specific 

guidance on Federal disability laws, which include requiring schools to provide for the education of students with 

disabilities and to take an individualized approach to providing services, consistent with the student’s individualized 

education program (IEP) developed under Part B of the Individuals with Disabilities Education Act (IDEA) or plan 

developed under Section 504 of the Rehabilitation Act of 1973 (hereafter, Section 504 and 504 plan), as appropriate.

A summary of legislative and policy resources related to the social, emotional, and behavioral supports and mental 

health services in the Elementary and Secondary Education Act (ESEA), IDEA, and Section 504 are provided in 

Appendix D. For information on these programs, the rights of children and students with disabilities and schools’ 

obligations under those Federal laws, please refer to information provided by the U.S. Department of Education’s 

Office of Safe and Supportive Schools in the Office of Elementary and Secondary Education; Office of Special

Education and Rehabilitative Services; and Office for Civil Rights. Please also refer to the U.S. Department of

Education's COVID-19 Resources for Schools, Students, and Families.

This document contains resources and examples that are provided for the user’s convenience. The inclusion of these 

materials is not intended to reflect their importance, nor is it intended to endorse any views expressed, or products or 

services offered. These materials may contain the views and recommendations of various subject-matter experts as 

well as hypertext links, contact addresses and websites to information created and maintained by other public and 

private organizations. The opinions expressed in any of these materials do not necessarily reflect the positions or 

policies of the U.S. Department of Education (Department). The Department does not control or guarantee the 

accuracy, relevance, timeliness, or completeness of any outside information included in these materials. For the 

reader’s convenience, this document contains examples of potentially useful products and resources. Inclusion of such 

information does not constitute an endorsement by the Department or the Federal government, nor a 

preference/support for these examples as compared with others that might be available and be presented. 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs iii

Contents

Executive Summary ...........................................................................................................................................................1 

Introduction ........................................................................................................................................................................3 

Challenges..........................................................................................................................................................................7 

1. Rising Mental Health Needs and Disparities Among Children and Student Groups.............................................7 

2. Perceived Stigma as a Barrier to Accessing Services Even When Available ......................................................14

3. Ineffective Implementation of Practices...............................................................................................................14

4. Fragmented Delivery Systems..............................................................................................................................15

5. Policy and Funding Gaps......................................................................................................................................16

6. Gaps in Professional Development and Support..................................................................................................17

7. Lack of Access to Usable Data to Guide Implementation Decisions...................................................................18

Recommendations............................................................................................................................................................19

1. Prioritize Wellness for Each and Every Child, Student, Educator, and Provider.................................................19

2. Enhance Mental Health Literacy and Reduce Stigma and Other Barriers to Access...........................................22

3. Implement a Continuum of Evidence-Based Prevention Practices......................................................................23

4. Establish an Integrated Framework of Educational, Social, Emotional, and Behavioral-Health Support

for All...................................................................................................................................................................27

5. Leverage Policy and Funding...............................................................................................................................29

6. Enhance Workforce Capacity...............................................................................................................................31

7. Use Data for Decision Making to Promote Equitable Implementation and Outcomes........................................32

Summary and State Spotlight.....................................................................................................................................34

References........................................................................................................................................................................37

APPENDIX A. Implementation Examples by Recommendation ...................................................................................53

APPENDIX B. Federal Technical Assistance Centers Related to Social- Emotional and Mental Health......................73

APPENDIX C. Technical Assistance Resources Related to Social, Emotional and Mental Health...............................81

APPENDIX D. Guidance on Existing Programs That Can Support Social- Emotional and Mental Health 

Services for Students .................................................................................................................................................93
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 1 

Executive Summary

Like physical health, positive mental health 

promotes success in life. As defined by the 

Centers for Disease Control and Prevention 

(CDC), “[m]ental health includes our emotional, 

psychological, and social well-being. It affects 

how we think, feel, and act. It also helps determine 

how we handle stress, relate to others, and make 

healthy choices. Mental health is important at

every stage of life, from childhood and 

adolescence through adulthood.” In schools, we 

prioritize three critical and inter-related 

components of mental health: social (how we 

relate to others), emotional (how we feel), and 

behavioral (how we act) supports to promote 

overall well-being (Chafouleas, 2020). 

This resource is intended to supplement the 

information in the ED COVID-19 Handbook, 

Volume 1: Strategies for Safely Reopening 

Elementary and Secondary Schools, Volume 2: 

Roadmap to Reopening Safely and Meeting All 

Students’ Needs, and Volume 3: Strategies for 

Safe Operation and Addressing the Impact of 

COVID-19 on Higher Education Students, 

Faculty, and Staff, by providing focused 

information and resources to enhance the 

promotion of mental health and social and 

emotional well-being among students. 

Many children and students struggle with mental 

health challenges that impact their full access to 

and participation in learning, and these challenges 

are often misunderstood and can lead to behaviors 

that are inconsistent with school or program 

expectations. The COVID-19 global pandemic 

intensified these challenges, accelerating the need 

to provide school-based mental health support and 

leverage our accumulated knowledge about how to 

provide nurturing educational environments to 

meet the needs of our nation’s youth. 

This resource highlights seven key challenges to 

providing school- or program-based mental health 

support across early childhood, K–12 schools, and 

higher education settings, and presents seven 

corresponding recommendations. The appendix 

provides additional useful information, including 

(a) numerous examples corresponding to the

recommendations highlighting implementation

efforts throughout the country; (b) a list of federal

resource centers; (c) a list of resources to assist

educators (teachers, providers, and administrators)

in implementing the recommendations; and

(d) guidance on existing programs that can support

social, emotional and mental health services

for students.
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 2 

Challenges Recommendations

1. Rising Mental Health Needs and Disparities 

Among Children and Student Groups

1. Prioritize Wellness for Each and Every 

Child, Student, Educator, and Provider

2. Perceived Stigma is a Barrier to Access 2. Enhance Mental Health Literacy and 

Reduce Stigma and Other Barriers to 

Access

3. Ineffective Implementation of Practices 3. Implement Continuum of Evidence-Based 

Prevention Practices

4. Fragmented Delivery Systems 4. Establish an Integrated Framework of 

Educational, Social, Emotional, and 

Behavioral-Health Support for All 

5. Policy and Funding Gaps 5. Leverage Policy and Funding

6. Gaps in Professional Development and 

Support

6. Enhance Workforce Capacity 

7. Lack of Access to Usable Data to Guide 

Implementation Decisions

7. Use Data for Decision Making to Promote 

Equitable Implementation and Outcomes
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 3 

Introduction

The mental health crisis for children and youth in 

the United States has reached a critical point. The 

pandemic has exacerbated already alarming trends 

in mental health, and, without increasing the 

number of high-quality, evidence-based mental 

health services, the increased need for services for 

children and youth will not be met. As schools and 

programs return to full in-person learning in the 

fall, and have new resources in the American 

Rescue Plan's Elementary and Secondary School 

Emergency Relief fund (ARP ESSER), and 

previous rounds of ESSER funding, to support this 

work, there is a unique opportunity to 

reconceptualize how we prioritize and provide 

school- and program-based mental health 

supports, an essential component of creating 

nurturing educational environments for children, 

students, families, educators, and providers. This 

includes dramatically expanding the number of 

social workers, school counselors, school nurses,

and school psychologists available to support 

students. 

As stated in Executive Order 14000, Supporting 

the Reopening and Continuing Operation of 

Schools and Early Childhood Education 

Providers, “every student in America deserves a 

high-quality education in a safe environment.” In 

addition, Volume 1 of the ED COVID-19 

Handbook describes the importance of planning 

and implementing comprehensive prevention 

strategies for all students. This resource is 

intended to supplement the information in the ED 

COVID-19 Handbook, Volume 1: Strategies for 

Safely Reopening Elementary and Secondary 

Schools, Volume 2: Roadmap to Reopening 

Safely and Meeting All Students’ Needs, and 

Volume 3, Strategies for Safe Operation and 

Addressing the Impact of COVID-19 on Higher 

Education Students, Faculty, and Staff, which 

were released earlier this year, with more

comprehensive information and resources to 

enhance the promotion of mental health, social, 

emotional, and behavioral well-being of children 

and students.

Congress has provided significant federal funding 

to assist in efforts to return to full in-person 

learning, but as stated in Volume 2, “for most 

schools, returning to the status quo will not 

address the full impact of COVID-19 on students’ 

physical and mental health; students’ social, 

emotional, behavioral, and educational needs; or 

the impact on educator and staff well-being.” As 

President Biden has often stated, we have an 

opportunity to “build back better.” One way to 

build back better is to intentionally integrate the 

current research and evidence on the importance 

of prevention and intervention practices to address 

the mental health needs of children and students. 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 4 

This should be done not just as a reaction to 

COVID-19 but as a deliberate action to fully 

address children and students’ overall well-being 

and their full access to education and 

opportunities. 

This resource highlights seven key challenges to 

providing school- or program-based mental health 

support across early childhood, K–12 schools, and 

higher education settings, and also presents seven 

corresponding recommendations. The appendix 

provides additional useful information, including 

(a) numerous examples corresponding to the 

recommendations highlighting implementation 

efforts throughout the country; (b) a list of federal 

resource centers; (c) a list of resources to assist in 

implementing the recommendations; and (d) a 

summary of legislation and policy addressing the 

provision of social, emotional, and behavioral 

supports to promote mental health and well-being. 

Mental Health Supports

Like physical health, positive mental health 

promotes success in life. As defined by 

the Centers for Disease Control and Prevention 

(CDC), “[m]ental health includes our emotional, 

psychological, and social well-being. It affects 

how we think, feel, and act. It also helps determine 

how we handle stress, relate to others, and make 

healthy choices. Mental health is important at 

every stage of life, from childhood and 

adolescence through adulthood” (Centers for 

Disease and Control, 2021). In schools, we 

prioritize three critical and inter-related 

components of mental health: social (how we 

relate to others), emotional (how we feel), 

and behavioral (how we act) supports to promote 

overall well-being (Chafouleas, 2020). 

However, many children and students struggle 

with mental health challenges that impact their full 

access to and participation in learning and result in 

behaviors inconsistent with school or program 

expectations. In young children mental health 

refers to the developing capacity of the child to 

form close relationships, manage and express 

emotions, explore the environment, and learn 

(Zero to Three, 2016). Researchers suggest that 

children’s experiences, even in the earliest stages 

(infancy), affect their social, emotional, and 

behavioral development (Dawson et al., 2000; 

Malik & Marwaha, 2018; Steele et al., 1999). 

Supporting students’ social, emotional, and 

behavioral development at early ages may mitigate 

the need for long-term services and supports 

(Yoshikawa et al. 2013; Bierman et al., 2018). 

Prior to the COVID-19 pandemic, 13–22% of 

school-aged youth experienced a mental health 

challenge at a level associated with formal 

diagnoses (NCSMHI, 2016; Maag, & Katsiyannis, 

2010). Researchers estimate that 80% of those 

children and youth have unmet treatment needs 

(McCance-Katz, & Lynch, 2019). Unmet needs 

may result in social, emotional, or behavioral 

challenges. In the absence of effective support, 

these children and students may experience 

reactive and exclusionary discipline practices 

(e.g., suspensions, expulsions) that further 

exacerbate mental health concerns, interrupt 

access to and participation in learning, limit 

opportunities, and negatively affect outcomes. 

In addition, early childhood programs that actively 

involve families, serve children in natural contexts 

where possible, incorporate evidence-based 

interventions, and take a comprehensive approach 

to treatment are associated with greater 

improvements in mental health outcomes 

(Hodgkinson, Godoy, Beers, & Lewin, 2017). 

School mental health services (a) broaden the 

reach of mental health services and (b) provide an 

access point for early and effective intervention in 

typical, everyday environments. For example, 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 5 

youth are six times more likely to complete mental 

health treatment in schools than in community 

settings (Jaycox et al., 2010), and mental health 

services are most effective when integrated into 

students’ academic instruction (Sanchez et al., 

2018). In 2018, nearly 3.5 million adolescents 

received mental health services in education 

settings. Adolescents with public insurance, from 

low‐income households and from racial/ ethnic 

minority groups, were more likely to only access 

services in an educational setting, compared with 

services in both educational and other settings or 

in other settings only (private specialty or general 

medical settings) (Ali et al., 2019). 

The COVID-19 pandemic exacerbated this mental 

health crisis, accelerating the need to provide 

school mental health support at an even larger 

scale to meet the needs of our nation’s youth. 

Research on the effects of prior pandemics and 

disasters clearly indicates that there will be both 

immediate and long-term adverse consequences 

for many children (Weist et al., 2002; Yoshikawa 

et al., 2020). Initial data related to the impact of 

the pandemic underscore an unprecedented 

magnitude of mental health needs that children, 

students, families, and staffs will continue to 

experience for many years to come:

 Emergency department visits related to mental

health increased 24% for 5–11-year-olds and

31% for 12–17-year-olds between January and

October 2020 (Leeb et al., 2020).

 Between March and June of 2020, more than

25% of American parents reported that their

child experienced declines in mental health

and 14% reported increases in behavior

problems (Patrick et al., 2020).

 In a survey conducted in April and May 2020,

one in four youth (ages 13–19) reported an

increase in sleep loss due to worry, feeling

unhappy or depressed, feeling constantly under

strain, and loss of confidence in themselves

(Margolius et al., 2020).

 A CDC report found one quarter of

respondents ages 18–24 had contemplated

suicide in the 30 days prior to completing the

survey (Czeisler et al., 2020).

For example, pediatricians in Washington State 

are reporting: 

 Significant increases in youth with eating

disorders, anxiety, mood disorders and

depression with suicidal thoughts and selfharm behaviors (nearly twice the rate of adults

over 40).

 Families experiencing long wait times and

limited access to mental health services.

 Lesbian, Gay, Bisexual, Transgender, Queer or

Questioning (LGBTQ2+) youth are having

specific challenges navigating limited social

support when affirmation and support are

particularly important, resulting in sleep

disturbances, decreased physical activity

leading to unhealthy weight gain, and abuse of

substances.

 A significant number of previously stable

youth have experienced new-onset or

exacerbated eating disorders, depression, or
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 6 

anxiety, with some requiring increased use of 

medications, hospitalization, or other higher 

levels of care.

 Children are experiencing a significant sense

of isolation and loss, which is negatively

impacting their learning and grades.

These data underscore the need for urgent action. 

We have the potential to accelerate support to 

meet this notably increased need for effective 

social, emotional, and behavioral practices and 

create a healthier path forward. We have a wealth 

of accumulated knowledge across prevention and 

behavioral science to create more nurturing 

environments that prioritize prevention and 

promote wellness (Biglan et al., 2020). This guide 

acknowledges the challenges inherent in scaling 

up school mental health services and supports and 

provides key recommendations to improve these 

supports and directly address this critical current 

societal need, based on advances in research on 

the implementation of evidence-based practices. 

Spotlight on Mental Health Crisis in Washington State: Identifying the Challenges

The Washington Department of Health forecasted

(based on models from disaster response) that 

“impacts from COVID-19 outbreak and related 

government actions will likely cause a surge in 

(services needed from the) behavioral health systems 

across the state.” Over the course of the year, some 

of those predictions have come to fruition.

In February 2021, Governor Inslee declared a 

State of Emergency across all counties in 

Washington State stating, “Although we have, for 

the time being, averted the crisis of overwhelming 

hospital capacity related to COVID-19 cases, we 

are in the midst of another crisis related to the 

mental health of many of our children and youth.”
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 7 

Challenges

This section explores seven current challenges 

impacting the effective provision of social, 

emotional, and behavioral supports to enhance 

children’s and students’ mental health and wellbeing. A discussion of the current evidence base 

follows each challenge.

1. Rising Mental Health Needs and

Disparities Among Children and

Student Groups

Even before the pandemic, the United States was 

experiencing a mental health crisis: the escalating 

mental health needs of children and youth were 

largely unmet due to insufficient capacity, 

multiple barriers to care, and disparities across 

populations. The COVID-19 pandemic continues 

to exacerbate this crisis. However, this crisis 

disproportionately affects populations that have 

been marginalized, and COVID-19 has 

exacerbated existing inequities and inadequacies 

across a range of social structures, including our 

nation’s education system. As described below, 

there are population-specific mental health 

challenges based on school level, socio-economic 

and housing status, race, color, national origin, 

1 With the exception of the Washington State example found on 

page eight that is reflective of report, for consistency, throughout 

this document we use the acronym ‘LGBTQI+’ when speaking 

on behalf of the Department. We recognize that other 

terminology may be used or preferred by certain groups or 

ethnicity, language, or immigration status, sex, 

LGBTQI+ status,1 religious identity, and disability.

Early Childhood

The American Psychological Association (2021) 

describes trauma as “an emotional response to a 

terrible event.” Trauma affects between half and 

two‐thirds of all children in the United States. 

These Adverse childhood experiences (ACEs), 

such as maltreatment, exposure to violence, and/or 

substance abuse have an important impact on 

mental health from childhood to adolescence and 

can predict poor mental health across the lifespan. 

ACEs can present particular risk when children 

experience them during early childhood when 

brain architecture is still rapidly developing and 

highly sensitive to environmental adversity 

(Yoshikawa et al. 2020; Lipscomb et al. 2021). 

Without adequate access to trauma-informed 

practices, some early childhood programs that 

serve infants, toddlers, and preschool children 

have struggled to systematically promote positive 

social, emotional, and behavioral development and 

adequately address manifestations of that trauma 

which are often perceived as challenging behaviors.

individuals, and our use of ‘LGBTQI+’ should be understood to 

include lesbian, gay, bisexual, transgender, queer, questioning, 

asexual, intersex, nonbinary, and other sexual orientation or 

gender identity communities. The term is meant to be inclusive.
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 8 

This lack of training and support leave 

practitioners ill-equipped to address students’ 

social, emotional, and behavioral needs and overly 

reliant on more punitive and exclusionary forms of 

discipline (e.g., suspensions and expulsions). 

Early research on preschool disciplinary practices 

by Gilliam (2005) reported that the rate of 

expulsion from state-funded pre-K programs is 

three times higher than that for K–12 programs. 

Later research and reports bolster these initial 

findings and further research report suspension 

and expulsion from early education 

disproportionately affects young boys of color 

(Gilliam & Reyes, 2018, Malik, 2017; Meek & 

Gilliam, 2016). Early childhood and education 

professionals require adequate training and 

ongoing supports, such as behavior specialists or 

mental health consultation, to support social, 

emotional, and behavioral development; address 

behaviors appropriately; and form supportive and 

nurturing relationships with all children and 

their families.

The COVID-19 pandemic further disrupted early 

childhood and education supports (Yoshikawa et 

al., 2020). With many childcare and early 

education facilities closed nationwide, and 

interactions with extended families limited, 

children have been deprived of both social and 

cognitive stimulation beyond their homes, as well 

as meals and other resources provided by many 

early childhood development programs 

(Yoshikawa et al., 2020). Children from families 

experiencing poverty (defined as those in families 

with incomes under $25,000 per year) have 

experienced the steepest declines in overall 

participation in center-based preschool programs 

and, especially, in-person participation. During the 

pandemic, only 13% of children in poverty were 

reported to receive in-person preschool education, 

compared to 38% of those above the poverty line 

(Barnett & Jung, 2021). The emotional well-being 

of young children is directly tied to the 

functioning of their caregivers and the families in 

which they live. Therefore, reducing the stressors 

affecting children requires addressing the stresses 

in the contexts of their families and communities.

K–12 Students

Even before the pandemic, as students entered 

their K–12 school experience, schools were 

reporting earlier onset, increased prevalence, and 

greater intensity and complexity of student mental 

health needs (Geiser et al., 2019; Hertz & Barrios, 

2020). COVID-19 has significantly disrupted 

supports (Stark & Basu, 2020; WHO, 2020) and 

increased concerns for K–12 students (CDC, 

2020; Mann, Bangar, & Kulkani, 2020). These 

concerns coupled with inadequate counselor 

staffing ratios, particularly for students of color 

and students from low-income families, stand to 

exasperate new and existing gaps (The Education 

Trust, 2019). 

For example, many children in the United States 

are experiencing increased loneliness, which is 

harming their psychosocial development given the 

critical role of relationships with peers during 

childhood and adolescence (Loades et al., 2020). 

Such increased loneliness is related to the loss of 

in-person school for over 223 million children 

worldwide, with strong evidence for the 

importance of in-person school on students’ 

adjustment (UNESCO, 2021). In addition to being 

unable to attend in-person school, other factors 

associated with poorer emotional adjustment of 

adolescents since the pandemic include 

COVID-19 worries, having problems with online 

learning, and having increased conflicts with 

parents (Magson et al., 2021). Now there are 

indications that children who experienced COVID 

were more likely to developmental health conditions

and these students may need even more support 

upon their return to school (West et al, 2021).
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 9 

The United States is not alone in these challenges, 

studies from Australia, China, and the United 

Kingdom document increased anxiety and 

depression among adolescents since the pandemic 

(Magson et al., 2021; Xiang, Cheung, & Xiang, 

2021; Dubicka, 2021), and some studies also 

document alarming increases in self-harm among 

adolescents (Dubicka, 2021). Without question, 

for K–12 students and families the pandemic has 

been a traumatic event and a catalyst for further 

trauma including social isolation, financial 

insecurity, and death of family members and 

friends.

Young-Adult University and College 

Students

The transition from high school to college can be 

challenging. The experience reflects dramatic 

changes in peer groups, separation from 

parents/caregivers, immersion within new cultures 

and lifestyles, and expansive learning 

opportunities. Further, the prevalence and 

complexity of mental health disorders among 

college students has increased over time (Xiao et 

al., 2017), and few college students seek support 

(Kaprea & Kalkbrenner, 2017). Despite efforts, 

students often encounter fragmented and 

disjointed mental health services (Farrington et al., 

2012; Morningstar et al., 2018). Just prior to 

typical entry to college, following high school, 

over one in five (22.2%) adolescents experience a 

mental disorder that has a severe impact on daily 

functioning (Merikangas et al., 2010). Examples 

of mental health risk factors impacting college 

students include (a) exposure to adverse childhood 

experience (e.g., exposure to substance abuse, 

such as the current opioid epidemic), 

(b) community stress or trauma such as 

experiencing or witnessing violence in the 

neighborhood, and (c) the presence of mental 

illness (Stephan et al., 2015). The challenges 

thrust upon students as they enter college can be 

overwhelming. Students must develop higher 

levels of academic and social competencies 

despite varied levels of prior training an increased 

independent study and autonomy, and refinement 

of their course of study to address specialization 

and career goals.

According to the most recent American College 

Health Association National College Health 

Assessment (2021), nearly 50% of college 

students experience moderate (23.8%) or serious 

(24%) psychological distress. This is consistent 

with previous research that found ninety-five 

percent of postsecondary school administrators 

note that social, emotional, and behavioral health 

are significant issues at their institutions 

(American Psychological Association, 2013). 

However, most college faculty and staff receive 

little formal preparation related to addressing what 

are referred to as non-academic barriers to college 

students’ success. Non-academic barriers are 

factors that extend beyond traditional academic 

matters that inhibit achievement, such as college 

students navigating moving, being away from 

home (and their long-term and consistent support), 

developing new friendships, and managing 

academic demands with a new level of 

independence. Recent research indicates the 

pandemic has had a significant impact on college 

student’s mental health, adding considerable stress 

and resulting in notably elevated mental health 

challenges during this time of life involving 

notable pre-existing developmental challenges 

(see Copeland et al., 2020).
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 10

Socio-Economic and Housing Status

Nearly one in five children in the United States 

live in poverty, and youth from lower income 

households are less likely to access health care 

(Cree et al., 2018) and more likely to experience 

significant mental health symptoms (e.g., 

suicidality among boys; Fang 2018). Further, 

youth experiencing food insecurity (Willis, 2021) 

or homelessness (Barnes et al., 2018) are at higher 

risk of mental health concerns. These challenges 

are heightened during the COVID-19 pandemic, 

with children and students losing access to 

academic, social, emotional, and behavioral 

supports and other mental health services, for 

example, as provided through school-based health 

centers, nursing services, and in-person school 

mental health support (Dooley et al., 2020; 

Williamson et al., 2020). Importantly, before the 

pandemic, these programs helped to reduce 

inequities in students’ access to support and care, 

and in many cases, these connections have been 

lost during the pandemic. In addition, the most 

accessible support for children and students is 

available by attending school in-person, but 

families with lower incomes and racial minorities 

have been more hesitant to attend in-person 

schooling during the COVID-19 pandemic (U.S. 

Department of Education, 2021). 

Race and Ethnicity

Based on race and ethnicity, youth experience 

differences in severity of mental health symptoms. 

Black teens have disproportionately higher rates of 

suicide than White teens (Price & Khubchandani, 

2019), and the odds of having attempted suicide 

within the past year were significantly greater 

among Asian international and Black college 

students than in previous years (Goodwill et al., 

2020). Further, there are differences among 

communities, by race and ethnicity, in the extent 

to which individuals seek, access, and use mental 

health services (DeFreitas et al., 2018; 

Hodgkinson et al., 2017; Kam et al., 2019; 

Whitaker et al., 2018). As stated, unmet mental 

health needs may manifest in behaviors 

inconsistent with school or program expectations 

and students of color who exhibit these behaviors 

are more likely to experience reactive and 

exclusionary discipline rather than interventions or 

additional supports and lose instructional time. 

Based on these experiences, children and youth of 

color often have poorer outcomes than white peers 

(Losen & Martinez, 2020; Morris & Perry, 2016; 

Quirk, 2020; U.S. Department of Education, 

2021). To be clear, racism, not race, is a critical 

risk factor for mental health concerns and poorer 

outcomes. For example, darker-skinned Latino 

children may be at increased risk for more severe 

and/or more persistent mental health problems, 

than fairer-skinned Latino children perhaps due to 

discrimination based on their skin color (Calzada 

et al., 2019). Underscoring the complexity of this 

background literature, there is also evidence that 

ethnic identity can be a significant positive 

predictor of mental health, whereas racial status, 

stress, and impostor feelings were negative 

predictors for Black college students (McClain et 

al., 2016). 

As briefly reviewed, there is a disproportionate 

burden of COVID-19 illness and death among 

racial and ethnic groups in the United States 

(CDC, 2020). Increased rates of coronavirus 

disease, racial discrimination, and hate crimes 

against Asian-Americans have been documented 

by reporting centers and polls (Margolius et al., 

2020). According to FBI data, hate crimes 

targeting people of Asian descent in the United 

States rose by 70 percent in 2020 compared to the 

numbers of such incidents in 2019 (FBI Hate 

Crime Statistics, 2021). Asian and Latino youth 

were more likely than any other racial/ethnic 

group to report poorer physical, cognitive, and 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 11

mental health since schools closed in March 2020. 

Non-Hispanic Black, female, and LGBTQI+ 

students were at highest risk of increases in 

depression symptoms (Fruehwirth, et al., 2021). 

English Learner (EL) or Immigration 

Status

Latino ELs have been identified as a unique group 

of students who are at an elevated social, 

emotional, and/or behavioral risk (Castro-Olivo et 

al., 2011). However, many screening assessments 

for social, emotional, and behavioral risk have 

limited data to support their reliability, validity, 

and usability with ELs, as screenings are not 

usually conducted in students’ native languages 

and may not capture student need (e.g., Lambert et 

al., 2018). During the COVID-19 pandemic, in 

addition to the stress of social isolation, food and 

shelter insecurity, and COVID-19 related health 

risk, some ELs had to confront additional 

challenges (Uro et al., 2020), such as: 

 Taking on adult responsibilities, such as 

dealing with the landlord, social service 

agencies, and school—if they have more 

English proficiency than their parents and no 

interpretation services are offered.

 Supporting younger siblings in navigating 

remote learning and helping them connect to 

digital platforms.

 Finding employment to provide vital income 

to help support their family.

 Lack of access to technology, which 

disproportionally impacts ELs’ access to 

online health services, including mental health 

support, creating a gap in accessibility to 

intervention supports when in-person services 

have been suspended. 

Youth with immigrant parents were 34% more 

likely to experience poorer physical, cognitive, 

and mental health than youth parents born in the 

United States (Margolius et al., 2020). In addition, 

existing stressors for newcomer or migrant EL 

communities were worsened with the pandemic, 

including feelings of isolation and disconnection 

from the community due to language and cultural 

barriers. School and program closures removed 

the very support systems these child and student 

populations and their families depended upon to 

cope with stressors related to learning and living 

in a new country. For example, food, childcare, 

and mental-health support services offered 

through public schools disappeared overnight for 

many of these families and undocumented families 

were exempt from stimulus support other 

American families received.

Moreover, teachers of migrants, refugees, and 

newcomers are often the people best positioned to 

identify and refer underserved migrant and refugee 

learners to mental health services within and 

outside of school. Teachers and providers can 

engage in substantial care work that may mitigate 

the stressors that newcomer children or students 

often experience, but their roles in doing this work 

have been severely constrained by the pandemic. 

Adding to this concern, immigrant families are not 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 12

accessing many social safety-net services, like the 

Women, Infants, and Children (WIC) Nutrition 

Program (Pelto et al., 2020). Even though 

immigrant families are eligible for some types of 

public assistance, some are fearful of accessing 

these resources.

It is vital that school psychologists, counselors, 

and other mental health professionals collaborate, 

in accordance with applicable law, with 

community agencies that can assist in the 

provision of services for their children and 

students and identify those that can work with 

families who do not speak English (Peterson et al., 

2021). It is critical that health care providers 

communicate in a language that is understood by 

ELs and their caregivers, and utilize qualified 

language service providers when needed. Concrete 

guidance about how to serve ELs, as well as other 

learners with complex needs, in challenging times 

is still emerging (Reich et al., 2020).

LGBTQI+ Status

Prior to the pandemic, youth who identify as 

LGBTQI+ experienced unique stressors such as 

emotional distress, symptoms of anxiety and 

depression, hopelessness, self-harm, 

alcohol/substance abuse, suicidal ideation, and 

suicidal behavior at rates higher than heterosexual 

and cisgender youth (Taylor, 2019). Further, 

individuals who identify as LGBTQI+ experience 

greater physical/sexual violence and bullying 

victimization, making them almost five times 

more likely to experience severe mental health 

symptoms (Heiden et al., 2020). Students who 

identify as LGBTQI+ may routinely hear antiLGBTQI+ language and experience victimization 

and discrimination at school, resulting in worse 

educational outcomes and poorer psychological 

well-being (Kosciw et al., 2018). College students 

with transgender and gender nonconforming 

identities reported significantly higher rates of 

depression and anxiety symptoms compared with 

students with cisgender identities. Additionally, 

the intersection of an individual’s gender identity 

and sexual orientation with other aspects of their 

identity impacts mental health, such that students 

of color who are also LGBTQI+ have significantly 

worse outcomes, such as depression and anxiety, 

and compromised educational functioning, than 

students in only one minority identity group 

(Borgogna et al., 2019). 

During the COVID-19 pandemic, LGBTQI+ 

students were among those at highest risk of 

increases in anxiety symptoms (Fruehwirth et al., 

2021). Young students who identify as LGBTQI+ 

are exposed to social inequalities, which, in some 

cases may be worsened by the pandemic, 

compounding their stress (Hunt et al., 2021; 

Gonzalez et al., 2020; Salerno et al., 2020). 

According to The Trevor Project polling in August 

of 2020, LGBTQI+ youth were significantly more 

likely than straight or cisgender youth to exhibit 

symptoms of depression, anxiety and/or both. In 

addition, loneliness was most acutely felt by 

transgender and Black LGBTQI+ youth. Overall, 

LGBTQI+ youth were more likely to report 

feeling “much more lonely” than straight or 

cisgender youth. The Trevor Project’s 2021 

National Survey on LGBTQI+ Youth Mental 

Health found 42% of LGBTQI+ youth considered 

attempting suicide in the past year, with higher 

percentages for transgender and nonbinary 

respondents. Specifically related to the pandemic, 

the survey (The Trevor Project, 2021) revealed 

70% of LGBTQI+ youth reported that their mental 

health was “poor” most of the time or always 

during the time of COVID-19. 

Religion

Prior to the pandemic, studies showed that 

religious minority students faced challenges from 

bullying. Research shows that more than 16% of 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 13

bullying incidents in public schools target students 

because of their religious identity (Schlanger & 

Shaffer, 2017). In one nationally representative

sample of American families, 42% of Muslims,

23% of Jews, and 6% of Catholics reported that at 

least one of their children had been bullied in the 

past year because of their religion (ISPU, 2017). 

The COVID-19 pandemic disrupted the ability of 

religious people to congregate at houses of 

worship, which likely further impacted children in

religious minority communities. The challenges 

experienced by religious minority students, 

whether due to bullying in school, or as a direct 

result of the pandemic, potentially raise unique 

mental health concerns. 

Disability

Compared to children and students without 

disabilities, children and students with disabilities

experience (a) higher rates of mental health

challenges; (b) more anxiety, depression, and 

academic-related distress; (c) higher rates of 

suicide ideation and suicide attempts, and nonsuicidal self-injury; and (d) greater peer

victimization (Coduti et al., 2016; Fleming et al., 

2016; Salle et al., 2018). Unique barriers to 

support include limited availability of resources,

behaviors inconsistent with school or program 

expectations, family characteristics and

involvement, lack of collaboration between 

partners and need for professional development 

(Poppen et al., 2016). Further, the current 

approach of assessment and provision of mental

health services for children and students with

disabilities is poorly conceptualized and 

fragmented (Carlson et al., 2020; Skaar et al., 

2020). 

COVID-19 has disproportionately impacted

children and students with disabilities (Pier et al.,

2021). School closures prevented children with

disabilities across most states from accessing the 

full range of instructional services and supports 

approved in their Individualized Education 

Program (IEP) specific to their individual needs. 

School closures have also impacted testing and 

eligibility decisions regarding early identification

of children with disabilities and additional service

needs (Cummings & Turner, 2020). 

Children and students with disabilities may face 

additional stress during the pandemic related to 

increased health and social risks. Discussions of 

health care rationing, especially early in the 

pandemic, contributed to heightened anxiety–for 

example, perceptions among children and students 

with disabilities such as, “[i]f people like me get 

sick, we won’t get care.” (Lund & Gabrielli, 

2021). Furthermore, immunocompromised 

children/students and kids with other high-risk 

conditions (e.g., Down Syndrome, Cystic Fibrosis, 

asthma, etc.) may experience greater risks due to 

COVID-19 which may result in increased anxiety–

especially if school districts are not requiring 

masks to be worn in the classroom).
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 14

2. Perceived Stigma as a Barrier to

Accessing Services Even When

Available

Many factors, including culture, tradition, 

availability of best practices and local advocacy, 

and access to education and healthcare, can shape 

public perceptions of mental health (Seeman, 

Tang, Brown, & Ing, 2016). Additionally, the 

profound impact of early experiences on mental 

health warrants increased public awareness. 

Research increasingly suggests that adverse events 

in early childhood are linked to persistent mental 

health problems. Childhood maltreatment, for 

example, increases the odds of developing 

depression or Post-Traumatic Stress Disorder in 

adulthood (Weir, 2012). However, perceived 

public stigma is (a) one of the major reasons 

people, including children, adolescents and 

families do not seek mental health care (Weist et 

al., 2019a) and (b) significantly associated with 

greater odds of suicide ideation, planning, and 

attempt (Goodwill et al., 2020). A similar stigma 

exists in institutions of higher education as well, 

where barriers to mental health access lead to 

increased suicide risks (Horwitz et al, 2020). 

Negative perceptions of mental health can be 

reduced through mental health literacy for 

educators, children, students, and families, which 

has therapeutic benefits and increases helpseeking. Further, there is growing evidence that 

many labels for children and students experiencing 

challenges in education and mental health systems 

are highly pejorative2

 (e.g., “disturbed,” “crazy”) 

and are associated with negative perceptions, 

reduced help-seeking, and ongoing and worsening 

self-stigmatization (Weist et al., 2019a). 

Exacerbating these experiences, unmet mental 

2 Section 504 protects students from disability harassment. Schools 

have an obligation to investigate reports of disability-based 

bullying or harassment. For more information, see the Office for 

Civil Rights guidance on Bullying of Students with Disabilities 

health needs may manifest as behavioral 

challenges, resulting in exclusionary discipline 

(e.g., suspension, expulsion), and further 

decreasing the likelihood of students accessing 

educational, social, emotional, and behavioral 

support in school.

To the extent that unmet mental health needs are 

related to a disability, schools must be mindful of 

their obligations under the IDEA and Section 504, 

which include providing appropriate supports 

when addressing behavior that is disability related. 

Further, where a mental health-related disability 

has not been identified, but there is reason to 

believe that a student may have a disability, based, 

at least in part, on a student’s undesirable 

behavior, schools are reminded of their obligations 

under the IDEA and Section 504, which include 

identifying and evaluating students. Finally, 

schools are reminded that both the IDEA and 

Section 504 have requirements with respect to the 

limitation of and prohibition of exclusionary 

discipline.

3. Ineffective Implementation of

Practices

There are many limitations in the ways mental 

health services are traditionally implemented for 

children, students, and families. Clinicians 

typically provide services in specialty clinics 

outside of the school or program setting, and often 

barriers prevent families and children from 

effectively and efficiently connecting to care (e.g., 

poor knowledge of mental health, perceived 

stigma, long distances to centers, or poor 

communication among agencies). Further, there 

are questions about the quality of care (see Eklund 

et al., 2020): some clinical staff continue to 

at https://www2.ed.gov/about/offices/list/ocr/letters/colleaguebullying-201410.pdf.
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 15

implement practices that are not supported by 

research evidence and, even when practices are 

evidence-based, clinical staff may have 

insufficient training and support to effectively 

implement practices (Evans & Weist, 2004; 

Massey & Vroom, 2020). Moreover, some 

arrangements result in mental health clinicians 

only being present in a school on a limited basis 

(e.g., one or two days per week), without being 

considered part of the school support team. In 

some cases, some school staff may not know who 

the outside clinicians are working with or what 

they are working on (see Barrett et al., 2013). In 

addition, school personnel often relegate 

addressing all mental health services to more 

clinical mental health staff.

More well-trained, experienced clinicians, whether 

school-based staff or community-based 

professionals, are critical for children with 

intensive mental health needs, but all school and 

program staff should be (a) trained to support and 

respond to general social, emotional, and 

behavioral needs as an integrated part of teaching 

and learning and (b) aware of communication and 

collaboration strategies to engage clinicians for 

more intensive mental health needs. However, 

school environments are busy and complex, and 

environmental challenges may inhibit the delivery 

of evidence-based supports (Eklund et al., 2020). 

Therefore, it will be critical that schools consider 

what they should stop doing (or de-implement) 

alongside conversations about what to implement. 

For example, schools may consider discontinuing 

efforts that are not supported by evidence and 

practices that result in stigma or harm to children 

and students (e.g., exclusionary discipline 

practices for behaviors that result from an 

underlying mental health need). Unmet mental 

health needs can be barriers to staying on task or 

learning new information, schools may consider 

their efforts to ensure all students have access to at 

least some tier one supports as a part of their core

mission to educate students. 

Unmet mental health needs can also be related to a

disability. For this reason, when a student engages 

in behaviors inconsistent with school or program 

expectations, schools and programs must be 

mindful of their obligations under the IDEA and 

Section 504, which include identifying and 

evaluating students for a suspected disability, 

providing appropriate supports when addressing 

behavior that is disability-related, and complying 

with requirements imposing limitations and 

prohibitions pertaining to exclusionary discipline. 

4. Fragmented Delivery Systems

The current system is not working for many

children, students, families, and staff, with notable

problems that existed before the pandemic made 

much worse during the pandemic. Medical and 

mental health care are frequently siloed—provided 

in separate facilities by different providers and

with different payment streams—making it 

cumbersome and confusing to obtain needed care 

(Knickman et al., 2016). Similarly, within schools, 

those providing direct services to children and 

students, including teachers, counselors, school 

psychologists, and social workers, are often siloed 

and work in relative isolation from one another 

(Adelman & Taylor, 2021b) affecting all children

and students, including those with disabilities 

(Skaar et al., 2020). 

For young children, many states are now working 

to strengthen supports for emotional growth and 

mental health. However, great variation exists in 

the capacity of state early childhood systems to 

identify and meet the needs of infants and toddlers 

who have social, emotional, or behavioral delays; 

mental health conditions; or circumstances that put 

them at high risk of developing these difficulties

(Smith et al., 2020). These challenges include 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 16

inconsistencies in practices related to screening;

referral; service provision for mental health or 

social, emotional, and behavioral challenges; and 

provider standards and competencies. An 

additional level of both complexity and risk exist 

for young children in early education programs 

who are also being served in a variety of different

mixed delivery settings from home, family child

care, center-based child care, and schools which 

impact the types of services that may be available.

Current systems focus on individual level needs, 

leaving out community supports. One important 

approach is Asset-Based Community

Development which has a long track record of 

bringing communities together to identify their 

inherent assets and support collective and selfdetermined solutions to challenges. Also 

recommended is human-centered design to 

support community development 

approaches. These and other approaches support a 

more focused understanding of equity and 

empowerment by including the larger community 

in which schools operate. 

5. Policy and Funding Gaps

Meeting the comprehensive mental health needs of

all children and students requires coordinated

policy and multiple funding streams (McCanceKatz, & Lynch, 2019); however, school, district, 

and state staff often lack the knowledge of these 

systems to satisfy requirements for funding (Maag 

& Katsiyannis, 2010). Local and state 

organizations struggle with the ability to provide

the full continuum of expanded school mental 

health services, necessitating grants, contracts, and

funding from other federal, state, local, and private 

mechanisms (Evans et al., 2003; Weist et al.,

2003). Gaps in funding between public and private 

sources lead to many children and students 

receiving limited or no services for documented 

mental health needs (Maag & Katsiyannis, 2010). 

Further, funding streams vary significantly 

by state.

To date, there is limited guidance on policies that 

will improve and help to implement evidencebased social, emotional, and behavioral health 

practices in schools and programs (National 

Center for School Mental Health, 2021). 

Education law and policy prioritize supports to 

promote educational benefit with less direct 

emphasis on mental health supports. (Bateman & 

Yell, 2019). For example, mental health needs are

not consistently considered across evaluations for 

all the eligibility categories under Part B of the

IDEA and thus there may not be an assessment of

mental health needs “related to the suspected 

disability” (Skaar et al., 2020). Section 504 

requires the provision of related services to meet 

the individual educational needs of students with 

disabilities as adequately as the needs of students 

without disabilities are met. As discussed in 

Appendix D’s sections on “How a Student with a 

Disability Can Receive Services

Under IDEA and Section 504” and “Mental 

Health Services,” these related services may 

include mental health services to address the 

student’s needs. State guidelines related to 

provision of mental health services vary, with 

many states having no or vague guidance 

(Education Commission of the States, 2020), and 

there is a lack of focus on fidelity and outcome 

data to drive provision and evaluation of supports. 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 17

Additionally, there is a gap in strong and effective 

policy that prohibits ineffective disciplinary

practices. Instead, states, districts, schools, and 

programs may rely on ineffective policy, such as 

zero tolerance, that often result in disproportionate 

and/or inappropriate use of exclusionary discipline 

(Skiba & Peterson, 2000). Further, not all states 

have policies that prohibit inappropriate 

disciplinary practices, such as corporal

punishment, seclusion, and restraint3that

disproportionately impact children of color and 

children with disabilities (Children’s Equity 

Project & Bipartisan Policy Center, 2020). Note 

that seclusion and restraint have been found by 

GAO and congressional investigators to have been

connected with a number of cases of alleged abuse 

and death, including cases which have resulted in

convictions or findings of civil and criminal 

liability. (GAO, 2009) 

Moreover, there is concern that some traditional 

special education programs and supports 

inadequately address student mental health 

concerns (Carlson et al., 2020; Skaar et al., 2020). 

For example, Spiel et al. (2014) assessed goals, 

objectives and plans for 97 middle school students 

with Attention-Deficit/Hyperactivity Disorder 

with IEPs (62% of the sample) or receiving

support through Section 504. In general, 

recommendations in school programs had little or 

no research to support their effectiveness, and 

particular evidence-based programs were rarely

mentioned. Instead, to comply with IDEA and 

Section 504, individualized programs should 

(a) support children and students in each area of

unique need—including educational, social,

emotional, behavioral, and related areas—with

high-quality and evidence-based support and

3The use of restraint and seclusion can result in discrimination 

against children and students with disabilities, which would be a 

violation of Section 504. For more information, see OCR's 

Guidance on the Use of Restraint and Seclusion in Schools at

(b) employ functional behavioral assessment to

develop individualized behavioral intervention

plans for students whose behaviors interfere with

their ability to access and benefit from the

education program.

6. Gaps in Professional

Development and Support

Resources to address child and student mental 

health needs vary across schools, programs, and 

districts, often focus on crisis management, and 

rest heavily on reactive responses to individual 

child or student issues rather than a 

comprehensive system of support (Geiser et al., 

2019). Many school staff have limited mental 

health knowledge (Frauenholtz et al., 2017), and 

schools rely on community-based mental health 

services to provide or supplement their school 

mental health supports. Community-based mental 

health supports may be less accessible (Fazel, 

Hoagwood, Stephan, & Ford, 2014), available, 

and coordinated (Frauenholtz et al., 2017), 

presenting particular challenges to underresourced, rural communities (Shelton & Owens, 

2021). 

Often children and students from underserved 

groups are less likely to be referred for additional 

social, emotional, behavioral support and mental 

health services (Vincent et al., 2012). Continued 

professional development and assistance from 

leadership may be helpful to neutralize potential 

bias in decision making regarding the need for 

additional supports (McIntosh et al., in press).

Again, this scenario underscores the critical 

importance of true education-mental health system 

partnerships. For example, one approach hinges on 

https://www2.ed.gov/about/offices/list/ocr/letters/colleague201612-504-restraint-seclusion-ps.pdf. 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 18

school mental health working systematically 

within a Multi-Tiered System of Supports 

(MTSS), articulated by the Positive Behavioral 

Interventions and Supports (PBIS) framework (see 

Barrett et al., 2013; Eber et al., 2019) and the 

Pyramid model framework.

Further, educators may experience stress or mental 

health challenges that affect their ability to support 

children and students. Teachers who experience 

high occupational stress tend to demonstrate a lack 

of emotional support and negative interactions 

with students (Hamre Pianta, 2005; Oberle et al., 

2016). Similar findings have been reported in 

early childhood education, with elevated stress a 

common experience among early childhood 

teachers and providers. Teacher stress correlates to 

unfavorable teaching practices (e.g., less positive 

attention to children, more punitive responses to 

children’s behaviors inconsistent with school or 

program expectations, less attention to social, 

emotional, and behavioral learning), more 

conflictual teacher-child relationships, and less 

optimal child outcomes (e.g., less positive 

behavior, lower engagement in classroom 

activities; Smith & Lawrence, 2019). Black 

children and students (Murray et al., 2016), may 

be more negatively impacted by teacher stress, 

which may heighten the impact of implicit biases 

and lead to further inequities in discipline and 

academic achievement (Girvin et al., 2017). 

7. Lack of Access to Usable Data to 

Guide Implementation Decisions

Schools, districts, campuses, and programs 

experience significant challenges with collecting 

and accessing usable data (accurate, readily 

available, and comprehensive) including the high 

cost of some proprietary measurement systems, 

variability in measures used between 

schools/districts, insufficient staffing, insufficient 

training and implementation support, and the fastpaced environment of schools (Arora et al., 2016). 

Beyond collecting data (attendance, discipline 

records, climate surveys and school satisfaction 

ratings), schools, districts, campuses and programs 

struggle with (a) effectively using the data to 

guide programming within the MTSS for selection 

of evidence-based practices; (b) identifying and 

screening for early risk factors for children, 

students, and families; (c) implementing programs 

to prevent problems, address them early, and 

provide more intensive intervention; 

(d) evaluating and improving the fidelity of 

program delivery; (e) monitoring child or student 

progress in relation to programs/interventions 

received; (f) documenting program impacts on 

child or student social, emotional, behavioral, and 

academic functioning; and (g) using progress 

monitoring and outcome data to refine, strengthen 

and scale up programs that are working and move 

toward replacing or eliminating programs that are

not working (Eber et al., 2019; Center on PBIS, 

2017).
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 19

Recommendations

To increase the capacity of states, districts, 

schools, programs, and institutions of higher 

education to provide social, emotional, and 

behavioral health support and to improve 

outcomes for children and students, we 

recommend the following:

1. Prioritize wellness for each and every child, 

student, educator, and provider.

2. Enhance mental health literacy and reduce 

stigma and other barriers to access.

3. Implement a continuum of evidence-based 

prevention practices.

4. Establish an integrated framework of 

educational, social, emotional, and behavioralhealth support for all.

5. Leverage policy and funding. 

6. Enhance workforce capacity. 

7. Use data for decision making to promote 

equitable implementation and outcomes.

Prioritizing these recommendations can help 

create more nurturing programs and schools, 

including higher education, and, through them, a 

more responsive and inclusive society (see Biglan 

et al., 2020) that promotes mental health and wellbeing for children, students, educators, and 

providers. As a reminder, other than statutory and 

regulatory requirements included in the overall 

document, the contents of this document (i.e., 

these recommendations) do not have the force or 

effect of law and are not meant to bind the public. 

The strategies listed are intended only as 

recommendations to increase capacity to meet the 

social, emotional, and behavioral health needs of 

children and students. 

For each strategy, we provide educator action 

steps and offer implementation tips. Appendix A 

includes implementation examples organized by 

recommendation. As described in the opening 

paragraph, these recommendations have 

application across early childhood, K–12, and 

higher education settings; however, the current 

evidence base for implementation in higher 

education settings is more limited.

1. Prioritize Wellness for Each and 

Every Child, Student, Educator, 

and Provider

Educator wellness is associated with child and 

student wellness (Harding et al., 2019). Educators 

who provide emotional support and establish 

positive relationships influence children’s and 

students’ health, overall mental wellness, and life 

satisfaction (Stewart & Suldo, 2011). Wellness is 

multidimensional and may include medical, 

emotional, environmental, occupational, physical, 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 20

intellectual, spiritual, social, and financial 

components (Lever et al., 2017). Educators’ 

wellness is an important component to ensuring a 

healthy school climate, and educator wellness 

programs are associated with greater workplace 

satisfaction and lower rates of absenteeism (Lever 

et al., 2017). Promoting staff wellness benefits 

staff, children, and students. 

Action Steps for State, District, School, 

and Program Leaders

Assess well-being. School, district, and program 

leadership teams can use data to determine their 

specific wellness needs and areas of focus 

(Alliance for a Healthier Generation, 2016).

 Conduct educator well-being assessments 

(e.g., Professional Quality of Life 

https://proqol.org/; Hudnall Stamm, 2009) and 

universal wellness screening for children and 

students (see additional detail in 

Recommendation 7).

 Use existing data sources like staff perception 

of school climate, campus climate surveys, 

staff attendance rates, and focus group 

information to gain insight into staff’s 

satisfaction and overall impact from the stress 

of their work. 

 Consider using universal staff 

surveys/strengths and needs assessment data to 

strengthen and promote access to existing 

Employee Assistance Programs (EAP) for 

educators and additional supports for students 

(Recommendation 4).

Emphasize wellness programming for children, 

students, and staff. While schools and districts 

are faced with a significant educational and 

developmental slide for many children and 

students associated with the pandemic, there is a 

need for balanced programming that supports 

learning, while also supporting their social, 

emotional, and behavioral adjustment, including 

wellness programming for them and for staff. For 

example, prioritize stress reduction, mental and 

physical wellness routines such as daily 

opportunities for movement, yoga, mindfulness 

activities, meditation, and any additional calming 

routines to promote self-regulation (e.g., lights off, 

music, breathing, drawing). These routines 

(a) promote resilience and health among children 

who have experienced trauma (Sciaraffa et al., 

2018) and (b) reduce stress and increase health 

and focus among adults. In the higher education 

setting, colleges and universities can distribute 

resources, such as wellness kits, to support 

students. 

Teams may consider the following approaches to 

promote wellness and de-stress staff.

 Eliminate ineffective or redundant efforts such 

as non-instructional administrative duties and 

non-critical meetings so educators can direct 

their attention and energy toward better and 

sustained implementation of high-quality 

practices for all children or students, especially 

those with high risk. 

 Establish a realistic workload, child or student 

to teacher ratio, and a manageable approach to 

teaching an aligned and integrated curriculum 

for academics and social-emotional, and 

behavioral health instruction. Feeling 

competent is part of wellness. When educators 

feel like they have the skills, resources, and 

supports to do their job well, they feel less 

stressed and are able to better meet the needs 

of their children, students and families 

(Grayson & Alvarez, 2008; Shackleton et al., 

2019). 

 Provide time for debriefing after stressful days 

(Miller, 2010).Provide quiet space for staff to 

regroup and reset (McIntosh et al., 2018). 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 21

 Integrate wellness into professional 

development approaches by providing 

adequate planning time for staff that includes 

opportunities for collaboration, training, peer 

coaching, and supportive performance 

feedback.

 Allow departments focused on health and 

wellness to combine efforts and create campus 

wide focus on well-being (NASPA, 2017). 

 Prioritize collaborative planning time for 

delivery of instruction. Use Communities of 

Practice or Professional Learning 

Communities, which provide collaborative 

opportunities to engage in group learning 

focused on a common issue and grade 

level/core/department team meetings to create 

small systems of support for staff (see 

Cashman et al., 2014). 

 Ensure wages and benefits are competitive, 

including by ensuring those professionals 

serving children birth to five are compensated 

competitively with kindergarten educator 

peers, when similarly qualified. 

Implementation Tip

Focus on effectiveness and efficiency, embracing 

the concept that “more is not necessarily better.” 

Consider investing in a small number of evidencebased practices that are matched explicitly to the 

needs of the community and have the potential of 

impacting children and students with identified needs.

Action Steps for Educators

Promote habits of connection. Ensure daily 

connection with others using a regular schedule of 

communication through various platforms. This 

could be as simple as emotional check-ins, or 

using humor in an appropriate way. Reach out to 

colleagues in multiple formats to model care and 

emotional support to promote a mentally healthy 

work environment. 

 Reach out to colleagues in multiple formats to 

model care and emotional support to promote 

a mentally healthy work environment. 

 Consider protecting time in all meeting 

agendas to check in with others as a simple 

way to integrate this into daily work.

 Similarly, classroom staff can focus on 

building emotional safety in classroom 

conversations and start their instructional day 

with greetings/check-ins with their children 

and students. 

 We should be discussing how to provide 

meaningful learning, as well as mentalhealth systems that prioritize 

belongingness and well-being. We 

should focus on creating environments 

that will welcome students back to a 

transformed system.”

—Kurt Hatch, PhD

Create, normalize, and prioritize habits of 

physical and mental wellness for ourselves and 

others. Consider building habits of positive and 

proactive practices (e.g., actively engaging 

children or students in learning,) using positive 

feedback to promote growth), as described in the 

Habits of Effective Classroom Brief. 

 Interact and deepen connections with children 

and students and staff across the day.

 Establish predictable environments throughout 

with increased structure and routines, teaching 

positive expectations that incorporate a focus 

on wellness (e.g., care for others, self, 

environment), and celebrate or reinforce 

wellness practices for staff and children or 

students. 

 Build routines within daily schedule for social 

time, self-care, and program or school wide 

calming strategies.
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 22

2. Enhance Mental Health Literacy 

and Reduce Stigma and Other 

Barriers to Access

Given increased mental health needs associated 

with the pandemic and social challenges (e.g., 

racial injustice), there is an urgent need to improve 

access to mental health support by reducing 

barriers, changing attitudes and perceptions about 

mental health, and eliminating discriminatory 

practices that harm students with mental health 

challenges. This will require intentional efforts 

including providing information, building skills, 

actively engaging learners in intervention, 

empowering individuals with mental health 

challenges, and engaging in structural and policy 

change (Nyblade et al., 2019). The goal is to 

eliminate stigma associated with seeking mental 

health support. 

Campaigns to change attitudes and behaviors need 

to be based on sound evidence (Stuart, 2016), and 

inclusive of all children and students (Brock & 

Brant, 2015). Importantly, there is a critical need 

to broadly define mental health (e.g., thoughts, 

feelings and actions that promote success in life, 

or developing capacity of the child or student to 

form close relationships, manage and express 

emotions, and explore the environment and learn) 

and improve mental health literacy. Mental health 

literacy is defined as “knowledge about mental 

health disorders that is associated with their 

recognition, management, and prevention” 

(Furnham & Swami, 2018, p.1). Low levels of 

mental health literacy contribute to the 

misperception of mental health needs and access to 

services (Miles et al., 2020), whereas gains in 

mental health literacy are associated with increased 

help-seeking intentions and potential treatment 

utilization (McCance-Katz, & Lynch, 2019).

Offering a range of mental health literacy 

interventions at the community level (e.g., 

wellness campaigns, embedding services within 

educational programs, and providing information 

on websites) can empower families and 

community members to take action for better 

mental health (Jorm, 2012). Mental health literacy 

training programs, now widely available, can also 

empower school staff and families with skills to 

recognize and assist children or students 

experiencing mental health needs and better 

prepare them to make appropriate referrals. 

Increasingly, these mental health literacy 

programs are being implemented in schools and 

play an important role in Tier 1 MTSS 

programming (see Clauss-Ehlers et al., 2020). 

Further, offering mental health services in the 

school setting may be met with less stigma than in 

a traditional, community-based mental health 

setting (Hoover et al., 2019). Additionally, there 

are fewer barriers to school-based services when 

the child or student does not have to leave the 

setting to attend appointments, so children or 

students may be more willing to receive mental 

health services (Clauss-Ehlers et al., 2020). 

Encouraging the use of or providing the 

opportunity to receive Telemental health (mental 

healthcare that is provided remotely via electronic 

device) may also reduce the barrier of stigma 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 23

associated with seeking mental health treatment, 

especially for college students. College students 

view this treatment option as convenient, 

accessible, easy to use and helpful (Hadler et al., 

2021). This intervention not only provides 

additional flexibility to students navigating busy 

class schedules, but offers additional opportunities 

for students who may otherwise be reluctant to 

seek care.

Action Steps for Educators

Model understanding and appreciation for 

mental health and mental health challenges. 

School and program leaders, teachers, and staff set 

the tone about the acceptance and importance of 

mental health. A consistent message should be 

shared by all school and program staff that taking 

care of mental health is just as important as caring 

for physical health. Challenges are common and 

are even more prevalent since the pandemic. 

When school and program staff model the ways 

people have addressed them on a personal level it 

helps to reduce stigma and increase supportive 

discussions and actions among staff, children or 

students and families.

Recognize and respond using a similar process 

across social, emotional, behavioral, and 

educational supports. Increase mental health 

literacy (e.g., Youth Mental Health First Aid, 

programs on Adverse Childhood Experiences) and 

develop marketing campaigns (e.g., Prevent, 

Recognize, and Respond) to look for signs and 

symptoms of social, emotional, and behavioral 

needs.

 Look for behavior and mood changes in 

children, students, and staff. 

 Be explicit about how to get help. 

 Create a positive process for teachers and 

providers to seek assistance.

 Identify a school or program person to manage 

the request for assistance process from 

teachers and providers to ensure assistance is 

provided in a timely manner (e.g., not having 

to wait for a meeting to identify support).

 Consider ways to bundle the request for 

assistance process, providing supports for staff 

and families.

Implementation Tip

Establish processes to actively include and engage 

all community members, including children, 

students, and parents whose primary language is 

not English. Spend time discussing language, 

terms, and acronyms. Host listening sessions and 

focused community interviews to ensure all 

members of the community have a voice and role 

in supporting wellness activities. 

3. Implement a Continuum of 

Evidence-Based Prevention 

Practices

Implementing evidence-based practices within a 

Multi-Tiered Systems of Support (MTSS) 

framework provides an effective organizing 

structure for schools, programs, and districts. 

MTSS is an integrated implementation framework 

for organizing a continuum of evidence-based 

practices to support each child’s and student’s 

educational, social, emotional, and behavioral 

needs (see https://mtss.org/overview/ for a detailed 

description of integrated MTSS).

Within the context of an effective MTSS 

framework, it is important to prioritize primary 

prevention (Tier 1) practices that establish 

positive, predictable, and safe environments and 

routines (Center on PBIS, 2020; Office of Special 

Education Programs, 2015). Examples of primary 

prevention practices include: (a) creating a 

welcoming physical environment for children or 

students, staff, and families; (b) intentionally 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 24

making connections with children or students 

using simple strategies, like positive greetings, to 

set children or students up for success; 

(c) establishing consistent and predictable 

routines; (d) explicitly teaching, prompting, and 

reinforcing a few positive expectations; 

(e) delivering effective, engaging, and culturallyrelevant academic instruction; (f) using screening 

tools to plan, implement, and assess instruction 

and; (g) providing specific and supportive 

feedback. These practices promote wellness and 

are associated with desired educational, 

developmental, social, emotional, and behavioral 

outcomes (Allday et al., 2011; Alter & Haydon, 

2017; Cook et al., 2017; Cook et al., 2018; 

Hancock & Carter, 2016; Kern & Clemens, 2007; 

Simonsen et al., 2008; Simonsen et al., 2021). 

In addition to these critical primary prevention 

practices, schools and programs may use their data 

to identify universal needs and adopt a Tier 1 

mindfulness-based practice to teach resilience and 

other coping skills to students (Gueldner & 

Feuerborn, 2015) or other social, emotional, and 

behavioral learning approaches (Fazel et al., 2014; 

Hoover et al., 2017). Research shows even greater 

improvements in overall mental health and 

reductions in externalizing behaviors when 

combining Social-emotional Learning (SEL) and 

PBIS (Cook et al., 2015). 

Beyond primary prevention, secondary 

prevention (Tier 2) provides targeted support for 

students who continue to experience social, 

emotional, and/or behavioral risk. Targeted 

support intensifies the core features of universal 

support, providing, for example, more frequent 

opportunities for connection, reminders, skill 

practice, feedback, and acknowledgement. For 

students with chronic or intense social, emotional, 

or behavioral needs, tertiary prevention (Tier 3)

provides intensive and individualized support. To 

individualize support, teams (a) use individual 

assessment data to identify specific areas of 

strength and need and (b) develop an 

individualized plan that promotes educational, 

social, emotional, and behavioral skill 

development and improves overall mental health 

or well-being. 

MTSS is a fluid and data-driven framework for 

organizing supports, not children or students. In 

other words, children and students likely have 

needs that are met by supports within and across 

all tiers. For example, a student may benefit from 

Tier 1 support in math, Tier 2 support in reading, 

and Tier 3 social, emotional, and behavioral 

support. Further, supports are layered; a student 

who receives Tier 3 support should also have 

access to relevant Tier 1 and 2 supports. For 

example, a child who receives Tier 2 social skills 

instruction should also participate in the classroom 

Tier 1 social skills instruction. Using a MTSS 

Framework to organize evidence-based practices, 

educators can effectively and efficiently meet the 

educational, social, emotional, and behavioral 

needs of all children and students. 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 25

Action Steps for Educators

Organize practices into an integrated 

continuum. Ensure that all children or students 

have opportunities to maximize educational, 

developmental, social, emotional, behavioral, and 

physical outcomes. Adjust to ensure that some 

children or students get whatever additional 

supports they need in a timely manner. See the 

federal technical assistance centers from Appendix 

B for additional support on organizing practices 

into an integrated continuum (e.g., National 

Center for Pyramid Model Innovations, National 

Technical Assistance Center on Positive 

Behavioral Interventions and Supports).

 Primary prevention (Tier 1). Emphasize 

universal support and wellness promotion for 

all. At Tier 1, this should include a holistic 

emphasis on wellness for both children or 

students, families, and staff, emphasizing 

positive and proactive classroom practices 

(e.g., culturally-relevant and engaging 

instruction, predictable routines, positive 

expectations, explicit instruction in key social, 

emotional, and behavioral skills); 

opportunities to connect; and additional selfcare strategies that include elements of 

mindfulness, relaxation and stress 

management, problem solving, exercise, sleep, 

and nutrition (George et al., 2014). Integrating 

programs involving culture, the arts, and sports 

provides additional opportunities for staff,

children, and students to interact in nonacademic subjects to build deeper 

relationships. With effective implementation, 

most (~80%) individuals will benefit from Tier 

1 support. To identify children and students 

who require additional support, schools should 

engage in universal screening (described in 

Recommendation 7) and consider appropriate 

targeted (Tier 2) or intensive (Tier 3) supports, 

as needed, tailored to student needs. 

 Secondary prevention (Tier 2). Implement 

targeted support for children and students who 

continue to demonstrate social, emotional, 

and/or behavioral risk. Select empirically 

based targeted supports such as Check In 

Check Out (CICO; Hawken et al., 2009); 

Check & Connect (Sinclair et al., 2003); 

Check, Connect, and Expect (Cheney et al., 

2009); social skills groups; or similar targeted 

supports for children and students with 

emerging needs. With targeted Tier 2 supports 

layered on top of universal Tier 1 supports, the 

majority (~95%) of children and students 

will benefit. 

 Tertiary prevention (Tier 3). Prioritize 

intensive and individualized support for 

children and students who demonstrate chronic 

or high-intensity social, emotional, and/or 

behavioral need. Tier 3 interventions are 

typically (a) based on individual student 

assessment data (e.g., functional behavioral 

assessment, psycho-educational evaluation); 

(b) developed by a child- or student-centered 

team that includes relevant experts (e.g., 

behavior coach, school psychologist, 

clinician), educators, family members, and the 

child or student; and (c) supported by on-going 

data collected to monitor implementation and 

outcomes. Children and students receiving 

Tier 3 support should continue to access 

support in Tiers 1 and 2 (Eber et al., 2019). 

For example, connect work of clinicians at 

Tier 3 to work of educators in implementing 

CICO at Tier 2, and include common 

emphases on stress management and wellness 

at both tiers. In addition, for students with 

complex needs that require a coordinated 

approach, use a wraparound process, a 

comprehensive approach to support for a 

student and family, to (a) create partnerships 

between children or students, their families, 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 26

educators, and other community resources to 

meet their individual mental health needs;

(b) center supports on student and family 

strengths and needs; (c) adopt a flexible and 

coordinated approach to supporting needs; and 

(d) implement, monitor, and celebrate 

implementation successes (Maag & 

Katsiyannis, 2010). 

 Crisis response. Throughout the continuum of 

support, ensure there is a process for 

developing crisis response plans for children 

and students who may be actively in crisis 

(e.g., experiencing suicidal thoughts, 

homelessness, or domestic violence) that is 

(a) proactive and preventive, (b) aligned with 

intervention tiers, and (c) guided by evidence 

and data. 

Focus on integration and alignment of 

practices. Integrate educational social, emotional, 

behavioral, and trauma-informed practices to 

maximize efficiency. For example, (a) engage in 

complementary prevention practices (e.g., 

predictable routines are part of effective instruction

and also considered a trauma-informed approach); 

(b) teach and remind students to engage in desired 

social, emotional, and behavioral skills during 

academic instruction; (c) provide specific, 

positive, and supportive feedback for academic, 

social, emotional, and behavioral skills; and 

(d) incorporate wellness practices (e.g., 

connections, self-care breaks, mindful minutes) 

into classroom routines. Engage participants in 

discussion about the benefits and challenges 

related to each step of integration (Florida PBIS, 

2020). 

Address the specific needs of underserved 

children and students. Develop specific 

strategies to support children and students from 

race, ethnicity, socio-economic, and LGBTQI+ 

groups, who are underserved and 

disproportionately at higher risk for experiencing 

harassment, discrimination, mental health 

challenges, and barriers to effective mental health 

care (DeFreitas et al., 2018). Differentiate support 

to meet the needs of all children and students, 

including those with disabilities (Bradshaw et al., 

2012; Gage et al., 2019; Grasley-Boy et al., 2019; 

Loman et al., 2018). In addition, improve the 

coordination and collaboration with social service 

and community agencies that serve children that 

are the most marginalized (e.g., children 

experiencing homelessness, substantiated cases of 

abuse and neglect).

Engage families and students. Establish two-way 

communication between schools, programs, and 

families in a genuinely collaborative fashion 

(Weist, Garbacz, Lane, & Kincaid, 2017). 

• Use simple language and minimize jargon 

(Owens et al., 2002). 

• Promote engagement with children, 

students, and their families to provide 

them a voice in their care and assure that 

processes are appropriate for receiving 

more intensive programs/services 

(Adelman & Taylor, 2021a; Maag & 

Katsiyannis, 2010). 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 27

Consider supports for specific contexts (e.g., 

higher education). Protective practices and 

strategies to build resiliency in college settings 

(e.g., support systems involving peers and faculty, 

ready access to counseling services) are important 

to help reduce these risk factors and build resiliency

to enhance success in college (Knoster, 2020). 

Identify and intervene early. Early interventions 

conducted by comprehensive school mental health 

personnel are associated with enhanced educational

or developmental performance, decreased need for 

special education, fewer disciplinary encounters, 

increased engagement with school, and elevated 

rates of graduation (McCance-Katz, & Lynch, 

2019; Weist et al., 2018). 

Implementation Tip

Create daily classroom schedules to allow time for 

explicit instruction on and support for social, 

emotional, and behavioral skill development.

4. Establish an Integrated 

Framework of Educational, 

Social, Emotional, and 

Behavioral-Health Support for All

To effectively support the social, emotional, and 

behavioral needs of all, it is critical to 

intentionally integrate systems such as education, 

health, and mental health within a MTSS 

framework. Mental health promotion is a critical 

part of education, but schools and programs 

struggle with how to establish a comprehensive 

system of mental health support. There is 

increasing recognition of the need to (a) move 

away from co-located programs involving ad-hoc 

involvement of mental health system staff in 

schools or programs and (b) move toward 

approaches that clearly integrate education and 

mental health systems, such as the Interconnected 

Systems Framework (ISF). ISF is a MTSS 

framework that intentionally integrates school 

mental health and PBIS at the school, district, and 

state levels (Barrett et al., 2013; Eber et al., 2019). 

Integrating systems within an MTSS framework is 

an incremental process requiring intentional 

investment (time and political will) by people with 

decision making authority to blend funding, 

develop policy, change job descriptions, etc. This 

process is guided by implementation science and 

data informed improvement cycles. Information 

sharing must be done in a manner that is consistent

with applicable privacy laws, such as the Family 

Educational Rights and Privacy Act (FERPA) and 

the Confidentiality Provisions of IDEA.

Children and students learn more, report feeling 

safer, and develop more authentic trusting 

relationship with peers and adults if the learning 

and social environments of the school are positive. 

Educators foster safe and supportive environments 

by maximizing child and student connections, 

arranging engaging and successful learning, and 

being positively constructive in responding to the 

needs of children and students. 

Implementation Tip

To implement an integrated MTSS approach, start 

by establishing positive, nurturing environments 

where all children, students, and staff thrive; and 

layer on additional supports to address the unique 

needs of some.

Action Steps for Educators

Communicate shared priority. Implementation 

support to schools and programs is shared by 

education and mental health systems, and as 

above, ideally with other systems such as child 

welfare, juvenile justice, and primary care (see 

Lever et al., 2003).

 At state and district levels, identify standards 

to support social, emotional, and behavioral 

development and align them with other 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 28

initiatives/standards (e.g., those emphasizing 

educational support) so that schools and 

programs are not having to do the work of 

alignment-that should happen above the level 

of implementation.

 At school and classroom levels, develop 

schedules to prioritize time for (a) explicit 

instruction and support around social, 

emotional, and behavioral health and 

(b) careful planning for the integration of 

social, emotional, and behavioral health 

practices within educational content.

Implementation Tip

Alignment of student services and supports from 

different agencies is a district responsibility. It 

should not fall on the shoulders of school 

administrators or individual educators.

Focus on effective teams. Leadership teams are 

key to implementing this kind of framework 

(Barrett et al., 2019; Splett et al., 2017). However, 

having too many teams decreases the system’s 

ability to work efficiently. Look for opportunities 

to expand or merge existing leadership teams (e.g., 

school improvement) with similar goals. 

 Design a system of support driven by 

community voices, including children, 

students, families, and community partners, 

and include ways for educators to support one 

another as well as acquire and improve skills 

to address diverse child or student needs.

• At the district level, this work should be 

led by a team that includes cabinet level 

members who can make decisions to 

change budgets, policy, job descriptions, 

professional development, and human 

resources, including but not limited to staff 

health plans.

• At the school and program level, these 

efforts should be led by administration and 

the current school or program (Tier 1) 

leadership team. Establishing a plan to 

gather, honor, and reflect voice and choice 

within school, district and community 

decision making may require expanding 

team membership to include broader 

participant representation and other 

community partners that support 

wellness efforts.

 Co-design a comprehensive and contextual 

plan focused on strengthening mental health 

promotion and prevention. Bring on experts to 

the existing school or program improvement 

team or form a workgroup that has direct 

connection to the existing team. With new 

partners at the table, create space for building 

trust to co-develop norms and routines, share 

expertise, and engage in authentic 

collaboration.

Implementation Tip

Do not create separate teams and systems for 

Mental Health and Return to School. Consider 

bringing on experts to the existing school 

improvement team or forming a workgroup that has 

direct connection to the existing team. Schools 

won’t be able to do this effort alone. Families, childserving partners, and community providers will be 

critical. It will be important to have a team focused 

on trends and patterns with focus on developing/

strengthening Mental Health promotion and 

prevention. Hold space to build trust and work 

toward establishing norms and routines together.

Integrate implementation support. District 

leadership should develop a training and coaching 

plan to increase the number of school or program 

personnel with social, emotional, and behavior 

expertise and to ensure everyone understands their 

role within an interconnected system. (See 

Recommendation 6 for further information.)
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 29

Implementation Tip

Commit to integration and alignment of district, 

school, or program-wide initiatives to organize 

resources and supports for staff. The Technical 

Guide on Alignment of Initiatives may be a helpful 

resource for teams.

5. Leverage Policy and Funding

Policy reviews can help the team examine the 

extent to which current policies support an 

integrated system and highlight where changes to 

policies could eliminate potential barriers to 

integration.

Despite current fragmentation, districts and states 

have been able to improve local policy and 

leverage funds to improve mental health support. 

For example, several states expanded their schoolbased Medicaid programs since elimination of the 

free care rule by the Centers for Medicare & 

Medicaid Services (CMS) in 2014, allowing states 

to receive federal reimbursement for services 

provided to any child or student enrolled in 

Medicaid and meet other specific requirements, 

instead of limiting exclusively to those with IEPs.

A critical need for policy/funding efforts is to 

ensure there are sufficient mental health staff in 

educational settings (e.g., psychologists, 

counselors, social workers, behavior specialists), 

and that they are working in optimal roles versus 

those that may be less critical in the current 

moment. While the national average remains at a 

1:464 school counselor staffing ratio, the 

recommended best practice is 1:250, with 80% of 

their time working directly with or indirectly for 

students (The Education Trust, 2019). For 

example, many K–12 school counselors with 

advanced training in mental health spend a 

disproportionate amount of time in academic 

advising, including relatively straightforward tasks 

such as coordinating students’ class schedules, 

that could be assigned to other staff to free 

counselors up to engage in counseling. In early 

childhood, mental health consultation and access 

to mental health experts to discuss child and 

family needs, has emerged as an effective 

prevention and intervention strategy. Robust 

workforce development (training, supervision, 

mentoring, etc.) and quality assurance systems 

must be in place to ensure that mental health 

consultants have the needed knowledge and skills. 

Action Steps for Educators

Implementation Tip

Build a sustainable funding stream that allows 

clinicians to participate in system planning—

moving beyond the restriction of a fee-for-service 

delivery model. Flexible funding that is independent 

of diagnosis and insurance plans can expedite 

delivery of interventions, especially at Tiers 1 and 2.

Work to expand funding options for mental 

health. First, leverage federal funds available 

through programs and statutes such as IDEA, 

Social Security, Children’s Mental Health 

Services Program, Medicaid (EPSDT), formula 

grants (e.g., grants under the ESEA or 

administered by the Office of Juvenile Justice and 

Delinquency Prevention), grants (e.g., Garrett Lee 

Smith Suicide Prevention, Project AWARE, 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 30

SAMHSA Systems of Care, HRSA Workforce 

Development).

In addition, funds to address pandemic recovery 

include the Elementary and Secondary School 

Emergency Relief (ESSER) Fund, including the 

American Rescue Plan ESSER (ARP ESSER) 

program, the Governor’s Emergency Education 

Relief (GEER) Fund, and the Higher Education 

Emergency Relief Fund (HEERF) can be used for 

this purpose. Leverage funds to hire additional 

staff and develop a coordinated plan for 

(a) selecting key social, emotional, and behavioral 

(i.e., mental health) outcomes; (b) aligning 

activities across funding streams that are 

consistent with selected outcomes; (c) prioritizing 

activities that build local capacity (e.g., teambased leadership, developing expertise among 

school and district leaders) to ensure efforts 

outlast specific funding sources; and 

(d) developing a comprehensive evaluation plan to 

monitor and adjust supports based on data. 

Second, investigate options for financing mental 

health services through other sources, such as 

advocacy groups, foundations, or community 

benefit investments (National Academies of 

Sciences, Engineering, and Medicine, 2017). The 

Department has released a Frequently Asked 

Questions use of funds document on ESSER and 

GEER as well as HEERF that includes additional 

information about how funds may be used to 

address social, emotional, and behavioral (i.e., 

mental health) needs. These existing and enhanced 

funding streams related to addressing mental 

health needs of children and students address an 

array of services and improvements in key areas 

and are critical to ensure needed supports are 

provided. 

Work to lower costs for providing needed 

mental health care. Implement preventive 

services such as PBIS and early interventions to 

reduce overall or long-term need (Maag & 

Katsiyannis, 2010). Identify mental health needs 

early to avoid intensive, and more costly programs 

and services, such as psychiatric hospitals and 

residential treatment programs (SAMHSA, 2020). 

Where available, use mobile crisis team services 

to provide more timely and cost-effective access 

to screening, behavioral health medication 

management, referral, and care (SAMHSA, 2020). 

Implementation Tip

Discipline policies should reflect an instructional, 

rather than punitive, approach and emphasize 

proactive evidence-based strategies to support 

student social, emotional, and behavioral needs.

Share success stories with policymakers. 

Sharing innovative approaches to providing 

services and supports may influence more 

supportive policies and increase needed funding. 

For example, consider the following:

Form groups to focus on public policy issues 

affecting children and families with the goal of 

advancing promising, evidence-informed public 

policy (Hill, 2021).

 Suggest policy changes to enhance school 

districts’ ability to partner with local health 

departments to leverage available federal 

funding (National Academies of Sciences, 

Engineering, and Medicine, 2017). 

Implement policy in districts, schools, and 

programs to support inclusion and 

implementation of effective social, emotional, 

and behavioral health practices. Ensure equal 

priority for learning outcomes and social, 

emotional, and behavioral health are reflected in 

local policies, procedures, and funding decisions. 

 When reviewing current policies, reflect on the 

need for mental health informed responses 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 31

rather than exclusionary responses to mental 

health needs.

 Implement standard policy to address how data 

will be shared to ensure children and students 

are linked to appropriate interventions and 

have their rights protected. 

 Prioritize a healthy workforce as part of the 

district vision and mission statements. Support 

this priority through consideration of budget 

and allocation formula with staff assignment, 

workload and context of school or program 

needs.

 Articulate new ways of working with 

community providers using a memorandum of 

understanding process. 

 Clearly articulate and communicate new or 

revised policies to impacted groups in 

languages they can understand. 

Implementation Tip

Provide clear guidance on how to implement 

policies consistently. Establish two-way 

communication channels to continuously improve 

policy based on input from implementers and new 

emerging knowledge on evidence-based practices.

6. Enhance Workforce Capacity

There is a critical need for all staff in schools 

(e.g., administrators, educators, school nurses, 

community health workers, family advocates, 

family resource developers, school liaisons, 

teacher aides, teacher assistants, student aides, 

class aides, behavior coaches, behavior 

interventionists, behavior aides) to be trained to 

fully support schools’ Tier 1 

(promotion/prevention) and Tier 2 (early 

intervention) programming (Gustafson et al., 

2021; McQuillin et al., 2019; Rusch et al., 2019). 

As underscored in this document, schools and 

programs are and will be contending with 

significantly elevated child and student social, 

emotional, and behavioral concerns as well as 

addressing the lost instructional time associated 

with the pandemic.

Funds provided from ARP and ESSR, can be used 

to hire additional staff such as social workers, 

counselors, mental health and behavioral specialist 

and school psychologists to meet the growing 

needs of students. Schools can also identify 

current and returning staff with responsibility for 

improving school climate, implementing wellness 

programming (as above), coordinating Tier 2 

programming, and providing additional support 

for Tier 3 services (e.g., to expand family 

outreach, case management). Emphasis should be 

placed on recruiting, training, and providing 

ongoing coaching and implementation support to 

this expanded workforce (see Gustafson et al., 

2021; McQuillin et al., 2019; Reddy, Lekwa, & 

Glover, 2020; Rusch et al., 2019). 

Action Steps for Educators

Leverage the existing workforce to support 

mental health. Expand or clarify functions of 

existing school, program, and district-level staff to 

provide mental health support. Use special 

education teachers or school nurses, for example, 

to deliver comprehensive mental health support 

where their skills align with need (Fazel et al., 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 32

2014). Recruit nurse practitioners to provide 

mental health support onsite (Fazel et al., 2014). 

Supplement school mental health staff with 

telemedicine for more specialized or intensive 

needs (Fazel et al., 2014). School social workers 

can act as conduits between community mental 

health organizations and school staff to provide 

training and support for mental health 

(Frauenholtz et al., 2017). 

 Develop processes for assessing current staff

resources and needs, refocusing staff to

address current child or student needs, and

using data to inform professional development

activities.

 Partner with community mental health

providers and expand their role to serve on

school leadership teams to provide a full

continuum of mental health service across all

tiers.

 Ensure school and community mental health

clinicians are visible, interact and are

accessible to school personnel across settings

providing mental health training and

consultation.

 Provide time for planning and collaboration

for an aligned educational, social-emotional,

and behavioral approach to instruction (e.g.,

small professional learning communities meet

frequently and are supported by district

coaches and community partners).

Enhance training. Modify or extend pre- and inservice professional development to include mental 

health training. Ensure that teacher preservice 

programs include mental health training. Offer 

blended professional development for teachers and 

other service providers so evidence-based practices 

can be implemented effectively and with high 

fidelity (Barrett et al., 2019).

Provide ongoing coaching. Implement coaching 

models to further strengthen teachers’ mental 

health knowledge and capacity (Cappella et al., 

2012). 

Connect with local community colleges and 

four-year colleges and universities. An 

important strategy is to map local community 

colleges and four-year colleges and universities to 

explore connections for college students to work 

in schools. For example, students in associates and 

undergraduate programs can be placed in 

externships in schools to assist in Tier 1 and Tier 2 

programming, and those in mental health graduate 

programs can work in externships focused on 

involvement across tiers, and involvement in Tier 

3 intervention under supervision. Such 

arrangements represent a “win-win,” giving 

students training experience, and helping schools 

expand their workforce capacity. 

7. Use Data for Decision Making to

Promote Equitable

Implementation and Outcomes

Regularly collecting, analyzing, and acting on data 

is critical to supporting the mental health needs of 

children, students, and staff. Data can inform 

decisions on specific mental health needs (Barrett 

et al., 2018) as well as academic needs that are 

impacted by underlying mental health issues 

(Hancock & Carter, 2016). Data can also be used 

for more systemic and proactive decisions in 

schools and districts (McCance-Katz, & Lynch, 

2019). Importantly, school and program staff 

should use data sources from the school and local 

educational system but also from the community 

to help guide planning and program 

implementation (e.g., foster care placements, 

psychiatric hospitalizations).
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 33

Action Steps for Leaders and 

Educators

Review school, program, and community-wide 

data. States, school districts, and community 

partners can evaluate and document outcomes, 

including impact on academic and classroom 

functioning, using school and community-wide 

data (McCance-Katz, & Lynch, 2019). For 

example, district teams can access communitylevel data to determine types and intensities of 

mental health needs that are present in their school 

or program communities. Examples of these data 

include: 

 Chronic absenteeism data, 

 School and campus climate survey results,

 Student visits to school specialists (e.g., 

counselors, nurses, social workers), 

 Calls to community crisis centers,

 The proportion of families in the community 

affected by substance abuse, incarceration, or 

domestic abuse,

 Grade retention, 

 Learning outcomes, including credit 

accumulation,

 Mental health service utilization,

 Community Health Assessments, and

 Other relevant indicators of need (Barrett et al.,

2018; The Steve Fund/JED Foundation, n.d.). 

These broader sources of data can (a) identify key 

areas of risk and resilience and (b) better position 

school and program personnel to identify and 

deliver appropriate interventions, and to monitor 

their progress with children and students (Barrett 

et al., 2018). 

Connect data review to goals, outcomes, and 

action plans. Similarly, school teams review 

relevant school and community data to determine 

which approaches will meet the needs of all 

children and students. Data should include figures 

of students referred for and receiving mental 

health services, which interventions are most 

frequently offered, and outcomes from those 

services (Hoover et al., 2019). In reviewing data, 

the team should establish measurable goals that 

include mental health outcomes. Reviewing data 

prior to and throughout the school year helps 

teams strengthen school-wide prevention efforts. 

In addition, annually track demographic changes 

in the composition of the program or school that 

may have an impact on service needs and 

utilization (The Steve Fund/JED Foundation, n.d.). 

Support teachers, staff, and providers in using 

data to document the needs and progress of 

children and students. At the classroom level, 

teachers, school, and program personnel in early 

childhood and K–12 can use tally sheets or 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 34

checklists to determine when students are most 

likely to demonstrate undesirable behaviors and 

which expectations students have the most 

challenges meeting, for example (Hancock & 

Carter, 2016). This data collection can better 

inform planning instruction and intervention to 

meet identified needs.

Implement an integrated universal screening 

process. Districts are encouraged to adopt a 

structured and comprehensive universal screening 

process to catch internalizing and externalizing 

child or student needs. “Internalizing problems are 

described as inner-directed and generating distress 

in the individual, while externalizing problems are 

described as outer-directed and generating 

discomfort and conflict in the surrounding 

environment” (Forns et al., 2014). An integrated 

screening process looks for early indicators of 

social, emotional, and behavioral strengths and 

concerns. First, train all school or program 

personnel to recognize mental health risk factors 

and act if they are concerned. Second, educators 

administer universal screening for every student 

three times a year in accordance with applicable 

law. The district oversees (a) selection and use of 

a reliable and valid universal screening 

tool/process across all schools, (b) use of universal 

screening data to inform universal support, 

(c) identification of strategies to gather additional 

information for children and students identified as 

potentially at-risk, and (d) targeted or intensive 

support based on data-indicated need.

Schools and districts may consider implementing a 

pilot screening with small groups of students prior 

to the comprehensive universal screening process. 

This allows leaders and educators to better 

understand the procedures, allows teams time to 

course correct, and provides opportunities to build 

upon successes.

Promote accountability. Child and student wellbeing is critical to ensure and enhance full access 

to educational opportunities. Implementation of 

data-based interventions is critical to meeting this 

obligation and demonstrating progress for students 

(Hoover et al., 2019). Thus, in addition to 

monitoring school, program, and community data, 

schools and programs should measure, monitor, 

and evaluate how effectively programs are 

implemented and if the desired outcomes are 

being achieved (Barrett et al., 2018). 

Implementation Tip

States, districts, schools, and programs need valid 

and reliable data to guide all decisions—from the 

selection of evidence-based practices to evaluation 

of implementation fidelity and outcomes.

Summary and State Spotlight

The mental health crisis in the United States is at a 

critical point. The pandemic has exacerbated 

already alarming trends in mental health needs of 

children and students. There is a unique 

opportunity to reconceptualize the role of schools 

and programs in creating nurturing environments 

for children, students, families, and educators to 

address the mental health needs and overall wellbeing of children and students. This resource 

highlighted seven key challenges to providing 

school and program mental health supports and 

presented seven corresponding recommendations. 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 35

Challenges Recommendations

1. Rising Mental Health Needs and Disparities 

Among Children and Student Groups

1. Prioritize Wellness for Each and Every 

Child, Student, Educator, and Provider

2. Perceived Stigma is a Barrier to Access 2. Enhance Mental Health Literacy and 

Reduce Stigma and Other Barriers to 

Access

3. Ineffective Implementation of Practices 3. Implement Continuum of Evidence-Based 

Prevention Practices

4. Fragmented Delivery Systems 4. Establish an Integrated Framework of 

Educational, Social, Emotional, and 

Behavioral-Health Support for All 

5. Policy and Funding Gaps 5. Leverage Policy and Funding

6. Gaps in Professional Development and 

Support

6. Enhance Workforce Capacity 

7. Lack of Access to Usable Data to Guide 

Implementation Decisions

7. Use Data for Decision Making to Promote 

Equitable Implementation and Outcomes

The continuing “Spotlight on Supporting Mental 

Health in Washington State” illustrates how 

Washington responded to the challenges, 

described in the first spotlight, by implementing 

these recommendations to address their local 

challenges. States, districts, and schools are 

encouraged to use data to guide and contextualize 

their own approach to implementing these 

recommendations. In addition to this example, 

please see Appendix A for additional examples 

organized by each of these recommendations.
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 36

Spotlight on Supporting Mental Health in Washington State: Moving Forward with 

Aligning and Implementing

Schools are the most common setting in which children 

and adolescents receive mental health services and 

supports. Shifting to a more integrated and effective 

approach to providing social-emotional, and behavioral 

support requires making changes to many of the 

standard approaches to prevention and intervention in 

schools. In the Northwest, the states of Idaho, Oregon, 

and Washington along with several organizations are 

streamlining and coordinating efforts to enable schoolaged students to access and benefit from a continuum of 

mental health support in the school environment, 

otherwise known as the Interconnected Systems 

Framework (ISF). Coordination efforts between the 

groups includes (a) combining and leveraging local, 

state, and federal funding sources, (b) co-sponsoring 

professional development resources and events, and 

(c) aligning messaging and resources for impacted 

groups. This joint effort aims to more effectively meet the 

needs of children and youth and to support their wellbeing by consolidating federal, state, community, and 

school resources.

The University of Washington SMART Center, as part of 

the Northwest Mental Health Technology Transfer 

Center, the Northwest PBIS Network, Idaho’s Project 

AWARE Washington’s State Education Agency, the 

Association of Washington School Principals, and the 

National Center on PBIS are working together to install 

and improve the implementation of evidence-based

mental health practices across the region. The 

installation of school-based interventions is an extension 

of the previous regional plans to scale PBIS.

The ISF is a structure and process that maximizes 

effectiveness and efficiency by blending the strengths of 

school and community mental health and strengths of

the MTSS framework used in PBIS (Barrett, Eber, 

Weist, 2013). Both PBIS and MTSS emphasize the 

need for detecting mental health needs in students at 

the earliest sign of need and responding effectively with 

evidence-based strategies. To address the well 

documented gap between onset of mental health 

disorders and treatment, schools must have the 

structures in place to recognize need in students at the 

first sign of need and respond rapidly. The ISF provides 

systematic steps for building capacity to identify 

problems and intervene early and effectively. The 

traditional hand-off to a community mental health 

practitioner common in most schools today can delay or 

discourage further treatment. Other traditional 

approaches to school mental health result in mental 

health practitioners providing services without feedback 

to the school or systems to monitor progress and 

outcomes. In an ISF framework, community and schoolbased clinicians’ partner on leadership teams, review 

data collectively with school staff, and ensure effective 

system structures at the school level. Regardless of 

who facilitates interventions, they are all selected, and 

progress monitored by the blended teams using both 

school and community data.

Training and Technical Assistance (TA) has increased 

the capacity of districts to install and sustain effective 

systems that support mental wellness of all students. 

The Training and TA providers facilitate the 

strengthening of the district and school teams to ensure 

school mental health services and supports provided by 

both school and community mental health providers, are 

data-informed, evidence-based, monitored frequently, 

implemented with fidelity and adjusted when outcomes 

are not realized.
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 37

References

Adelman, H., & Taylor, L. (2021a). Embedding mental health as schools change. University of California at 

Los Angeles: The Center for Mental Health in Schools & Student/Learning Supports. 

http://smhp.psych.ucla.edu/pdfdocs/mh20a.pdf

Adelman, H., & Taylor, L. (2021b). New directions for school counselors, psychologists, & social workers. 

University of California at Los Angeles: The Center for Mental Health in Schools & 

Student/Learning Supports. http://smhp.psych.ucla.edu/pdfdocs/report/framingnewdir.pdf

Algozzine, B., Wang, C., White, R., Cooke, N., Marr, M. B., Algozzine, K., Helf, S. S., & Duran, G. Z. 

(2012). Effects of multi-tier academic and behavior instruction on difficult-to-teach students. 

Exceptional Children, 79, 45–64. 

Ali, M. M., West, K., Teich, J. L., et al. (2019). Utilization of mental health services in educational setting by 

adolescents in the United States. Journal of Science Health, 89, 393–401. 

Allday R. A., Bush M., Ticknor N., & Walker L. (2011). Using teacher greetings to increase speed to task 

engagement. Journal of Applied Behavior Analysis. 44(2), 393–396. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3120079/

Alliance for a Healthier Generation (2016). Healthy Schools Program: Framework of Best Practices. 

https://www.niost.org/pdf/host/HealthySchoolsProgramFramework.pdf

Alter, P., & Haydon, T. (2017). Characteristics of effective classroom rules: A review of the literature. 

Teacher Education and Special Education, 40, 114–127. https://doi.org/10.1177/0888406417700962

American College Health Association. (2021). American College Health Association-National College 

Health Assessment III: Reference group executive summary Spring 2021. American College Health 

Association. https://www.acha.org/documents/ncha/NCHA-III_SPRING-2021_REFERENCE_

GROUP_EXECUTIVE_SUMMARY_updated.pdf

Ansary, N. S. (2021) Religious-Based Bullying: Insights on Research and Evidence-Based Best Practices 

from the National Interfaith Anti-Bullying Summit Report. Institute for Social Policy and 

Understanding (ISPU). https://www.ispu.org/wp-content/uploads/2018/09/ISPU-AMHP-ReligiousBased-Bullying.pdf

Arora, P., Connors, E.H., George, M.W., Lyon, A.R., Wolk, C.B., & Weist, M.D. (2016). Advancing 

evidence-based assessment in school mental health: Key priorities for an applied research agenda. 

Clinical Child and Family Psychology Review, 19(4), 271–284. 

Barnes, A. J., Gilbertson, J., & Chatterjee, D. (2018). Emotional Health Among Youth Experiencing Family 

Homelessness. Pediatrics, 141(1). https://pediatrics.aappublications.org/content/141/4/e20171767
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 38

Barrett, S., Eber, L., McIntosh, K., Perales, K., & Romer, N. (2018). Teaching Social-Emotional 

Competencies within a PBIS Framework. Washington, DC: National Center on Positive Behavioral 

Interventions and Supports (PBIS Center). https://www.pbis.org/resource/teaching-social-emotionalcompetencies-within-a-pbis-framework

Barrett, S., Eber, L., Perales, K., & Pohlman, K. (2019). Interconnected Systems Framework 201: When 

School Mental Health is Integrated Within a Multi-Tiered System of Support: What’s Different. 

Center on Positive Behavioral Interventions and Supports (PBIS Center)/Substance Abuse and 

Mental Health Services Administration (SAMHSA). https://www.pbis.org/resource/theinterconnected-systems-framework-201-when-school-mental-health-is-integrated-within-a-multitiered-system-of-support

Barrett, S., Eber, L., & Weist, M.D. (2013). Advancing education effectiveness: An interconnected systems 

framework for Positive Behavioral Interventions and Supports (PBIS) and school mental health. 

Center for Positive Behavioral Interventions and Supports (funded by the Office of Special Education 

Programs, U.S. Department of Education). Eugene, Oregon, University of Oregon Press. 

Bateman, D., & Yell, M. (2019). Free appropriate public education: The essence of special education. In D. 

Bateman and M. Yell (Eds.), Current trends and legal issues in special education (pp. 37–52). 

Thousand Oaks, CA: Corwin. 

Bevilacqua, L., Kelly, Y., Heilmann, A., Priest, N., Lacey, R.E. (2020). Adverse Childhood Experiences and 

Trajectories of Internalizing, Externalizing, and Prosocial Behaviors from Childhood to Adolescence. 

Child Abuse & Neglect, 112. https://doi.org/10.1016/j.chiabu.2020.104890

Bierman, K. L., Mathis, E. T., & Domitrovich, C. E. (2018). Serving the needs of young children with social, 

emotional, and behavioral needs: A commentary. School Mental Health, 10(3), 254–263. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6186455/

Biglan, A., Elfner, K., Garbacz, S. A., Komro, K., Prinz, R., Weist, M. D., Wilson, D., & Zarling, N. A. 

(2020). A strategic plan for strengthening America’s families: A brief from the Coalition of 

Behavioral Science Organizations. Clinical Child and Family Psychology Review, 23(2), 153–175. 

Bitsko, R. H., Holbrook, J. R., Robinson, L. R., Kaminski, J. W., Ghandour, R., Smith, C., Peacock, G., & 

Eds. (2016). Health care, family, and community factors associated with mental, behavioral, and 

developmental disorders in early childhood–United States, 2011–2012. MMWR: Morbidity & 

Mortality Weekly Report, 65(9), 221–226. 

Bradshaw, C. P., Mitchell, M. M., & Leaf, P. J. (2010). Examining the effects of schoolwide positive 

behavioral interventions and supports on student outcomes: Results from a randomized controlled 

effectiveness trial in elementary schools. Journal of Positive Behavior Interventions, 12, 133–148. 

http://www.fixschooldiscipline.org/wp-content/uploads/2020/09/5.Examining_Effects_Schoolwide_ 

Positive_Behavior_Interv_and_Supps_Student_Outcome.2010.pdf
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 39

Bradshaw, C., Waasdorp, T., & Leaf, P. (2012). Effects of school-wide positive behavioral interventions and 

supports on child behavior problems. Pediatrics, 130, 1136–1145. 

https://pediatrics.aappublications.org/content/130/5/e1136

Brock, S.E., & Brant, H.T. (2015). Four ways to improve student mental-health support. Bethesda, MD: 

National Association of School Psychologists (NASP). https://www.nasponline.org/resources-andpublications/resources-and-podcasts/mental-health/school-psychology-and-mental-health/four-waysto-improve-student-mental-health-support

Calzada, E. J., Kim, Y. & O’Gara, J. L. (2019). Skin color as a predictor of mental health in young Latinx 

children, Social Science & Medicine, 238, 112467 https://doi.org/10.1016/j.socscimed.2019.112467

Cappella, E., Hamre, B. K., Kim, H. Y., Henry, D. B., Frazier, S. L., Atkins, M. S., & Schoenwald, S. K. 

(2012). Teacher consultation and coaching within mental health practice: Classroom and child effects 

in urban elementary schools. Journal of Consulting and Clinical Psychology, 80(4), 597–610. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3399967/

Carlson, R., Hock, R., George, M. Kumpiene, G. Yell, M., McCartney, E., Riddle, D., & Weist, M.D. 

(2019). Relational factors influencing parents’ engagement in special education for high school youth 

with emotional/behavioral disorders. Behavioral Disorders, 45(2), 103–116. 

Cashman, J., Linehan, P., Purcell, L., Rosser, M., Schultz, S., & Skalski, S. (2014). Leading by convening: A 

blueprint for authentic engagement. Alexandria, VA: National Association of State Directors of 

Special Education.

Centers for Disease Control and Prevention (CDC). (2020). COVID-19 in racial and ethnic minority groups. 

Atlanta. https://stacks.cdc.gov/view/cdc/89820/cdc_89820_DS1.pdf

Centers for Disease Control and Prevention (CDC) (2021). Mental Health. National Center for Chronic 

Disease Prevention and Health Promotion, Division of Population Health. 

https://www.cdc.gov/mentalhealth/index.htm

Center for School Mental Health Assistance (2002). Empirically supported interventions in school mental 

health. Center for Mental Health Assistance.

Center on Positive Behavioral Interventions and Supports (PBIS Center) (n.d.). Mental health/socialemotional well-being. Washington, DC: U.S. Department of Education. 

https://www.pbis.org/topics/mental-healthsocial-emotional-well-being

Chafouleas, S. (August 2020). Four questions to ask now in preparing your child for school. Psychology 

Today. https://www.psychologytoday.com/us/blog/promoting-student-well-being/202008/4-

questions-ask-now-in-preparing-your-child-school
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 40

Cheney, D. A., Stage, S. A., Hawken, L. S., Lynass, L., Mielenz, C., & Waugh, M. (2009). A 2-year 

outcome study of the check, connect, and expect intervention for students at risk for severe behavior 

problems. Journal of Emotional and Behavioral Disorders, 17(4), 226–243. Children’s Equity 

Project & Bipartisan Policy Center, 2020). https://eric.ed.gov/?id=EJ863235

Clauss-Ehlers, C. S., Carpio, M. G., & Weist, M. D. (2020). Mental health literacy: a strategy for global 

adolescent mental health promotion. Adolescent Psychiatry, 10(2), 73–83. 

Coduti, W. A., Hayes, J. A., Locke, B. D., & Youn, S. J. (2016). Mental health and professional help-seeking 

among college students with disabilities. Rehabilitation Psychology, 61(3), 288–296. 

https://doi.org/10.1037/rep0000101

Cook, C. R., Fiat, A., Larson, M., Daikos, C., Slemrod, T., Holland, E. A., Thayer, A. J., & Renshaw, T. 

(2018). Positive greetings at the door: Evaluation of a low-cost, high-yield proactive classroom 

management strategy. Journal of Positive Behavior Interventions, 20, 149–159. 

Cook, C. R., Frye, M., Slemrod, T. Lyon, A. R., Renshaw, T. L., & Zhang, Y. (2015). An integrated 

approach to universal prevention: independent and combined effects of PBIS and SEL on youths’ 

mental health. School Psychology Quarterly, 30(2): 166–183. https://doi.org/10.1037/spq0000102

Cook, C. R., Grady, E. A., Long, A. C., Renshaw, T., Codding, R. S., Fiat, A., & Larson, M. (2017). 

Evaluating the impact of increasing general education teachers’ ratio of positive to negative 

interactions on students’ classroom behavior. Journal of Positive Behavior Interventions, 19(2), 

67–77. 

Copeland, W. E., McGinnis, E., Bai, Y., Adams, Z., Nardone, H., Devadanam, V., Rerrew, J., Hudziak, J. J. 

(2020). Impact of COVID-19 pandemic on college student mental health and wellness. Journal of the 

American Academy of Child & Adolescent Psychiatry, 60(1), 134–141.e2. 

https://doi.org/10.1016/j.jaac.2020.08.466

Cree R. A., Bitsko R. H., Robinson L. R., et al. (2018). Health care, family, and community factors 

associated with mental, behavioral, and developmental disorders and poverty among children aged 2–

8 Years — United States, 2016. MMWR Morbidity and Mortality Weekly Report, 67. 1377–1383. 

DOI: http://dx.doi.org/10.15585/mmwr.mm6750a1external icon

Cummings, A., & Turner, M. (2020). COVID-19 and Third-Grade Reading Policies. Education Policy 

Innovation Collaborative. https://epicedpolicy.org/wp-content/uploads/2020/10/RBG3-ReadingPolicies-FINAL-10-29-20.pdf

Czeisler, M. E., Lane, R. I., Petrosky, E., Wiley, J. F., Christensen, A., Njai, R., Weaver, M. D., Robbins, R., 

Facer-Childs, E. R., Barger, L. K., Czeisler, C. A., Howard, M. E., & Rajaratnam, A. M. W. (2020). 

Mental health, substance use, and suicidal ideation during the COVID-19 pandemic. MMWR 

Morbidity and Mortality Weekly Report 69, 1049–1057. http://dx.doi.org/10.15585/mmwr.mm6932a1
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 41

Dawson, G., Ashman, S. B., & Carver, L. J. (2000). The role of early experience in shaping behavioral and 

brain development and its implications for social policy. Development and Psychopathology, 12(4).

DeFreitas, S.C., Crone, T., DeLeon, M., & Ajayi, A. (2018). Perceived and Personal mental health stigma in 

Latino and African American college students. Public Health, 26. 

https://doi.org/10.3389/fpubh.2018.00049

Department of Education. (2021). Education in a Pandemic: The Disparate Impacts of COVID-19 on 

America’s Students. Office for Civil Rights. 

https://www2.ed.gov/about/offices/list/ocr/docs/20210608-impacts-of-covid19.pdf

Dooley, D. G., Bandealy, A., & Tschudy, M. M. (2020). Low-income children and Coronavirus disease 2019 

(COVID-19) in the US. JAMA Pediatrics 174(10): 922–923. 

Eber, L., Barrett, S., Perales, K., Jeffrey-Pearsall, J., Pohlman, K., Putnam, R., Splett, J., & Weist, M.D. 

(2019). Advancing education effectiveness: Interconnecting school mental health and school wide 

PBIS, Volume 2: An implementation guide. Center for Positive Behavioral Interventions and Supports 

(funded by the Office of Special Education Programs, U.S. Department of Education). Eugene, 

Oregon, University of Oregon Press. 

Eber, L., Barrett, S., Scheel, N., Flammini, A., & Pohlman, K. (2020). Integrating a trauma-informed 

approach within a PBIS framework. Washington, DC: National Center on Positive Behavioral 

Interventions and Supports (PBIS Center).

Education Commission of the States. (2020). What are the mental health and trauma training requirements 

for K–3 teachers?: 50-State Comparison. Denver, CO. https://files.eric.ed.gov/fulltext/ED608357.pdf

Eklund, K., Meyer, L., Splett, J., & Weist, M. D. (2020). Policies and practices to support school mental health.

In B. Levin, & A. Hanson, K. (Eds.), Foundations of behavioral health (pp. 139–161). New York: 

Springer. 

Evans, S. W., Glass-Siegel, M., Frank, A., Van Treuren, R., Lever, N. A., & Weist, M. D. (2003). 

Overcoming the challenges of funding school mental health programs. In M.D. Weist, S.W. Evans, & 

N.A. Lever (Eds.), Handbook of school mental health: Advancing practice and research (pp. 73–86). 

New York, NY: Springer. 

Evans, S. W., & Weist, M. D. (2004). Implementing empirically supported treatments in schools: What are 

we asking? Clinical Child and Family Psychology Review, 7, 263–267. 

Fang, M. (2018). School poverty and the risk of attempted suicide among adolescents. Social Psychiatry & 

Psychiatric Epidemiology, 53(9), 955–967. 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 42

Fazel, M., Hoagwood, K., Stephan, S., & Ford, T. (2014). Mental health interventions in schools 1: Mental 

health interventions in schools in high-income countries. Lancet Psychiatry, 1(5): 377–387. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4477835/

Fleming, A. R., Edwin, M., Hayes, J. A., Locke, B. D., & Lockard, A. J. (2018). Treatment-seeking college 

students with disabilities: Presenting concerns, protective factors, and academic distress. 

Rehabilitation Psychology, 63(1), 55–67. 

Florida PBIS, Florida Center for Inclusive Communities, & the University of South Florida. (2020). 

Integrating social and emotional learning into your School-Wide Positive Behavior Interventions and 

Supports framework. Presented at the 17th International Virtual Conference on Positive Behavior 

Support. https://assets-global.website-files.com/5d3725188825e071f1670246/ 

60fee55463745c71a95e0705_FLPBIS_SEL_Integration_0712.pdf

Forns, M., Abad, J., & Kirchner, T. (2011). Internalizing and Externalizing Problems. Encyclopedia of 

Adolescence. https://doi.org/10.1007/978-1-4419-1695-2_261

Fruehwirth, J. C., Biswas, S., & Perreira, K. M. (2021). The COVID-19 pandemic and mental health of firstyear college students: Examining the effect of COVID-19 stressors using longitudinal data. PLoS 

ONE, 16(3), 1–15. https://doi.org/10.1371/journal.pone.0247999

Frauenholtz, S., Mendenhall, A. N., & Moon, J. (2017). Role of school employees’ mental health knowledge 

in interdisciplinary collaborations to support the academic success of students experiencing mental 

health distress. Children & Schools, 39(2), 71–79. https://doi.org/10.1093/cs/cdx004

Furnham, A., & Swami, V. (2018). Mental health literacy: A review of what it is and why it matters. 

International Perspectives in Psychology: Research, Practice, Consultation, 7(4), 240–257. 

Gage, N. A., Grasley-Boy, N., George, H. P., Childs, K., & Kincaid, D. (2019). A quasi-experimental design 

analysis of the effects of school-wide positive behavior interventions and supports on discipline in 

Florida. Journal of Positive Behavior Interventions, 21(1), 50–61. 

https://doi.org/10.1177%2F1098300718768208

Geiser, K., Fehrer, K., Pyne, J., Gerstein, A., Harrison, V., Joshi, S., & Stanford University, J. W. G. C. for 

Y., and T. C. (JGC). (2019). San Mateo area teen mental health study. Research Brief. John W. 

Gardner Center for Youth and Their Communities. https://eric.ed.gov/?id=ED604087

Gilliam, W. S. (2005). Prekindergartners left behind: Expulsion rates in state prekindergarten systems. New 

Haven, CT: Yale University Child Study Center. https://medicine.yale.edu/childstudy/zigler/ 

publications/National%20Prek%20Study_expulsion%20brief_34775_5379_v1.pdf

Gilliam, W. S., & Reyes, C. R. (2018). Teacher decision-making factors that lead to preschool expulsion: 

Scale development and preliminary validation of the preschool expulsion risk measure. Infants and 

Young Children, 31(2), 93–108. 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 43

Gonzales, G., de Mola, E. L., Gavulic, K. A., McKay, T., & Purcell, C. (2020). Mental health needs among 

lesbian, gay, bisexual, and transgender college students during the COVID-19 pandemic. Journal of 

Adolescent Health, 67(5), 645–648. 

Goodwill, J. R., & Zhou, S. (2020). Association between perceived public stigma and suicidal behaviors 

among college students of color in the U.S. Journal of Affective Disorders, 262, 1–7. 

Grasley-Boy, N., Gage, N. A., & Lombardo, M. (2019). Effect of SWPBIS on disciplinary exclusions for 

students with and without disabilities. Exceptional Children, 86, 25–39. 

Gueldner, B. A., & Feuerborn, L. L. (2016). Integrating mindfulness-based practices into social and 

emotional learning: A case application. Mindfulness, 7:164–175. 

Gustafson, E. L., Lakind, D., Walden, A. L., Rusch, D., & Atkins, M. S. (2021). Engaging parents in mental 

health services: A qualitative study of community health workers’ strategies in high poverty urban 

communities. Administration and Policy in Mental Health and Mental Health Services Research, 

1–15. 

Hancock, C. L., & Carter, D. R. (2016). Building environments that encourage positive behavior: The 

Preschool Behavior Support Self-Assessment. Young Children, 71(1). https://www.naeyc.org/ 

resources/pubs/yc/mar2016/building-environments-encourage-positive-behavior-preschool

Harding, S., Morris, R., Gunnell, D., Ford, T., Hollingworth, W., Tilling, K., Evans, R., Bell, S., Grey, J., 

Brockman, R., Campbell, R., Araya, R., Murphy, S., & Kidger, J. (2019). Is teachers’ mental health 

and well-being associated with students’ mental health and well-being? Journal of Affective 

Disorders, 253, 460–466. 

Hawken, L. S., Adolphson, S. L., Macleod, K. S., & Schumann, J. (2009). Secondary-tier interventions and 

supports. In W. Sailor, G. Dunlap, G. Sugai, & R. Horner (Eds.), Handbook of positive behavior 

support (pp. 395–420). New York: Springer. 

Heiden, R. K., Salas, J., Moore, R., Hasan, S., & Wilson, L. (2020). Peer victimization and mental health 

outcomes for lesbian, gay, bisexual, and heterosexual youth: A latent class analysis. Journal of 

School Health, 90(10), 771–778. 

Hertz, M. F., & Barrios, L.C. (2021). Adolescent mental health, COVID-19, and the value of schoolcommunity partnerships. Inj Prev 27:85–86. 

Hill, T. J. (2021). Enhancing school capacity to support children’s mental health. Washington, DC: National 

Conference of State Legislators (NCSL). https://www.ncsl.org/Portals/1/Documents/Health/1-

Mental-Health-in-Schools_v04_web.pdf

Hodgkinson S., Godoy L., Beers L. S., & Lewin, A. (2017). Improving mental health access for low-income 

children and families in the primary care setting. Pediatrics, 139(1): e20151175. 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 44

Hoover, S., Lever, N., Sachdev, N., Bravo, N., Schlitt, J., Acosta Price, O., Sheriff, L. & Cashman, J. (2019). 

Advancing comprehensive school mental health: Guidance from the field. Baltimore, MD: National 

Center for School Mental Health. University of Maryland School of Medicine.

Horner, R. H., Sugai, G., & Lewis, T. J. (2020). Is school-wide positive behavioral interventions and 

supports (PBIS) an evidence-based practice? Center on PBIS, University of Oregon. 

https://www.pbis.org/resource/is-school-wide-positive-behavior-support-an-evidence-based-practice

Horner, R. H., Sugai, G., Smolkowski, K., Eber, L., Nakasato, J., Todd, A. W., & Esperanza, J. (2009). A 

randomized, wait-list controlled effectiveness trial assessing school-wide positive behavior support in 

elementary schools. Journal of Positive Behavior Interventions, 11, 133–144. 

https://doi.org/10.1177/1098300709332067

Horwitz, A. G., McGuire, T., Busby, D. R., Eisenberg, D., Zheng, K., Pistorello, J., Albucher, R., Coryell, 

W., & King, C. A. (2020). Sociodemographic differences in barriers to mental health care among 

college students at elevated suicide risk. Journal of Affective Disorders, 271, 123–130. 

https://doi.org/10.1016/j.jad.2020.03.115 

Jorm, A. F. (2012). Mental health literacy: Empowering the community to take action for better mental 

health. American Psychologist, 67(3), 231–243. 

Kam, B., Mendoza, H. & Masuda, A. (2019). Mental health help-seeking experience and attitudes in Latina/o 

American, Asian American, Black American, and White American college students. International 

Journal for the Advancement of Counselling, 41, 492–508. 

Kern, L., & Clemens, N. H. (2007). Antecedent strategies to promote appropriate classroom behavior. 

Psychology in the Schools, 44, 65–75.

Knickman, J., Krishnan, K. R. R., Pincus, H. A., Blanco, C., Blazer, D. G., Coye, M. J., Krystal, J. H., 

Rauch, S. L., Simon, G. E., & Vitiello, B. (2016). Improving access to effective care for people who 

have mental health and substance use disorders: A vital direction for health and health care. 

Discussion Paper: National Academy of Medicine. https://nam.edu/wp-content/uploads/2016/09/ 

Improving-Access-to-Effective-Care-for-People-Who-Have-Mental-Health-and-Sustance-UseDisorders.pdf

Kosciw, J. G., Greytak, E. A., Zongrone, A. D., Clark, C. M., & Truong, N. L. (2018). The 2017 National 

School Climate Survey: The experiences of lesbian, gay, bisexual, transgender, and queer youth in 

our nation’s schools. New York: GLSEN. https://www.glsen.org/sites/default/files/2019-10/GLSEN2017-National-School-Climate-Survey-NSCS-Full-Report.pdf

Lambert, M. C., Garcia, A. G., January, S. A., & Epstein, M. H. (2018). The impact of English language 

learner status on screening for emotional and behavioral disorders: A differential item functioning 

(DIF) study. Psychology in the Schools, 55(3), 229–239. 

https://onlinelibrary.wiley.com/doi/pdf/10.1002/pits.22103
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 45

Lane, K. L., Oakes, W. P., Buckman, M. M., Sherod, R., & Lane, K. S., (November 2020). Systematic 

screening for behavior in current K–12 Settings. Eugene, OR: Center on PBIS, University of Oregon. 

https://www.pbis.org/resource/systematic-screening-for-behavior-in-current-k-12-instructionalsettings

Lederer, A. M., Hoban, M. T., Lipson, S. K., Zhou, S., & Eisenberg, D. (2021). More than inconvenienced: 

The unique needs of U.S. college students during the COVID-19 pandemic. Health Education & 

Behavior, 48(1), 14–19. https://journals.sagepub.com/doi/pdf/10.1177/1090198120969372

Lee, A., & Gage, N. A. (2020). Updating and expanding systematic reviews and meta‐analyses on the effects 

of school‐wide positive behavior interventions and supports. Psychology in the Schools, 57, 783–804. 

https://onlinelibrary.wiley.com/doi/epdf/10.1002/pits.22336

Leeb, R. T., Bitsko, R. H., Radhakrishnan, L., Martinez, P., Njai, R., & Holland, K. M. (2020). Mental 

health–related emergency department visits among children aged <18 years during the COVID-19 

pandemic — United States, January 1–October 17, 2020. Morbidity and Mortality Weekly Report, 

69(45), 1675–1680. https://www.cdc.gov/mmwr/volumes/69/wr/mm6945a3.htm

Lever, N. A., Adelsheim, S., Prodente, C., Christodulu, K. V., Ambrose, M. G., Schlitt, J., & Weist, M. D. 

(2003). System, agency, and stakeholder collaboration to advance mental health programs in schools. 

In M. D. Weist, S. W. Evans, & N. A. Lever (Eds.), Handbook of school mental health: Advancing 

practice and research (pp. 149–162). New York, NY: Springer. 

Lever, N., Mathis, E., & Mayworm, A. (2017). School mental health is not just for students: Why teacher 

and school staff wellness matters. Report of Emotional and Behavioral Disorders in Youth, 17(1): 6–

12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6350815/

Lipscomb, S. T., Hatfield, B., Lewis, H., Goka-Dubose, E., & Abshire, C. (2021). Adverse Childhood 

Experiences and Children’s Development in Early Care and Education Programs. Journal of Applied 

Developmental Psychology, 72. https://doi.org/10.1016/j.appdev.2020.101218

Loman, S. L., Strickland-Cohen, M. K., & Walker, V. L. (2018). Promoting the Accessibility of SWPBIS for 

Students with Severe Disabilities. Journal of Positive Behavior Interventions, 20, 

https://journals.sagepub.com/doi/10.1177/1098300717733976

Losen, D. J., & Martinez, P. (2020). Is California doing enough to close the school discipline gap? The 

Center for Civil Rights Remedies at The Civil Rights Project, University of California Los Angeles. 

https://www.civilrightsproject.ucla.edu/research/k-12-education/school-discipline/is-california-doingenough-to-close-the-school-discipline-gap

Lund, E. M. (2020). Interpersonal violence against people with disabilities: Additional concerns and 

considerations in the COVID-19 pandemic. Rehabilitation Psychology, 65(3), 199–205. 

http://dx.doi.org/10.1037/rep0000347
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 46

Lund, E. M., & Gabrielli, J. (2021). The role of pediatric psychologists in mitigating disability-specific 

barriers among youth during the COVID-19 pandemic. Clinical Practice in Pediatric Psychology, 

9(1), 12–23. http://dx.doi.org/10.1037/cpp0000387

Maag, J. W., & Katsiyannis, A. (2010). School-based mental health services: Funding options and issues. 

Journal of Disability Policy Studies, 21(3), 173–180. https://www.researchgate.net/publication/

236135037_School-Based_Mental_Health_Services_Funding_Options_and_Issues/link/ 

0deec5183e3efa0455000000/download

Malik, F., & Marwaha, R. (2018). Developmental stages of social emotional development in children.

StatPearls Publishing. Jan–. PMID: 30521240.

Malik, R. (2017). New data reveal 250 preschoolers are suspended or expelled every 

day. https://www.americanprogress.org/issues/early-childhood/news/2017/11/06/442280/new-datareveal-250-preschoolers-suspended-expelled-every-day/

Margolius, M., Doyle Lynch, A., Pufall Jones, E. & Hynes, M. (2020). The State of Young People during 

COVID-19: Findings from a nationally representative survey of high school youth. America’s 

Promise Alliance. https://www.americaspromise.org/sites/default/files/d8/

YouthDuringCOVID_FINAL%20%281%29.pdf

Massey, O., & Vroom, E. (2019). The role of implementation science in behavioral health. In B. Levin, & A. 

Hanson, K. (Eds.), Foundations of behavioral health (pp. 101–118). New York: Springer. 

McCance-Katz, E., & Lynch, C (2019). Guidance to states and school systems on addressing mental health 

and substance use issues in schools. Washington, DC: Substance Abuse and Mental Health Services 

Administration (SAMHSA)/Centers for Medicare and Medicaid Services (CMS). 

https://store.samhsa.gov/sites/default/files/d7/priv/pep19-school-guide.pdf

McClain, S., Beasley, S. T., Jones, B., Awosogba, O., Jackson, S., & Cokley, K. (2016). An examination of 

the impact of racial and ethnic identity, impostor feelings, and minority status stress on the mental 

health of black college students. Journal of Multicultural Counseling & Development, 44(2), 

101–117. 

McIntosh, K., Girvan, E. J., Falcon, S., Santiago-Rosario, M. R., McDaniel, S. C., Izzard, S., Bastable, E., 

Nese, R. N. T., & Baldy, T. S. (in press). An equity focused PBIS approach reduces racial inequities 

in school discipline: A randomized controlled trial. School Psychology. 

McIntosh, K., Girvan, E. J., Horner, R. H., Smolkowski, K., & Sugai, G. (2018). A 5-point intervention 

approach for enhancing equity in school discipline. OSEP Technical Assistance Center on Positive 

Behavioral Interventions and Supports. 

McLeod, J. D., Uemura, R., & Rohrman, S. (2012). Adolescence Mental Health, Behavior Problems, and 

Academic Achievement. Journal of Health and Social Behavior, 53(4), 482–497. 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 47

McQuillin, S. D., Lyons, M. D., Becker, K. D., Hart, M. J., & Cohen, K. (2019). Strengthening and 

expanding child services in low resource communities: The role of task‐shifting and just‐in‐time 

training. American Journal of Community Psychology, 63(3–4), 355–365. 

Meek, S. E., & Gilliam, W. S. (2016). Expulsion and suspension in early education as matters of social 

justice and health equity. NAM Perspectives. Discussion Paper, National Academy of Medicine, 

Washington, DC. 

Meleo-Erwin, Z., Kollia, B., Fera, J., Jahren, Al., & Basch, C. (2021). Online support information for 

students with disabilities in colleges and universities during the COVID-19 pandemic. Disability and 

Health Journal, 14(1). https://doi.org/10.1016/j.dhjo.2020.101013

Miles, R., Rabin, L. Krishnan, A., Grandoit, E., & Kloskowski, K. (2020). Mental health literacy in a diverse 

sample of undergraduate students: Demographic, psychological, and academic correlates. BMC 

Public Health, 20:1699. https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-020-

09696-0.pdf

Miller, J. (2010). The use of debriefings in schools. Smith College Studies in Social Work, 71(2), 259–270. 

https://doi.org/10.1080/00377310109517627 

Morris, E. W., & Perry, B. L. (2016). The punishment gap: School suspension and racial disparities in 

achievement. Social Problems, 63, 68–86. 

National Academies of Sciences, Engineering, and Medicine. (2017). Communities in action: Pathways to 

health equity. Washington, DC: The National Academies Press.

National Association of School Psychologists. (2021). Comprehensive School-Based Mental and Behavioral 

Health Services and School Psychologists [handout]. 

National Association of Student Personnel Administrators (NASPA). (2017). A New Model for Campus 

Health: Integrating Well-Being into Campus Life. Leadership Exchange, 15(3). 

https://www.naspa.org/blog/a-new-model-for-campus-health-integrating-well-being-into-campus-life

National Center for School Mental Health (NCSMH). (2021). Advancing Comprehensive School Mental 

Health Systems: Guidance from the Field. University of Maryland School of Medicine, 

https://www.schoolmentalhealth.org/Resources/Foundations-of-School-Mental-Health/AdvancingComprehensive-School-Mental-Health-Systems--Guidance-from-the-Field

National Technical Assistance Center on Positive Behavioral Interventions and Supports. (2017). Technical 

guide for alignment of initiatives, programs, practices in school districts. Eugene, OR: 

https://www.pbis.org/resource/technical-guide-for-alignment-of-initiatives-programs-and-practicesin-school-districts
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 48

North Carolina School Mental Health Initiative (NCSMHI). (2016). Current status of mental health in 

children and youth. https://www.collectiveimpactforum.org/sites/default/files/initiativedocumnts/SMHI%20EXECUTIVE%20SUMMARY_FINAL.pdf

Office for Civil Rights. (2016). 2013– 2014 Civil Rights Data Collection: A first look. U.S. Department of 

Education. https://ocrdata.ed.gov/assets/downloads/2013-14-first-look.pdf

Office of Special Education Programs. (2015). Supporting and Responding to Behavior: Evidence-Based 

Classroom Strategies for Teachers. U.S. Department of Education. 

https://osepideasthatwork.org/sites/default/files/ClassroomPBIS_508.pdf

Owens, P. L., Hoagwood, K., Horwitz, S. M., Leaf, P. J., Poduska, J. M., Kellam, S. G., & Ialongo, N. S. 

(2002). Barriers to children's mental health services. Journal of the American Academy of Child & 

Adolescent Psychiatry, 41(6), 731–738. 

Patrick, S. W., Henkhaus, L. E., Zickafoose, J. S., Lovell, K., Halvorson, A., Loch, S., Letterie, M., & Davis, 

M. M. (2020). Well-being of parents and children during the COVID19 pandemic: A national survey.

Pediatrics, 146(4), 1–8. https://pediatrics.aappublications.org/content/146/4/e2020016824

Pelto, D. J., Ocampo, A., Garduño-Ortega, O., López, C. T. B., Macaluso, F., Ramirez, J., Gonzalez, J., & 

Gany, F. (2019). The nutrition benefits participation gap: Barriers to uptake of SNAP and WIC 

among Latinx American immigrant families. Journal of Community Health, 45, 488–491. 

Peterson, L. S., Pham, S., & Solé, M. (2021). Supporting English learners during virtual learning. 

Communique (0164775X), 49(6), 14–17. 

Pier, L., Christian, M., Tymeson, H., & Meyer, R. H. (2021). COVID-19 impacts on student learning: 

Evidence from interim assessments in California. Policy Analysis for California Education. 

https://edpolicyinca.org/publications/covid-19-impacts-student-learning

Poppen, M., Sinclair, J., Hirano, K., Lindstrom, L., & Unruh, D. (2016). Perceptions of mental health 

concerns for secondary students with disabilities during transition to adulthood. Education and 

Treatment of Children 39(2), 221–246. 

Price, J. H., & Khubchandani, J. (2019). The changing characteristics of African-American adolescent 

suicides, 2001–2017. Journal of Community Health, 44(4), 756–763. 

https://media.tristatehomepage.com/nxsglobal/tristatehomepage/document_dev/2019/05/22/PriceKhubchandani2019_Article_TheChangingCharacteristicsOfAf_1558536959621_88573150_ver1.0.pdf

Quirk, A. (2020). Mental health supports for students of color during and after the coronavirus pandemic. 

Center for American Progress. https://www.americanprogress.org/issues/education-k12/news/2020/07/28/488044/mental-health-support-students-color-coronavirus-pandemic/
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 49

Reddy, L. A., Lekwa, A. J., & Glover, T. A. (2020). Supporting paraprofessionals in schools: Current 

research and practice. Psychology in the Schools, 58(4), 643–647. https://doi.org/10.1002/pits.22457

Rusch, D., Walden, A. L., Gustafson, E., Lakind, D., Atkins, M. S. A qualitative study to explore 

paraprofessionals’ role in school‐based prevention and early intervention mental health 

services. Journal of Community Psychology. 2019; 47: 272–290. 

Salle, T. L., George, H. P., McCoach, D. B., Polk, T., & Evanovich, L. L. (2018). An examination of school 

climate, victimization, and mental health problems among middle school students self-identifying 

with emotional and behavioral disorders. Behavioral Disorders, 43(3), 383–392. 

Schlanger, P., & Shaffer, S. (2018). Protecting Religious Desegregation in Public Schools. Center for 

Educational Equity at MAEC. https://maec.org/wp-content/uploads/2017/06/Exploring-EquityProtecting-Religious-Desegregation.pdf

Simonsen, B., Goodman, S., Robbie, K., Power, M., Rodriguez, C., & Burns, D. (January 2021). Effective 

Instruction as a Protective Factor. Eugene, OR: Center on PBIS, University of Oregon. 

https://www.pbis.org/resource/effective-instruction-as-a-protective-factor

Sinclair, M. F., Christenson, S. L., Lehr, C. A., & Anderson, A. R. (2003). Facilitating Student Engagement: 

Lessons Learned from Check & Connect Longitudinal Studies. California School Psychologist, 8,

29–41. 

Skaar, N. R., Etscheidt, S. L., & Kraayenbrink, A. (August 2020). School-Based Mental Health Services

for Students with Disabilities: Urgent Need, Systemic Barriers, and a Proposal. Exceptionality. 

https://doi.org/10.1080/09362835.2020.1801437

practices for teaming and collaboration in the Interconnected Systems Framework. Journal of Applied 

School Psychology, 33(4), 347–368. 

Skiba, R. J., & Peterson, R. L. (2000). School discipline at a crossroads: From zero tolerance to early 

response. Exceptional Children, 66(3), 335–346. Smith & Lawrence, 2019. 

Smith, S., Ferguson, D., Burak, E. W., Granja, M. R., & Ortuzar, C. (2020). Supporting social-emotional and 

mental health needs of young children through part c early intervention: Results from a 50-state 

survey. National Center for Children in Poverty, Bank Street Graduate School of Education. 

Spiel, C. F., Evans, S. W., & Langberg, J. M. (2014). Evaluating the content of Individualized Education 

Programs and 504 Plans of young adolescents with attention deficit/hyperactivity disorder. School 

Psychology Quarterly, 29(4), 452–468. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4285444/

Splett, J. W., Perales, K., Halliday-Boykins, C. A., Gilchrest, C., Gibson, N. & Weist, M. D. (2017). Best

Stark, A. M. & Basu, A. Shifting from survival to supporting resilience in children and families in the 

COVID-19 pandemic: Lessons for informing U.S. mental health priorities. Psychological Trauma: 

Theory, Research, Practice and Policy, 12(1), 133–135. https://doi.apa.org/fulltext/2020-40856-001.pdf
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 50

Steele, H., Steele, M., Croft, C., & Fonagy, P. (1999). Infant‐mother attachment at one year predicts 

children’s understanding of mixed emotions at six years. Social Development, 8(2), 161–178. 

Stephan, S. H., Weist, M., Kataoka, S., Adelsheim, S., & Mills, C. (2007). Transformation of children's 

mental health services: The role of school mental health. Psychiatric Services, 58(10), 1330–1338. 

Stuart, H. (2016). Reducing the stigma of mental illness. Global Mental Health, 3. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5314742/

Substance Abuse and Mental Health Services Administration (SAMSHA). (2020). National guidelines for 

behavioral health crisis care best practice toolkit. Rockville, MD: Office of the Chief Medical 

Officer, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/ 

sites/default/files/national-guidelines-for-behavioral-health-crisis-care-02242020.pdf

Substance Abuse and Mental Health Services Administration (SAMSHA). (2019). Ready, Set, Go, Review: 

Screening for behavioral health risk in Schools. Rockville, MD: Office of the Chief Medical Officer, 

Substance Abuse and Mental Health Services Administration. 

https://www.samhsa.gov/sites/default/files/ready_set_go_review_mh_screening_in_schools_508.pdf

Taylor, J. (2019). Mental health in LGBTQ Youth: Review of research and outcomes. Communique, 48(3), 

4–6. 

The Education Trust, Reach Higher, American School Counselors Association. (2019). School Counselors 

Matter. https://www.schoolcounselor.org/getmedia/b079d17d-6265-4166-a120-3b1f56077649/ 

School-Counselors-Matter.pdf

The Steve Fund/JED Foundation. (n.d.). Equity in mental health framework. 

https://equityinmentalhealth.org/wp-content/uploads/2017/11/Equity-in-Mental-Health-Frameworkv17.pdf

The Trevor Project. (2020). How COVID-19 is impacting LGBTQ youth. West Hollywood, CA: The Trevor 

Project. https://www.thetrevorproject.org/wp-content/uploads/2020/10/Trevor-Poll_COVID19.pdf

The Trevor Project. (2021). 2021 National Survey on LGBTQ Youth Mental Health. West Hollywood, CA: 

The Trevor Project. https://www.thetrevorproject.org/wp-content/uploads/2021/05/The-TrevorProject-National-Survey-Results-2021.pdf

Uro, G., Lai, D., Alsace, T., & Council of the Great City Schools. (2020). Supporting English learners in the 

COVID-19 crisis. Council of the Great City Schools. https://files.eric.ed.gov/fulltext/ED607280.pdf

U.S. Department of Education. (2021). ED COVID-19 Handbook Volume 2: Roadmap to Reopening Safely 

and Meeting All Students’ Needs. https://www2.ed.gov/documents/coronavirus/reopening2.pdf?utm_content=&utm_medium=email&utm_name=&utm_source=govdelivery&utm_term=
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 51

Vincent, C. G., Tobin, T. J., Hawken, L. S., & Frank, J. L. (2012). Discipline referrals and access to 

secondary level support in elementary and middle schools: Patterns across African-American, 

Hispanic-American, and white students. Education and Treatment of Children, 35, 431–458. 

Weir, K. (2012). The beginning of mental illness. Monitor on Psychology, 43(2), 36.

Weist, M. D., Eber, L., Horner, R., Splett, J., Putnam, R., Barrett, S., Perales, K., Fairchild, A. J., & Hoover, 

S. (2018). Improving multitiered systems of support for students with “internalizing” 

emotional/behavioral problems. Journal of Positive Behavior Interventions, 20(3), 172–184. 

Weist, M. D., Franke, K., Lucio, R., Bass J., Doan, T., & Blalock, D. (in press). Privatization and school 

mental health. Journal of Public Mental Health. 

Weist, M. D., Garbacz, A., Lane, K., & Kincaid, D. (2017). Enhancing progress for meaningful family 

engagement in all aspects of Positive Behavioral Interventions and Supports and Multi-Tiered 

Systems of Support. In M. Weist, A. Garbacz, K. Lane, & D. Kincaid (Eds.), Aligning and 

integrating family engagement in Positive Behavioral Interventions and Supports (PBIS): Concepts 

and strategies for families and schools in key contexts (pp. 1–8). Center for Positive Behavioral 

Interventions and Supports (funded by the Office of Special Education Programs, U.S. Department of 

Education). Eugene, Oregon, University of Oregon Press. 

Weist, M. D., Goldstein, J., Evans, S. W., Lever, N. A., Axelrod, J., Schreters, R., & Pruitt, D. (2003). 

Funding a full continuum of mental health promotion and intervention programs in the schools. 

Journal of Adolescent Health, 32, 70–78. 

Weist, M. D., Mellin, E. A., Garbacz, S. A., & Anderson-Butcher, D. (2019b). Reducing the use of language 

that stigmatizes students. Communique, 47(8), 1–22. 

Weist, M. D., Shapiro, C. J., Hartley, S. N., Bode, A. A., Miller, E., Huebner, S., Terry, J., Hills, K., & 

Osher, D. (2019a). Assuring strengths- and evidence-based approaches in child, adolescent, and 

school mental health. In Osher, D., Mayer, M. J., Jagers, R. J., Kendziora, K., & Wood, L. (Eds). 

Keeping Students Safe and Helping Them Thrive: A Collaborative Handbook on School Safety, 

Mental Health, and Wellness, Volume 2. ABC-CLIO.

West, K. D., Ali, M. M., Schreier, A., & Plourde, E. (2021). Child and Adolescent Mental Health During 

COVID-19: Considerations for Schools and Early Childhood Providers. Office of the Assistant 

Secretary for Planning and Evaluation Issue Brief. 

https://www.aspe.hhs.gov/reports/child-adolescent-mental-health-during-covid-19

Whitaker, K., Nicodimos, S., Pullmann, M. D., Duong, M. T., Bruns, E. J., Wasse, J. K., & Lyon, A. R. 

(2018). Predictors of disparities in access and retention in school-based mental health services. 

School Mental Health, 10(2), 111–121. 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 52

Williamson, S., Hoover, S., & Lever, N. (2020). Addressing students’ immediate mental health needs on reengaging for the 2020-21 school year. National Center on Safe Supportive Learning Environments. 

https://safesupportivelearning.ed.gov/sites/default/files/BIF%201%20Slides%20Addressing%20Imm

ediate%20MH%20Needs%20August%202020_Final.pdf

Willis, D. E. (2021). Feeding inequality: food insecurity, social status, and college student health. Sociology 

of Health & Illness, 43(1), 220–237. 

World Health Organization (WHO). (2020a). COVID-19 disrupting mental health services in most countries, 

WHO survey. Geneva: World Health Organization. 

World Health Organization (WHO). (2020b). Guidelines on mental health promotive and preventive 

interventions for adolescents: Helping adolescents thrive. Geneva: World Health Organization.

Xiao, H., Carney, D. M., Youn, S. J., Janis, R. A., Castonguay, L. G., Hayes, J. A., & Locke, B. D. (2017). 

Are we in crisis? National mental health and treatment trends in college counseling 

centers. Psychological Services, 14(4), 407–415. 

Yoshikawa, H., Weiland, C., Brooks-Gunn, J., Burchinal, M. R., Espinoza. L. M., Gormley, 

W. T., Ludwig, J., Magnuson, K. A., Phillips, D., Zaslow, M. J. (2013). Investing in our future: The 

evidence base on preschool education. New York, NY: Foundation for Child Development. 

Yoshikawa, H., Wuermli, A. J., Dreyer, B., Leckman, J. F., Lye, S. J., Britto, P. R., Ponguta, L. A., Richter, 

L. M., & Stein, A. (2020). Effects of the global Coronavirus disease-2019 pandemic on early 

childhood development: Short- and long-term risks and mitigating program and policy actions. The 

Journal of Pediatrics, 223, 188–193. https://doi.org/10.1016/j.jpeds.2020.05.020
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 53

APPENDIX A. 

Implementation Examples by Recommendation

K–12 Schools, Early Childhood Programs and 

Institutions of Higher Education around the 

country are intentionally prioritizing their efforts 

to enhance child and student wellness, focusing on 

social, emotional, and mental health strategies and 

supports. Here are some examples organized by 

the seven recommendations discussed earlier.

1. Prioritize Wellness for Each and

Every Child, Student, Educator,

and Provider

 Mental health will always be important, 

whether the virus is here or not.”

 — Bryan Jandres,

Youth Panel on Wellness

Mental Health For ALL: 

Strengthening Community 

Partnerships

Using the Interconnected Systems Framework 

(ISF), the Central School District in Oregon has 

strengthened and relied upon its community 

partnerships to prioritize the social and emotional 

needs of students, staff, and families during the 

Pandemic. A Community Planning Committee 

was formed, including representation of key staff, 

student, family, and community partner voices for 

the planning and development of Central’s 

Comprehensive Distance Learning, Limited InPerson Instruction, and Hybrid Learning models. 

From that larger committee, the Interconnected 

Systems Framework District Community 

Leadership Team has solidified its focused work 

on building District systems that support “mental 

health for all” through an MTSS framework. The 

leadership team continues to use school and 

community data to identify student needs and 

support mental health holistically including 

community resources and partnerships to provide 

support. Central has maintained a strong focus on 

building and maintaining positive relationships 

with students through live class connections, 

family and student outreach, home visits, and 

more. The district continues to focus on Tier 1 

school-wide practices to teach and model healthy 

coping strategies and stress management and 

expanded their procedures to identify and connect 

students and families to further support as needed. 

Central has implemented the “Handle with Care” 

program, met basic needs through food 

distribution to students and families, and provided 

students access to reliable internet through 

partnerships with the cities of Monmouth and 

Independence and their local internet provider. 

Staff wellness has been a high priority for school 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 54

and district administrators, along with Central’s 

employee wellness program, Get Fit, and the 

Whole Child Program that has supported 

educators with mental health and wellness 

resources and weekly virtual staff wellness groups 

throughout the Pandemic.

 Equity has been a key focus of the 

Central School District’s Pandemic 

response as we have worked to 

consistently include staff, family, and 

student voices that truly represent our 

community and work to support every 

single student. We are partnering with 

Western Oregon University to embed 

equity into every aspect of our 

professional learning”.

 — Jennifer Kubista

Superintendent

Early Intervention is Key

Infant and Early Childhood Mental 

Health Consultation (IECMHC) is a preventive 

and inclusive intervention for promoting young 

children’s social, emotional, and behavioral health 

in early childhood settings. The cornerstone of 

IECMHC is a collaborative relationship between 

the Mental Health Consultant (MHC) and the 

adults who care for young children (e.g., parents 

and other family members, early childhood 

educators, home visitors).

Promotion of Student WellBeing Through Shared 

Learning and Enhanced 

Prevention Efforts

The Massachusetts School Mental Health 

Consortium is comprised of Massachusetts school 

districts committed to improving the mental health 

services and supports available to students across 

the Commonwealth. Consortium member districts 

recognize the growing needs of our student 

populations relative to mental illness and 

substance use and seek creative solutions to 

enhance prevention efforts, reduce wait time for 

therapeutic services, and increase the quality and 

sustainability of school mental health services and 

supports. Through shared learning, collaboration, 

and consultation, member districts will actively 

engage in efforts to improve the well-being of 

students in order to support their future success.

Leveraging the MTSS 

Framework to Support 

Wellness

Clifton Public Schools in New Jersey have 

leveraged their Multi-Tiered Systems of Support 

(MTSS) Framework to support their transitions 

among in-person, remote, and hybrid learning 

modes. During this time, they have built a strong 

district leadership team that includes 

representation from each school, key areas of 

expertise (e.g., mental health/wellness, physical 

education/wellness, special education), and 

representation from families. This team 

coordinates with other school and community 

partners (e.g., food service, local law enforcement, 

child welfare) to proactively support students and 

families. Each of their schools uses the MTSS 

framework to teach, remind, and reinforce positive 

expectations to support learning and wellness. To 

ensure expectations are accessible to most families 

and students, educators presented expectations in 

English, Spanish, and Arabic. Further, staff used 

district-wide data to drive decisions about 

intensifying their universal support (for all), 

targeted support (for some), and intensive support 

(for individual students identified with significant 

need). And they did all of this while building a 

strong, positive, and vibrant community—

celebrating the “Heart of the Mustang.”
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 55

 Our loss is huge, and we need our 

teachers to help us process our grief. We 

need to have time to talk. They can set 

aside the curriculum and teach us how to 

breathe, facilitate discussions in class. 

This will help relieve the pressure.” 

Supporting Families of 

Preschool Children with IEPs

In North Carolina, preschool teachers 

implementing the Pyramid Model focus on the 

importance of building relationships with families 

of children with IEPs to assess the children's 

social-emotional and mental health needs. 

Establishing and building these relationships helps 

assess needs and develop support strategies that 

are relevant and meaningful to the family's unique 

cultural context, routines, and priorities. Candace 

Land from Floyd L. Knight School Preschool 

Program in Lee County, NC is one of many NC 

teachers who demonstrate this as shown in a video 

interview with Ms. Land: 

https://ectacenter.org/topics/disaster/preschoolpan

demic-episode11.asp. 

Community-Driven Design

Native American Community Academy

(NACA), in Albuquerque, New Mexico, 

serves K–12 students with an emphasis on 

community-driven design that centers the concept 

of holistic wellness. NACA has established an 

integrated curriculum prioritizing identity and 

culture development through culturally relevant 

lessons such as land-based learning as a part of a 

broader academic and college prep program.

Center on the Social and 

Emotional Foundations for 

Early Learning Pyramid Model 

and the Provision of Infant and Early 

Childhood Mental Health Consultation

In Maryland, the Infant and Early Childhood 

Mental Health consultation model can assist with 

the implementation of trauma-informed care, 

strategies to enhance children's positive 

relationships with caregivers and will provide 

consultation related to staff or families 

experiencing depression, substance abuse, or other 

adversities.

https://www.mdpyramidmodelsefel.org/iecmhconsultation

Cross-System Learning

The Federal National Workgroup on 

School Mental Health Partnership 

affiliates federal agencies, university centers, 

professional associations, and advocacy groups 

around cross-system learning. With the support of 

the Bainum Family Foundation, the Substance 

Abuse and Mental Health Services Administration 

(SAMHSA) convened three expert panels in 

partnership with the National Center on School 

Mental Health (NCSMH) and the Federal National 

School Mental Health Partnership to coalesce 

community members from all sectors around 

comprehensive school mental health systems. The 

recommendations of the three panels are 

summarized in Advancing Comprehensive School 

Mental Health Systems: Guidance from the Field.

Recognizing that no one group can make the 

changes outlined in their recommendations, the 

Workgroup began co-creating Dialogue Guides

with these partners. The guides enable them to 

hold conversations within their own networks, 

learn about the realities of practice and encourage 

partners to come together in action. System 

leaders, mental health practitioners, educators and 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 56

families participated together in developing 

dialogue starters that will enable conversations, 

share perspectives, build understanding, and 

reduce barriers. These collaboratively developed 

tools are available on the National Center for 

School Mental Health website.

Supporting Mental Health in 

Higher Education 

The University of South Carolina 

Department of Psychology Student Advisory 

Board composed a mental health and department 

climate survey in an effort to better understand 

graduate student perceptions and mental health 

needs. This information was especially critical to 

have during the COVID-19 pandemic. The results 

of the October 2020 survey revealed that majority 

of the graduate students surveyed (27/39) reported 

experiencing 3 or more symptoms of negative 

mental health. In an effort to address these 

concerns, the department formed a Mental Health 

and Well-Being Committee, composed of program 

faculty (Experimental, Clinical-Community, and 

School Psychology Ph.D. programs) and graduate 

student representatives to meet twice a month in 

an effort to address graduate student mental health 

needs and overall climate. Throughout the 2020-

21 academic year this committee facilitated the 

setup of graduate student support groups led by 

recent alumni to provide support and a safe space 

to process the stressors of graduate school. This 

committee also helped advocate for other supports 

(e.g., mentor-mentee contract that provides a 

number of discussion prompts to facilitate 

communication) and provide feedback to the 

department leadership to increase social 

responsiveness. In addition, the committee 

organized a number of socially distanced social 

activities, including discussion walks, and outside 

lunches. 

Helpful Hint

Universal mental health promotion for all students 

and staff in the school community is foundational to 

any implementation framework. This includes 

positive school climate, positive discipline 

practices, teacher and school staff well-being, 

mental health literacy, positive behaviors and 

relationships and social-emotional learning. Socialemotional and behavioral health and well-being 

skills are skills that should be taught by all staff 

across all school settings and embedded in daily 

practices. 

2. Enhance Mental Health Literacy 

and Reduce Stigma and Other 

Barriers to Access

Increasing Mental Health 

Literacy and Reducing Stigma 

with Student-Led Campaign

Beginning in 2014, Fauquier County Public 

Schools (FCPS) in Virginia, along with 

community partners, the Mental Health 

Association of Fauquier County, and the PATH 

Foundation, successfully implemented community 

training in Youth Mental Health First Aid 

(YMHFA). YMHFA is a training program 

supported by the National Council for Behavioral 

Health designed to educate people in the 

community about mental health issues and how to 

guide people experiencing mental health issues 

towards treatment. To date, over 1,600 adults in 

the Fauquier community have been trained in 

YMHFA. A high percentage of those trained were 

teachers and other staff within the FCPS. In 2018 

at a community safety conference, FCPS pointed 

out that they did not know which staff were 

trained, so they were unsure how to seek help. The 

students aptly pointed out the number of adults 

trained was impressive, but the value was not 

there if students did not know who to go to when 

they needed help, so FCPS provided purple 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 57

lanyards to staff who had received training in 

YMHFA. The district worked with students to 

develop video messages shown to all students so 

that they knew who to approach when they needed 

help. The Purple Lanyard Project was an 

important part of the district’s efforts to build a 

support network for students experiencing mental 

health challenges. Given success in implementing 

YMHFA in this community and its schools, the 

National Council for Behavioral Health selected 

Fauquier High School to pilot Teen Mental Health 

First Aid (TMHFA), a similar version of mental 

health training designed for students. During the 

2019-2020 school year, 260 tenth-grade students 

were trained in TMHFA. Plans are underway to 

expand the TMHFA training to our remaining 

high schools in the 2021-2022 school year. The 

impact of the YMHFA training and the Purple 

Lanyard project includes many examples of staff 

using the knowledge acquired through the training 

to help students. Equally important, the effort and 

attention focused on the training have increased 

awareness and acceptance in FCPS schools and 

the larger community regarding mental health.

Web-link for YMHA: https://sites.google.com/ 

fcps1schools.net/ymhfa/home

Helpful Hint

Meet as a team after training to determine how to 

apply new content in your setting. Consider using a 

marketing campaign to increase visibility of staff 

who are serving as mental health ambassadors. 

Provide ongoing coaching and support for staff.

Supporting Military Families

Military Child Education Coalition 

(MCEC)- Military-connected families 

move every 2–3 years, and their children often 

change schools 6–9 times during their K–12 

education, which is three times more than their 

nonmilitary peers. For students with mental health 

challenges, this complicates an already difficult 

situation. Each year the MCEC holds a National 

Training Seminar to help families, and 

practitioners and providers world-wide come 

together to learn the most about promising 

practices. MCEC, with the support of the United 

States Army Medical Command, the National 

Association of State Directors of Special 

Education and the National Center for Systemic 

Improvement launched a new training session 

designed to help attendees make an impact at their 

current duty station and carry best practices when 

they move to a new assignment. The Leaving 

Your Footprint Series is a two-part process. 

During the National Training Seminar, 

participants work with behavioral health experts 

from the United States Medical Command around 

issues of youth mental health, in particular 

Attention Deficit Hyperactivity Disorder, Anxiety, 

and Depression. Then, participants co-create 

infographics to help them share the information 

simply. Based on the infographics, they work 

together onsite and virtually to develop dialogue 

guides that will help parents and others bring 

attention to these issues at their current duty 

station. As they move to a new duty station, they 

take the infographics and dialogue guides with 

them while leaving their ‘footprint’ on the issue 

and an activity at their former assignment with the 

intent to sustain the focus on youth mental health. 

The Leaving Your Footprint Series of Behavioral 

Health Guides are found on the Military Child 

Education Coalition (MCEC) website. 

Mental Health Professionals 

Supporting Educators and 

Caregivers

Infant and Early Childhood Mental Health 

Consultation is a preventive and inclusive 

intervention for promoting young children’s 

social, emotional, and behavioral health in early 

childhood settings. The cornerstone of Infant and 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 58

Early Childhood Mental Health Consultation is a 

collaborative relationship between the Mental 

Health Consultant and the adults who care for 

young children (e.g., parents and other family 

members, early childhood educators, home 

visitors). The Mental Health Consultant helps 

caregivers learn to identify, understand, and 

address the needs of children at risk for mental 

health problems as early as possible (SAMHSA, 

2014). 

Promoting Young Children’s 

Social-Emotional Development 

to Address Undesirable

Behaviors

Greene County Educational Service Center (ESC) 

in Ohio developed the Early Childhood Mental 

Health Consultation (ECMHC) program to 

promote young children’s social and emotional 

development, to address undesirable behaviors, 

and to assist parents/caregivers of young children 

in the region who have experienced high levels of 

trauma or toxic stress. The Greene County ESC 

ECMHC program has taken a two-prong approach 

to spread understanding about the foundations of 

child social and emotional development while 

normalizing the need to seek help for parenting 

and child behavioral problems. Parents and 

caregivers experiencing chronic toxic stress first 

need help building their own resilience and 

protective factors in order to help the children in 

their care. Using this approach, the Greene ESC 

early childhood mental health professional 

developed the program and provided consultation 

to the schools and community agencies in 

response to the needs of the adults and children. 

(Excerpted from Project LAUNCH, Grantee/Filed 

Spotlights, https://healthysafechildren.org/granteefield-spotlight/early-childhood-mental-healthconsultation-ecmhc) 

Early Intervention with SocialEmotional Screening

In Illinois, 25 local Child and Family 

Connections offices serve as the system point of 

entry for families referred to Part C Early 

Intervention. State policy requires that at the initial 

intake meeting and with the family’s consent, a 

service coordinator administers the Ages & Stages 

Questionnaires: Social-Emotional, Second Edition 

(ASQ:SE-2), a validated social-emotional-focused 

screening tool. The service coordinator uses the 

results of the ASQ:SE-2, along with information 

gathered during the Routines Based Interview 

assessment and other sources to determine who 

will be on the family’s evaluation/ assessment 

team. A positive screen on the ASQ:SE-2 

indicates that the evaluation team should consider 

including a professional with a background in 

infant-toddler early childhood mental health and 

social-emotional development. This practice helps 

ensure that infant and toddler needs in the socialemotional domain will be identified early in the 

family’s involvement with Early Intervention so 

that interventions to address social-emotional 

needs can be included in the Individual Family 

Service Plan (Excepted from Smith, Ferguson, 

Burak, Granja, & Ortuzar, 2020). 

College Mental Wellness 

Ambassadors

Utilizing a peer-to-peer model, Foothills 

College in California has strengthened and 

augmented its Office of Psychological Services 

and Personal Counseling by creating a Mental 

Wellness Ambassadors program. The ambassadors 

are the student representatives of Psychological 

Services whose aim is to promote mental health 

services, reduce stigma surrounding mental health 

disorders, create community, and foster an 

inclusive and non-judgmental campus culture. 

This program was created during the COVID-19
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 59

pandemic while students were learning remotely, 

not physically active on campus, and experiencing 

traumas associated with the pandemic.

3. Implement a Continuum of 

Evidence-Based Prevention 

Practices

Transforming the System 

Requires Educating Staff AND 

Providing Ongoing Support for 

Implementation

The Northwest Mental Health Technology 

Transfer Center (MHTTC) utilizes various content 

from sources such as the National School Mental 

Health Best Practices: Implementation Guidance 

Modules for States, Districts and Schools and the 

U.S. Department of Education’s Trauma Sensitive 

Modules to support a systems transformation 

effort that are a part of targeted technical 

assistance that includes team-based training, data 

for decision making, coaching supports, and 

family engagement and youth involvement. 

Pairing content with implementation strategies 

increases the likelihood of sustainability and 

positive student outcomes.

Did You Know?

Thirty-one states are implementing the Pyramid 

Model as a tiered system of evidence-based 

practices that promote social-emotional 

competence and prevent undesirable behavior in 

infants and young children. 

https://challengingbehavior.cbcs.usf.edu/index.htm; 

https://childcareta.acf.hhs.gov/resource/resourceguide-developing-integrated-strategies-supportsocial-and-emotional-wellness

Statewide Wellness Initiative

At the Center for School-Based Mental 

Health Programs in Ohio – Ohio School 

Wellness Initiative

(https://www.miamioh.edu/cas/academics/centers/

csbmhp/initiatives/geer/index.html), a Miami 

University-led project to aid mental health and 

substance use supports for Ohio’s K–12 students 

and staff received $6 million from the Governor’s 

Emergency Education Relief Fund. The project 

aims to explore, implement, and sustain a full 

continuum of care for K–12 students within local 

districts who adopt student assistance programs, 

Tier 2/3 supports, and staff wellness frameworks.

Rooted in Relationships

Nebraska’s Rooted in Relationships 

initiative guides communities to 

implement evidence-based practices that enhance 

the social-emotional development of children birth 

through age eight. Each community has a 

multidisciplinary stakeholder team that 

implements a long-range plan to enhance the early 

childhood systems of care and the implementation 

of the Pyramid Model. 

https://challengingbehavior.cbcs.usf.edu/Pyramid

Nation/State/docs/NE_2019_rir_executive_ 

summary.pdf

Supporting University Students 

at Home

The Ohio State University has leveraged 

their campus wellness center to support their 

students experience through the COVID-19 

pandemic with an online webinar series entitled, 

“Staying Calm and Well in the Midst of the 

COVID-19 Storm.” This series provides evidencebased tactics on topics ranging from managing 

stress to mindfulness to ensuring a good night’s 

sleep amongst the stressors of the pandemic. The 

videos are posted on an easily accessible website 

with other wellness tips such as healthy recipes 

and additional resources. Having this information 

in one location mitigates any stress from finding 

resources and allows the students to personalize 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 60

their experience with the resources they need the 

most at any given time. 

Helpful Hint

Use the Hexagon Tool to ensure you aren't 

responding to the crisis by overwhelming the 

system. Greater efficiency with teaching will reduce 

feelings of being overwhelmed with too many 

different instructional tasks that compete for 

teacher time, energy, and fluency.

4. Establish an Integrated

Framework of Educational,

Social, Emotional, and

Behavioral-Health Support for All

Building an Interconnected 

Systems Framework

Monterey County in California began 

the journey of building an Interconnected Systems 

Framework (ISF) in 2016, shortly after learning 

about the model at the PBIS National Leadership 

Forum in Chicago. As a recipient of a School 

Climate Transformation Grant to address alarming 

levels of trauma and community violence, the 

Monterey County Office of Education (MCOE) 

had an established Leadership Team to coordinate 

efforts in PBIS implementation comprised of 

participating school districts and various 

community and county members, including 

Monterey County Behavioral Health (MCBH). 

Given that MCBH had existing memoranda of 

understanding to serve students in both general 

education and special education with all PBIS 

school districts along with robust staffing and 

executive leadership buy-in to support changes 

needed to implement ISF, this county agency was 

well positioned to incorporate necessary changes 

into their service model for success. As the 

leadership team’s collaboration and partnerships 

deepened and the need for mental health 

integration into PBIS became increasingly 

apparent, the collective decision was made to add 

ISF to the Strategic Plan as the primary focus for 

the remainder of the grant cycle and beyond. 

Implementing ISF to fidelity required examining 

the MCBH program model and making significant 

changes to reflect mental health integration at 

every tier of PBIS intervention, as well as 

changing the role of the mental health clinicians. 

While MCBH clinicians were co-located on 

school campuses, most were itinerant and 

providing only individual therapy with no 

coordination with the PBIS teams at the school 

sites they were serving. Additionally, the MCBH 

Services to Education program was divided into 

two separate teams serving students in either 

general education or special education, which 

further reinforced the existing siloed ways of 

working. As PBIS informs us that relationships 

and consistency are essential ingredients in 

cultivating a positive climate and culture, critical 

adjustments to the program model included 

assigning clinicians to specific school sites and 

expanding PBIS teams at the school sites to 

include them so that they could become part of the 

decision-making process and share their expertise 

in identifying mental health interventions for 

students. MCBH also established a full continuum 

of mental health services and supports that aligns 

with the PBIS framework and allows time for 

clinicians to provide Tier 2 groups in collaboration 

with school counselors, as well as Tier 1 training 

and consultation that will build capacity of all staff 

for responding to the mental health needs of 

students. 

Along with changes to the MCBH program model 

and clinician involvement with the PBIS teaming 

process that supported ISF implementation, 

MCBH clinicians were also included in district 

PBIS trainings provided by MCOE. Initially, 

school staff and MCBH clinicians had difficulty 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 61

understanding the purpose of receiving training in 

PBIS and how it related to mental health, and this 

eventually shifted as cultures merged and they 

began to experience the value of having MCBH 

clinicians participate in the PBIS process and 

share expertise in that helped inform team 

decision-making. As MCBH and MCOE worked 

with school districts to identify ISF Knowledge 

Development Sites, ISF Working Agreements 

were established with each site outlining roles and 

responsibilities, in addition to a detailed scope and 

sequence that provided a clear timeline of how ISF 

would be implemented throughout the school year 

and how each agency would be working together 

to support implementation to fidelity.

Now that Monterey County is several years into 

implementation, those involved in this movement 

have embraced a new way of working together to 

support the mental health and wellness of the 

learning communities, an indication of the positive 

changes and ripples of meaningful impact can be 

seen across all child serving systems. The School 

Climate Leadership Team continues to hold ISF as 

the guiding framework and philosophy for all 

training offerings while MCBH has been woven 

into every layer of decision making at county, 

district, and site levels. School district staff who 

were familiar with the former MCBH program 

model report feeling more connected to the 

clinicians working at their school sites and have a 

better understanding of their role and how to 

support students presenting with mental health 

problems as clear pathways for referrals have been 

created. There has also been increased sense of 

purpose for MCBH clinicians as many requests to 

remain at the same sites each new school year so 

that they can maintain the positive working 

relationships they have worked so hard to cultivate 

within the learning communities they serve. As 

with any large-scale change that impacts the hearts 

and minds of so many, success lies in the quality 

of relationships. The abundance of strong working 

relationships is the foundation that Monterey 

County uses to continue the journey of ISF.

Addressing Toxic Stress

To address toxic stress among children 

growing up in poverty, an innovative 

collaboration was developed between a 

community center, Operation Breakthrough (OB), 

and a tertiary care children’s hospital, Children’s 

Mercy Hospital. OB houses the largest Head Start 

program in Missouri, serving more than 300 

children each day in its center. It started as a day 

care center but has expanded and developed ways 

to provide shelter, safety, food, employment, 

education, and health care. Currently 96% of its 

preschool children enter kindergarten ready to 

learn. Current CLASSTM scores for Emotional 

Support, Organizational Support, and Instructional 

Support exceed national averages. 

Creating a Single System of 

Delivery

Vermont’s Agency of Education (VT 

AOE) in collaboration with the Department of 

Mental Health have prioritized the Interconnected 

Systems Framework (ISF) to enhance and expand 

School Mental Health. The leadership saw the 

need to create a single system of delivery that 

could be consistent across the state, while 

allowing local flexibility. The ISF provides the 

opportunity to assess current resources, strengths 

and needs and a process to efficiently and 

effectively build a continuum of support. As local 

educational agencies (LEAs) develop their 

Recovery Plan, districts are well positioned to use 

their multi-disciplinary leadership teams to assess 

student need and address three VT AOE identified 

priorities: (1) social-emotional functioning, mental 

health, and well-being;( 2) student engagement; 

and (3) academic achievement and success. The 

3 LEAs who have been utilizing the ISF are well 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 62

positioned to successfully implement their 

Recovery Plans as they have already been working 

with community partners in an integrated 

approach to meet student needs.

As part of the ISF work at the school level, school 

leaders have been prioritizing youth voice (e.g., 

engaging students with data to assess socialemotional behavioral well-being strengths and 

needs). The emphasis on stakeholder engagement 

to include students, families, and community 

within the PBIS and ISF framework positions the 

LEA to establish two-way communication 

feedback loops and authentic engagement that 

includes voice and choice. 

Using Implementation Science 

to Build State Capacity for 

Implementation of the Pyramid 

Model in North Carolina, Connecticut, 

and New York

North Carolina and Connecticut use 

implementation science and implementation 

structures to build statewide capacity to adopt the 

Pyramid Model. These structures include a state 

leadership team, a network of program 

implementation coaches, implementation sites, 

and data decision-making.

The North Carolina state team develops and 

implements a plan based on implementation stages 

and drivers. 

https://nceln.fpg.unc.edu/ncppmresources

The Connecticut strategic plan outlines action and 

budgeting across implementation stages. 

https://challengingbehavior.cbcs.usf.edu/Pyramid

Nation/State/docs/CT_strategic_plan.pdf

In New York, the New York State Early 

Childhood Advisory Council has included equity 

and social-emotional wellness through the 

implementation of the Pyramid Model as part of 

their strategic plan for developing a 

comprehensive and sustainable early childhood 

system. 

http://www.nysecac.org/application/files/7916/16

79/0961/ECAC_Strategic_Plan_Final_3.26.21.pdf

Embedding SEL and Trauma 

into Existing Framework

STEAM Academy at Woodrow Wilson 

is an elementary school in Port Huron, Michigan 

that has been implementing PBIS for a number of 

years. During the last two years, they have worked 

to embed more social-emotional learning into their 

PBIS framework through the integration of 

trauma-informed practices. The School Leadership 

Team that guides their PBIS work also took the 

lead on embedding trauma-informed practices into 

PBIS for their school to ensure that it was not a 

separate initiative, but an enhancement of their 

current system that would better meet the needs of 

their students.

The School Leadership Team began by looking at 

what already existed within their PBIS system that 

included a trauma-informed lens, then built upon 

it. For example, they were able to make small 

changes to many areas of their behavior matrix to 

ensure it was written in a way that would build up 

students that have experienced trauma. From 

there, the team determined that they needed to add 

a column that really focused on bringing some 

social-emotional skills to the forefront of what 

was being taught. The column for Coping Skills 

was added to the school-wide behavior matrix so 

they could be more intentional about helping 

students develop these skills. Additionally, the 

school added a row to the bottom of the matrix 

titled “Staff Anchors” which describes how staff 

will model and support students with this skill 

development. Much of the same language is then 

mimicked in the classroom matrix, which allows 

teachers to add in any nuances for their particular 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 63

classroom. The classroom matrix sits right next to 

teacher workstations so they can easily reference it 

as they model and teach the social-emotional skills 

that are identified within it in their interactions 

with students. 

The team developed a professional development 

plan to ensure teachers had what they needed to be 

successful in their work with students around the 

integration of trauma-informed practices. The 

administrator wanted to make sure staff were 

supported in the teaching and modeling of the 

coping skills that were included in the matrix. 

Staff were provided professional learning on 

trauma and trauma-informed practices, given time 

to develop products for their classroom, and 

received coaching both from a school-level and 

district-level coach. Given that, they have a 

greater skill set related to teaching socialemotional skills in the classroom.

STEAM Academy has been using the school-wide 

PBIS Tiered Fidelity Inventory (TFI) since 2015 

to measure their PBIS implementation fidelity. 

Upon beginning the work of embedding traumainformed practices, they decided to use the 

trauma-informed TFI companion guide that 

includes enhancements to the items and 

walkthrough in order to collect data on their 

practices. The team used the data from this tool to 

determine the needs of the school and develop an 

action plan to achieve them. For example, after 

they began implementation of their new practices, 

they conducted the walkthrough with the 

additional trauma-informed questions and realized 

that the adults had not yet spent enough time on 

teaching the coping skills to students. The team 

went back and made plans to ensure the staff were 

very intentional with their teaching of these socialemotional skills. They continue to alter their 

action plan based on their data and the changing 

needs of the students and school, such as including 

more coping skills that students can engage in 

right at their seats given the pandemic. Recorded 

interview with Joe Kramer, principal at STEAM 

Academy.

Providing Screening and 

Treatment to All Incoming 

University Students

Free mental health screenings that are available to 

all incoming students and will eventually be made 

available to the entire UCLA community are just 

one part of the UCLA Depression Grand 

Challenge, a campus wide effort to reduce the 

health and economic impacts of depression by half 

globally by the year 2050. The online screening 

and treatment program are thought to be the firstever campus wide mental health screening 

program conducted at a university. 

The announcement in 2017 signaled a new phase 

in the Depression Grand Challenge, which has 

brought together more than 100 researchers from 

more than 25 academic departments — and 

growing — to develop better methods of 

detecting, evaluating, and treating depression. 

Researchers also aim to eliminate the stigma 

associated with depression, which is often a 

barrier to seeking diagnosis and treatment.

5. Leverage Policy and Funding

Statewide Integration Through 

Legislation

Through legislation, Minnesota has 

concretely linked education and mental health 

services and established a grant program to build 

capacity of educators and clinicians to serve the 

social, emotional and behavior needs of students 

in schools. Their goals include: 

 improving clinical service quality through the 

support, training, and provision of evidencebased treatments;
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 64

 increasing the number of mental health

clinicians who are trained in and providing

Evidence-Based Practices;

 improving capacity and infrastructure

development to support the expansion and

sustainability of services long-term throughout

Minnesota;

 developing and strengthening partnerships

between mental health providers and host

school districts, and

 increasing the number of school districts who

have both a School-Linked Mental Health

(SLMH) and PBIS framework.

Two of the features in the Minnesota approach are 

exceptionally promising. 

 First, Minnesota intentionally embeds the

PBIS framework in a comprehensive approach

to school mental health. Minnesota draws on

the behavioral approaches currently in place in

schools developed through PBIS initiatives

and integrates that knowledge with the array of

evidence-based strategies that Mental Health

partners bring.

• The partnership between Minnesota PBIS

and SLMH has a history of collaboration

spanning over 13 years and have become

increasingly aligned over the years.

Currently, SLMH services are provided in

51% of Minnesota schools; 63% of the

PBIS trained schools have SLMH services

and 46% of all SLMH schools are in a

PBIS trained building.

 Additionally, and potentially most important,

Minnesota attends to the relationship building

between school staff and mental health

providers. As part of the co-written grant

application, potential partners must identify

what they hope to ‘give’ and ‘get’ in the new

relationship. They must commit to learning

more deeply about their complementary roles 

in achieving their goals. 

Funding to Increase School 

Mental Health Providers and 

School Nurses

Michigan passed legislation allocating $31 million 

for hiring school mental health providers for 

general education students and also required their 

state to expand their Medicaid school-based 

services. The state has been able to use the 

increased funding to go from 1,738 school-based 

behavioral health providers statewide to 2,975 

school-based behavioral health providers 

statewide and increased school nursing staff from 

253 to 307. 

Leveraging Funding with Youth 

Voice and Decision Making

The 2019 Oregon State Legislature 

dedicated $7.5 million to continue to support 

School-Based Health Center mental health 

capacity during the 2019–2021 biennium. Most of 

this funding was reserved to support School-Based 

Health Center (SBHC) mental health capacity by 

adding mental health staff and expanding current 

mental health staff hours at Oregon School-Based 

Health Center. An additional $700,000 was 

allocated to support youth-led mental health 

projects that would reduce mental health stigma 

and promote student resiliency at School-Based 

Health Center SBHC host schools. In the 2019–

2021 biennium, 15 School Based Health Centers 

received funding and technical assistance from the 

Oregon Health Authority to operate Youth 

Advisory / Action Councils. Youth Advisory 

Councils are youth-driven groups that focus on 

advising, supporting, and advocating for SBHCs 

and their services while also providing space for 

students to connect with one another, build 

relationships with a facilitator who is 

knowledgeable in youth adult partnerships, and 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 65

create change in their schools, School Based 

Health Centers, and communities.

During the 2019–2020 school year, student-led 

projects included: 

 Food Pantry and hygiene supply closets 

 Stress management resources for students

 Creation of materials promoting SBHCs and 

addressing misconceptions

 Attendance at State Youth Advisory Council 

Summit

 Education campaigns about issues identified 

by Youth Advisory Council members 

 Celebrate Love tabling event during school 

lunch promoting love outside of just romantic 

relationships

 Attendance at School Health Advocacy Day at 

the Oregon State Capital 

Youth Advisory Councils that received state 

funding are asked to do a Youth Participatory 

Action Research (YPAR) project where the youth 

are authentically engaged in a research and 

decision-making process around a topic of their 

choice. YPAR is an innovative approach to 

positive youth and community development based 

in social justice principles in which young people 

are trained to conduct systematic research to 

improve their lives, their communities, and the 

institutions intended to serve them. 

During the 2017–2019 biennium some examples 

of YPAR questions included: 

 What affects student mental health and how do 

students deal with stress?

 How do students experience and cope with 

anxiety while in school? 

 Do individuals who identify as male have a 

healthier body image than students who 

identify as female?

For more information on School-Based Health 

Centers and Youth Advisory Councils in Oregon 

please visit: www.healthoregon.org/sbhc. 

Removing the Funding Barrier

Lake Washington School District is 

located in Redmond, Washington east of 

Seattle serving over 32,000 students. As a 

strategic priority, Lake Washington School 

District has worked with national and local experts 

to support the implementation of mental health 

and well-being supports within a Multi-Tiered 

Systems of Support framework throughout 55 

schools. Through district directed and local 

dollars, about 1 million dollars, Lake Washington 

has worked to remove barriers for timely mental 

health supports for students and families. By 

removing eligibility requirements such as 

insurance and diagnostic assessments, students 

and schools can mobilize supports and 

interventions earlier than later.

The collaborative partnership with community 

mental health partners focuses on an integrated 

approach that embeds the providers so that they 

are part of the school community. Students and 

staff see them regularly in the building. Through a 

memorandum of understanding the community 

mental health partners also support prevention and 

promotion efforts that enhance Tier 1 supports. 

Each secondary building has a mental health 

provider 20–40 hours a week and their middle 

schools are building a framework to support 

mental health providers. During COVID-19 they 

have been able to adjust the mental health 

providers hours to reach more families–something 

they will continue through and after the pandemic. 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 66

Flexible Funding

California’s early childhood mental 

health efforts in San Francisco have 

been built on existing collaboration, spurred by 

flexible funding from Temporary Assistance for 

Needy Families welfare reform. The city has 

created a network of early childhood mental health 

consultants responsive to different ethnic needs, 

primarily providing prevention and early 

intervention services. The initiative uses a pooled 

funding strategy that involves multiple agencies 

and federal, state, and local funding streams.

Using Data and Cost Analyses 

to Study the Impact of the 

Pyramid Model

Wisconsin has successfully used data and cost 

analyses to increase resources for the Pyramid 

Model implementation and scale-up. The 

Governor's budget also includes a funding increase 

for Pyramid Model coordination, which provides 

professional development and resources focused 

on trauma-informed practices for daycare 

providers to reduce undesirable behavior in young 

children.

Aligning State Grants and 

Initiatives

“The Collaboratory” in Nevada 

integrates various state grants and initiatives to 

ensure a climate of collaboration. State leaders 

worked together to develop a State Integration 

Team to include many state initiatives in order to 

align the work across the state. The initiatives 

include: Project AWARE, School Climate 

Transformation, Pre-K Development, Systems of 

Care, Office for a Safe and Respectful Learning 

Environment, OJJDP Comprehensive School 

Safety Initiative, and State Youth Treatment 

Planning for Substance Abuse. The State 

Integration Team meets monthly to coordinate the 

work of all Nevada grants, and this team ensures 

the work and initiatives are integrated into one 

system to build a strong capacity for sustainability 

of successful initiatives.

“The Collaboratory” leaders work together to 

align the work of each initiative and combine 

efforts of each grantee in order to “work smarter, 

not harder.” This process has led to integration of 

all grant initiatives into a collaborative effort to 

provide cross training across disciplines in schools 

and community agencies/organizations; to align 

and implement programming in schools; and to 

collect data across systems informing state leaders 

of best practices for the work of creating safe and 

violence-free schools. “The Collaboratory” 

worked together to develop and submit legislative 

House and Senate bill drafts for the 2017 

Legislative Assembly to consider. The team 

submitted eleven (11) bills of which nine (9) were 

approved for legislation. (Excerpted from Project 

LAUNCH, Grantee/Filed Spotlights, 

https://healthysafechildren.org/grantee-fieldspotlight/state-and-community-integrationinitiatives-create-safe-and-violence-free) 

6. Enhance Workforce Capacity

Using the Pyramid Model in 

Minnesota and Wisconsin

Minnesota has been implementing the 

Pyramid Model for over ten years and has trained 

and coached hundreds of practitioners, 

administrators, and families. The evaluation of 

training and support efforts are included in the 

following report: 

https://challengingbehavior.cbcs.usf.edu/Pyramid

Nation/State/docs/MN_pm_executive_summary_2

020.pdf

Wisconsin has been building the capacity of early 

childhood programs and practitioners to 

implement the Pyramid Model since 2009. A 

cross-sector state leadership team works to build 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 67

and guide this effort to provide Pyramid Model 

training and support to practitioners and leaders in 

childcare, public preschool, early childhood 

special education, family resource centers, and 

Head Start programs. In 2016, an evaluation of the 

Pyramid Model work in two Wisconsin 

communities found that children in Pyramid 

Model programs had better social and emotional 

skills and less problematic behavior than children 

in non-Pyramid Model programs. The positive 

outcomes achieved through the implementation of 

the Pyramid Model resulted in a substantial 

funding allocation for the work from the State 

Department of Children and Families.

The Greater Watertown Community Health 

Foundation in Wisconsin is also supporting the 

implementation of the Pyramid Model for 

Promoting Social and Emotional Competence in 

Young Children in all early childhood education 

programs within a two-county service area 

through a phased cohort model approach. 

Committed to ensuring access to high-quality 

early care and education, the Greater Watertown 

Community Health Foundation has invested to 

support program-wide implementation of the 

Pyramid Model in 7 sites within a two-county 

area. Using a cohort model, the Foundation’s 

Early Childhood Learning Innovation Coach 

guides program leadership teams and internal 

coaches in five childcare and two school district 

programs. They also support community partners 

to provide parent training related to Pyramid 

Model practices. For infants and toddler, the 

training is conducted within playgroups where 

parent-child relationships are strengthened, and 

families are guided in their responsive 

interactions. Parent training for parents and 

caregivers of preschool children is offered through 

the Positive Solutions for Families workshop 

series that provides training to families of 

preschool children with undesirable behavior. 

Virginia Partnership for School 

Mental Health

A new statewide project, the Virginia 

Partnership for School Mental Health, aims to 

strengthen school mental health services through 

two major pathways: by building a pipeline of 

graduate student trainees to high-need school 

divisions, and by creating an inter-professional 

network of school mental health practitioners. 

Funded by a five-year, $2.5 million grant from the 

U.S. Department of Education, the partnership 

between the Virginia Department of Education 

and the University of Virginia’s School of 

Education and Human Development was 

announced in 2020. 

School Behavioral Health 

Community of Practice

The District of Columbia has been 

working across systems and alongside educational 

partners to ensure that every school and student 

has access to comprehensive school behavioral 

health services and supports. A key factor in its 

success has been connecting with communitybased organizations (CBOs) to supplement the 

services and support already available through 

school-hired behavioral health providers. 

In 2019, school teams, composed of educators, 

school staff, CBO clinicians and other interested 

groups from all DC public and public charter 

schools, joined the School Behavioral Health 

Community of Practice (DC CoP). Along with 

other community partners and District agency 

leaders, DC CoP members come together monthly 

to learn from each other, solve problems of 

practice and to support the implementation of best 

practices in school behavioral health to promote 

healthy development and well-being for all 

students and their families.
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 68

The DC CoP offers a space for system level 

leaders to interact with on the ground service 

providers—and learn about the urgent challenges 

facing students, staff and families, and 

providers—so all invested partners are empowered 

to respond quickly and use numerous 

communication channels to carry the learning into 

the broader system.

CoP members also join Practice Groups and Work 

Groups led by volunteers representing different 

roles. Some examples of the Practice Groups and 

Work Groups include: Trauma-Informed Practices 

in Schools, Crisis Response and Intervention, 

Family and Youth Engagement, and Positive 

School Climate and Social and Emotional 

Learning Implementation, Suicide Prevention and 

Teacher Wellness. Over 100 practitioners, 

educators and family members engage in shared 

work through the DC CoP. 

Pennsylvania Department of 

Education (PDE) Released 

Creating Equitable School 

Systems: A Roadmap for Education 

Leaders that Addressed Supporting 

Social and Emotional Wellness for 

Staff and Students

PDE is set to release a new learning series on 

Accelerated Learning, which will provide a 

process and system of support for local 

educational agencies to make key decisions for 

school reopening. Fostering supportive learning 

environments through equitable, trauma-informed 

principles and focusing on comprehensive mental 

health is a key component of Accelerated 

Learning. The modules around supportive learning 

environments are set to focus on comprehensive 

mental health and utilize portions of the National 

Center for School Mental Health/Mental Health 

Technology Transformation Center School mental 

health curriculum to support teaming and resource 

mapping. Additional modules will focus on 

staff/student wellness and data usage for mental 

wellness.

Increased Funding to Expand 

the Workforce in Alabama, 

Kentucky, and Tennessee

Alabama: State Funding for a New Position: 

School-Based Mental Health Service Coordinators

 In 2020, the Alabama State Legislature

allocated $4.5 million in grants for local

educational agencies to employ School-Based

Mental Health Service Coordinators in

2020-2021.

 Responsibilities:

• Complete a needs assessment and a

resource map of school mental health

services for all schools in their jurisdiction

• Coordinate and support student mental

health services (including Tier 1, Tier 2,

and Tier 3 services) throughout the school

district

Alabama: State Funding to Expand the 

Workforce: Master’s Level Clinicians

 Seven years ago, the AL Department of

Mental Health and AL Department of

Education placed master’s level mental health

clinicians in public schools using local

dollars.

 In FY 2019–2021, the Governor and Alabama

Legislature appropriated $1.75 million in state

funding to expand this workforce in 21

additional school systems.

Kentucky: State Funding to Expand the 

Workforce 

 HB 352 (enacted April 2020)
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 69

• Appropriated $7.4 million to fund

additional school-based mental health

provider full-time equivalent positions in

FY 2020-2021 on a reimbursement basis

• Goals committed to under SB 8, 2020:

 At least one school counselor per

public school, 60% allocated to

services

 At least one school counselor or

school-based mental health services

provider (statutory definition) for every

250 students

Tennessee: State Funding to Expand the 

Workforce 

 Governor's budget for FY 2020-2021

(finalized June 2020)

• Allocated $3 million (recurring) to fund 59

new school-based behavioral health

liaisons

• Responsibilities:

 Assist schools in conducting needs

assessments

 Provide training and education for

school personnel on behavioral health

topics

 Implement Tier 1, 2, and 3 services

 Foster positive family-schoolcommunity relationships

Screening in Early Childhood

and Statewide SocialEmotional Learning

Competencies

In each of the three Safe Schools/Healthy Students 

Local Educational Agencies in Michigan, 100% of 

early childhood staff were trained in early 

childhood social-emotional learning and 

development, with “booster sessions” (e.g., 

coaching, additional workshops, follow-up to 

assessments) provided during the school year. In 

addition, 100% of children and youth in each Safe 

Schools/Healthy Students (SS/HS) Local 

Educational Agencies have been screened for 

early social, emotional, or developmental delays 

and a follow-up screening process has been 

institutionalized. 

The state developed Michigan Social Emotional 

Learning Competencies for ages birth to eighteen 

and is in the process of working collaboratively 

with a cross representation of diverse partners 

including educators on a corresponding 

implementation guide to align curriculum to the 

competencies for effective utilization. These 

competencies are expected to be utilized across 

the SS/HS LEAs post-grant for sustainability of 

effective practices. (Excerpted from Project 

LAUNCH, Grantee/Filed Spotlights, 

https://healthysafechildren.org/grantee-fieldspotlight/promoting-early-childhood-social-andemotional-learning-development) 

Personnel Standards for InfantEarly Childhood Mental Health 

Specialists

Illinois’ Child and Family Connections 

Procedure Manual has an extensive set of 

recommended qualifications for the Part C Early 

Intervention program’s social-emotional 

consultants. These include “master’s degree in 

child development, special education, psychology, 

social work, or a related field; supervised clinical 

experience with children and families; training in 

infant development; diagnosis of mental health 

disorders in infancy; impact of stress and trauma 

in infancy; assessment of parent/child relationship; 

intervention to support parent/child relationship; 

and knowledge about and skill in providing 

reflective supervision and consultation.” 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 70

Developing University 

Telehealth Services

Prior to the March 2020 shut down of 

Heidelberg University in Tiffin, Ohio, there were 

no telehealth services for student’s mental health 

care. The creation of telehealth services was to 

target postsecondary students who were enrolled 

at Heidelberg University. The 

materials/information accessed to create this 

service included: Ohio Administrative Code 4757-

5–13, which outlined the legal and ethical steps to 

provide telehealth services appropriately, 

American Psychological Association’s Office & 

Technology Checklist For Telepsychological 

Services which offered a checklist of items from 

technology to beginning of virtual session to 

verify engaging in a telehealth in an appropriate 

manner, and The Center for Connected Health 

Policy: Current State Laws and Reimbursement 

Policy which outlined definitions regarding 

Telehealth, defined consent, as well as highlighted 

limitations and restrictions as set forth by the 

individual states. Counselors at Heidelberg have 

seen an increase in the usage of the telehealth 

services as students navigated the pandemic.

7. Use Data for Decision Making to

Promote Equitable

Implementation and Outcomes

Listening and Learning from 

the Community

Recently, Michigan’s Multi-Tiered 

System of Support (MiMTSS) Technical 

Assistance Center paused the training offered on a 

behavior screening tool. This pause allowed time 

to listen and learn from the Michigan community. 

The MiMTSS Center wanted to examine how 

screening is affected by or addresses concerns of 

inequities. Through current work, the MiMTSS 

Center realized that the use of a valid and reliable 

screening tool must be embedded within an 

efficient screening process that considers multiple 

sources of information. It is important that an 

effective and equitable multi-tiered system of 

support is in place to (1) prevent possible concerns 

and (2) provide intervention and supports when 

need is identified. All of this is nested within 

educational systems and the community, ensuring 

responsiveness to context and culture. (See figure 

for illustrating these connections.) 

Screening process:

Information gathering process to 

identify needed supports that can 

include a screening tool

MTSS: Providing a 

continuum of supports 

matched to student need 

an allocation within a 

system to allocate 

supports

Educational 

Systems: Schools, 

LEAs, ISDs structures 

and process for 

providing educational 

program

Community: the 

people of the region 

with regards to context 

of social values and 

responsibilities
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 71

The ultimate goal is to provide comprehensive 

guidance, training and resources connecting 

screening with systems. To achieve this goal, they 

are utilizing a phased process. They released a 

brief document with considerations to identify and 

support social-emotional-behavior-well-being. A 

more extensive document will be released that 

builds upon the brief. By the end of the 2021–

2022 school year, they will have a comprehensive 

manual for a screening process that was developed 

with diverse and stakeholder input as well as 

usability testing. Each document supports work 

toward technical adequacy, an equity focus, and 

meaningful outcomes.

Preparing the System for 

Screening

Battle Ground School District No. 119 

is a public school district in Clark County, 

Washington. To set the stage for effective mental 

health screening for next year, the district team 

created a 6-week plan emphasizing socialemotional learning supports, adjusted previous 

intervention practices to support youth during the 

COVID-19 climate, as well as supporting staff via 

monthly newsletters addressing those socialemotional behavior topics such as staff wellness, 

recognizing and responding to trauma, and 

practices to use in the transition back into the 

classroom.

Including Students in Decision 

Making

Forest Park Middle School, in Forest 

Park, Illinois, has created equitable, identity 

affirming, and co-created learning spaces for 

students. The school's emphasis on circle 

leadership ensures that decisions are made with 

students, not for them, and that students are 

included in every part of the change-making cycle.

Engaging Students with 

Information

Providing students with an opportunity 

to be heard can yield important outcomes. As part 

of ongoing PBIS implementation, Roanoke 

County Public Schools in Virginia engaged youth 

with both school-wide climate data and Youth 

Risk Behavior Survey data. Students were 

provided a structure for reviewing those data. The 

first group of students who were invited to take 

part in this activity were all secondary students. 

Students identified behavioral health as a need, 

specifically expressing their concerns about 

suicidal ideation. The students made connections 

in the data between substance use, unhealthy 

choices, and high incidence of suicidal 

ideation. Having heard from the initial group of 

secondary students, district leadership visited each 

of the 27 schools, including elementary schools, 

and interviewed students, asking students what 

concerned them about their school. The students’ 

responses enlightened leadership and allowed 

them to take intentional steps to incorporate 

social-emotional behavior supports. 

Connecting Pre-K Students to 

Additional Supports

The Lamar County Early Learning 

Collaborative in Mississippi uses the Pyramid 

Model for Promoting the Social and Emotional 

Competence of Young Children as a MTSS for 

their pre-K students. These procedures include a 

flow chart to help determine which children need 

Tier 2 and Tier 3 interventions and a system for 

linking areas of need with state social-emotional, 

math, or English Language Arts performance 

standards progress monitoring. For children 

receiving Tier 3 non-academic interventions, they 

use the Pyramid Model’s Behavior Incidence 

Report System to help determine the functions of 

behavior and to provide individualized supports 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 72

such as assisting children develop targeted socialemotional skills.

What is Your Call to Action?

Through their review of data, Medical 

Lake School District recognized a 

substantial gap of unmet needs for its most 

underserved students, and this was their call to 

action. By developing protective factors and a 

robust system of support for their youth, they are 

fostering knowledge and promoting the 

development of skills that prepare students to be 

informed, thoughtful, and productive individuals 

and citizens, and teach individuals to recognize 

risk factors and warning signs pertaining to 

mental health. 

Using the PBS Pyramid Model 

in Classrooms

Chelsea Public Schools in 

Massachusetts has been engaged in Positive 

Behavior Support Pyramid Model since 2016. 

Presently, all 45 classrooms across Pre-K to first 

grade are working with the framework. The 

district has served children remotely for all of the 

2020–2021 school year, just now shifting back to 

in-person instruction. 

Program leaders note that teachers across the 

school have embedded principles of Positive 

Behavior Support Pyramid Model into daily 

routines of classrooms, which has carried over into 

remote learning. Much of the work of embedding 

social-emotional learning curricula into lesson 

plans has continued this year, with daily lessons 

devoted to social-emotional skills.

Additionally, there has been a particular focus 

during remote learning to revisit routines and 

schedules multiple times a day and using plenty of 

visuals. "One of the things making the biggest 

difference is remembering that kids have to have 

routines and expectations laid out every day all 

year long... that really impacted us a lot." Over 

the years, the school has also made efforts to 

increase free playtime for young children, 

expanding recess from 15 to 30 minutes, and 

shifting from an at times 'academic focus' to 

include plenty of free time.

The leadership team regularly uses data to help 

guide progress. For example, teachers are using 

the electronic Behavior Incident Reporting system. 

The leadership team meets monthly to review 

patterns and trends in classrooms, identify schoolwide professional development, and identify 

individual student needs. Overall, program leaders 

suggest that among the general population of 

students, the Pyramid Model has led to a decrease 

in behaviors that require intervention outside of 

the classroom. As the school returns to in-person 

instruction, they will continue expanding their use 

of Pyramid Model practices and fidelity to the 

model.
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 73

APPENDIX B. 

Federal Technical Assistance Centers Related to SocialEmotional and Mental Health

Comprehensive Center Network 

(CCNetwork)

Funded by the U.S. Department of 

Education

CCNetwork comprises 19 Regional 

Comprehensive Centers and one National Center 

that provide capacity-building technical assistance 

to states, districts and schools in their design and 

implementation of evidence-based policies, 

practices, programs, and interventions that 

improve instruction and educational outcomes for 

all students. State educational agencies may 

request capacity-building support from their 

Comprehensive Centers. 

The CCNetwork produces and disseminates 

research-based tools and resources to build the 

capacity of educational leadership in socialemotional, behavioral learning and mental health 

approaches to better support the well-being of 

school staff, students, and families.

Select CCNetwork resources include:

 The Social, Emotional, and Behavioral 

Learning and Trauma-Informed Practice 

resource collection is designed to increase the 

capacity of state and district leadership to 

support their school communities create 

trauma-informed approaches for social, 

emotional, and behavioral learning. The 

resources within the collection are also 

targeted to specific needs and contexts, such as 

schools in rural communities, or schools that 

are in the early stages of implementing social 

and emotional learning (SEL) strategies.

 Reimagining Excellence: A Blueprint for 

Integrating Social and Emotional WellBeing and Academic Excellence in Schools, 

designed with input from in-person and remote 

educators, leaders, researchers, professional 

learning providers, and technical assistance 

providers, details the indicators of learning 

programs that successfully integrate equity, 

well-being, and academics and discusses how 

to improve student outcomes through a cycle 

of strong planning, action, and continuous 

monitoring.

 Informational Resources on Improving 

Social and Emotional Learning and 

Outcomes provides resources for 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 74

understanding, prioritizing, and measuring 

students’ SEL competencies and on evidencebased SEL programs and interventions. The 

document organizes resources and information 

about SEL into nine categories listed under 

two broad headings: What is SEL? and How is 

SEL being implemented?

 Supporting Well-Being and Learning

Through a Concerns-Based Approach

provides guidance to school leaders on

supporting teacher well-being through

implementation of the Concerns-Based

Adoption Model (CBAM). A series of blogs

opens with an introduction to using the CBAM

framework and includes action steps to apply

three diagnostic tools (i.e., Stages of Concern,

Levels of Use, and Innovation Configuration

Maps) to help maintain a focus on improving

student learning while simultaneously

supporting teacher well-being.

Website: https://compcenternetwork.org/

Center to Improve Social and 

Emotional Learning and School 

Safety (CISELSS)

Funded by the U.S. Department of 

Education

The purpose of the CISELSS is to provide 

technical assistance to support states and districts 

in the implementation of social and emotional 

learning (SEL) evidence-based programs and 

practices. Our charge from the U.S. Department of 

Education is to build the knowledge and capacity 

of (1) state educational agencies (SEAs) to support 

their local educational agencies (LEAs) and 

(2) LEAs to support their schools.

Like some other federally funded technical 

assistance centers, it provides technical assistance 

in three tiers:

 General. The first, general tier is conceived to

serve the broadest audience and consists of a

growing inventory of carefully curated online

resources, including evidence-based

professional learning opportunities, videos,

tools, resources, and other publications. This

tier also includes reports, tools, and protocols

developed by Center staff.

 Targeted. The second, targeted tier of

technical assistance includes peer-to-peer

collaborative opportunities for SEAs to work

on a shared problem of practice relevant to the

broader field. The work will yield participantdesigned and -tested tools and resources that

will then be disseminated more broadly to

the field.

 Intensive. Finally, the third, intensive tier

supports the SEL and school safety needs of

individual SEAs and LEAs. These one-on-one

consulting engagements will aim to build their

capacity to lead and sustain the work.

Website: https://selcenter.wested.org/

Center of Excellence on Infant and 

Early Childhood Mental Health 

Consultation (CoE for IECMHC)

Funded by the U.S. Department of 

Health and Human Services

The CoE for IECMHC is a national technical 

assistance center dedicated to the advancement 

and impact of the field of IECMHC through 

training, technical assistance, and resource 

development. The CoE is supported by the U.S. 

Department of Health and Human Services’ 

Substance Abuse and Mental Health Services 

Administration in partnership with the 

Administration for Children and Families and 

Health Resources and Services Administration.
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 75

IECMH consultants support professionals in early 

care and education, home visiting, early 

intervention, and other early childhood settings. 

The CoE for IECMHC provides technical 

assistance to programs, communities, states, 

territories, and tribal communities, and individual 

mental health consultants to increase access to 

high quality mental health consultation throughout 

the country. 

The CoE for IECMHC has three areas of focus:

 To serve as a clearinghouse for best practice

resources related to developing, implementing,

and maintaining an IECMHC program at a

state, territorial, community or tribal level.

 To provide technical assistance to states,

territories, programs, communities, or tribal

nations in any stage of IECMHC program

development.

 To provide professional development to

IECMH consultants nationally.

Website: https://www.iecmhc.org/

National Technical Assistance 

Center for the Education of 

Neglected or Delinquent Children 

and Youth (NDTAC)

Funded by the U.S. Department of 

Education

In 2002, the U.S. Department of Education 

established the NDTAC, which is overseen by 

Longevity Consulting and its partners Child 

Trends, BreakFree Education and Cyber Synergy. 

NDTAC’s overarching mission is to improve 

educational programming for children and youth 

who are neglected or delinquent or at risk. Within 

this overarching mission, NDTAC focuses on 

three key goals:

 Collect and disseminate information and

resources related to the education of children

and youth who are neglected or delinquent

and/or at risk of dropping out of school.

 Foster coordination and collaboration among

neglected or delinquent programs focused on

the practice of educating children and youth 

who are neglected or delinquent. 

 Synthesize and provide existing evidencebased research to expand the general

knowledge base about the education of

children and youth who are neglected or

delinquent.

Website: https://neglected-delinquent.ed.gov/
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 76

National Center on Afterschool and 

Summer Enrichment (NCASE)

Funded by the U.S. Department of 

Health and Human Services

The National Center on Afterschool and Summer 

Enrichment (NCASE) is part of the Office of 

Child Care (OCC) Technical Assistance network. 

NCASE provides training and technical assistance 

to the state, territory, and tribal Child Care and 

Development Fund lead agencies and their 

designated networks, which include the statewide 

afterschool networks, state and local educational 

agencies, provider associations, and Child Care 

Resource and Referral agencies. The goal of 

NCASE is to ensure that school-age children in 

families of low income have increased access to 

high-quality afterschool and summer learning 

experiences that contribute to their overall 

development and academic achievement. 

Selected NCASE resources include:

 Social and emotional learning

 Addressing adverse childhood experiences

 Supporting positive social-emotional climates

in out-of-school time

Website: https://childcareta.acf.hhs.gov/centers/ 

national-center-afterschool-summer-enrichment

National Center on Early Childhood 

Development, Teaching, and 

Learning (NCECDTL)

Funded by the U.S. Department of 

Health and Human Services

This Center is part of a comprehensive Training 

and Technical Assistance System funded by the 

Office of Head Start. NCECDTL advances best 

practices in the identification, development, and 

promotion of the implementation of evidencebased child development and teaching and 

learning practices that are culturally and 

linguistically responsive and lead to positive child 

outcomes across early childhood programs. They 

also support strong professional development 

systems. NCECDTL is responsive to the unique 

needs of dual language learners, American Indian 

and Alaskan Native and Migrant and Seasonal 

Head Start programs, in particular, as well as other 

diverse populations. It uses professional 

development strategies that support states, tribes, 

and agencies in serving low-income families. The 

Center's work includes, but is not limited to: 

 Professional development for the infant,

toddler, and preschool workforce

 Evidence-based curriculum

 Intentional teaching and home visiting

practices

 Effective transitions

 Developmental screening instruments and ongoing assessment tools

 Practice-based coaching

 Culturally, linguistically, and age-appropriate

practices

 Enhancing teacher-child interactions

 Supporting children with disabilities and

suspected delays (Part C and Part B)

 Using data to improve practice

Website: https://eclkc.ohs.acf.hhs.gov/ncecdtl
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 77

National Center on Health, 

Behavioral Health, and Safety 

(NCHBHS)

Funded by the U.S. Department of 

Health and Human Services

This Center is part of a comprehensive Office of 

Head Start Training and Technical Assistance 

System and works collaboratively with a 

consortium of partners. NCHBHS designs 

evidence-based resources and delivers innovative 

training and technical assistance to build the 

capacity of Head Start and other early childhood 

programs to: 

 Support children’s healthy development and

school success

 Promote the safety of children, families, and

staff

 Provide inclusive, culturally, and linguistically

responsive services

 Address disaster preparedness, response, and

recovery

 Mitigate adversity through trauma-informed

care

 Advance health equity by improving child and

family well-being

NCHBHS is responsive to the unique needs of 

children who are dual language learners, children 

in Tribal or Migrant and Seasonal Head Start 

programs, children with special health care needs, 

and children who are living in foster care or 

experiencing homelessness.

Website: https://childcareta.acf.hhs.gov/centers/ 

national-center-health-behavioral-health-andsafety

National Center for Homeless 

Education (NCHE)

Funded by the U.S. Department of 

Education

This Center operates the U.S Department of 

Education's technical assistance center for the 

federal Education for Homeless Children and 

Youth (EHCY) Program. In this role, NCHE 

works with educators, service providers, parents, 

youth, and other interested groups to ensure that 

children and youth experiencing homelessness can 

enroll and succeed in school. NCHE, based at the 

University of North Carolina at Greensboro, 

creates publications, hosts webinars, and delivers 

onsite and virtual presentations in addition to 

providing individual assistance via a national 

helpline at 800-308-2145. 

Website: https://nche.ed.gov/

National Center on Parent, Family, 

and Community Engagement 

(NCPFCE)

Funded by the U.S. Department of 

Health and Human Services

This Center is part of a comprehensive 

Department of Health and Human Services/Office 

of Head Start Training and Technical Assistance 

System. NCPFCE provides training and technical 

assistance for Head Start and Early Head Start 

staff who work with 

families. NCPFCE professional development 

activities reflect current evidence and lead to 

improved: 

 Family outreach, recruitment, and attendance

 Family well-being

 Expanded family engagement in children’s

learning and development
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 78

 Enhanced community partnerships that support

families

 Strengthened outcomes for children and

families enrolled in Head Start and Early Head

Start programs

NCPFCE also offers professional development in 

areas, including but not limited to: 

 Staff-family relationship building that is

culturally and linguistically responsive

 Family employment, career pathways, and

financial stability

 Equity and inclusiveness in family

engagement

 Parent leadership, advocacy, and transitions to

kindergarten

Website: https://eclkc.ohs.acf.hhs.gov/aboutus/article/national-center-parent-familycommunity-engagement-ncpfce

National Center for Pyramid Model 

Innovations (NCPMI)

Funded by the U.S. Department of 

Education

The Center works to improve and support the 

capacity of state systems and local programs to 

implement an early childhood multi-tiered system 

of support to improve the social, emotional, and 

behavioral outcomes of young children with, and 

at risk for, developmental disabilities or delays. 

The goals of the Center are to assist states and

programs in their implementation of sustainable 

systems for the implementation of the Pyramid 

Model for Supporting Social Emotional 

Competence in Infants and Young Children 

(Pyramid Model) within early intervention and 

early education programs with a focus on 

promoting the social, emotional, and behavioral 

outcomes of young children birth to five, reducing 

the use of inappropriate discipline practices, 

promoting family engagement, using data for 

decision-making, integrating early childhood and 

infant mental health consultation, and fostering 

inclusion. 

Website: https://challengingbehavior.cbcs.usf.edu/

National Center on Safe Supportive 

Learning Environments (NCSSLE)

Funded by the U.S. Department of 

Education

NCSSLE is funded by the Department’s Office of 

Safe and Supportive Schools. The Center offers 

information and technical assistance to states, 

districts, schools, institutions of higher education, 

and communities focused on improving school 

climate and conditions for learning. NCSSLE 

operates under the premise that, with the right 

resources and support, educational partners can 

collaborate to sustain safe, engaging, and healthy 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 79

school environments that support student 

academic success. The website includes 

information about the Center’s training and 

technical assistance resources, products and tools, 

and latest research findings.

NCSSLE’s three main areas of support are:

 Providing training and support to state

administrators, including 27 grantees funded

under the Mental Health Service Professional

Demonstration Grant program, 15 grantees

funded under the Project Prevent Grant

program, 5 grantees funded under the Trauma

Recovery Demonstration Grant program,

school and district administrators, institutions

of higher education, teachers, support staff at

schools, communities and families, and

students.

 Seeking to improve schools’ climate and

conditions for learning through measurement

and program implementation, so that all

students have the opportunity to realize

academic success in safe and supportive

environments.

 Promoting and managing the U.S. Department

of Education School Climate Surveys

(EDSCLS) maintenance and help desk hotline.

To contact the National Center on Safe Supportive 

Learning Environments, call 1-800-258-8413 or email ncssle@air.org. 

Website: https://safesupportivelearning.ed.gov

The National Center for School 

Mental Health (NCSMH)

Funded by the Health Resources and 

Services Administration

The NCSMH at the University of Maryland 

School of Medicine conducts research, training, 

policy, and practice to advance school mental 

health nationally. The NCSMH engages school, 

district, state, and territory leaders in assessing and 

improving their comprehensive school systems via 

a free online portal, The School Health 

Assessment and Performance Evaluation 

(SHAPE) System. The SHAPE System offers 

individuals and teams the opportunity to assess 

school mental health quality using national 

performance measures and provides targeted tools 

and resources to support quality improvement and 

strategic action planning. Through facilitation of 

School Mental Health Collaboratives on 

Improvement and Innovation Networks, national 

communities of practice, state coalitions, and other 

learning collaboratives at local, district, state, 

regional, and national levels, the NCSMH 

analyzes diverse sources of information, develops 

and disseminates practical tools, issue and policy 

briefs, and promotes the utilization of knowledge 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 80

and actions to advance successful, innovative, and 

sustainable school mental health policies, 

practices, and programs.

Website: http://www.schoolmentalhealth.org/

National Training and Technical 

Assistance Center for Child, Youth, 

and Family Mental Health (NTTAC)

Funded by the Substance Abuse and 

Mental Health Services Administration

NTTAC provides states, tribes, and communities 

with training and technical assistance on 

children’s behavioral health, with a focus on 

systems of care. NTTAC is funded to increase 

access to, effectiveness of, and dissemination of 

evidence-based mental health services for young 

people (birth to age 21) and their families, 

including young people experiencing serious 

mental illness or serious emotional disturbance. 

NTTAC supports a system of care that is traumainformed and person-centered. NTTAC is 

committed to equity, inclusion, and diversity, and 

promotes authentic partnership with youth and 

families. NTTAC supports Children’s Mental 

Health Initiative grantees and provides an array of 

trainings, technical assistance, and resources to 

providers, organizations, and agencies from across 

the system of care.

Website: https://nttacmentalhealth.org/

National Technical Assistance 

Center on Positive Behavioral 

Interventions and Supports (PBIS)

Funded by the U.S. Department of 

Education

The PBIS Center has been funded since 1998. The 

purpose of the Center is to improve the capacity of 

state educational agencies, local educational 

agencies, and schools to establish, scale-up, and 

sustain the PBIS framework to (a) scale up tiered 

systems of support to improve outcomes for 

students with or at-risk for disabilities, (b) enhance 

school climate and school safety, and (c) improve 

conditions for learning to promote the well-being 

of all students.

The Center on PBIS (a) provides the technical 

assistance to encourage large-scale 

implementation of multi-tiered systems of support 

(MTSS) to address social-emotional, behavioral, 

and mental health needs; (b) provides the 

organizational models, demonstrations, 

dissemination, and evaluation tools needed to 

comprehensively and effectively implement 

MTSS across an extended array of contexts; and 

(c) extends the lessons learned from PBIS

implementation to the broader agenda of

educational reform. The Center also provides

support to the School Climate Transformation

District and State grants.

The website includes resources, tools, and 

trainings to enhance district and state efforts to 

build capacity and systemically integrate social, 

emotional, behavioral, and mental health strategies 

and supports in schools. 

Website: www.pbis.org
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 81

APPENDIX C. 

Technical Assistance Resources Related to Social, 

Emotional and Mental Health

Assessment

Title: Using Student Achievement Data to 

Support Instructional Decision Making

Link: https://ies.ed.gov/ncee/wwc/ 

PracticeGuide/12

Description: This guide offers five

recommendations to help educators effectively use 

data to monitor students’ academic progress and 

evaluate instructional practices. The guide 

recommends that schools set a clear vision for 

schoolwide data use, develop a data-driven 

culture, and make data part of an ongoing cycle of 

instructional improvement. The guide also 

recommends teaching students how to use their 

own data to set learning goals.

Early Childhood

Title: Seven Impacts of the Pandemic on Young 

Children and their Parents: Initial 

Findings from NIEER’s December 2020 

Preschool Learning Activities Survey. 

New Brunswick, NJ: National Institute 

for Early Education Research

Link: https://nieer.org/wp-content/uploads/2021/ 

02/NIEER_Seven_Impacts_of_the_Pandemic_on_

Young_Children_and_their_Parents.pdf

Description: This study highlights seven impacts 

the pandemic has had on children and their 

parents. The research was conducted by the 

National Institute for Early Education Research 

(NIEER) at the Graduate School of Education, 

Rutgers University, New Brunswick, NJ, where 

they conduct and disseminate independent 

research and analysis to inform early childhood 

education policy. 

Title: Checklist of Early Childhood Practices 

that Support Social-Emotional 

Development and Trauma-Informed 

Care (NCPMI)

Link: https://challengingbehavior.cbcs.usf.edu/ 

docs/Informed-Care-Checklist.pdf

Description: This checklist is a list of practices 

that will help guide your thinking about how to 

support the social-emotional development of 

young children who have experienced trauma. 

This list of practices is not exhaustive nor is it 

meant to be a substitute for treatment or 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 82

counseling for children and families. Many of 

these practices are part of the Pyramid Model (i.e., 

the Teaching Pyramid Observation Tool), while 

other practices may not be explicitly described in 

the Pyramid Model practices yet they align well 

with Pyramid Model practices that you may 

already be using. 

Families

Title: National Federation of Families: 

Education and Mental Health During 

COVID-19 

Link: https://www.ffcmh.org/crisis-hotlines

Description: The link offers free, national 

hotlines and helplines that can assist parents, 

caregivers, families, and youth.

Title: Supporting Students with Disabilities at 

School and Home: A Guide for Teachers 

to Support Families and Students

Link: https://www.pbis.org/resource/supportingstudents-with-disabilities-at-school-and-home-aguide-for-teachers-to-support-families-andstudents

Description: This guide highlights five key 

practices for teachers and families to support all 

students, including students with disabilities, at 

school and home. For each practice, the guide 

provides (a) tips for teachers to support students 

with disabilities during instruction; (b) tips for 

families that educators can share to support or 

enhance learning at home, especially during 

periods of remote instruction; and (c) free-access 

resources that include strategies shown to be 

effective by research (e.g., informational guides, 

downloadable materials, research-based 

programs). 

Mental Health

Title: Advancing Comprehensive School 

Mental Health Systems: Guidance from 

the Field

Link: http://www.schoolmentalhealth.org/ 

Resources/Foundations-of-School-MentalHealth/Advancing-Comprehensive-SchoolMental-Health-Systems--Guidance-from-theField/

Description: This resource synthesizes school 

mental health knowledge and guidance of over 75 

experts nationally. This resource is a 

foundational document in the field to help guide 

local, state, and national efforts to strengthen 

school mental health efforts and to start to 

understand and bring consensus to the quality 

domains of school mental health. A partnership of 

national school mental health leaders and 

organizations contributed to the development of 

the guidance. 

Title: National School Mental Health Best 

Practices: Implementation Guidance 

Modules for States, Districts, and Schools

Link: https://mhttcnetwork.org/centers/globalmhttc/national-school-mental-health-best-practices

Description: The Guidance was co-developed by 

the Mental Health Technology Transfer Center 

Network Coordinating Office and the National 

Center for School Mental Health to help states, 

districts, and schools across the United States 

understand the core components of comprehensive 

school mental health and engage in a planning 

process around implementation of services. The 

modules are intended to be used with school and 

district teams that can influence, develop, and 

oversee school mental health systems at the school 

district and building levels.
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 83

Title: Classroom WISE (Well-Being 

Information and Strategies for 

Educators)

Link: https://mhttcnetwork.org/free-smh-course

Description: Educators and school personnel play 

a vital role in promoting mental health and wellbeing and identifying and responding to emerging 

mental illness in children and adolescents. 

However, they often have not received the 

education, training, and/or ongoing support 

needed to respond in the classroom. To address 

this need, the Mental Health Technology Transfer 

Center Network, in partnership with the National 

Center for School Mental Health at the 

University of Maryland School of Medicine, has 

developed a FREE self-guided online course, a 

video library + resource collection and a website 

focused on educator mental health literacy. The 3-

part training package is informed by and codeveloped with educators from across the nation. 

These resources will present concrete, universal 

approaches to promoting student mental health 

and creating safe and supportive classroom 

environments, describe student behaviors that may 

indicate a mental health concern, and provide 

specific skills and strategies to engage and support 

students with mental health concerns. 

Title: CDC’s Division of Adolescent and School 

Health (DASH) School Mental Health 

Quality Guide Series

Link: https://www.cdc.gov/healthyyouth/mentalhealth/index.htm

Description: CDC’s DASH promotes the health 

and well-being of adolescents through schools, 

enabling these adolescents to become healthy and 

productive adults. DASH provides funding and 

technical assistance to local educational agencies 

and supports surveillance and research to promote 

student and staff well-being. 

Title: School Connectedness Tip Sheets—

School Mental Health Quality 

Guide Series

Link: https://www.cdc.gov/healthyyouth/ 

protective/school_connectedness.htm

Description: Data shows that students who say 

that they feel connected to their school (that their 

teachers care about them, that they feel like they 

belong, that they feel safe there) are less likely to 

engage in many risk behaviors, including early 

sexual initiation, alcohol, tobacco, and other drug 

use, and violence and gang involvement, less 

likely to report symptoms of anxiety or 

depression, and are more likely to report higher 

grades and test scores, have better school 

attendance, and stay in school longer. This 

webpage contains links to resources for school 

administrators and parents, and other 

interested groups. 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 84

Title: Social and Emotional Climate

Link: https://www.cdc.gov/healthyschools/ 

sec.htm

Description: The Social and Emotional Climate 

webpage contains information about why a 

positive social-emotional climate is important, 

ways to foster a positive climate, and links to other 

resources, including a resource on the relationship 

between nutrition and social-emotional climate.

Title: How to Cope with Stress and Anxiety

Link: https://www.cdc.gov/coronavirus/2019-

ncov/daily-life-coping/managing-stressanxiety.html

Description: The COVID-19 pandemic has had a 

major effect on our lives. Many of us are facing 

challenges that can be stressful, overwhelming, 

and cause strong emotions in adults and children. 

Public health actions, such as social distancing, 

are necessary to reduce the spread of COVID-19, 

but they can make us feel isolated and lonely and 

can increase stress and anxiety. This webpage 

contains suggestions about how to cope with stress 

in a healthy way will make you, the people you 

care about, and those around you become more 

resilient.

Title: CDC Mental Health Tools and Resources

Link: https://www.cdc.gov/mentalhealth/toolsresources/index.htm

Description: The series developed by the National 

Center for School Mental Health provides 

guidance to school mental health leaders to 

advance the quality of their services and supports. 

The guides contain background information on 

each domain, best practices, possible action steps, 

examples from the field, and resource guidance. 

In addition, the Division of Adolescent and School 

Health will also be adding a research-informed 

resource on classroom management approaches that 

foster school connectedness to our safe supportive 

environments website, linked here: 

https://www.cdc.gov/healthyyouth/whatworks/ 

what-works-safe-and-supportive-environments.htm. 

Positive Behavioral Interventions 

and Supports

Title: Teaching Social-Emotional Competencies 

Within a PBIS Framework 

Link: https://www.pbis.org/resource/teachingsocial-emotional-competencies-within-a-pbisframework

Description: Positive behavioral interventions and 

supports (PBIS) provides an ideal framework for 

promoting social-emotional competencies to 

improve outcomes for the whole child. The 

purpose of this brief is to describe how school 

personnel can teach social-emotional 

competencies within a PBIS framework to support 

systematic, school-wide implementation through 

one system, rather than trying to improve student 

outcomes through separate, competing initiatives. 

School Climate

Title: Strategies for Trauma-Informed Distance 

Learning

Link: https://selcenter.wested.org/wpcontent/uploads/sites/3/2020/05/SEL_Center_ 

Strategies_for_Trauma_Informed_Distance_

Learning_Brief.pdf

Description: To help educators use traumainformed teaching practices in distance learning 

contexts, this brief offers some general strategies, 

with specific examples, for how to recognize and 

respond to students’ social and emotional needs 

while teaching remotely. The strategies are 

organized by Perry’s 3 Rs: Regulate, Relate, and 

Reason.
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 85

Social-Emotional Learning

Title: NCPMI Resources: Practical Strategies 

to Promote Social-Emotional Skill 

Development and Mental Health in 

Young Children- Back to School: 

Promoting Social-Emotional Skills and 

Preventing Challenging Behavior

Link: (Downloadable, Captioned) 

https://challengingbehavior.cbcs.usf.edu/videos/ 

Back-to-School_CC.mp4

Description: Brief video (9 min) that describes 

the strategies that might be used by early 

childhood programs and educators to promote 

social and emotional skills and prevent 

challenging behavior. The video provides 

information on universal and targeted practices 

and materials that might be used by classroom 

teachers.

Title: NCPMI Resources: The Leadership 

Team’s Guide for Re-Opening Programs

Link: https://challengingbehavior.cbcs.usf.edu/ 

docs/Leadership_ReOpening_Guide.pdf

Description: This document is designed to guide 

the Program Leadership Team around 

considerations for supporting children, families, 

and staff as they return to the program. The 

guidance provides 29 links to practical strategies 

and encourages you to think about those strategies 

from a trauma-informed perspective. While the 

leadership team may not know who among 

children, families, and staff have or are 

experiencing trauma, a trauma-informed approach 

guides programs in providing a safe and nurturing 

environment where children, families, and staff 

can build resilience, feel safe, and recover.

Title: NCPMI Resources: Helping Young 

Children Understand Emotions When 

Wearing Masks 

Link: https://challengingbehavior.cbcs.usf.edu/ 

docs/Wearing-Masks_Tipsheet.pdf

Description: Here are tips and ideas for helping 

children identify emotions when your face, your 

most expressive feature, is covered by a mask. Use 

these strategies to let children know that behind 

the mask, a kind and warm expression is 

still there!

Title: NCPMI Resources: Practical Strategies 

to Promote Social-Emotional Skill 

Development and Mental Health in 

Young Children—Tucker Turtle 

Takes Time to Tuck and Think 

Link: https://challengingbehavior.cbcs.usf.edu/ 

docs/TuckerTurtle_Story.pdf

Description: Tucker the Turtle provides a scripted 

story to teach young children how to calm down 

when they have strong feelings by tucking into 

their shell and taking deep breaths. The story also 

includes visuals to help children learn how to use 

the self-regulation strategy. A home version is 

offered so that caregivers can partner with the 

classroom in teaching this important selfregulation skill.

Spanish school version: 

https://challengingbehavior.cbcs.usf.edu/docs/ 

TuckerTurtle_Story_sp.pdf

Home version: 

https://challengingbehavior.cbcs.usf.edu/docs/ 

TuckerTurtle_Story_Home.pdf

Spanish home version: 

https://challengingbehavior.cbcs.usf.edu/docs/ 

TuckerTurtle_Story_Home_SP.pdf
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 86

Title: We Can Be Problem Solvers!

Link: https://challengingbehavior.cbcs.usf.edu/ 

docs/ProblemSolving_Story.pdf

Description: This scripted story helps children 

understand the steps to social problem solving. 

The story includes problem scenario cards and a 

solution kit to help young children practice finding 

a solution to common social problems. A home 

version is offered so that caregivers can partner 

with the classroom in teaching these important 

skills.

Spanish school version: 

https://challengingbehavior.cbcs.usf.edu/docs/ 

ProblemSolving_Story_SP.pdf

Home version: 

https://challengingbehavior.cbcs.usf.edu/docs/ 

ProblemSolving_Story_Home_EN.pdf

Spanish home version: 

https://challengingbehavior.cbcs.usf.edu/docs/ 

ProblemSolving_Story_Home_SP.pdf

Title: Self-Care Strategies for Educators 

During the Coronavirus Crisis: 

Supporting Social and Emotional WellBeing—Resources Related to Social, 

Emotional, and Mental Health for 

Teachers, Providers, and Leaders— 

Developed by the Center to Improve 

Social and Emotional Learning and 

School Safety (CISELSS)

Link: https://selcenter.wested.org/wpcontent/uploads/sites/3/2020/05/Self_Care_ 

Strategies_for_Educators_During_the_Coronavirus

_Crisis.pdf

Description: The brief offers practical 

information and guidance on self-care in these 

challenging times. In this rapidly changing 

context, teachers are called upon to continue 

educating their students, often teaching from home 

while also supporting families and communities in 

new ways. But in order to support others, 

educators must support themselves first. In fact, 

across helping professions generally, self-care is 

considered an ethical imperative.

Title: Community-Care Strategies for Schools 

During the Coronavirus Crisis—

Resources Related to Social, Emotional, 

and Mental Health for Teachers, 

Providers, and Leaders—Developed by 

the Center to Improve Social and 

Emotional Learning and School Safety 

(CISELSS) 

Link: https://selcenter.wested.org/wpcontent/uploads/sites/3/2020/05/Brief_Community

_Care_Strategies.pdf

Description: This brief offers practical guidance 

for educators and other school staff, and for 

administrators and other leaders, to help you ensure 

that school communities are effective, cohesive, 

collaborative, healthy, and sustainable while coping 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 87

with the stresses of social isolation, school closures, 

and changes to how services are provided.

Title: Connecting Teacher Practice with Social 

and Emotional Learning—Resources 

Related to Social, Emotional, and Mental 

Health for Teachers, Providers, and 

Leaders—Developed by the Center to 

Improve Social and Emotional Learning 

and School Safety (CISELSS)

Link: https://selcenter.wested.org/resource/

connecting-teacher-practice-with-social-andemotional-learning/

Description: Promoting teacher social and 

emotional learning (SEL) benefits the entire 

school community. Not only does it support 

teacher effectiveness and help make the work 

sustainable for teachers; it also supports student 

well-being, higher achievement, and a healthy 

school climate and culture. In this interview, 

listeners will learn about: (1) the unique ways that 

mentoring programs can help develop teacher 

SEL, strengthen school-based relationships, and 

support effective instruction and (2) the 

importance of teacher SEL (and well-being) to 

school and classroom culture.

Title: Center on PBIS—Guidance to Support 

States, Districts, and Schools During and 

After Pandemic: Returning to School 

During and After Crisis: A Guide to 

Supporting States, Districts, Schools, 

Educators, and Students through a MultiTiered Systems of Support Framework

Links:

Main Guide: 

https://www.pbis.org/resource/returning-toschool-during-and-after-crisis

State Guide: 

https://www.pbis.org/resource/a-state-guide-forreturning-to-school-during-and-after-crisis

District Guide: 

https://www.pbis.org/resource/a-district-guide-forreturning-to-school-during-and-after-crisis

School Guide: 

https://www.pbis.org/resource/a-school-guide-forreturning-to-school-during-and-after-crisis

Description: This guide describes the use of a 

multi-tiered systems of support framework to 

support students, families, and educators during 

the transitions back to school during and following 

the global pandemic in a manner that prioritizes 

their health and safety, social and emotional 

needs, and behavioral and academic growth. The 

comprehensive guide provides information to 

support implementation at the state, district, 

school, and classroom levels. To learn more about 

how to use this resource, please view the video 

Guide to the Guide. For more streamlined 

guidance, please view the state, district, and 

school guides.

Title: Center on Positive Behavioral 

Interventions and Supports (PBIS)—

Guidance to Support States, Districts, 

and Schools During and After Pandemic: 

Supporting PBIS Implementation 

Through Phases of Crisis Recovery 

Link: https://www.pbis.org/resource/supportingpbis-implementation-through-phases-of-crisisrecovery

Description: As school and district communities 

consider options for effectively supporting 

students, educators, and families during and after a 

crisis, it can be difficult to identify critical 

impactful actions. The PBIS framework can serve 

as a road map to meeting this challenge. This 

practice brief provides strategies to guide 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 88

implementation efforts through the various phases 

of crisis recovery for schools and districts that are 

(a) getting started or (b) strengthening and 

maintaining current implementation.

Title: How the Pandemic is Reshaping 

Education

Link: https://www.washingtonpost.com/education/

2021/03/15/pandemic-school-yearchanges/?arc404=true

Description: This article features topics that cover 

the changes schools had to make during the 

pandemic. The third topic is on Mental Health and 

includes comments from Sharron Hoover, one of 

the Directors of the School Mental Health 

Technical Assistance Center.

Title: Connecting Teacher Practice with Social 

and Emotional Learning

Link: https://selcenter.wested.org/resource/

connecting-teacher-practice-with-social-andemotional-learning/

Description: Promoting teacher social and 

emotional learning (SEL) benefits the entire school 

community. Not only does it support teacher 

effectiveness and help make the work sustainable 

for teachers; it also supports student well-being, 

higher achievement, and a healthy school climate 

and culture. In this interview, listeners will learn 

about: (1) the unique ways that mentoring programs 

can help develop teacher SEL, strengthen schoolbased relationships, and support effective 

instruction and (2) the importance of teacher SEL 

(and well-being) to school and classroom culture.

Supporting and Responding to 

Behavior

Title: Returning to School: Considerations for 

Students with the Most Intensive 

Behavioral Needs, A Guide to Supporting 

Students with Disabilities, Their 

Families, and Educators During the 

2020–21 School Year 

Link: https://www.pbis.org/resource/returning-toschool-considerations-for-students-with-the-mostintensive-behavioral-needs-a-guide-to-supportingstudents-with-disabilities-their-families-andeducators-during-the-2020-21-school-year

Description: This document is a set of strategies 

and key practices to restart classrooms and schools 

in a manner that students, their families, and 

educators can use effectively, efficiently, and 

relevantly in the current climate.

Title: What Works Clearinghouse 

Link: https://ies.ed.gov/ncee/wwc/FWW/

Results?filters=,Behavior

Description: The What Works Clearinghouse 

(WWC) reviews the existing research on different

programs, products, practices, and policies in 

education. The goal is to provide educators with 

the information they need to make evidence-based 

decisions. WWC focuses on the results from highquality research to answer the question “What 

works in education?” This direct link includes a 

filter to review topics related to behavior.
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 89

Teachers and Providers

Title: Building a Culture of Staff Wellness 

Through Multi-Tiered System of 

Supports

Link: https://www.pbis.org/resource/building-aculture-of-staff-wellness-through-multi-tieredsystem-of-supports

Description: The purpose of this brief is to 

provide recommendations to district and school 

leadership teams on how the components of 

Positive Behavioral Interventions and Supports 

can be used to prioritize staff health and wellbeing. 

Title: Installing an Interconnected Systems 

Framework at the District/Community 

Level: Recommendations and Strategies 

for Coaches and District Leaders

Link: https://www.pbis.org/resource/installing-aninterconnected-systems-framework-at-the-districtcommunity-level-recommendations-andstrategies-for-coaches-and-district-leaders

Description: The Interconnected Systems 

Framework (ISF) is a process to create a more 

stream-lined approach to school mental health and 

wellness by connecting all social-emotionalbehavioral (SEB) efforts through one system, 

while eliminating barriers inherent in systems that 

previously have operated separately. This Practice 

Guide describes and illustrate how 

district/community leaders can embed mental 

health supports within the Positive Behavioral 

Interventions and Supports framework to create a 

unified and comprehensive system of SEB 

supports in schools. One district’s experience 

building such an ISF is portrayed including how 

they engaged community partners, families, and 

school personnel. Technical assistance strategies 

and tools for coaches guiding the ISF process in 

districts/communities and schools are included. 

Title: Installing an Interconnected Systems 

Framework at the School Level: 

Recommendations and Strategies for 

School Leadership Teams, Practitioners 

and Coaches

Link: https://www.pbis.org/resource/installing-aninterconnected-systems-framework-at-the-schoollevel-recommendations-and-examples-to-guideschool-leadership-teams-practitioners-and-coaches

Description: This Practice Guide describes and 

illustrates how schools, with support from coaches 

and district/community leaders, can benefit from 

the integration of mental health supports within 

the Positive Behavioral Interventions and Supports 

(PBIS) Framework. District/school leaders and 

coaches can use this information to support their 

efforts building an Interconnected Systems 

Framework (ISF) of mental health and PBIS. This 

Guide highlights practical strategies from one 

school’s successful experiences, including 

indications of the impact on students’ success 

while building strong partnerships with families 

and community partners. Suggested Technical 

Assistance strategies for coaches are provided.

Title: Advancing Education Effectiveness: 

Interconnecting School Mental Health 

and School-Wide Positive Behavioral 

Interventions and Supports, Volume 2: 

An Implementation Guide

Link: https://www.pbis.org/resource/ 

interconnecting-school-mental-health-and-pbisvolume-2

Description: This implementation guide provides 

a step by step process with examples, activities, 

and resources for district and school teams to 

install and implement an Interconnected Systems 

Framework.
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 90

Title: Community-Care Strategies for Schools 

During the Coronavirus Crisis

Link: https://selcenter.wested.org/wpcontent/uploads/sites/3/2020/05/Brief_Community

_Care_Strategies.pdf

Description: This brief offers practical guidance 

for educators and other school staff, and for 

administrators and other leaders, to help you 

ensure that school communities are effective, 

cohesive, collaborative, healthy, and sustainable 

while coping with the stresses of social isolation, 

school closures, and changes to how services are 

provided. 

Trauma

Title: Addressing Trauma in Educational 

Settings, Module 3: School Systems, 

Policies, and Procedures to Support 

Students Experiencing Trauma (Regional 

Educational Laboratory Appalachia) 

Link: https://ies.ed.gov/ncee/edlabs/regions/ 

appalachia/events/event_12-21-20_addressingtrauma-in-educational-settings_module-2.asp

Description: Regional Educational Laboratory 

Appalachia staff held a total of three webinars, in 

which they shared research, resources, and 

strategies to support students and educators in the 

context of trauma. 

Title: Addressing Collective Trauma and 

Supporting the Well-Being of Students 

and School Staff (Regional Educational 

Laboratory Southwest) 

Link: https://ies.ed.gov/ncee/edlabs/regions/ 

southwest/events/2021/webinar-012121.aspx

Description: This was a free virtual event that 

addressed collective trauma in the current context 

of COVID-19 and social injustice. Presenters 

discussed how collective trauma may affect staff 

and students.

Title: Integrating a Trauma-Informed 

Approach within a Positive Behavioral 

Interventions and Supports (PBIS) 

Framework

Link: https://www.pbis.org/resource/integratinga-trauma-informed-approach-within-a-pbisframework

Description: As educators have become 

increasingly aware of the impact of trauma on the 

school success of children and youth, they have 

been investing in professional development about 

how to address childhood trauma in schools. 

However, evaluation to support evidence of 

impact are lacking. This Guide describes how to 

integrate trauma-informed approaches into the 

PBIS framework to ensure efforts are linked to 

student outcomes. Strategies and tools to ensure 

effectiveness are included.

Technical Assistance

Title: Comprehensive Center Network 

(CCNetwork)

Link: https://compcenternetwork.org/

Description: The Comprehensive Center Network

(CCNetwork) is comprised of 19 Regional 

Comprehensive Centers and 1 National Center that 

provide capacity-building technical assistance to 

states, districts and schools in their design and 

implementation of evidence-based policies, 

practices, programs, and interventions that 

improve instruction and educational outcomes for 

all students. State educational agencies may 

request capacity-building support from their 

Comprehensive Centers.

The CCNetwork produces and disseminates 

research-based tools and resources to build the 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 91

capacity of educational leadership in socialemotional, behavioral learning and mental health 

approaches to better support the well-being of 

school staff, students, and families.

Title: Social, Emotional, and Behavioral 

Learning and Trauma-Informed Practice 

(CCNetwork)

Link: https://compcenternetwork.org/nationalcenter/our-work/collection/6278

Description: The Social, Emotional, and 

Behavioral Learning and Trauma-Informed 

Practice resource collection is designed to 

increase the capacity of state and district 

leadership to support their school communities 

create trauma-informed approaches for social, 

emotional, and behavioral learning. The resources 

within the collection are also targeted to specific 

needs and contexts, such as schools in rural 

communities, or schools that are in the early 

stages of implementing social and emotional 

learning strategies.

Title: Reimagining Excellence: A Blueprint for 

Integrating Social and Emotional WellBeing and Academic Excellence in School 

(CCNetwork)

Link: https://selcenter.wested.org/resource/

reimagining-excellence-a-blueprint-forintegrating-social-and-emotional-well-being-andacademic-excellence-in-schools/

Description: Reimagining Excellence: A 

Blueprint for Integrating Social and Emotional 

Well-Being and Academic Excellence in Schools, 

designed with input from in-person and remote 

educators, leaders, researchers, professional 

learning providers, and technical assistance 

providers, details the indicators of learning 

programs that successfully integrate equity, wellbeing, and academics and discusses how to 

improve student outcomes through a cycle of 

strong planning, action, and continuous 

monitoring.

Title: Informational Resources on Improving 

Social and Emotional Learning and 

Outcomes (CCNetwork)

Link: https://compcenternetwork.org/sites/default/

files/R6CC%20SEL_InformationalResources.pdf

Description: Informational Resources on 

Improving Social and Emotional Learning and 

Outcomes provides resources for understanding, 

prioritizing, and measuring students’ social and 

emotional learning (SEL) competencies and on 

evidence-based SEL programs and interventions. 

The document organizes resources and 

information about SEL into nine categories listed 

under two broad headings: What is SEL? and How 

is SEL being implemented? 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 92

Title: How Are You Doing? Supporting WellBeing and Learning Through a 

Concerns-Based Approach (CCNetwork)

Link: https://region12cc.org/how-are-you-doingsupporting-well-being-and-learning-through-aconcerns-based-approach/

Description: Supporting Well-Being and 

Learning Through a Concerns-Based 

Approach provides guidance to school leaders on 

supporting teacher well-being through 

implementation of the Concerns-Based Adoption 

Model (CBAM). A series of blogs opens with an 

introduction to using the CBAM framework and 

includes action steps to apply three diagnostic 

tools (i.e., Stages of Concern, Levels of Use, and 

Innovation Configuration Maps) to help maintain 

a focus on improving student learning while 

simultaneously supporting teacher well-being.

Title: Trauma-Informed Practices Resource 

List Dashboard (CCNetwork)

Link: https://app.smartsheet.com/b/publish? 

EQBCT=f250258487f7488594d1a0327ace297b

Description: This dashboard by the National 

Comprehensive Center contains curated 

collections of resources in four Trauma-Informed 

Practices Topics: Distance Learning, Addressing 

Grief, Historical Trauma and Self-Care for 

Educators. The collections are updated regularly.

Title: Better Together: A Coordinated 

Response for Principals and District 

Leaders (CCNetwork)

Link: https://compcenternetwork.org/sites/default/

files/Better_Together.pdf

Description: This brief published by the National 

Comprehensive Center for school and district 

leadership presents strategies, research and a 

structured approach to manage and support the 

social-emotional well-being of adults in the school 

building as well as the families and students they 

serve post COVID-19 closures.

Title: Student Engagement in Online Classes: 

Tips for Teachers Based on TraumaInformed Approaches and Social and 

Emotional Learning (SEL) Strategies 

(CCNetwork)

Link: https://compcenternetwork.org/sites/default/

files/Tip%20sheet%20for%20online%20teaching.pdf

Description: This fact sheet compiled by the 

National Comprehensive Center provides 

concrete strategies that middle and high school 

teachers can incorporate into their online teaching 

to increase engagement with students. The authors 

present a framework based on trauma-informed 

approaches and social and emotional learning 

strategies to ensure students feel safe, connected, 

engaged, and ready to learn. 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 93

APPENDIX D. 

Guidance on Existing Programs That Can Support SocialEmotional and Mental Health Services for Students

American Rescue Plan (ARP)

In March 2021, the President signed the American 

Rescue Plan (ARP) Act into law, which allocated 

substantial funding to States (as well as the 

Commonwealth of Puerto Rico and the District of 

Columbia), districts, schools, educators, students, 

and families as the country continues to recover 

from the COVID-19 pandemic. The ARP funds 

may be used to address the many impacts of 

COVID-19, including the provision of mental 

health services and supports.4

American Rescue Plan Elementary and 

Secondary School Emergency Relief 

(ARP ESSER) Fund

The ARP ESSR funds provide support to States, 

LEAs, and schools as they work to reopen schools 

safely, maximize in-person instructional time, and 

address the impact of the COVID-19 pandemic on 

4 Secretary of Education Letter, American Rescue Plan (ARP) Act 

of 2021 (March 2021), https://oese.ed.gov/files/2021/03/ 

ARP_Letter_Sec_to_Chiefs_FINAL.pdf

5 Press Release, Department of Education Announces American 

Rescue Plan Funds for all 50 States, Puerto Rico, and the District 

of Columbia to Help Schools Reopen (March 2021), 

https://www.ed.gov/news/press-releases/department-educationstudents, educators, and families.5

 Funds may be 

used to implement actionable strategies to meet 

the urgent needs of students and educators as 

LEAs and schools work to return to and safely 

sustain in-person instruction, address the 

educational inequities that have been exacerbated 

by the COVID-19 pandemic, and address 

students’ social, emotional, mental health, and 

academic needs.6 ARP specifically allows the use 

of funds to support the mental health of children 

and staff through the provision of evidence-based 

interventions and critical services.7

 This includes 

dramatically expanding the number of social 

workers, school counselors, school nurses, and 

school psychologists available to support students. 

The Higher Education Emergency 

Relief Fund III (HEERF III)

The Higher Education Emergency Relief Fund III 

(HEERF III) provides funding to support 

announces-american-rescue-plan-funds-all-50-states-puerto-ricoand-district-columbia-help-schools-reopen 6 Fact Sheet: American Rescue Plan Act of 2021, Elementary and 

Secondary School Emergency Relief Fund (ARP ESSER) (2021), 

https://oese.ed.gov/files/2021/03/FINAL_ARP-ESSER-FACTSHEET.pdf

7 Id. 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 94

institutions of higher education to serve students 

and ensure learning continues during the 

COVID-19 pandemic.8 This includes emergency 

financial aid grants for mental health support at 

the student and institutional level.9

Individuals with Disabilities Education 

Act (IDEA) American Rescue Plan 

Funds

ARP also provided additional funding through 

IDEA for state educational agencies and IDEA 

Part C Early Intervention state lead agencies to 

help recover from the impact of the coronavirus 

pandemic and to safely re-open schools and 

sustain safe operations.10 ARP supplemental 

IDEA funds extend the capacity of states to 

provide early intervention and special education 

supports and services, including psychosocial 

services, to children and adolescents eligible for 

IDEA services.11

Elementary and Secondary 

Education Act—Programs 

Supporting Mental Health Services

The Elementary and Secondary Education Act 

(ESEA) makes available funds that may be used to 

develop and provide mental health services to 

support students in grades Pre-K–12. There are 

two primary sources of funds for mental health 

services under the ESEA. The first is a formula 

grant program–Title IV, Part A, the Student 

Support and Academic Enrichment Grants 

program (SSAE).

12 The second is the School 

Safety National Activities (SSNA) authority,

13

under which the Department funds several 

8 Office of Postsecondary Education, ARP: American Rescue Plan 

(HEERF III) (September 2021), 

https://www2.ed.gov/about/offices/list/ope/arp.html

9 Frequently Asked Questions, Higher Education Emergency Relief 

Fund III (May 2021), 

https://www2.ed.gov/about/offices/list/ope/arpfaq.pdf

10 Materials Page, IDEA American Rescue Plan Funds (July 2021), 

https://www2.ed.gov/policy/speced/leg/arp/index.html

competitive grant programs that address the need 

for mental health services in schools.

Title IV, Part A of the ESEA—SSAE 

Program

Under the SSAE program, the Department 

allocates funds to state educational agencies 

(SEAs) based on a formula, and SEAs in turn 

allocate funds to local educational agencies 

(LEAs). LEAs must use the funds in three content 

areas, one of which is safe and healthy students.14

Among the allowable activities in the content area 

of safe and healthy students are services 

addressing mental health. These include 

(1) school-based mental health services, which

may be provided by school-based mental health

services providers; and (2) school-based mental

health services partnership programs, conducted in

partnership with a public or private mental health

entity or health care entity, that provide

comprehensive school-based mental health

services and staff development for school and

community personnel working in the school.

Allowable activities in the area of safe and healthy

students also include schoolwide positive

behavioral interventions and supports (PBIS),

including through coordination with similar

activities carried out under the Individuals with

Disabilities Education Act (IDEA). These

specifically identified mental health services are

illustrative and not exclusive, so LEAs also have

considerable flexibility to use their SSAE funds to

develop and provide other kinds of mental health

services, consistent with program and

administrative requirements for the use of funds.

11 Id. 12 Sections 4101–4112 of the Elementary and Secondary Education 

Act (ESEA), as amended, 20 U.S.C. 7111, et seq.

13 Section 4631 of the ESEA, 20 U.S.C. 7281.

14 Section 4108 of the ESEA, 20 U.S.C. 7118.
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 95

In fact, under a second SSAE content area, wellrounded educational opportunities,15 LEAs may 

use funds for a broad category described as 

activities that support student access to, and 

success in, a variety of well-rounded education 

experiences. Such activities could include mental 

health services and activities that promote socialemotional learning (SEL).

Of note, the flexibility that LEAs have under the 

SSAE program also means that they are not 

required to use their SSAE funds for mental health 

services. LEAs are required to conduct a needs 

assessment every three years, and the SSAE 

program contemplates that they will use funds 

consistent with the results of their needs 

assessments. Therefore, to the extent that mental 

health services are indicated as a result of its needs 

assessment, an LEA might choose to use a portion 

of its SSAE funds to develop programs and 

activities to meet those needs.

Under SSAE, SEAs reserve a portion of their 

allocation to carry out state-level activities.16

These activities may include supporting LEAs in 

implementing evidence-based mental health 

awareness training programs and in expanding 

access to, or coordinating resources for, schoolbased counseling and mental health programs, 

such as through school-based mental health 

services partnership programs. Again, these 

identified activities are illustrative and not 

exhaustive, and similar to LEAs, SEAs have 

flexibility in developing SSAE-funded programs 

that support LEAs in delivering needed mental 

health services to students.

15 Section 4107 of the ESEA, 20 U.S.C. 7117.

16 Section 4104 of the ESEA, 20 U.S.C. 7114.

17 Section 4001(a) of the ESEA, 20 U.S.C. 7101(a).

18 Section 4001(b) of the ESEA, 20 U.S.C. 7101(b).

SEAs and LEAs must obtain prior written, 

informed consent from the parent of each child 

who is under 18 years of age before they 

participate in any SSAE-funded mental-health 

assessment or service.17 Additionally, services 

provided under SSAE may not include medical 

services or drug treatment or rehabilitation, except 

for integrated student supports, specialized 

instructional support services, or referral to 

treatment for impacted students.18

The Department’s non-regulatory guidance for the 

SSAE program19 acknowledges the connection that 

can exist between students’ unaddressed mental 

health issues and poor academic achievement. It 

emphasizes that SSAE program activities can 

positively impact safe and supportive learning 

environments and student mental health. The 

guidance includes examples describing how LEAs 

may use funds to address student mental health, 

including PBIS and SEL activities.

19 Non-Regulatory Guidance, Student Support and Academic 

Enrichment Grants (October 2016), https://www2.ed.gov/policy/ 

elsec/leg/essa/essassaegrantguid10212016.pdf
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 96

SSNA Programs

Under the SSNA authority, the Department 

reserves funds to support activities that improve 

students’ safety and well-being, during and after 

the school day. The Department has used the 

flexibility that it has under this authority to 

develop and fund several competitive grant 

programs that address the critical area of student 

mental health, including programs focused on 

expanding school capacity to provide mental 

health services and programs focused on 

improving systems for providing those services. 

These programs are described below.

Mental Health Service Professional 

Demonstration Grants

This grant program supports innovative 

partnerships to train and deploy school-based 

mental health service providers in schools. The 

purpose is to expand the pipeline of high-quality, 

trained professionals to address shortages of

mental health services in high-need schools and to 

provide supports that encompass social and 

emotional learning, mental wellness, resilience, 

and positive connections between students and 

adults. Eligible entities are high-need LEAs and 

SEAs on behalf of one or more high-need LEAs.

Project Prevent Grants

These grants focus on increasing LEA capacity to 

identify, assess, and serve students exposed to 

pervasive violence, helping to ensure that affected 

students are offered mental health services for 

trauma or anxiety; support conflict resolution 

programs; and implement other school–based 

violence prevention strategies in order to reduce 

the likelihood that these students will later commit 

violent acts. LEAs are eligible entities under this 

program. 

School-Based Mental Health Services 

Grants

This program focuses on increasing the number of 

qualified (i.e., licensed, certified, well- trained, or 

credentialed) mental health service providers that 

provide school-based mental health services to 

students in LEAs with demonstrated need. Grants 

are awarded to SEAs.

School Climate Transformation Grants 

(SCTG)

This program assists grantees in developing, 

enhancing, or expanding systems of support for, 

and technical assistance to, schools implementing 

an evidence-based multi-tiered behavioral 

framework for improving behavioral outcomes 

and learning conditions for all students. The 

Department funds two SCTG programs, one for 

SEAs and one for LEAs. 

Grants to States for School Emergency 

Management

The purpose of these grants is to expand the 

capacity of SEAs to provide training and technical 

assistance to LEAs for the development and 

implementation of high-quality school emergency 

operations plans (EOPs). Grant programs include 

mental health integration into EOPs.

Summary of Federal Disability Laws

Federal disability laws support the ability of 

children and students with disabilities to access 

and receive mental-health related services when 

needed in the context of their education and also 

to protect these children and students from 

discrimination on the basis of disability. These 

laws are Part B of IDEA, Section 504, and Title II 

of the Americans with Disabilities Act of 1990 

(Title II). IDEA is the Federal law that, among 

other things, provides Federal funds to states, and, 

through them, to eligible local educational 

agencies (LEAs) to assist in providing a free 

appropriate public education (FAPE) to eligible 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 97

children and students with disabilities in the least 

restrictive environment. Section 504 prohibits 

discrimination on the basis of disability by 

recipients of Federal financial assistance and also 

has a FAPE requirement for public elementary and 

secondary school students with disabilities. Title II 

prohibits discrimination on the basis of disability 

by state and local governmental entities, 

regardless of receipt of Federal funds.20

How and Which Children and 

Students with Disabilities Can 

Receive Services Under IDEA and 

Section 504

IDEA requires states and school districts to ensure 

that all children with disabilities residing in the 

state, regardless of the severity of their disability, 

who need special education and related services 

are identified, located, and evaluated. This 

responsibility is known as child find. Similarly, 

Section 504 requires that schools evaluate a child 

who because of disability needs or is believed to 

need special education or related services. A 

school district must obtain the consent of the 

parent or guardian to conduct the evaluation. Each 

child’s evaluation must be individualized and 

comprehensive in order to assess the nature and 

extent of the student’s disability and educational 

20 The Office of Special Education Programs (OSEP) in the U.S. 

Department of Education (Department) administers IDEA. See 

20 U.S.C. § 1400 et seq. and 34 C.F.R. Part 300. For general 

information about IDEA, please see: http://idea.ed.gov. The 

Department’s Office for Civil Rights (OCR) enforces Section 

504 as applied to recipients of Federal financial assistance from 

the U.S. Department of Education. See 29 U.S.C. § 794 and 34 

C.F.R. Part 104. For more information about Section 504, please

see: https://www2.ed.gov/about/offices/list/ocr/docs/504-

resource-guide-201612.pdf. In the education context, OCR

shares responsibility for compliance with Title II with the U.S.

Department of Justice. See 42 U.S.C. §§ 12131-12134 and 28

C.F.R. Part 35. The information about elementary and secondary

education in this document focuses on IDEA and Section 504.

For more information about Title II, please see: www.ada.gov.

For more information about OCR, please see:

https://www.ed.gov/ocr; For more information about how to file

a complaint alleging discrimination with OCR, please see:

https://www2.ed.gov/about/offices/list/ocr/docs/howto.html.

and related needs, including, if appropriate, the 

child’s social and emotional status.

Under IDEA, eligible students are entitled to 

FAPE,21 which includes special education and 

related services provided at no cost to the parents, 

in conformity with an IEP. Depending on state law 

or practice, a child’s entitlement to FAPE can 

begin at the child’s third birthday (i.e., preschool) 

and could last until the child’s 22nd birthday.

The vehicle for determining the program of 

special education and related services to be 

provided to a child with a disability is the IEP. 

The IEP is a written document that contains a 

statement of the student’s annual goals, including 

academic and functional goals, and the special 

education and related services and other supports 

to be provided to the child to enable the child to be 

involved and make progress in the general 

education curriculum, i.e., the same curriculum as 

for nondisabled students and to participate with 

other children with disabilities and nondisabled 

children in extracurricular and other nonacademic 

activities. The IEP is developed at a meeting of the 

IEP Team, which includes: the child’s parents; at 

least one of the child’s regular education teachers 

if the child is, or may be, participating in the 

regular educational environment; at least one 

OCR also enforces laws that prohibit discrimination based on 

race, color, or national origin and sex by recipients of Federal 

financial assistance

21 Under IDEA, children with disabilities placed by their parents in 

private schools are not entitled to FAPE, but are eligible to be 

considered for equitable services in accordance with the 

requirements in 34 C.F.R. §§ 300.130-300.144. Parentallyplaced private school children with disabilities do not have an 

individual entitlement to receive some or all of the services they 

would receive if enrolled in a public school. However, if a school 

district or other public agency is unable to educate a child with a 

disability in a program it operates, it may place that child in a 

private school or facility as a means of providing special 

education and related services to the child in accordance with an 

IEP at no cost to the parents. A publicly-placed child with a 

disability has all of the rights of a child with a disability who is 

served by a school district or other public agency. 34 C.F.R. § 

300.146. 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 98

special education teacher or provider for the child; 

a public agency representative who is qualified to 

provide or supervise the provision of specially 

designed instruction to meet the unique needs of 

children with disabilities and is knowledgeable 

about the general curriculum and agency 

resources; an individual who can interpret 

evaluation results; the child whenever appropriate; 

and, at the discretion of the parent or public 

agency, other individuals who have knowledge or 

special expertise regarding the child, including 

related services personnel. Disagreements about 

the child’s evaluation, placement, and content of 

the child’s IEP can be resolved through IDEA’s 

dispute resolution procedures, which include 

mediation, due process complaint and hearing 

procedures, or state complaints.

Under Section 504, a public early childhood, 

elementary or secondary child or student with a 

disability is entitled to protection against 

disability-based discrimination. As part of this 

protection, public elementary and secondary 

schools must provide FAPE to all qualified public 

elementary and secondary school students with 

disabilities.22

All students with disabilities who are eligible for 

services under IDEA are also protected under 

Section 504. FAPE under Section 504 consists of 

regular or special education and related aids and 

services designed to meet a student’s individual 

educational needs as adequately as the needs of 

students without disabilities are met and that 

satisfy certain procedural requirements related to 

educational setting, evaluation and placement, and 

procedural safeguards.23 One means of meeting 

the Section 504 FAPE requirements for students 

22 Section 504 does not require FAPE for students with disabilities 

in public preschool programs. 34 C.F.R. § 104.38. 

23 Note that private schools that receive Federal financial assistance 

from the U.S. Department of Education are not required to meet 

the same requirements described in this document that apply to 

who are IDEA-eligible is through the 

implementation of an IEP developed under the 

IDEA.24 In general, Section 504 students who are 

not IDEA-eligible have plans developed under 

Section 504, commonly called Section 504 plans, 

that reflect the services and supports the school 

will provide to the student. Placement decisions 

under Section 504, including decisions about the 

student’s program and services, must be made by 

a group of persons knowledgeable about the child, 

the meaning of evaluation data, and placement 

options. Disputes about the content of a student’s 

evaluation, Section 504 plan, and placement can 

be resolved through Section 504 due process 

procedures including impartial hearing procedures.

Mental Health Services

It is not necessary for a preschool, elementary 

school, or secondary school child or student under 

IDEA or an elementary or secondary school 

student under Section 504 to be identified as 

having a specific emotional or mental impairment 

in order for the student to receive mental healthrelated services. Under IDEA, children and 

students with disabilities, regardless of disability 

classification, must receive a range of support 

services known as related services, if the supports 

are required for them to benefit from special 

education services. Under Section 504, students 

with disabilities must receive mental health 

support services if these services are needed to 

ensure that their educational needs are met as 

adequately as those of students without 

disabilities. These determinations are made by the 

student’s IEP Team or the group that develops the 

student’s Section 504 plan, as appropriate. Under 

IDEA, a number of related services, which could 

school districts and public schools in educating students with 

disabilities. Information about the requirements that apply to 

private school recipients is in 34 C.F.R. § 104.39 of the Section 

504 regulation.

24 34 C.F.R. § 104.33(b)(2). 
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 99

address mental-health and disability-related 

educational needs are referenced and include 

psychological services, school health and school 

nurse services, social work services in schools, 

counseling services, parent counseling and 

training, and medical services provided by a 

licensed physician for diagnostic and evaluation 

purposes only. Also, in developing an IEP or 504 

plan, a factor to be considered is whether the 

student needs positive behavioral interventions 

and supports and other strategies to address 

behavior if the student’s behavior impedes the 

student’s learning or that of others. 

Federal disability laws can provide a vehicle to 

assist students in acquiring the skills they need to 

overcome mental health challenges, both as a 

result of conditions predating the COVID-19 

pandemic and the circumstances resulting from the 

pandemic, such as the transition to remote 

learning, social isolation, and severe illness or 

death of close family members as a result of 

COVID-19. Providing mental health services to 

students with disabilities who require them in 

order to receive FAPE can help to ensure that 

these students have the opportunity to acquire the 

social and emotional skills they need to pursue 

college and careers and lead meaningful and 

productive adult lives. 

Application of Section 504 to 

Institutions of Higher Education

While IDEA and Section 504 FAPE requirements 

do not apply to public or private institutions of 

higher education, these institutions have certain 

obligations to students with disabilities under 

Section 504.25

Under Section 504, covered institutions of higher 

education may not, on the basis of disability, 

exclude a qualified student with a disability from, 

or otherwise subject to discrimination under, any 

part of its programs or activities. An institution of 

higher education must provide program 

modifications, which can include appropriate 

academic adjustments, to ensure that it does not 

discriminate on the basis of disability. Academic 

adjustments may include, for example, changes in 

the length of time permitted for the completion of 

degree requirements and substitution of specific 

courses required for the completion of degree 

requirements. Institutions of higher education are 

not required to modify essential academic 

requirements. Generally, in addition to providing 

reasonable modifications to policies, practices, 

and procedures, institutions of higher education 

may need to provide auxiliary aids and services, 

such as accessible electronic and information 

technology, qualified interpreters, qualified 

readers, and note takers, to ensure effective 

communication and so that students with 

disabilities may have an equal opportunity to 

participate. Institutions of higher education are not 

required to provide modifications or auxiliary aids 

or services where doing so would impose an 

undue burden or cause a fundamental alteration to 

a service, program, or activity. If a student with a 

disability requests a modification, an institution 

may ask the student to provide reasonable 

documentation of disability and the need for the 

modification. Students with disabilities who have 

mental health needs can request modifications 

from institutions of higher education. 

25 In addition, Title II prohibits discrimination on the basis of 

disability by public institutions of higher education. Title III of 

the Americans with Disabilities Act prohibits discrimination on 

the basis of disability by certain private entities, including certain 

private institutions of higher education. See 42 U.S.C. §§ 12181-

12189 and 28 CFR Part 36. The U.S. Department of Justice 

interprets and enforces Titles II and III. For more information on 

the ADA, please visit https://www.ada.gov/
U.S. Department of Education Supporting Child and Student Social, Emotional, Behavioral, and Mental Health Needs 100