IES Blog

Institute of Education Sciences

Delivering Mental Health Supports to Adolescents in School Settings

Mental Health Awareness Month was established in May of 1949 to increase awareness of the importance of mental health and wellness in Americans’ lives and to celebrate improvements in mental health treatment. Nearly 75 years later as we honor mental health awareness in this country, we are confronted with an alarming rise in mental health needs among America’s youth that the U.S. Surgeon General advises could be helped in part with school-based prevention and intervention supports.

One approach to school-based mental health is being tested in an IES-funded efficacy replication study called School Adolescent Mood Project: Efficacy of IPT-AST in Schools. This project is being led by Dr. Jami Young, associate chair of research in the Department of Child and Adolescent Psychiatry and Behavioral Sciences, faculty member in the PolicyLab at the Children’s Hospital of Philadelphia (CHOP), and professor of psychiatry at the University of Pennsylvania Perelman School of Medicine. Dr. Young was interviewed by Rebecca Sun, IES Intern, to help us learn more about conditions on the ground in her study and how telehealth-delivered Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) is working in these schools.

Tell us about the schools you are working in and the different mental health needs you are seeing. How do you think the pandemic influenced what you are seeing now? 

In the School Adolescent Mood Project (SAM project), we have been working closely with 16 schools in Pennsylvania and New Jersey that serve 9th and 10th grade students. Over the past three years, what we are seeing in these 16 schools is very different than what we are used to seeing in our past two decades of school-based depression prevention work. Compared to our earlier studies (see this one for example), in the current SAM project, the rate of teens with elevated scores on our depression screening has more than doubled, as has the percentage of students with scores indicating more significant depression.

The increases we have seen in the SAM project mirror increases in depression and anxiety that have been reported by others during the pandemic, including the most recent findings reported by the CDC. Our still unpublished screening data from the SAM project suggest that there are a substantial number of adolescents who are experiencing mental health difficulties and would benefit from services in schools and/or the community. There is much work that needs to be done, including increases in funding and workforce expansion, to grow and sustain school-based services to support these students. Additionally, establishing connections between schools and mental health agencies is essential, so students who need more intensive services can receive timely care.

What do the youth in your study say are their biggest concerns? 

We are seeing many adolescents who are reporting significant issues with depression and anxiety. Unfortunately, we have also seen an increase in adolescents who report suicidal thoughts and behaviors. The pandemic was difficult for many adolescents as they experienced school closures, loss of loved ones to COVID-19, and feelings of loneliness and social isolation. Even with the return to in-person learning and afterschool activities in the 2021-2022 school year that allowed many students to regain a sense of normalcy, other adolescents found the return to school to be a challenging adjustment. In the SAM project, we saw an increase in the number of adolescents who reported serious thoughts of wanting to kill themselves or who had made a suicide attempt from the 2020-2021 school year when most schools were virtual or hybrid to the 2021-2022 school year when schools were back to in person learning. Unfortunately, we have continued to see an increase in the percentage of adolescents reporting thoughts of wanting to kill themselves this academic year.      

Our school partners have also noted a significant increase in students with suicide-related concerns. One school counselor shared, “I think we have done more suicide risk assessments this year than the past 5 years combined.” This points to a critical need to fund and implement evidence-based screening, assessment, and prevention initiatives for youth suicide.

What have you learned so far about the feasibility and effectiveness of providing the IPT-AST intervention in a telehealth format?

We needed to think creatively about how to ensure that students received the support that they needed and to consider how we could promote continuity of care if schools needed to close again. We made the decision to deliver IPT-AST through telehealth. We thought the COVID pandemic was an important opportunity to capitalize on the recent growth and innovations in digital health and to study the acceptability and efficacy of IPT-AST when delivered through telehealth.

We’ve interviewed a subset of adolescents who participated in our IPT-AST groups to get their feedback about the program, including how they felt about IPT-AST being delivered through telehealth. We are still analyzing these interviews and looking at our other data on acceptability and feasibility, including attendance and satisfaction data. Anecdotally, we have noticed a change in the acceptability of telehealth over the course of our study. In our first year, providing our group online meant that students could receive services and interact with their peers even when school was closed. As we have moved further from school closures, more adolescents have expressed a desire to return to in-person groups. Several adolescents have suggested we consider hybrid models that incorporate both in-person and virtual sessions. One positive benefit of running IPT-AST groups online is that we have been able to include students from different schools in the same group. If we find positive benefits of telehealth-delivered IPT-AST, it will be interesting to see whether some schools and districts prefer to continue this approach as it will enable providers to deliver these services outside of the school day.

Do you think the pandemic has eased the stigma surrounding seeking mental health?

We do not measure stigma specifically in our study but hope that all the attention around mental health has been beneficial. As May is Mental Health Awareness Month, we think it is important to emphasize that mental health is health. If we can continue to spread this message, stigma around mental health will continue to decrease. We are hopeful that the increased focus on youth mental health, decreases in stigma, and proposed policy solutions to increase access to mental services will mean that more adolescents will be able to get the care they need.


This blog was produced by Emily Doolittle (Emily.Doolittle@ed.gov), NCER team lead for social behavioral research.

 

Integrating Intervention Systems to Address Student Mental Health and Social-Emotional-Behavioral Functioning

In honor of Mental Health Awareness Month, NCSER is featuring an IES-funded study on student behavioral supports and interventions that best address the mental health needs of students. Positive Behavioral Interventions and Supports (PBIS) and school mental health (SMH) are both evidence-based interventions that provide student mental health support independent of one another. For this blog, we interviewed Dr. Brandon Schultz, principal investigator of a current study investigating the integration of both PBIS and SMH into a comprehensive school intervention. In the interview below, he discusses the differences between PBIS and SMH, how this research contributes to equity and inclusion in the classroom, and his research journey.

Your study is comparing schools that integrate PBIS and SMH into the enhanced version of the Interconnected Systems Framework (ISF) to schools that implement these as separate, parallel systems. Can you describe PBIS and SMH, and explain the key differences between the integrated framework and parallel systems?

Headshot of Dr. Brandon Schultz

PBIS is a tiered prevention system that addresses student behavioral needs. It provides universal support (Tier 1) to all students, including clear schoolwide behavioral expectations and a rewards system for desired behaviors. For students who do not respond to these efforts, Tier 2 provides targeted help through classroom-level or small group interventions, such as teacher consultation or student mentoring/counseling. For students who need intensive support, Tier 3 provides specialized one-to-one behavioral services. SMH, in contrast, focuses specifically on mental illnesses (for example, anxiety, trauma, depression) and, in some cases, involves community-based therapists working contractually with schools. Typically, PBIS and SMH function separately as co-located services, but there is a growing recognition that student needs are best met when these efforts are meaningfully integrated. Integration, however, is challenging because it requires educators to rethink their teaming and progress monitoring practices and include different stakeholders in critical decision-making processes. This study tests innovations to the ISF model, designed by my co-PI, Dr. Mark Weist (University of South Carolina), to meet the challenges of integrating these systems in two diverse school districts.

How did you become interested in this area of research?

My previous research was mostly focused on school-based interventions for students with ADHD, but it became clear that without systems-level change, interventions meant to help students with ADHD are unlikely to be implemented or sustained effectively, no matter how well they are designed. So, I became interested in understanding school systems and identifying the elements, processes, and resources that are critical for student support services of all kinds. 

How does your research contribute to equity and inclusion in education?

Part of my current study is focused the degree to which innovations to the ISF model can reduce racial inequities in school disciplinary actions. Research shows that Black students receive higher rates of exclusionary punishments (for example, suspensions and expulsions) than their White counterparts, even after controlling for the type of infraction. The modified ISF model aims to reduce the overall need for exclusionary punishments, especially among students of color. By improving team functioning, ISF allows educators to identify systemic problems that lead to racial inequities in disciplinary referrals and to generate new strategies to address student needs in a fair and equitable manner. With this model, we anticipate increased support for students of color that obviates disciplinary referrals. We are working with school districts now to examine disciplinary data before, during, and after the implementation of the enhanced ISF. Our hope is to identify strategies that close race-related gaps and share the lessons learned broadly.

Have you encountered any challenges in studying this integrated framework in elementary schools?

Yes, absolutely. Systems-level change in general is difficult, as it requires change agents to overcome structural inertia rooted in local norms, routines, and expectations. Those challenges have been exacerbated by the COVID-19 pandemic and preexisting trends in childhood mental illnesses. 

During the pandemic, student progress in mathematics and reading have dramatically declined. Meeting these academic needs, a priority for teachers, can divert attention away from student mental health needs. For example, all teachers in one of our states are required to take a year-long online course in reading instruction, partly to address student learning loss. Although commendable, this requirement creates a significant burden for teachers that can leave little room for other concerns. 

Preexisting mental health trends demonstrate that mental illness was increasing sharply among school-age children; by 2018, nearly 15% of all K-12 students experienced a psychiatric condition each year. Then, with the onset of the pandemic, indicators of childhood mental illness (for example, emergency room visits for suicidal behavior) spiked. Childhood anxiety and depression doubled worldwide from pre-pandemic estimates, and it is unclear whether those rates will return to baseline.

Together, these events have created real challenges, not just for our research, but for student support services in general.

What is currently the greatest area of need in studying school-based systems that support student mental health, particularly for those students with or at risk for emotional and behavioral disorders?

Perhaps the greatest area of need for supporting students with emotional and behavioral disorders is understaffing in critical school mental health positions. There is a significant shortage of school psychologists, counselors, social workers, and nurses nationwide. In North Carolina, the current ratio of school psychologists to students is 1:2,527, five times higher than recommended. This understaffing hinders schools’ ability to provide high-quality services and complicates efforts to test and refine innovative practices because field-based practitioners are unable to collaborate on research efforts. Researchers have had to hire individuals to fulfill critical roles, such as behavioral consultants, that might otherwise have been assigned to district-employed staff. Trained personnel then exit the school district when the research project ends and that skillset is lost. We hope that states prioritize the hiring of school mental health practitioners in the coming years to ensure optimal student support services and that university-school research collaborations can reliably lead to sustainable innovations.

NCSER looks forward to seeing the results of this efficacy trial and will continue to fund research aimed at supporting the mental health and social-emotional-behavioral needs of students with or at risk for disabilities.

This blog was authored by Isabelle Saillard, student volunteer for NCSER and undergraduate at the University of Virginia.

Exploring Gender Integration in Classrooms

As part of the IES 20th Anniversary celebration, we are continuing to highlight projects that exemplify research conducted through an equity lens. For this blog, we asked Carol Martin (Arizona State University) to discuss her IES-funded project focused on exploring associations between gender integration in classrooms and student academic engagement and performance in elementary school grades.    

What motivated your team to study the relation between gender integration in classrooms and academic outcomes?

Think about the last time you watched children playing with their peers. Did you notice how the children formed groups, with boys hanging out and talking to other boys, and girls doing the same with other girls? This is a common pattern: Children (and adults) tend to seek out others like themselves. Classic research from the 1970s demonstrated that this used to be common in classrooms, but in over 50 years, there has been almost no research confirming that this pattern might still be happening in contemporary U.S. classrooms.

Our IES-funded team set off to see if it was still occurring, and if so, whether this pattern might limit academic success. We hypothesized that if a student does not feel a sense of belonging or comfort with most students in their class, the school environment is unlikely to be conducive for learning and engagement. In contrast, when students feel comfortable and accepted by most of their peers in the classroom, learning and motivation at school should be enhanced.

What are your research findings?

In our research involving 3rd- to 5th-grade students in the Phoenix metro area in Arizona, we began with questions about how to best measure what we are calling gender integration (GI).  We acknowledge that gender is fluid and not a binary of women/girls and men/boys; however, most children in elementary school have stereotypes about these two groups, so it made sense to us to focus on these groups.

In one study, to measure GI, we asked every student how often they interacted with every other student in class. When we looked at these scores by classroom, we found that gender segregation is strong even today. Out of the 26 classrooms included in the study, 24 showed higher levels of interactions among same-gender peers in working groups as compared to what was seen in mixed-gender groups. In addition, we found that feeling included by other-gender peers early in the school year contributed to later improved feelings about school, and this mattered more than did feeling included by same-gender peers.

We recently finished a study in which we examined whether GI is related to academic outcomes such as math and science self-concepts and STEM achievement. We found that GI measured in the fall semester was related to STEM achievement, measured in the spring semester, through improved STEM academic beliefs. We thought it might be the case that this pattern would be found for girls but not boys because of the stereotyped nature of STEM; however, both girls and boys showed this pattern.

Based on your preliminary research findings, what advice would you give to teachers or school leaders?

First off, it is clear that gender segregation is still very strong today. As such, it is important for teachers (and other adults) to be mindful of the need to encourage students to develop relationships with diverse classmates. Teachers can intentionally shape interactions within their classes in a variety of ways. One is by student seating arrangements, and another is in choices of how students are grouped to work together. Teachers can also ensure that students recognize the value of having diverse peer experiences by letting students know that interacting with others who differ from themselves is useful and beneficial. Also, there are relatively simple strategies such as “buddy up” in which teachers mindfully pair students for classwork, which has been shown to help students to mingle more widely with others and to learn from them.

How does your research contribute to a better understanding of the importance of diversity, equity, and inclusion in education?

Every aspect of our work is related to the importance of diversity, equity, and inclusion in education. We study the importance of having diverse classrooms (mixed-gender in our case) and breaking down barriers that separate people from each other but stress that this diversity matters only when it is perceived as inclusive and fosters a sense of belonging. For some students, additional supports might be needed to feel included, and we hope to identify which students may need these additional supports and what types of support they need to promote equity in classrooms around issues of social belongingness. When these pieces come together, students are supported, and the learning environment is greatly enhanced.

What are the next steps for your research team?

We are interested in expanding our work to consider other individual characteristics of students and how those relate to GI and academic success. For instance, once all our data are amassed, we intend to examine race and ethnic differences in GI. Furthermore, we are interested in assessing how gender beliefs and identity of students relate to their academic success. In future work, we are interested in exploring in-depth how interventions such as buddying strategies work in classrooms, and how to promote more diverse interactions and classroom experiences that promote optimal academic and social competence.


This blog was produced by Christina Chhin, NCER (christina.chhin@ed.gov).

Innovative Approaches to High Quality Assessment of SEL Skills

In celebration of IES’s 20th anniversary and SEL Day, we are highlighting NCER’s investments in field-initiated research. In this blog, program officer Dr. Emily Doolittle discusses a persistent barrier to supporting social and emotional learning (SEL) in schools—the lack of high quality, reliable, and valid SEL assessments—and the innovative research supported by IES to tackle this challenge.

High quality measurement is critical for education research and practice. Researchers need valid and reliable assessments to answer questions about what works for whom and why. Schools use assessments to guide instruction, determine student response to intervention, and for high-stakes decision-making such as provision of special education services.

For social and emotional learning (SEL), assessment can be particularly challenging due to lack of precision in defining core SEL competencies. One consequence of this imprecision is that measures and intervention targets are often misaligned. SEL assessment also tends to rely on student, teacher, and parent reports despite the lack of agreement among reporters and the potential for biased responding. Through NCER, IES is supporting the development and validation of SEL measures using new technologies and approaches to address some of these challenges. Here are some examples of this innovative measurement work.

  • SELweb is a web-based direct assessment of four specific SEL skills - emotion recognition, social perspective taking, social problem solving, and self-control. It is available for use with elementary school students in grades K-3 and 4-6 with a middle school version currently under development. The SEL Quest Digital Platform will support school-based implementation of SELweb and other SEL assessments with an instrument library and a reporting dashboard for educators.
  • vSchool uses a virtual reality (VR) environment to assess prosocial skills. Students in 4th to 6th grades build their own avatar to interact with other characters in school settings using menu-driven choices for prosocial (helping, encouraging, sharing) and non-prosocial (aggressive, bullying, teasing) behaviors.
  • VESIP (Virtual Environment for Social Information Processing) also uses a VR school environment with customizable avatars to assess 3rd through 7th grade students’ social information processing in both English and Spanish.

Other assessments take a different approach to the challenges of SEL measurement by looking for ways to improve self, teacher, and parent reports.

  • In Project MIDAS, the research team is creating a system to integrate the different information provided by students, teachers, and parents to see if combining these reports will lead to more accurate identification of middle school students with SEL needs.
  • In Project EASS-E, the researchers are creating a teacher-report measure that will incorporate information about a child’s environment (e.g., neighborhood and community context) to better support elementary school students’ needs.

Please check out IES’s search tool to learn more about the wide variety of measurement research we fund to develop and validate high quality assessments for use in education research and practice.


Written by Emily Doolittle (Emily.Doolittle@ed.gov), NCER Team Lead for Social Behavioral Research

 

Intervention Strategies on Dropout Prevention and College and Career Readiness for Students with Disabilities: An Interview with Dr. Kern

In honor of Career and Technical Education (CTE) Month, we asked principal investigator Dr. Lee Kern how her intervention research reduces dropouts and prepares students with emotional and behavioral disorders (EBD) for college and career readiness (CCR). The purpose of her current IES project is to develop and pilot test an intervention, Supported College and Career Readiness (SCCR), that augments typical school-based college and career readiness activities for students at or at risk for EBD.

What motivated you to conduct this research?

Headshot of Lee Kern

Given the high dropout rate among students with EBD, I am interested in strategies that keep them in school. Because post-graduation experiences serve as important indicators of positive educational outcomes, I want to establish a stronger connection between school and life after school to ensure that students are fully prepared. My co-PIs, Jennifer Freeman and Chris Liang, were motivated to collaborate on the current research project as well because of their unique focus on different aspects of CCR, allowing us to address multiple dimensions in the development of our intervention.

Can you provide us with an update on the project? What work have you completed to date on the development of the SCCR program?

We recognized and addressed a gap in the college and career readiness literature with this group of students. During the first 2 years of the project, we completed two literature reviews and two conceptual papers, which are in press, and we are in the process of completing a third literature review. Our completed literature reviews indicated (a) limited attention to CCR for individuals with emotional and behavioral problems, (b) lack of defined components of CCR interventions, (c) the need to evaluate the effectiveness of CCR interventions with students of color, and (d) aspects of CCR interventions that might be important for individuals with diverse sexual identities. These papers helped us develop our multi-component CCR intervention for students with or at risk for EBD.

The development phase was vital to creating our multi-component program. Schools practice different approaches to college and career preparation, so we needed to create a flexible program that could fit the many permutations in course scheduling, career interest assessments, career exposure activities, and other factors. Receiving teacher and student feedback on the program during the second year of the project was helpful and appreciated as we refined SCCR. We initiated a randomized controlled trial and ran the study in four schools this academic year. We will expand the research into four additional schools in the 2023-24 academic year.

What other types of research are needed to move forward in the field of CTE for students with or at risk for EBD?

Although we know that students, especially those with or at risk for EBD, need more preparedness for college or their future careers, research must specify intervention components that result in improved outcomes in these areas. Also, it must determine whether the interventions are effective across diverse groups of students and ascertain adaptations that address the needs of all students. Existing and ongoing research must be conducted to better assess student skills. Identifying assessments directly linked to critical and effective interventions that practitioners can implement will be important for future progress.

NCSER looks forward to learning the results of the pilot study to better understand the promise of the SCCR program for improving the college and career readiness of students with or at risk for EBD. For more highlights on the CTE-related work that IES is supporting, please check out our IES CTE page

Dr. Kern is a professor and the director of the Center for Promoting Research to Practice at Lehigh University. She has more than 30 years of experience in special education, mental health, and behavior intervention for students with EBD.

This CTE blog post was produced by Alysa Conway, NCSER student volunteer and University of Maryland, College Park graduate student. Akilah Nelson is the program officer for NCSER’s Career and Technical Education grants.