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?
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.