This paper describes a school-based mental health model for identifying, intervening, and referring students who are at risk for, or are exhibiting, mental health problems. This paper describes the County Schools Mental Health Coalition as a model for improving mental health outcomes for youth. The County Schools Mental Health Coalition, referred to here as the Coalition, is a multidisciplinary collaborative among six independent school districts and private schools residing in one county, and school psychology and social work faculty researchers from the local university. The Coalition was formed to overcome several barriers to children and youth receiving mental health supports. The barriers include lack of systems to adequately identify students early before mental health issues become severe, and lack of provision or access to evidence-based practices and interventions (EBPs) to ameliorate concerns or promote positive youth development. The manuscript describes how the Coalition has sought to overcome the barriers to support youth in county schools grades K to 12 through the creation of a tiered comprehensive system of early identification, prevention, and implementation of EBPs. The process and procedures utilized within this comprehensive data-based model are detailed, including how universal screening data are used at the county, school district, school, grade level, and individual student levels. In addition, case examples of universal, selective, and indicated interventions within this model are provided. Implications for research, practice, and policy will be discussed.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Adelman, H. S., & Taylor, L. (2000). Shaping the future of mental health in schools. Psychology in the Schools, 37, 49–60.
Alonzo, J., Tindal, G., & Robinson, Q. (2008). Using schoolwide response to intervention to close the achievement gap in reading. ERS Spectrum, 26, 1–9.
Barrish, H. H., Saunders, M., & Wold, M. M. (1969). Good behavior game: Effects of individual contingencies for group consequences on disruptive behavior in a classroom. Journal of Applied Behavior Analysis, 2, 119–124.
Beardslee, W. R., Keller, M. B., Lavori, P. W., Staley, J., & Sacks, N. (1993). The impact of parental affective disorder on depression in offspring: A longitudinal follow-up in a nonreferred sample. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 723–730.
Becker, K., & Domitrovich, C. (2011). Conceptualization, integration, and supports of evidence-based interventions in schools. School Psychology Review, 40, 582–589.
Biglan, A., Mrazek, P. J., Carnine, D., & Flay, B. R. (2003). The integration of research and practice in the prevention of youth problems behaviors. American Psychologist, 58, 433–440. doi:10.1037/0003-066X.58.6-7.433.
Bringewatt, E. H., & Gershoff, E. T. (2010). Falling through the cracks: Gaps and barriers in the mental health system for America’s disadvantaged children. Children and Youth Services Review, 32(10), 1291–1299.
Centers for Disease Control and Prevention. (2013). Mental health surveillance among children—United States, 2005–2011. Morbidity and Mortality Weekly Report, 62, 1–35. Retrieved from www.cdc.gov.
Copeland, W. E., Miller-Johnson, S., Keeler, G., Angold, A., & Costello, J. E. (2007). Childhood psychiatric disorders and young adult crime: A prospective, population-based study. American Journal of Psychiatry, 164, 1668–1675. Retrieved from ajp.psychiatryonline.org.
Costello, E. J., He, J. P., Sampson, N. A., Kessler, R. C., & Merikangas, K. R. (2014). Services for adolescents with psychiatric disorders: 12-month data from the National Comorbidity Survey-Adolescent. Psychiatric Services, 65(3), 359–366.
Darney, D., Reinke, W. M., Herman, K. C., Stormont, M., & Ialongo, N. (2013). Children with co-occurring academic and behavior problems in 1st grade: Distal outcomes in 12th grade. Journal of School Psychology, 51, 117–158.
Department of Health and Human Services (DHHS), (2003). New freedom commission on mental health, achieving the promise: Transforming mental health care in America. Final Report. DHHS Pub. No. SMA-03-3832. Rockville, MD.
Famer, E., Burns, B., Phillips, S., Angold, A., & Costello, E. (2003). Pathways into and through mental health services for children and adolescents. Psychiatric Services, 54, 60–66.
Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M. & Wallace, F. (2005). Implementation research: A synthesis of the literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network (FMHI Publication #231).
Fletcher, J., & Vaughn, S. (2009). Response to intervention: Preventing and remediating academic difficulties. Child Development Perspective, 3, 30–37.
Gini, G., & Espelage, D. L. (2014). Peer victimization, cyberbullying, and suicide risk in children and adolescents. JAMA Pediatrics, 185, 435–442.
Goodman, R. (2001). Psychometric properties of the strengths and difficulties questionnaire. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 1337–1345.
Greenberg, M. T. (2004). Current and future challenges in school-based prevention: The researcher perspective. Prevention Science, 5, 5–13.
Herman, K. C., Lambert, S. F., Ialongo, N. S., & Ostrander, R. (2007). Academic pathways between attention problems and depressive symptoms among urban African American children. Journal of Abnormal Child Psychology, 35, 265–274.
Huntington, D. D., & Bender, W. N. (1993). Adolescents with learning disabilities at risk? Emotional well-being, depression, suicide. Journal of Learning Disabilities, 26, 159–166.
Jokela, M., Ferrie, J., & Kivimäki, M. (2008). Childhood problem behaviors and death by midlife: The British National Child Development Study. Journal of the American Academy of Child and Adolescent Psychiatry, 48, 19–24.
Kovaleski, J. (2007). Response to intervention: Considerations for research and systems change. School Psychology Review, 36, 638–645.
Kratochwill, T. R., Clements, M. A., & Kalymon, K. M. (2007). Response to intervention: Conceptual and methodological issues in implementation. In S. R. Jimerson, M. K. Burns, & A. M. VanDerHeyden (Eds.), Handbook of response to intervention: The science and practice of assessment and intervention. New York: Springer.
Laugeson, E. A. (2014). The PEERS curriculum for school-based professionals: Social skills training for adolescents with autism spectrum disorder. New York: Routledge.
Lehrer, J. A., Shrier, L. A., Gortmaker, S., & Buka, S. (2006). Depressive symptoms as a longitudinal predictor of sexual risk behaviors among US middle and high school students. Pediatrics, 118, 189–200. doi:10.1542/peds.2005-1320.
Levitt, J. M., Saka, N., Romanelli, L. H., & Hoagwood, K. (2007). Early identification of mental health problems in the schools: The status of instrumentation. Journal of School Psychology, 45, 163–191.
Lewinsohn, P., Rohde, P., Seeley, J., Klein, D., & Gotlib, I. (2003). Psychosocial functioning of young adults who have experienced and recovered from Major Depressive Disorder during adolescence. Journal of Abnormal Psychology, 112, 353–363.
Li, G., Ling, J., Discala, C., Nordenholtz, K., Sterling, S., & Baker, S. P. (1997). Characteristics and outcomes of self inflicted pediatric injuries: The role of method of suicide attempt. Injury Prevention, 3, 115–119.
Maras, M. A., Splett, J. W., Reinke, W. M., Stormont, M., & Herman, K. (2014). School practitioners’ perspectives on planning, implementing, and evaluating best practices. Children and Youth Services Review, 47, 314–322.
Merikangas, K. R., He, J. P., Brody, D., Fisher, P. W., Bourdon, K., & Koretz, D. S. (2010). Prevalence and treatment of mental disorders among US children in the 2001–2004 NHANES. Pediatrics, 125, 75–81.
Merikangas, K. R., He, J. P., Burstein, M., Swendsen, J., Avenevoli, S., Case, B., et al. (2011). Service utilization for lifetime mental disorders in US adolescents: Results of the National Comorbidity Survey-Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 50(1), 32–45.
Merrell, K. W., & Buchanan, R. (2006). Intervention selection in school-based practice: Using public health models to enhance systems capacity of schools. School Psychology Review, 35, 167–180.
National Center for Education Statistics. (2016). Fast facts: Back to school statistics. Retrieved from http://nces.ed.gov/fastfacts.
National Research Council & Institute of Medicine, (2009). Committee on the Prevention of Mental Disorders and Substance Abuse among Children, Youth, and Young Adults: Research Advances and Promising Interventions. Washington, D.C.: National Academies Press. ISBN-13: 978-0-309-12674-8.
Reinke, W. M., Herman, K. C., Petras, H., & Ialongo, N. S. (2008). Empirically derived subtypes of child academic and behavior problems: Co-occurrence and distal outcomes. Journal of Abnormal Child Psychology, 36, 759–770.
Reinke, W. M., Herman, K. C., & Sprick, R. (2011). Motivational interviewing for effective classroom management: The classroom check-up. New York: Guilford Press.
Stormont, M., Reinke, W. M., Herman, K. C., & Lemke, E. (2012). Academic and behavior supports for at-risk students: Tier 2 interventions. New York: Guilford Press.
Substance Abuse and Mental Health Services Administration. (2014). Results from the 2013 national survey on drug use and health: Mental health findings, NSDUH Series H-49, HHS Publication No. (SMA) 14-4887. Rockville, MD: Substance Abuse and Mental Health Services Administration.
Sugai, G., & Horner, R. H. (2002). Introduction to the special sciences series on positive behavior support in schools. Journal of Emotional and Behavioral Disorders, 10, 130–135.
Taylor, L. D., Davis-Kean, P., & Malanchuk, O. (2007). Self-esteem, academic self-concept, and aggression at school. Aggressive Behavior, 33, 130–136. doi:10.1002/ab.20174.
U.S. Public Health Service (2000). Report of the surgeon general’s conference on children’s mental health: A national action agenda (Stock No. 017-024-01659-4). Washington, DC: U.S. Department of Health and Human Services. Retrieved from http://www.surgeongeneral.gov/cmh/childreport.htm.
Williams, D., & Cole, L. (2007). Teachers’ approaches to finding and using research evidence: An information literacy perspective. Educational Research, 49, 185–206.
Zentall, S. (2005). Theory and evidence-based strategies for children with attentional problems. Psychology in the Schools, 42, 821–836.
This project was funded by the Boone County Children’s Services Fund.
Conflict of interest
The authors do not have any conflict of interests to disclose.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
The manuscript describes a program evaluation that used measures that were collected as part of routine clinical practice. Thus, informed consent for the evaluation aspects of this project were not needed as these were archival data collected as part of standard care.
The research reported here was supported by the Boone County Children Services funds. The opinions expressed are those of the authors and do not represent views of the County.
About this article
Cite this article
Reinke, W.M., Thompson, A., Herman, K.C. et al. The County Schools Mental Health Coalition: A Model for Community-Level Impact. School Mental Health 10, 173–180 (2018). https://doi.org/10.1007/s12310-017-9227-2
- School mental health
- Universal screening
- Evidence-based practice