This study examined principal perspectives on barriers and strengths or assets associated with the delivery of school mental health services in their school and considered whether the common determinants that principals identify vary by geographic locales (i.e., city, suburban, town, and rural). Participants were 638 principals from across the four locale categories. Principals completed open-ended survey questions that addressed perceived barriers and strengths or assets with the delivery of school mental health. Thematic analysis was conducted of principal responses. There were differences in the most common barriers principals identified across locale. For example, principals in suburban areas identified lack of personnel, principals in cities identified a lack of a shared understanding about mental and behavioral health and associated services, and principals in towns and rural areas identified financial concerns as primary barriers in addressing student mental health needs. Across all four locales, the most common stated strength or asset in schools was having school-based mental and behavioral health personnel and resources. Implications for practice and future research are discussed.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price excludes VAT (USA)
Tax calculation will be finalised during checkout.
Aderet-German, T., & Ben-Peretz, M. (2020). Using data on school strengths and weaknesses for school improvement. Studies in Educational Evaluation, 64, 100831. https://doi.org/10.1016/j.stueduc.2019.100831
Aldridge, J. M., & McChesney, K. (2018). The relationships between school climate and adolescent mental health and wellbeing: A systematic literature review. International Journal of Educational Research, 88, 121–145.
Atkins, M. S., Hoagwood, K. E., Kutash, K., & Seidman, E. (2010). Toward the integration of education and mental health in schools. Administration and Policy in Mental Health, 37(1–2), 40–47. https://doi.org/10.1007/s10488-010-0299-7
Blackman, K. F., Powers, J. D., Edwards, J. D., Wegmann, K. M., Lechner, E., & Swick, D. C. (2016). Closing the gap: Principal perspectives on an innovative school-based mental health intervention. The Urban Review, 48(2), 245–263. https://doi.org/10.1007/s11256-016-0353-1
Blackstock, J., Chae, K. B., Mauk, G. W., & McDonald, A. (2018). Getting rural children through the door: Perceived barriers to mental health care for school-aged children in rural areas. The Rural Educator, 39(1), 12–15. https://doi.org/10.35608/ruraled.v39i1.212
Carta, M. G., Fiandra, T. D., Rampazzo, L., Contu, P., & Preti, A. (2015). An overview of international literature on school interventions to promote mental health and well-being in children and adolescents. Clinical Practice & Epidemiology in Mental Health, 11(1), 16–20. https://doi.org/10.2174/1745017901511010016
Castillo, J. M. (2020). The Intersection between systems change, implementation science, and human beings: A call to investigate people and context in future systems-level consultation research. Journal of Educational and Psychological Consultation, 30(4), 402–411. https://doi.org/10.1080/10474412.2020.1728283
Eklund, K., Meyer, L., Splett, J., & Weist, M. (2020). Policies and practices to support school mental health. In B. L. Levin & A. Hanson (Eds.), Foundations of behavioral health (pp. 139–161). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-030-18435-3_7
Evans, S. W., Randy Koch, J., Brady, C., Meszaros, P., & Sadler, J. (2013). Community and school mental health professionals’ knowledge and use of evidence based substance use prevention programs. Administration and Policy in Mental Health and Mental Health Services Research, 40(4), 319–330. https://doi.org/10.1007/s10488-012-0422-z
Forman, S. G., Serene Olin, S., Hoagwood, K. E., Crowe, M., & Saka, N. (2008). Evidence-based interventions in schools: Developers’ views of implementation barriers and facilitators. School Mental Health, 1(1), 26–36. https://doi.org/10.1007/s12310-008-9002-5
Frabutt, J. M., & Speach, G. (2012). Principals’ perspectives on school mental health and wellness in U.S. Catholic elementary schools. School Mental Health, 4(3), 155–169. https://doi.org/10.1007/s12310-012-9081-1
Garbacz, S. A., Hirano, K., McIntosh, K., Eagle, J. W., Minch, D., & Vatland, C. (2018). Family engagement in schoolwide positive behavioral interventions and supports: Barriers and facilitators to implementation. School Psychology Quarterly, 33(3), 448–459. https://doi.org/10.1037/spq0000216
Geverdt, D. (2019). Education demographic and geographic estimates program (EDGE): Locale boundaries file documentation, 2017 (NCES 2018–115). U.S. Department of Education. National Center for Education Statistics. http://nces.ed.gov/pubsearch.
Goforth, A. N., Yosai, E. R., Brown, J. A., & Shindorf, Z. R. (2017). A multi-method inquiry of the practice and context of rural school psychology. Contemporary School Psychology, 21, 58–70. https://doi.org/10.1007/s40688-016-0110-1
Green, J. G., McLaughlin, K. A., Alegría, M., Costello, E. J., Gruber, M. J., Hoagwood, K., Leaf, P. J., Olin, S., Sampson, N. A., & Kessler, R. C. (2013). School mental health resources and adolescent mental health service use. Journal of the American Academy of Child and Adolescent Psychiatry, 52(5), 501–510. https://doi.org/10.1016/j.jaac.2013.03.002
Holmes, A. G. D. (2020). Researcher positionality—A consideration of its influence and place in qualitative research—A new researcher guide. Shanlax International Journal of Education, 8(4), 1–10. https://doi.org/10.34293/education.v8i4.3232
Iachini, A. L., Pitner, R. O., Morgan, F., & Rhodes, K. (2016). Exploring the principal perspective: Implications for expanded school improvement and school mental health. Children & Schools, 38(1), 40–48. https://doi.org/10.1093/cs/cdv038
Jensen, P. S., Goldman, E., Offord, D., Costello, E. J., Friedman, R., Huff, B., Crowe, M., Amsel, L., Bennett, K., Bird, H., Conger, R., Fisher, P., Hoagwood, K., Kessler, R. C., & Roberts, R. (2011). Overlooked and underserved: “Action signs” for identifying children with unmet mental health needs. Pediatrics, 128(5), 970–979. https://doi.org/10.1542/peds.2009-0367
Kim, H., Sefcik, J. S., & Bradway, C. (2017). Characteristics of qualitative descriptive studies: A systematic review. Research in Nursing & Health, 40(1), 23–42.
Langley, A. K., Nadeem, E., Kataoka, S. H., Stein, B. D., & Jaycox, L. H. (2010). Evidence-based mental health programs in schools: Barriers and facilitators of successful implementation. School Mental Health, 2(3), 105–113. https://doi.org/10.1007/s12310-010-9038-1
Leech, N. L., & Onwuegbuzie, A. J. (2007). An array of qualitative data analysis tools: A call for data analysis triangulation. School Psychology Quarterly, 22(4), 557–584. https://doi.org/10.1037/1045-38220.127.116.117
McIntosh, K., Martinez, R. S., Ty, S. V., & McClain, M. B. (2013). Scientific research in school psychology: Leading researchers weigh in on its past, present, and future. Journal of School Psychology, 51(3), 267–318. https://doi.org/10.1016/j.jsp.2013.04.003
McIntosh, K., Predy, L. K., Upreti, G., Hume, A. E., Turri, M. G., & Mathews, S. (2014). Perceptions of contextual features related to implementation and sustainability of school-wide positive behavior support. Journal of Positive Behavior Interventions, 16(1), 31–43. https://doi.org/10.1177/1098300712470723
Michael, K. D., & Jameson, J. P. (Eds.). (2017). Handbook of rural school mental health. Cham: Springer International Publishing. https://doi.org/10.1007/978-3-319-64735-7
Monk, D. H. (2007). Recruiting and retaining high-quality teachers in rural areas. The Future of Children, 17(1), 155–174. https://doi.org/10.1353/foc.2007.0009
Moon, J., Williford, A., & Mendenhall, A. (2017). Educators’ perceptions of youth mental health: Implications for training and the promotion of mental health services in schools. Children and Youth Services Review, 73, 384–391. https://doi.org/10.1016/j.childyouth.2017.01.006
Nastasi, B. K., & Schensul, S. L. (2005). Contributions of qualitative research to the validity of intervention research. Journal of School Psychology, 43(3), 177–195. https://doi.org/10.1016/j.jsp.2005.04.003
Nguyen, A. J., McDaniel, H., Braun, S. S., Chen, L., & Bradshaw, C. P. (2021). Contextualizing the association between school climate and student well‐being: The moderating role of rurality. Journal of School Health, 91(6), 463–472. https://doi.org/10.1111/josh.13026
Nichols, L. M., Goforth, A. N., Sacra, M., & Ahlers, K. (2017). Collaboration to support rural student social-emotional needs. Rural Educator, 38(1), 38–48.
Owens, J. S., Lyon, A. R., Brandt, N. E., Warner, C. M., Nadeem, E., Spiel, C., & Wagner, M. (2013). Implementation science in school mental health: Key constructs in a developing research agenda. School Mental Health, 6(2), 99–111. https://doi.org/10.1007/s12310-013-9115-3
Patton, M. Q. (2002). Qualitative evaluation and research methods (3rd ed.). Sage.
Perou, R., Bitsko, R. H., Blumberg, S. J., Pastor, P., Ghandour, R. M., Gfroerer, J. C., Hedden, S. L., Crosby, A. E., Visser, S. N., Schieve, L. A., Parks, S. E., Hall, J. E., Brody, D., Similie, C. M., Thompson, W. W., Baio, J., Avenevoli, S., Kogan, M. D., & Huang, L. N. (2013). Mental health surveillance among children–united states 2005–2011 MMWR. Surveillance Summaries, 62(Suppl 2), 1–40.
Petersen, M. M. (2019). Elementary school administrators’ perspectives of expanded school mental health systems and implications for further training [Doctoral dissertation, The University of Nebraska]. https://digitalcommons.unomaha.edu/studentwork/3675/
Reinke, W. M., Stormont, M., Herman, K. C., Puri, R., & Goel, N. (2011). Supporting children’s mental health in schools: Teacher perceptions of needs, roles, and barriers. School Psychology Quarterly, 26(1), 1–13. https://doi.org/10.1037/a0022714
Showalter, E., Klein, R., Johnson, J., & Hartman, S. L. (2017). Why rural matters 2015–2016: Understanding the changing landscape. The Rural School and Community Trust.
Substance Abuse and Mental Health Services Administration. (2019). Key substance use and mental health indicators in the United States: Results from the 2018 national survey on drug use and health (HHS Publication No. PEP19–5068, NSDUH Series H-54). Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/
Weist, M. D., Lever, N. A., Bradshaw, C. P., & Owens, J. S. (2014). Further advancing the field of school mental health. In M. D. Weist, N. A. Lever, C. P. Bradshaw, & J. S. Owens (Eds.), Handbook of school mental health: Research, training, practice, and policy (pp. 1–14). Boston, MA: Springer US. https://doi.org/10.1007/978-1-4614-7624-5_1
The research reported here was supported by a State Longitudinal Data Systems grant from the U.S. Department of Education, Institute for Education Sciences to the Wisconsin Department of Public Instruction (R372A150031).
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Garbacz, S.A., Godfrey, E., Twombly, T. et al. Principal Perspectives on Addressing Youth Mental Health Within Schools. School Mental Health 15, 737–753 (2023). https://doi.org/10.1007/s12310-023-09588-9