Abstract
To date, minimal research has explored the perceptions of secondary school staff regarding their realized and potential contributions to the redress of mental health stigma and support of students with mental health concerns within school environments. The aim of this study was to identify and describe the practicable roles school staff perceive of themselves to hold with respect to promoting mental health, challenging stigma, and responding to student mental health problems. Using an interpretive qualitative approach, semi-structured interviews were conducted following purposive and convenience sampling of school staff (n = 48) including classroom teachers, school counsellors, psychologists, administrators, and various support staff members employed with two secondary schools in southern Alberta, Canada. A structured interview guide was utilized to assess the roles, tasks, and processes school staff undertake to assist students with their mental health concerns. Four main themes inductively emerged from the data: (1) Relationships matter: Establishing and maintaining strong relationships with students, their caregivers, and other staff members are critical to addressing student mental health issues; (2) Empathetic and receptive communication is an antidote to stigma: Various communication processes contribute to disclosures of mental health concerns and challenges; (3) Connecting and facilitating timely access to the right person is key for students experiencing emotional crises; and (4) Facilitators and barriers to addressing student mental health concerns. Clinical implications and policy recommendations are provided to inform directions for administrators, educators, and caregivers regarding student mental health supports.
Levels of Evidence: Qualitative study.
Similar content being viewed by others
References
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. https://doi.org/10.1016/j.ijer.2018.01.012
Andrews, A., McCabe, M., & Wideman-Johnston, T. (2014). Mental health issues in the schools: Are educators prepared? The Journal of Mental Health Training, Education and Practice, 9(4), 261–272. https://doi.org/10.1108/JMHTEP-11-2013-0034
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 and Mental Health Services Research, 37(1–2), 40–47. https://doi.org/10.1007/s10488-010-0299-7
Atkins, M., Shernoff, E., Frazier, S., Schoenwald, S., Cappella, E., Maríñez-Lora, A., Mehta, T., Lakind, D., Cua, G., Bhaumik, R., & Bhaumik, D. (2015). Redesigning community mental health services for urban children: Supporting schooling to promote mental health. Journal of Consulting and Clinical Psychology, 83(5), 839–852.
Beames, J. R., Johnston, L., O’Dea, B., Torok, M., Boydell, K., Christensen, H., & Werner-Seidler, A. (2020). Addressing the mental health of school students: Perspectives of secondary school teachers and counselors. International Journal of School and Educational Psychology. https://doi.org/10.1080/21683603.2020.1838367
Belfer, M. L. (2008). Child and adolescent mental disorders: The magnitude of the problem across the globe. Journal of Child Psychology and Psychiatry, 49(3), 226–236. https://doi.org/10.1111/j.1469-7610.2007.01855.x
Berzin, S. C., O’Brien, K. H. M., Frey, A., Kelly, M. S., Alvarez, M. E., & Shaffer, G. L. (2011). Meeting the social and behavioural health needs of students: Rethinking the relationship between teachers and school social workers. Journal of School Health, 81(8), 493–550. https://doi.org/10.1111/j.1746-1561.2011.00619.x
Birt, L., Scott, S., Cavers, D., Campbell, C., & Walter, F. (2016). Member checking: A tool to enhance trustworthiness or merely a nod to validation? Qualitative Health Research, 26(13), 1802–1811. https://doi.org/10.1177/1049732316654870
Bowers, H., Manion, I., Papadopoulos, D., & Gauvreau, E. (2013). Stigma in school-based mental health: Perceptions of young people and service providers. Child and Adolescent Mental Health, 18, 165–170. https://doi.org/10.1111/j.1475-3588.2012.00673.x
Bowles, T., & Arnup, J. (2016). Should I stay or should I go? Resilience as a protective factor for teachers’ intention to leave the teaching profession. Australian Journal of Education, 60(3), 229–244. https://doi.org/10.1177/0004944116667620
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa
Breeman, L. D., Wubbels, T., Van Lier, P. A. C., Verhulst, F. C., Van der Ende, J., Maras, A., & Tick, N. T. (2015). Teacher characteristics, social classroom relationships, and children’s social, emotional, and behavioral classroom adjustment in special education. Journal of School Psychology, 53(1), 87–103. https://doi.org/10.1016/j.jsp.2014.11.005
Brière, F. N., Pascal, S., Dupéré, V., & Janosz, M. (2013). School environment and adolescent depressive symptoms: A multilevel longitudinal study. Pediatrics, 131(3), e702–e708.
Briner, R., & Dewberry, C. (2007). Staff wellbeing is key to school success: A research study into the links between staff wellbeing and school performance. Worklife Support.
Carr, W., Kutcher, S., Wei, Y., & Heffernan, A. (2017). Preparing for the classroom: Mental health knowledge improvement, stigma reduction, and enhanced help-seeking efficacy in Canadian preservice teacher education. Canadian Journal of School Psychology. https://doi.org/10.1177/0829573516688596
Child and Youth Mental Health: Signs and Symptoms. (n.d) Canadian Mental Health Association. https://ontario.cmha.ca/documents/child-and-youth-mental-health-signs-and-symptoms/
Clark, C., & Teravainen-Goff, A. (2018). Mental wellbeing, reading and writing: How children and young people’s mental wellbeing is related to their reading and writing experiences. National Literacy Trust Research Report.
Durlack, J., Dymnicki, A., Taylor, R., Weissberg, R., & Schellinger, K. (2011). The Impact of enhancing students’ social and emotional learning: A meta-analysis of school-based universal interventions. Child Development, 82(1), 405–432. https://doi.org/10.1111/j.1467-8624.2010.01564.x
Etikan, I., Musa, S. A., & Alkassim, R. S. (2015). Comparison of convenience sampling and purposive sampling. American Journal of Theoretical and Applied Statistics, 5(1), 1–4. https://doi.org/10.11648/j.ajtas.20160501.11
Franklin, C. G. S., Kim, J. S., Ryan, T. N., Kelly, M. S., & Montgomery, K. L. (2012). Teacher involvement in school mental health interventions: A systematic review. Children and Youth Services Review, 34(5), 973–982. https://doi.org/10.1016/j.childyouth.2012.01.027
Froese-Germain, B., & Riel, R. (2012). Understanding teachers’ perspectives on student mental health (pp. 1–22, Rep.). Canadian Teachers’ Federation. (ERIC Document Reproduction Service No. ED544259).
Gale, N. K., Heath, G., Cameron, E., Rashid, S., & Redwood, S. (2013). Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Medical Research Methodology, 13(1), 117–125. https://doi.org/10.1186/1471-2288-13-117
Georgiades, K., Duncan, L., Wang, L., Comeau, J., & Boyle, M. H. (2019). Six-month prevalence of mental disorders and service contacts among children and youth in Ontario: Evidence from the 2014 Ontario Child Health Study. The Canadian Journal of Psychiatry, 64(4), 246–255. https://doi.org/10.1177/0706743719830024
Goldston, D. B., Walsh, A., Arnold, E. M., Reboussin, B., Daniel, S. S., Erkanli, A., Nutter, D., Hickman, E., Palmes, G., Snider, E., & Wood, F. B. (2007). Reading problems, psychiatric disorders, and functional impairment from mid- to late adolescence. Journal of the American Academy of Child & Adolescent Psychiatry, 46(1), 25–32. https://doi.org/10.1097/01.chi.0000242241.77302.f4
Green, J. G., Keenan, J. K., Guzman, J., Vinnes, S., Holt, M., & Comer, J. S. (2017). Teacher perspectives on indicators of adolescent social and emotional problems. Evidence-Based Practice in Child and Adolescent Mental Health, 2(2), 96–110. https://doi.org/10.1080/23794925.2017.1313099
Halladay, J., Bennett, K., Weist, M., Boyle, M., Manion, I., Campo, M., & Georgiades, K. (2020). Teacher-student relationships and mental health help seeking behaviours among elementary and secondary students in Ontario Canada. Journal of School Psychology, 81, 1–10. https://doi.org/10.1016/j.jsp.2020.05.003
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K., & Walters, E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry, 62(6), 593–602. https://doi.org/10.1001/archpsyc.62.6.593
Kessler, R. C., Amminger, G. P., Aguilar-Gaxiola, S., Alonso, J., Lee, S., & Ustün, T. B. (2007). Age of onset of mental disorders: A review of recent literature. Current Opinion in Psychiatry, 20(4), 359–364. https://doi.org/10.1097/YCO.0b013e32816ebc8c
Kidger, J., Gunnell, D., Biddle, L., Campbell, R., & Donovan, J. (2010). Part and parcel of teaching? Secondary school staff’s views on supporting student emotional health and well-being. British Educational Research Journal, 36(6), 919–935. https://doi.org/10.1080/01411920903249308
Kidger, J., Araya, R., Donovan, J., & Gunnell, D. (2012). The effect of the school environment on the emotional health of adolescents: A systematic review. Pediatrics, 129(5), 925–949. https://doi.org/10.1542/peds.2011-2248
Klem, A. M., & Connel, J. P. (2004). Relationships matter: Linking teacher support to student engagement and achievement. Journal of School Health, 74(7), 262–273. https://doi.org/10.1111/j.1746-1561.2004.tb08283.x
Kutcher, S., Venn, D., & Szumilas, M. (2010). Mental health: The next frontier of health education. Education Canada, 49(2), 44–45.
LaRusso, M. D., Romer, D., & Selman, R. L. (2008). Teachers as builders of respectful school climates: Implications for adolescent drug use norms and depressive symptoms in high school. Journal of Youth and Adolescence, 37(4), 386–398. https://doi.org/10.1007/s10964-007-9212-4
Leggio, J., & Terras, K. (2019). An investigation of the qualities, knowledge, and skills of effective teachers for students with emotional/behavioural disorders: The teachers’ perspective. The Journal of Special Education Apprenticeship, 8(10), 1–15.
Luborsky, M. R., & Rubinstein, R. L. (1995). Sampling in Qualitative Research. Research on Aging, 17(1), 89–113. https://doi.org/10.1177/0164027595171005
Malla, A., Shah, J., Iyer, S., Boksa, P., Joober, R., Andersson, N., Lal, S., & Fuhrer, R. (2018). Youth mental health should be a top priority for health care in Canada. Canadian Journal of Psychiatry, 63(4), 216–222. https://doi.org/10.1177/0706743718758968
Mansour, M. E., Kotagal, U. P., DeWitt, T. G., Rose, B., & Sherman, S. N. (2002). Urban elementary school personnel’s perceptions of student health and student health needs. Ambulatory Pediatrics: The Official Journal of the Ambulatory Pediatric Association, 2(2), 127–131. https://doi.org/10.1367/1539-4409(2002)002%3C0127:UESPSP%3E2.0.CO;2
Manvell, E. C. (2012). The violence continuum: Creating a safe school climate. London: R&L Education.
Mariu, K. R., Merry, S. N., Robinson, E. M., & Watson, P. D. (2012). Seeking professional help for mental health problems, among New Zealand secondary school students. Clinical Child Psychology and Psychiatry, 17(2), 284–297. https://doi.org/10.1177/1359104511404176
Mazzer, K. R., & Rickwood, D. J. (2015). Teachers’ role breadth and perceived efficacy in supporting student mental health. Advances in School Mental Health Promotion, 8(1), 29–41. https://doi.org/10.1080/1754730X.2014.978119
Mbwayo, A. W., Mathai, M., Khasakhala, L. I., Kuria, M. W., & Vander Stoep, A. (2019). Mental health in Kenyan Schools: Teachers’ perspectives. Global Social Welfare, 7(2), 155–163. https://doi.org/10.1007/s40609-019-00153-4
Mellin, E. A., Ball, A., Iachini, A., Togno, N., & Rodriguez, A. M. (2017). Teachers’ experiences collaborating in expanded school mental health: Implications for practice, policy and research. Advances in School Mental Health Promotion, 10(1), 85–98. https://doi.org/10.1080/1754730X.2016.1246194
Mihalas, S., Morse, W., Allsopp, D., & McHatton, P. (2008). Cultivating caring relationships between teachers and secondary students with emotional and behavioural disorders. Remedial and Special Education, 30(2), 108–125. https://doi.org/10.1177/0741932508315950
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.
Phillippo, K. L., & Kelly, M. S. (2014). On the fault line: A qualitative exploration of high school teachers’ involvement with student mental health issues. School Mental Health, 6(3), 184–200.
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.
Reschly, A. L., & Christenson, S. L. (2012). Jingle jangle and conceptual haziness: Evolution and future directions of academic engagement. In S. L. Christenson, A. L. Reschly, & C. Wylie (Eds.), Handbook of research on student engagement (pp. 3–20). Springer.
Rickwood, D., Deane, F. P., Wilson, C. J., & Ciarrochi, J. (2005). Young people’s help-seeking for mental health problems. Australian e-Journal for the Advancement of Mental Health, 4(3), 218–251. https://doi.org/10.5172/jamh.4.3.218
Rones, M., & Hoagwood, K. (2000). School-based mental health services: A research review. Clinical Child and Family Psychology, 3(4), 223–241. https://doi.org/10.1111/j.1475-3588.2012.00673.x
Rowling, L., Whitman, V., Biewener, C., & Biewener, M. (2009). International survey of principals concerning emotional and mental health and well-being. International Association of Child and Adolescent Mental Health and Schools (Intercamhs)/International Confederation of Principals (ICP). http://www.hhd.org/sites/hhd.org/files/mental-health-booklet.pdf
Shelemy, L., Harvey, K., & Waite, P. (2019). Supporting students’ mental health in schools: What do teachers want and need? Emotionoal and Behavioural Difficulties, 24(1), 100–116. https://doi.org/10.1080/13632752.2019.1582742
Smith, J., & Firth, J. (2011). Qualitative data analysis: The framework approach. Nurse Researcher, 18(2), 52–62. https://doi.org/10.7748/nr2011.01.18.2.52.c8284
Srivastava, A., & Thomson, S. B. (2009). Framework Analysis: A qualitative methodology for applied policy research. Journal of Administration and Governance, 4(2), 72–79.
Stoll, M., & McLeod, J. (2020). Guidance teachers’ and support staff’s experience of working with pupils with mental health difficulties in two secondary schools: An IPA study. British Journal of Guidance and Counselling, 48(6), 815–825. https://doi.org/10.1080/03069885.2020.1785391
Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349–357. https://doi.org/10.1093/intqhc/mzm042
Townsend, L., Musci, R., Stuart, E., Ruble, A., Beaudry, M. B., Schweizer, B., Owen, M., Goode, C., Johnson, S. L., Bradshaw, C., Wilcox, H., & Swartz, K. (2017). The association of school climate, depression literacy, and mental health stigma among high school students. Journal of School Health, 87(8), 567–574. https://doi.org/10.1111/josh.12527
US Public Health Service. (2000). Report of the Surgeon General’s conference on mental health: A national action agenda. Department of Health and Human Services.
Waddell, C., McEwan, K., Shepherd, C. A., Offord, D. R., & Hua, J. M. (2005). A public health strategy to improve the mental health of Canadian children. The Canadian Journal of Psychiatry, 50(4), 226–233.
Whitley, J., Smith, J. D., & Vaillancourt, T. (2012). Promoting mental health literacy among educators: Critical in school-based prevention and intervention. Canadian Journal of School Psychology, 28(1), 56–70. https://doi.org/10.1177/0829573512468852
Wong, M. D., Dosanjh, K. K., Jackson, N. J., Rünger, D., & Dudovitz, R. N. (2021). The longitudinal relationship of school climate with adolescent social and emotional health. BMC Public Health, 21(1), 1–8. https://doi.org/10.1186/s12889-021-10245-6
Funding
This study is funded by Brain and Mental Health Strategic Research Fund, University of Calgary, and the Alberta Innovates Translational Health Chair in Child and Youth Mental Health.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no competing interests.
Availability of data and material
Data are available from the corresponding author on reasonable request.
Ethics approval
Approval for this study was obtained from the University of Calgary’s Conjoint Health Research Ethics Board (REB 16-1352).
Consent to participate
Written informed consent was obtained from all participants prior to participation.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Dimitropoulos, G., Cullen, E., Cullen, O. et al. “Teachers Often See the Red Flags First”: Perceptions of School Staff Regarding Their Roles in Supporting Students with Mental Health Concerns. School Mental Health 14, 402–415 (2022). https://doi.org/10.1007/s12310-021-09475-1
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12310-021-09475-1