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School Mental Health Quality Assessment—District Version
The School Mental Health Quality Assessment— District Version (SMHQA-D) is designed for school district teams to 1) assess the
comprehensiveness of their school mental health system and 2) identify priority areas for improvement. The SMHQA covers seven
domains of comprehensive school mental health, which includes a full continuum of supports for the well-being of students, families,
and the school community.
Instructions: Complete this assessment with an existing team or identify a
new team. Broad and diverse participation ensures meaningful
assessment, successful planning, and implementation. Your team may
include school- or community-employed staff and other partners and
stakeholders, including youth and families. Most questions ask about
mental health system implementation in your schools. Some questions ask
about district-level implementation or how the district supports its
schools. Many districts have a range of school mental health
implementation and quality among their schools. We recommend you
answer based on what you know about the schools in your district as a whole. If this is your first SMHQA-D, we recommend you
report on the previous school year. Otherwise, you may select any time frame you wish (e.g., last month, last six months).
What if we have difficulty answering a question? Make an informed guess. You may also reassess at any time with different team
members who may have more information about school mental health systems in your schools or district.
Using Your Results: Most teams start out with low scores. Do not be discouraged! Instead, use your results to prioritize and plan key
improvement areas. This a quality improvement tool to facilitate structured conversations, drive strategic planning, provide a metric
for reassessment, and optimize all aspects of your school mental health system over time.
Quality Domains:
Teaming pg 2
Needs Assessment & Resource Mapping pg 7
Mental Health Screening pg 12
Mental Health Promotion (Tier 1) pg 14
Early Intervention and Treatment (Tiers 2 & 3) pg 26
Funding and Sustainability pg 34
Impact pg 39
Score Summary Page pg
46
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• Anti-Racist involves opposing racism and promoting racial equity through policies and practices.
1
• BIPOC stands for Black, Indigenous, and People of Color. The "B" and "I" also call attention to Black and Indigenous folks' unique experiences to
white supremacy in the U.S. given its history of enslavement of people of African descent and genocide of Indigenous people.2
• CARE stands for Culturally responsive, Anti-Racist, and Equitable.
In a culturally responsive school, students’, families’, and educators’ cultural references are included in all aspects of schooling, including
supports and services that promote well-being and mental health. Anti-racist policies and practices promote equity and oppose racism and
other forms of oppression. Equitable schools provide the climate and resources that enable all students and educators to perform at their
highest level. Culturally responsive, anti-racist and equitable schools embrace cultural differences and assets, use cultural knowledge to
promote wellness and academic success, mediate power imbalances based on cultural identities, and work to dismantle systems of injustice.
• Cultural competence involves the ability to understand, appreciate and interact with people from cultures or belief systems different from one's
own.
• Cultural humility describes a lifelong commitment to self-evaluation and critique to learn, understand, appreciate and interact with people from
cultures or belief systems different from one's own. This reflects an ability to maintain an interpersonal stance that is other-oriented (or open to
the other) in relation to aspects of cultural identity.3
• Cultural responsiveness within schools involves acknowledging, embracing, and incorporating the cultural differences and assets of each person’s
culture in all aspects of schooling.
4
• Disaggregated data is data that has been separated by specific demographic categories (I.e., gender identity, race/ethnicity, socioeconomic
status, etc.) to reveal differences, including inequities, that may not be fully reflected in aggregated or combined data.
• Equity describes the absence of avoidable or remediable differences among groups of people. Equity is distinguished from equality. Equality
involves providing people with equal access to resources, whereas equity involves providing people with needed access to resources. An equity
approach involves recognizing that some people/groups need different (i.e., more) access to resources because they experience more structural
barriers that get in the way of their ability to thrive.
• Healing-centered engagement is an expanded approach to trauma-informed care that is strengths-based, holistic, and incorporates culture,
spirituality, civic action and collective well-being into its practices.
5
• Historically Marginalized Communities are groups that are impacted by historical and present-day systemic oppression. These groups have been
undervalued, harmed and excluded from social, economic, educational and cultural life based upon, but not limited, to age, disability status,
ethnicity, gender identity and expression, language, national origin, race, religion, sexual orientation, sex, and socioeconomic status.
• Person-centered engagement involves a provider seeking to empower those they serve to take charge of their own health rather than being
passive recipients of services. As such, the individual’s values and preferences guide all aspects of their health and mental health services and
supports. This strategy is based on the belief that the individual’s views, input, and experiences can help improve overall quality of life outcomes.
School Mental Health-Quality Assessment Definitions
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• Disproportionality involves overrepresentation or underrepresentation of a specific group within a particular category (e.g., students suspended)
compared with that group’s percentage in the total population (e.g., total student enrollment). For example, imagine a situation where
Black/African American students make of 30% of students suspended in schools but only 10% of the total student enrollment is Black/African
American. This is a suspension disproportionality due to un-equal representation of Black/African American students among those suspended
and the total population.
• Disparity is defined by unequal outcomes of one group compared with outcomes for another group.
• Re-traumatization occurs when a person re-experiences a previously traumatic event, either consciously or unconsciously. Re-traumatization can
be prompted by any of the following: a situation, including an interaction with another person; an attitude or expression; or by certain
environments that recreate the dynamics of the original trauma (e.g. loss of safety).
• Social determinants of health include conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a
wide range of health, functioning, and quality-of-life outcomes and risks.
6
• Systems of oppression exist when laws, policies and practices of a system (e.g., criminal legal, educational, mental health system, etc.) result in
inequitable treatment of social identity group(s).
• Trauma-informed care recognizes the presence of trauma symptoms and acknowledges the role trauma may play in an individual's life and
community. In a trauma-informed school, the school community cultivates a healing-centered environment that recognizes and responds to the
individual and collective causes and impact of adversity, stress, and trauma. Adults are prepared to recognize and respond to those who have
been impacted by traumatic stress. Students are provided with clear expectations and strategies to guide them through stressful situations.
Trauma-informed schools leverage individual and community strengths to foster healing.
References:
1. The BIPOC Project (2021). A Black, Indigenous and People of Color Movement. Retrieved from: https://www.thebipocproject.org/ 2.
Kendi, I. X. (2019). How to be an antiracist. New York: One World.
3. Ladson-Billings, G. (1995). Toward a theory of culturally relevant pedagogy. American Educational Research Journal, 32, 465-491.
4. Tervalon, M., & Murray-García, J. (1998). Cultural humility versus cultural competence: a critical distinction in defining physician training outcomes
in multicultural education. Journal of Health Care for the Poor and Underserved, 9(2), 117–125. https://doi-org.proxy- hs.researchport.umd.edu/10.1353/hpu.2010.0233
5. Ginwright, S. (2018). The Future of Healing: Shifting from Trauma Informed Care to Healing Centered Engagement. Retrieved from:
https://ginwright.medium.com/the-future-of-healing-shifting-from-traumainformed-care-to-healing-centered-engagement-634f557ce69c
6. Healthy People 2030. (2021). Social Determinants of Health. Retrieved from: https://health.gov/healthypeople/objectives-and-data/social- determinants-health
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NCSMH, 2021 School Mental Health Quality Assessment www.theShapeSystem.com
Teaming
Schools are in the position of ensuring that school mental health efforts are appropriately staffed and supported by multidisciplinary teams that have effective
communication and collaboration practices. Many schools have teams that meet to discuss and strategize about student mental health issues. Schools may have one team
devoted to the full continuum of mental health supports (mental health promotion to early intervention and treatment) or they may have multiple teams that address
different parts of the continuum (e.g., school climate team, student support team, Individualized Education Program team, intervention/tertiary care team, Tier 2/3 team,A
and any other team that addresses student mental health concerns). School teams should involve students, families, staff, and community partners that represent diverse
cultural identities and backgrounds including diversity of age, disability, ethnicity, gender identity and expression, language, national origin, race, religion, sexual
orientation, sex, socioeconomic status. All school teams should prioritize trauma-informed approaches and cultural responsiveness, anti-racism, and equity as they relate to
the team’s mission, goals, and deliverables.
To what extent did schools in your district use best practices to...
Best Practices
1. ... ensure your school
mental health team is
multidisciplinary and
diverse?
•Use recruitment and hiring practices to attract diverse team members.
•Include team members who reflect the diversity of students, families,
and staff.
•Ensure that representatives of different groups regularly attend and
have an active and equitable voice in team meetings and decision- making processes.
•Engage school mental health system team members from the
following groups:
a. School health and behavioral health staff
b. Teachers
c. School administrators
d. Youth/Students
e. Caregivers/Families
f. Community health and behavioral health (mental
health/substance use) providers
g. Child welfare staff
h. Juvenile justice staff
i.Community leaders
Never
Rarely
Sometimes
Often
Almost Always
Always
1 2 3 4 5 6
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NCSMH, 2021 School Mental Health Quality Assessment www.theShapeSystem.com
j.Community Schools coordinator
k. English Language Learning educator
l. Homelessness Liaison
m. Family Advocate Representative
2. ... meaningfully involve
students and families to
plan and improve the
school mental health
system?
• Involve students and families in all aspects of prevention, intervention,
and health promotion design, implementation and evaluation; students
and families can provide insight on school strengths and areas of need,
program selection, implementation considerations, and on-going
quality assessment and progress monitoring
• Involve multiple students and families on teams; provide guidance and
foundational information prior to each meeting so that they can have a
meaningful and structured role
• Gather additional input and feedback about school mental health from
students and families using surveys, interviews, and focus groups.
Ensure that individuals who lead and develop interviews and focus
groups represent the diverse identities of students
• Ensure written materials use clear and plain language that is free of
jargon, and where applicable provide written materials in the first
languages of students and families
• Identify existing youth and family mental health advocacy and
navigation organizations in your community, prioritizing those that
value cultural responsiveness, anti-racism, and equity (CARE)
• Partner with youth and family organizations to bring knowledge and
passion based on practical, real-life experiences and expertise to
support providers and other students and families within the system
• Demonstrate equity in partnerships with students and families from
groups that have been historically marginalized, by amplifying and
prioritizing their voices (e.g., engaging them in leadership positions,
shared decision-making)
1 2 3 4 5 6
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3. ...facilitate effective
school-community
partnerships?
• Establish communication mechanisms (e.g., team meetings, email
communications, conference calls) to ensure ongoing and effective
communication between school leadership/staff and community
partners
• Engage community partners that represent and are trusted in the
community and value cultural responsiveness, anti-racism, and equity
(CARE) and trauma-informed, healing-centered approaches
• Use memorandums of understanding or other agreements to detail the
terms of the partnership (e.g., by whom, what, when, where, and how
will services/supports be provided)
• Support a full continuum of care within a multi-tiered system of
support by school and community partners working together and
maximizing their respective knowledge and resources
• Use data sharing agreements, that have been informed by youth and
families, to allow for accessing and sharing data to inform needed
services and supports and the impact of partnership activities
Never
Rarely
Sometimes
Often
Almost
Always
Always
1 2 3 4 5 6
4. ...ensure teaming
structures address each
tier of the multi-tiered
system of support?
• Establish a team or teams to effectively address Tier 1, Tier 2, and Tier 3
• Establish a clear delineation of purpose, target goals, activities, and
processes of each team
• Establish effective communication between teams addressing Tier 1,
Tier 2, and/or Tier 3
1 2 3 4 5 6
5. ... avoid duplication and
promote efficiency of
teams?
• Establish well-defined and unique goals for distinct teams with
structures in place to avoid duplication of team effort
• Practice consistent communication and coordination among various
teams
• Address any confidentiality barriers to facilitate regular information
sharing across and within teams
• Have a system to evaluate existing team structures, with existing team
continuation and new establishment only as necessary
1 2 3 4 5 6
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6. ...conduct meetings, both
in terms of structure and
process?
• Schedule and hold regular team meetings
• Accommodate differences in family and community partner schedules
when planning meetings that include them
• Accommodate, to the extent possible, differences in languages (to
support caregiver participation)
• Track attendance and troubleshoot as needed to ensure consistent
attendance
• Establish a routine scheduling process and use family engagement
strategies (e.g., reminder calls) to increase attendance
• Create and use an agenda
• Use meeting practices that promote inclusion (e.g., active listening,
ensuring all opinions are heard)
• Focus on making actionable decisions
• Use meeting time to follow up on the status of action items
1 2 3 4 5 6
7. ...delineate staff roles and
responsibilities?
• Clarify roles and responsibilities for both school-employed and
community partnered school mental health staff
• Ensure roles and responsibilities reflect the skills, training, knowledge
and areas of expertise of each type of staff member
• When there are multiple individuals with the responsibility of a given
role and/or responsibility, have a clear plan for who will address the
issue first and how responsibilities will be assigned
• Ensure that identification of disproportionalities and/or disparity and
advocacy for youth and families from historically marginalized
communities is included in the responsibilities of staff
1 2 3 4 5 6
8. ...make mental health
referrals to school-based
mental health services?
(school-based mental health
services refer to services
offered directly in the school
building whether provided
by school or community
staff)
• Use an up-to-date school mental health team resource map or guide
(name of team member, description of their
role/responsibilities/services, school location including days and hours,
eligibility requirements or students they work with, how to refer
students)
• Identify and integrate student’s and family's unique cultural needs and
assets when providing resources
• Address impact of stigma and mistrust of education and mental health
institutions throughout referral process
1 2 3 4 5 6
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• Refer to school-based mental health services that are trauma- informed, healing-centered, culturally responsive and anti-racist and
offer culturally specific or relevant interventions
• Provide clear information for students and families to self-refer and
connect directly to mental health services
• Promote direct contact to, from, and among school-based providers to
confirm referral, service availability, and facilitate a seamless entry into
services and supports
• Hold routine referral feedback meetings or use Referral Feedback
Forms to let referral sources know the outcome of the referral
9. ...make mental health
referrals to community- based mental health
services? (community-based
mental health services refer
to services offered by
community staff outside of
the school building)
• Use an up-to-date community resource map (name of program or
organization, description of service, website, address, phone number,
hours of service, eligibility requirements, insurance accepted, cost of
service, wait list status,
any other unique considerations)
• Develop a clear, consistent referral process to community providers to
promote successful linkage including:
• Referral consultation meeting with student and family to
review, strengths, needs, outcomes of value to the student
and family, referral options, and to complete any releases of
information
• Direct contact with community provider to confirm referral,
service availability, and facilitate a seamless entry into
services and supports
• Clear referral instructions for student and family with up-to- date contactinformation
• Discussion of potential barriers to following through with
referral and how to overcomethem
• Referral follow-up meeting with student and family to
confirm linkage and address any remaining barriers
• Consider student’s and family's unique cultural needs and assets when
providing resources
• Consider impact of stigma and mistrust of education and mental
health institutions throughout referral process
1 2 3 4 5 6
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• Refer to community-based mental health services that are trauma- informed, healing-centered, culturally responsive and anti-racist and
offer culturally specific or relevant interventions
• Follow-up with community provider and family to facilitate ongoing
coordination and information sharing
10. ...use data (through
screening or another
process) to determine
what mental health
services and supports (Tier
1, 2, and 3) were needed
by students?
• Use multiple data sources to match mental health interventions with
student strengths, needs, and valued outcomes
• Use validated, culturally responsive screening/assessment/survey
tool(s) that reflect valued outcomes and are appropriate (e.g.,
developmentally) to your student population and in the first
language(s) of students and families.
• Use tools that incorporate screening for social determinants of health
(e.g., poverty, housing stability), protective factors and assets (e.g.,
extended family support), and trauma exposure and traumatic stress
• Use consistent and systematic process of using screening and
assessment data to match students with appropriate levels of support
Never
Rarely
Sometimes
Often
Almost Always
Always
1 2 3 4 5 6
11. ...collect and share data
among school mental
health team members?
• Align data definitions
• Use data systems that allow for easy data entry and retrieval for review
and sharing. Protocols are in place to:
• Allow for valid, reliable data collection
• Address confidentiality considerations (with respect to where data are
maintained and who can access them)
1 2 3 4 5 6
Teaming Total (Questions 1-11): ____
Teaming Average (Total/11): ____
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To what extent did your district use best practices to....
12. ...establish and disseminate
written, standard policies and
procedures for teaming in
your schools?
• Develop policies and procedures to reflect teaming best practices
• Ensure that the policies and procedures are trauma-informed and healing- centered
• Ensure that the policies and procedures are culturally responsive and anti- racist
• Disseminate policies and procedures to all schools in an accessible format
and in first languages of school community.
Never
Rarely
Sometimes
Often
Almost Always
Always
1 2 3 4 5 6
13. ...support the implementation
of teaming in your schools?
• Use comprehensive implementation supports in all schools including:
• Participation of administration
• Protecting staff time for implementation
• Provision of resources
• Ongoing professional development
• Provide technical assistance, consultation, and coaching
1 2 3 4 5 6
14. ...monitor teaming in your
schools?
• Use a transparent and systematic process in all schools for monitoring the
structure and process of school teaming including:
• District observation of school team meetings
• Regular reporting by schools of teaming structures, staffing and
processes
• Assess fidelity to district policies and procedures
1 2 3 4 5 6
15. ...assess and refine district
supports (e.g., policies,
procedures, monitoring,
implementation supports) for
teaming in your schools?
• Assess the utility, equity, and effectiveness of district supports via a
transparent and systematic process that includes school feedback from
diverse stakeholders
• Ensure that district supports reflect current best practices in teaming
• Implement a quality improvement process to refine district supports
1 2 3 4 5 6
District Support Total (Questions 12-15): ____
District Support Average (Total/4): ____
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Needs Assessment/Resource Mapping
A needs assessment is a collaborative process used by a system to identify gaps between current and desired conditions and system strengths. It allows a school to
identify and address mental health needs that are the most pressing, understand how well existing services and supports are meeting student needs, identify and
leverage strengths, and inform priorities and actions for school mental health programming.
Resource mapping is an active process to identify, visually represent, and share information about internal and external supports and services to inform effective
utilization of resources. The resource map or guide that results from this process is often based on your school’s needs assessments and other information about
strengths and needs in your school and community. A resource map may also be referred to as an asset map or environmental scan.
To what extent did schools in your district use best practices to...
Best Practices
1. ... assess student mental health
needs?
• Convene a diverse team to develop and conduct a needs assessment.
Team should include representation from several groups (e.g.,
Caregivers, students, school and community health and mental health
providers, school administrators, school staff, community leaders) and
reflect diverse demographic characteristics (i.e., age, disability,
ethnicity, gender identity and expression, language, national origin,
race, religion, sexual orientation, sex, socioeconomic status)
• Needs assessment should reflect diverse team members’ input and values
related to identified needs and strengths
• Review existing data (e.g., office referrals, expulsion and
suspension rates, attendance and truancy records, nursing and
counselor logs, crisis referrals, emergency petitions, school
climate and behavioral surveys, incident reports, homework
completion rates, homelessness rates) to identify needs,
disproportionalities, and disparities
• Identify additional data, such as student risk assessment, community- level stressors or potentially traumatic events, and school campus
physical safety, that might inform student needs and develop a
process to gatherit
• Use needs assessment tools and processes that are
Never
Rarely
Sometimes
Often
Almost
Always
Always
1 2 3 4 5 6
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psychometrically sound and culturally relevant
• Include items in needs assessment tools that allow for
disaggregation by demographic characteristics (i.e., age,
disability, ethnicity, gender identity and expression, language,
national origin, race, religion, sexual orientation, sex,
socioeconomic status).
• Pilot needs assessment with students, families and other relevant
groups for feedback and revisions before large-scale data collection
• Conduct needs assessment through multiple platforms and in
multiple languages as appropriate to access all members of the
community.
• Summarize and review needs assessment data to determine:
• most pressing needs impacting most students (Tier 1), some
students (Tier 2), and just a few students (Tier 3)
•patterns of needs (e.g., emotional/behavioral, medical,
basic [e.g., food, housing], social support, financial
needs, family functioning)
•whether current services and supports are trauma- informed and healing-centered
•whether current services and supports are culturally
responsive and anti-racist
•how well current services and supports are meeting student
needs with the use of all disaggregated data
•Disaggregate data to identify inequities and disparities for BIPOC
and other marginalized students.
2. ... assess student mental health
strengths?
• Convene a diverse team to conduct a strengths assessment. Team
should include representation from several groups (students and
families, school and community health and mental health providers,
school administrators, school staff, community leaders) and reflect
diverse demographic characteristics (i.e., age, disability, ethnicity,
gender identity and expression, language, national origin, race,
religion, sexual orientation, sex, socioeconomic status).
• Review existing data (e.g., school climate surveys, focus groups) to
Never
Rarely
Sometimes
Often
Almost
Always
Always
1 2 3 4 5 6
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identify strengths
• Collect data to identify student strengths and developmental
assets (e.g., school connectedness, social skills, belonging,
gratitude, self-determination, grit, self-awareness, self- management, personal responsibility, decision making,
community engagement)
• Use strengths assessment tools and processes that are
psychometrically sound and culturally relevant
• Pilot your strengths assessment with students, families and other
relevant individuals for feedback and revisions before large-scale
data collection
• Conduct strengths assessment through multiple platforms and in
multiple languages as appropriate to access all members of the
community.
• Summarize and review strengths assessment data to determine
how current supports and services leverage and address gaps in
student strengths
• Disaggregate data to identify inequities and disparities for BIPOC
and other marginalized students.
3. ...use your needs assessment to
inform decisions about selecting,
planning, and implementing
appropriate services and
supports?
• Develop a comprehensive needs assessment report that is
relevant, and easily accessible to inform decisions
• Use needs assessment data to inform how gaps can be
addressed with existing or new services and supports
• Use needs assessment data to prioritize selection of areas of
focus, programs and strategies, and action steps
1 2 3 4 5 6
4. ...conduct resource mapping or
have access to an updated
resource map or guide to identify
• Use multiple sources to identify community-trusted resources
available to students, families and communities that promote
mental health (e.g., SAMHSA’s Behavioral Health Treatment
Services locator, recreational activities) across a multi-tiered system
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existing school and community
mental health services and
supports, including services and
supports that address social
determinants of health?
of supports. Consider resources that mitigate racism and other
inequities and that impact mental health beyond only individual- focused supports (e.g., faith-based organizations, Learning for
Justice, American Civil Liberties Union, Federation of Families for
Children’s Mental Health).
• Identify mental health resources that are trauma-informed,
healing-centered, culturally responsive and anti-racist
• Create and foster school-community partnerships to ensure
ongoing communication about existing and new programs,
services, and supports available to students and families
• Develop a user-friendly, updated, comprehensive
resource map or guide that includes data (e.g., name of
the program/organization, description of service,
website, address, phone number, hours of service,
eligibility requirements, insurance accepted, cost of
service, wait list status, any other unique considerations–
e.g., language, culture, immigration status) about each
resource
• Include target outcomes and evidence of impact for each service
• Ensure resource map or guide is easily accessible to diverse groups,
including students and families
• Establish a process and dedicated staff time to regularly
evaluate, update and improve the resource map or guide
1 2 3 4 5 6
5. ... use an updated resource map
or guide to inform decisions and
selection, planning, and
implementation of appropriate
services and supports?
• Pair needs and strengths/assets assessment data with
resource map to consider how needs can be met and
strengths used to inform existing school and community
supports and services
• Collaborate with diverse stakeholders to consider reducing or
abandoning services and supports that lack evidence of impact for the
intended population
• Prioritize services and supports that are trauma-informed, healing- centered, culturally responsive, anti-racist, and equitable; abandon or
partner to improve services and supports that do not reflect these
principles and practices
Never
Rarely
Sometimes
Often
Almost
Always
Always
1 2 3 4 5 6
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• Use resource map to identify areas of need and strength that are
not adequately addressed or acknowledged by existing supports
and services and seek to identify existing or develop new referral
options to meet the need
• Consider whether services have demonstrated impact
within a sample reflective of the school/district population
and demonstrated equitable impact
6. ...align existing mental health
supports and services?
• Use your diverse team (school staff, community partners,
Caregivers, and students), to identify and gather information about
current or prospective school mental health supports and services
(Include who is implementing, how students are identified, data
collected/analyzed, the intended target outcome(s), and training
and ongoing support involved)
• Identify areas of overlap and/or misalignment
• Make decisions about how to align existing services and supports to
avoid duplication
• Consider reducing or abandoning services that are redundant
• Develop a team-based process for ensuring complementarity of
initiatives
1 2 3 4 5 6
Needs Assessment/Resource Mapping Total (Questions 1-6): ____
Needs Assessment/Resource Mapping Average (Total/6): ____
To what extent did your district use best practices to...
Best Practices
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7. ...establish and disseminate
written, standard policies and
procedures for needs
assessment/resource mapping
in your schools?
• Develop policies and procedures to reflect needs assessment and
resource mapping best practices
• Ensure that the policies and procedures are trauma-informed and
healing-centered
• Ensure that the policies and procedures are culturally responsive
and anti-racist
• Disseminate policies and procedures to all schools in an accessible
format and in first languages of school community
Never
Rarely
Sometimes
Often
Almost Always
Always
1 2 3 4 5 6
8. ...support the implementation
of needs assessment/resource
mapping in your schools?
• Use comprehensive implementation supports in all schools including:
• Participation of administration
• Protecting staff time for implementation
• Provision of resources
• Ongoing professional development
• Provide technical assistance, consultation, and coaching
1 2 3 4 5 6
9. ...monitor needs assessment
and resource mapping in your
schools?
• Use a transparent and systematic process in all schools for monitoring the
structure and process of school needs assessment/resource mapping
including:
• District observation of school team meetings
• Regular reporting by schools of needs assessment/resource
mapping structures, staffing and processes
• Assess fidelity to district policies and procedures
1 2 3 4 5 6
10. ...assess and refine district
supports (e.g. policies,
procedures, monitoring,
implementation supports) for
needs assessment/resource
mapping in your school?
• Assess the utility, equity, and effectiveness of district supports via a
transparent and systematic process that includes school feedback from
diverse stakeholders
• Ensure that district supports reflect current best practices in needs
assessment/resource mapping
• Implement a quality improvement process to refine district supports
1 2 3 4 5 6
District Support Total (Questions 7-10): _____
District Support Average (Total/4): _____
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Mental Health Screening
Screening is assessment in the absence of known risk factors to identify supports and interventions (e.g., individual, family, school, community, system
interventions) to prevent or address mental health concerns. Screening instruments may assess for individual, family, and community needs and strengths. This can
be accomplished with a systematic tool or process, that is culturally relevant for the population, including standardized student-, caregiver-, and/or teacher-report
measures, mental health surveillance data, or a structured teacher nomination.
Best Practices
1. To what extent did schools in
your district use best practices
for mental health screening,
planning, and implementation?
• Include students and families in informing the screening, planning,
and implementation process
• Identify a culturally relevant (i.e., normed with population, measures
indicators valued by population) screening tool or process that
considers reliability, feasibility, cost, and fit with the goals for
screening
• Select a tool or process that assesses student social and emotional
strengths as well as risk for mental health concerns (including
exposure to trauma)
• Consider screening tools that assess social determinants of health and
education (e.g., racism, poverty, social injustice, food insecurity).
• Share information about screening in multiple formats prior to
implementation with consideration for diverse cultures and
languages.
• Engage students and families in a consent process about
screening procedures in advance of implementation and offer
the opportunity to consent or opt out
• Support families’ understanding and decision making about the
screening procedures.
• Ensure there is an updated list of internal and external mental health
resources to support students/families screened for specific
concerns/needs, including poverty, food insecurity, and trauma- specific services
• Roll out initial screening efforts gradually to ensure the
Never
Rarely
Sometimes
Often
Almost
Always
Always
1 2 3 4 5 6
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effectiveness of all processes before scaling up
• Screen students according to goals of screening and based
on system and staff capacity to administer and respond to
screening
• Consider also screening students not in school (e.g., due to
absence or distance learning)
• Respond to risk of harm to self and others immediately
• Have a defined and timely process to assess
screening/assessment results that allows for triaging students
to further assess the need for Tiers 2 and 3 services and
supports
o Have information sharing agreements/protocols in
place to promote coordination and continuity of care
o Assess for disparities (e.g., race, gender,
socioeconomic status, disability status) among
students screened and referred for services
2. How many students were enrolled in your district (maximum number of students who could have been screened)? ________
3. How many students were screened within schools for mental health concerns of any type in the absence of known risk
factors? ______________________________________
4. Based on the screening process, how many students were identified as being at-risk for or already experiencing mental
health problems? _________________
5. Of the students identified in Question 4 above, how many students are members of marginalized groups (e.g., BIPOC,
LGBTQ+, immigrant)? _____________
6. Of the students identified in Question 4 above, how many students were referred to a mental health service (with a
school or community mental health professional) due to being at-risk for or having a mental health problem? _____________
7. Of the students identified in Question 4 above, what was the number of unduplicated students who received a mental
health service (in-person contact with a school or community mental health professional) following identification of
being at-risk for or having a mental health problem?
8. Based on screening, how many system-level changes (e.g., training school staff in trauma-informed practices, revising
discipline policies) were implemented? Please describe system-level changes that were implemented.
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Note: students at imminent risk of harming themselves or others should receive immediate follow-up within 24 hours and
should be included in this count as long as the follow-up occurred within 7 days.
9. In your district, of those students who were screened within schools, how many were screened for:
o Depression? ______________________
• If more than 0, what tool(s) did you administer? __________________________________________________________
o Suicidality? ______________________
• If more than 0, what tool(s) did you administer? _________________________________________________________
o Substance use? ______________________
• If more than 0, what tool(s) did you administer? __________________________________________________________
o Trauma? ____________________
• If more than 0, what tool(s) did you administer? ___________________________________________________________
o Anxiety? ______________________
• If more than 0, what tool(s) did you administer? ___________________________________________________________
o General mental health (risk factors and symptoms)?
• If more than 0, what tool(s) did you administer? ___________________________________________________________
o Well-being or protective factors (e.g. resilience, developmental assets)?
• If more than 0, what tool(s) did you administer? ___________________________________________________________
o Other mental health (e.g. ADHD, conduct, life satisfaction, academic engagement, sense of safety at school, social/emotional
competencies) ?
• If more than 0, what tool(s) did you administer? ___________________________________________________________
o Social determinants of mental health and well-being (e.g., racism, discrimination, poverty, food insecurity, housing security)?
• If more than 0, what tool(s) did you administer? ___________________________________________________________
To what extent did your district use best practices to...
Best Practices
10. ...establish and disseminate
written, standard policies and
procedures for screening in your
schools?
• Develop policies and procedures to reflect mental health screening
best practices
• Ensure that the policies and procedures are trauma-informed and
healing-centered
Never
Rarely
Sometimes
Often
Almost
Always
Always
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• Ensure that the policies and procedures are culturally responsive and
anti-racist
• Disseminate policies and procedures to all schools in an accessible
format and in first languages of school community
1 2 3 4 5 6
11. ... support the implementation of
screening in our schools?
• Use comprehensive implementation supports in all schools including:
• Participation of administration
• Protecting staff time for implementation
• Provision of resources
• Ongoing professional development
• Provide technical assistance, consultation, and coaching
1 2 3 4 5 6
12. ... monitor screening in your
schools?
• Use a transparent and systematic process in all schools for monitoring
the structure and process of school screening including:
• District observation of school team meetings
• Regular reporting by schools of screening structures, staffing
and processes
• Assess of fidelity to district policies and procedures
1 2 3 4 5 6
13. ... assess and refine district
supports (e.g., policies,
procedures, monitoring,
implementation supports) for
screening in your schools?
• Assess the utility, equity, and effectiveness of district supports via a
transparent and systematic process that includes school feedback
• Ensure that district supports reflect current best practices in screening
• Implement a quality improvement process to refine district supports
1 2 3 4 5 6
District Support Total (Questions 8-11): ____
District Support Average (Total/4): ____
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Mental Health Promotion Services and Supports (Tier 1)
Mental health promotion services and supports (Tier 1) are mental health-related activities that are designed to meet the needs of all students regardless of whether
they are at risk for mental health problems. Tier 1 activities include promotion of positive social, emotional, and behavioral skills and well-being. These activities also
include efforts to support staff well-being, improve school climate, and promote positive behavior. These activities can be implemented school- wide, at the grade
level, and/or at the classroom level and can be provided by school-employed and community-employed, school-based professionals.
Examples include school-wide mental health education lessons, school climate improvement efforts, and classroom-based social emotional learning for all students.
To what extent did schools in your district use best practices to...
Best Practices
1. ... assess school climate?
• Develop a clear plan for how data will be collected, stored, analyzed
and shared
• Assess multiple dimensions of school climate including student
engagement, student-staff/student-student/staff-staff
relationships/family-staff/community-staff, inclusiveness, and
racial/cultural climate
• Disaggregate school climate data based on demographics (I.e., age,
sex, gender identity and expression, race, ethnicity, national origin,
religion, sexual orientation, disability status, language, and
socioeconomic status) to identify differences by demographic group.
• Obtain input from representative individuals across a variety of
groups including students, their caregivers, instructional staff, non- instructional staff and administrators
• Assess school climate using more than one modality for input
(e.g., surveys, interviews, focus groups, school administrative
data)
• Allow anonymous input on surveys and other data collection
• Align the data collected with school vision of school climate and
improvement strategies
• Select evidence-informed, culturally relevant tools
Never
Rarely
Sometimes
Often
Almost
Always
Always
1 2 3 4 5 6
2. ...improve school climate? • Designate or form a core school climate planning team that
includes broad representation of educators, administrators, 1 2 3 4 5 6
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mental health and health staff, youth, family members,
community partners.
• Align and integrate school climate efforts with other school
improvement efforts, including academic improvement
efforts
• Ensure that data from school climate measures are used to
select priority areas of focus and activities to promote school
climate improvement
• Share and discuss results from school climate assessment
with diverse stakeholders (students, families, educators,
community partners, administrators, mental health and health
professionals) in a manner that is engaging, easy to
understand, and invites feedback
• Embed school climate improvement into policies, practice
and systems in the school with transparency
• Use data to assess the impact of school climate improvement
activities
• Use disaggregated data to identify and address inequities
and disparities in school climate for student groups across
relevant demographics (e.g., age, disability, ethnicity, gender
identity and expression, language, national origin, race,
religion, sexual orientation, sex, socioeconomic status).
• Involve groups who reported worse school climate in school
climate improvement planning and implementation.
• Implement school climate initiatives with an explicit focus on
equity and reducing disparities
3. ...assess teacher and staff well- being?
• Select evidence-informed, culturally relevant assessment tools and
processes
• Establish a clear process and system for collecting, analyzing, and
storing data
Never
Rarely
Sometimes
Often
Almost
Always
Always
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• Facilitate well-being assessment with teachers and all school staff
using multiple methods of data collection (I.e., paper/pencil and
electronic assessments, affinity groups, focus groups)
• Assess staff well-being regularly and at least annually
• Assess for strengths and needs for both individual and collective well- being
• Ensure privacy of information and anonymity when assessing
staff well-being using surveys, interviews, focus groups or
other means
• Assess a range of well-being components (e.g.,
physical, occupational, emotional, racial, cultural,
environmental, social, mental, intellectual, spiritual)
• Assess for secondary traumatic stress, compassion
fatigue, and burnout
• Check for any disparities in self-reported well-being
among subgroups of educators (e.g., members of
BIPOC, special education teachers, first year teachers)
1 2 3 4 5 6
4. ...improve teacher and staff well- being?
• Align staff well-being improvement efforts with needs
identified by your staff well-being assessment
• Address both organizational and individual factors that
contribute to stress and well-being (e.g., secondary traumatic
stress, compassion fatigue, staff control and input, supervision
and support, safe, supportive social and physical environment,
racism and other marginalizing systems)
• Offer an array of well-being education resources and activities
related to:
✓ Onsite mental health screening
✓ Self-care, resilience
✓ Health promotion (e.g., sleep hygiene, nutrition)
✓ Staff burnout
✓ Stress management and mindfulness
✓ Trauma, including racial trauma
✓ Secondary traumatic stress and compassion fatigue
✓ Employee assistance programs/community mental
1 2 3 4 5 6
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health services
• Make well-being resources and activities optional and readily
available at no-cost and accessible both during and outside of school
hours
5. ...set schoolwide expectations
about positive behaviors?
• Settings: The physical layout of the school is designed to
support optimal functioning and safety of all staff and
students based on needs and ability (including those with
disabilities, emotional and behavioral health difficulties,
learning disorders)
• Routines: Predictable schoolwide routines are developed and taught
• Collaborate with students and families representative of
diverse cultural groups and identities to develop rules that are
relevant and appropriate for diverse students and that do not
inadvertently reinforce systems of oppression
• Expectations: 3-5 positively stated school-wide and clearly
defined expectations are posted around school in the primary
languages of students
• Expectations apply to both students and staff
• Rules are linked to expectations
• Rules are clearly posted, defined, and explicitly taught
• Rules are enforced consistently across staff and equitably toward
students
• Train staff to teach students expectations/rules and how
rewards are developed, scheduled, and delivered.
• Teach students how expectations/rules/rewards are developed,
scheduled, and delivered, using multiple modes of communication
(I.e., visual aids and cues, written/verbal aides using clear and plain
language and the primary languages of students in school
community).
• Involve families and community members to develop
and implement expectations about positive behaviors
1 2 3 4 5 6
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6. ...implement schoolwide positive
reinforcement systems that
promote positive behaviors?
• Rewards:
• A system of rewards is implemented consistently across
campus
• A variety of methods, including both extrinsic and intrinsic
reward systems, are used to reinforce positive behavior
• Supervision: School staff provide reminders and actively scan, move,
and interact with students
• Opportunity: School staff provide high rates, varied and
equitable opportunities for all students to respond to or
demonstrate positive behaviors
• Acknowledgement: School staff use specific praise and
other strategies to let students know when they meet
expectations
• Prompts and Pre-corrections: School staff provide consistent
reminders that clearly describe the expectation
• Error Corrections: School staff use brief, contingent, and specific
statements when misbehavior occurs and consider voice tone,
posture, and physical distance when responding, including students’
potential trauma triggers
• Staff receive training and support to understand how individual and
system biases impact how perceptions of and responses to student
behaviors and how to counteract those biases
• Other Strategies: School staff use trauma-informed culturally
responsive strategies that preempt escalation, minimize inadvertent
reward of a problem behavior, create a learning opportunity for
emphasizing desired behavior, support and strengthen relationships,
and maintain optimal instructional time
Never
Rarely
Sometimes
Ofte
n
Almost
Always
Always
1 2 3 4 5 6
7. ...use classroom and school- based strategies to proactively
build healthy relationships and a
sense of community to prevent
• Use informal and formal processes that are trauma-informed, healing- centered, culturally responsive, anti-racist and equitable, and that
precede wrongdoing, to proactively build relationships and a sense of
community to prevent conflict and wrongdoing
Never
Rarely
Sometimes
Often
Almost
Always
Always
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and address conflict and wrong
doing? These classroom and
school-based strategies are often
referred to as restorative practices.
• Consider whether traumatic exposure plays a role in student behavior
• Use circles, groups and other trauma-informed, healing-centered,
culturally responsive processes to provide opportunities for students to
share their feelings, build relationships and solve problems, and when
there is wrongdoing, to play an active role in addressing the wrong and
making things right
• Teach and model healing and restorative problem solving and conflict
resolution skills in the classroom
1 2 3 4 5 6
8. ...use discipline policies and
practices aimed at reducing
exclusionary responses (e.g.,
suspensions, expulsions)?
• Collaborate with students and families representative of diverse cultural
groups and identities to define problem behaviors and appropriate
strategies to address them.
• Implement discipline policies and procedures that are trauma- informed and healing-centered
• Implement discipline policies and procedures that are culturally responsive,
anti-racist and promote equity
• Describe discipline process in narrative format or depict graphically.
• Include documentation procedures in discipline protocol.
• Train and support school staff in evidence-informed, culturally
responsive crisis de-escalation strategies and techniques
• Train and support staff in equitable implementation of disciplinary
practices in ways that reduce racial/ethnic disproportionality in
discipline responses
• Develop a multi-tiered system of culturally responsive, anti-racist
emotional and behavioral health services and supports for students at
risk for disruptive behavior related to mental health concerns or
trauma exposure
• Use restorative practices that encourage student disciplinary practices
that focus on repairing the harm caused by an incident and allowing the
people most affected by the incident to participate in its resolution
• Use a process of graduated responses that are clearly defined, do not
re-traumatize youth, limit involvement of law enforcement (e.g.,
School Resource Officers, community police), and eliminate
exclusionary disciplinary practices when possible
• Examine number of suspensions/expulsions by demographic group to
better understand any differences in policies or practices contributing
1 2 3 4 5 6
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to disproportionality and disparity
• Collaborate with students and families representative of diverse cultural
groups and identities to define problem behaviors and appropriate
strategies to address them
9. ...increase mental health literacy
for all students and staff?
Mental health literacy is defined as:
1. Understanding how to foster
and maintain good mental
health
2. Understanding mental health
disorders and their treatments
3. Decreasing Stigma
4. Understanding how to seek
help effectively
www.mentalhealthliteracy.org
(Kutcher and Wei, 2019)
• Develop a clear plan for assessing current mental health literacy of
students and school staff, as baseline data and to inform your team’s
plan for further improvement
• Work with students, caregivers, and school staff of various cultural
identities and groups to determine the most meaningful, feasible ways
to promote mental health literacy
• Deliver and evaluate culturally responsive professional learning
opportunities, from pre-K-12 , to 1) understand how to optimize and
maintain good mental health for themselves and others 2) understand
stress and trauma and mental health conditions and their treatment 3)
reduce stigma about mental health needs and supports and understand
the ways that culture and oppression influence mental health, stigma,
and help-seeking behaviors 4) increase skills to link students to mental
health prevention or intervention supports when needed
• Ensure mental health literacy activities and skills taught are culturally
relevant and build on cultural strengths and assets of diverse cultural
groups and identities
• Ensure mental health literacy activities are developed with and
communicated by students, caregivers, and members of the school
community who represent diverse cultural groups and identities
• Ensure mental health literacy activities are ongoing throughout the
school year (i.e., activities go beyond a one-time training or
educational materials posted in the building)
• Reassess mental health literacy on a routine basis to monitor progress
and inform team planning for ongoing activities
1 2 3 4 5 6
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10. ...increase social and emotional
(SEL) skills for all students?
SEL is the process through which all young people
and adults acquire and apply the knowledge, skills
and attitudes to develop healthy identities,
manage emotions and achieve personal and
collective goals, feel and show empathy for others,
establish and maintain supportive relationships,
and make responsible and caring decisions.
SEL competencies are:
1) Self-awareness: Know your strengths and
limitations, with a well-grounded sense of
confidence, optimism, and a “growth mindset;”
integrate personal and social identities; Identify
personal, cultural, and linguistic assets; examine
prejudices and biases
2) Self-management: Effectively manage stress,
control impulses, and motivate yourself to set
and achieve personal and collective goals;
demonstrate personal and collective agency
3) Social awareness: Understand the perspectives of
others and empathize with them, including
those from diverse backgrounds and cultures.
understand broader historical and social
norms for behavior in different settings, and
recognize family, school, and community
resources and supports; Understand the
influences of organizations/systems on
behavior
4) Relationship skills: Communicate clearly, listen
well, cooperate with others, resist inappropriate
social pressure, negotiate conflict constructively,
demonstrate cultural competency and humility;
• Develop a clear, plan for assessing current SEL skills among staff
and students, as baseline data and to inform your team’s plan for
further improvement
• Incorporate SEL skills that promote anti-racism and equity,
including recognizing and making sense of oppressive social
forces, effecting societal/system change, and challenging injustice
and affirming diverse ways of being (e.g., diverse ways of
expressing emotion).
• As a team with school staff, community partners, caregivers, and
students (who represent diverse cultural groups and identities),
identify current activities or programs that support SEL skill
development in the school and assess to what degree they are
being implemented with fidelity and achieving desired outcomes
• As a team with school staff, caregivers, and students
(who represent diverse cultural groups and identities),
identify, select and/or adapt culturally responsive SEL skill
development practices or programs that meet the needs
and strengths of all students
• Ensure SEL skill development activities are developed
with and communicated by students, caregivers, and
members of the school community who represent
diverse cultural groups and identities
• Monitor implementation of SEL skill development
activities for fidelity, feasibility, cultural responsiveness,
and acceptability to school staff and students, and
families
• Re-assess SEL skill development on a routine basis to monitor
progress and inform feedback to school staff and team planning
for ongoing activities
1 2 3 4 5 6
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navigate settings with differing social and cultural
demands and opportunities; stand up for the rights
of others; and seek and offer help when needed.
5) Responsible decision-making: Make constructive
choices about personal behavior and social
interactions based on ethical standards, safety, and
social norms; evaluate the benefits and
consequences of various actions for personal,
social, and collective well-being.
evaluate personal, interpersonal, community, and
institutional impacts
(www.casel.org)
11. To what extent are mental health
promotion (Tier 1) services and
supports evidence-informed (based
on research evidence, as recognized
in national registries, and/or
supported by practice-based
evidence of success in local or similar
schools or communities)?
1 = None of our mental health promotion (Tier 1) services and supports are evidence- informed
2 = 1-25% of our mental health promotion (Tier 1) services and supports are evidenced- informed
3 = 26-50% of our mental health promotion (Tier 1) services and supports are evidenced-informed
4 = 51-75% of our mental health promotion (Tier 1) services and supports are evidenced-informed
5 = 76-99% of our mental health promotion (Tier 1) services and supports are evidenced-informed
6 = All of our mental health promotion (Tier 1) services and supports are evidence-informed
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12. ... determine whether Tier 1
mental health services and
supports are evidence-informed?
• Create a program and practice selection committee with
diverse representation (school and community mental health
providers, administrators, teachers, students, caregivers)
• Use national evidence-based practice registries
(e.g., IES What Works Clearinghouse, Blueprints for
Healthy Youth Development, OJJDP Model
Programs Guide, Society of Clinical Child &
Adolescent Psychology Effective Child Therapies),
research literature
• Use resources that center and affirm the identities
of individuals from groups that have been
historically marginalized to inform selection of
evidence-informed interventions
In selecting a program or intervention consider whether:
• Randomized controlled trials (RCTs) for the intervention
demonstrate effectiveness and valued outcomes with the
intended student population
• The settings (e.g.,
urban/suburban/rural/frontier;
school/outpatient/inpatient) are comparable
to the intended setting
• The outcomes are consistent with those valued
and prioritized by members of the school
community
• The intervention is culturally responsive, in
that it reflects cultural norms and values of the
diverse cultural groups of students
• The intervention is demonstrated to be
effective with diverse cultural groups and
identities
• The intervention is effective at reducing
disparities
Review of evidence of success (e.g., process or
outcome data from program evaluation or quality
improvement efforts, fidelity data) in schools with
Never
Rarely
Sometimes
Often
Almost Always
Always
1 2 3 4 5 6
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similar characteristics and student populations
13. ...ensure Tier 1 services and
supports are equitable and fit the
unique strengths, needs, and
cultural/linguistic considerations
of students and families in your
school?
• Collect data on social and cultural demographics
(i.e., age, disability, ethnicity, gender identity and
expression, language, national origin, race, religion,
sexual orientation, sex, socioeconomic status, etc.)
and disaggregate data to ensure equitable
engagement in Tier 1 supports.
• Create an intervention selection committee with diverse
representation (e.g., school and community mental health
providers, school administrators, teachers, students,caregivers)
• Consider intervention fit with unique school considerations
through a review of:
• School’s student body, inclusive of age, disability,
ethnicity, gender identity and expression, language,
national origin, race, religion, sexual orientation, sex,
socioeconomic status
• School’s and community’s mental health needs, and
strengths
• Evaluate fit of existing or prospective interventions with respect
to the strengths, needs and cultural/linguistic consideration of
students, families, and communities to inform adoption,
adaptation, or abandonment of interventions
1 2 3 4 5 6
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• Pilot test new practices with school population to help inform fit
• As appropriate, adapt the practice to fit school population unique
considerations, and evaluate impact of adaptations
14. ...ensure adequate resource
capacity to implement mental
health promotion (Tier 1) services
and supports?
• Evaluate staffing capacity, including staff training
requirements and qualifications and staff time, needed to
implement services and supports
• Evaluate staffing capacity in terms of availability of staff
with training and/or expertise in providing culturally
responsive, anti-racist and equitable Tier 1 supports
• Evaluate implementation supports (ongoing
training, coaching, peer support, supplies)
needed to implement services and supports
with fidelity
• Evaluate costs associated with training and implementation
• Determine whether staffing, implementation supports,
and costs of services and supports are achievable
within current school mental health system
Never
Rarely
Sometimes
Often
Almost
Always
Always
1 2 3 4 5 6
15. ... support training/professional
development, including ongoing
implementation supports, for
mental health promotion (Tier 1)
services and supports?
• Provide interactive trainings (with opportunity for skills
practice, role plays, action planning)
• Provide ongoing support for implementation (by regular
coaching, consultation, or supervision that includes skills
practice, role plays, and corrective feedback, as well as
fidelity monitoring and feedback processes).
• Ensure trainings and other implementation supports
appropriately attend to cultural responsiveness, anti-racism
and equity
• NOTE: Distribution of materials and one-time didactic trainings
without follow-up support are not best practices to support
training and implementation of practices and are generally
necessary but insufficient to support implementation in schools
1 2 3 4 5 6
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16. ...monitor fidelity of mental
health promotion (Tier 1) services
and supports implementation
across tiers?
• Identify fidelity monitoring tools specific to the practice you are
implementing or develop a tool specific to the practice and the
implementation context in school (based on fidelity monitoring
tools for similar evidence-based practices). Tools might involve
reviewing student records or progress, directly observing school
staff who are implementing the practice and/or talking with
anyone implementing or receiving the practice
• Ensure your fidelity monitoring tool or system measures the
following:
• Adherence to intervention’s core content (what is being
implemented)
• Adaptations to maximize cultural fit and relevancy
• Quality of program delivery (manner in which facilitator
delivers/implements program)
• Logistics (conducive implementation environment,
number/length of sessions implemented)
• Participant responsiveness to and staff engagement in
services and supports by cultural group or identity (I.e., age,
disability, ethnicity, gender identity and expression,
language, national origin, race, religion, sexual orientation,
sex, socioeconomic status) relevant to the program and
school community
• Determine frequency of fidelity measurement based on what
is feasible and will yield actionable information
• Establish a benchmark for acceptable levels of feasibility (e.g., not
acceptable, adequate, excellent)
• Monitor and track changes or adaptations to the practice
• Provide feedback to anyone implementing and use the
results to continuously improve, adapt, and sustain
implementation
Never
Rarely
Sometimes
Often
Almost Always
Always
1 2 3 4 5 6
Mental Health Promotion Services and Supports (Tier 1) Total (Questions 1-16): ____
Mental Health Promotion Services and Supports (Tier 1) Average (Total/16): ____
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To what extent did your district use best practices to...
Best Practices
17. ...establish and disseminate
written, standard policies and
procedures for Tier 1 services
and supports in your schools?
• Develop policies and procedures to reflect mental health promotion
services and supports best practices
• Ensure that the policies and procedures are trauma-informed and
healing-centered
• Ensure that the policies and procedures are culturally responsive
and anti-racist
• Disseminate policies and procedures to all schools in an accessible
format and in first languages of school community
Never
Rarely
Sometimes
Often
Almost Always
Always
1 2 3 4 5 6
20. ...support the
implementation of Tier 1 services
and supports in your schools?
• Use comprehensive implementation supports in all schools
including:
• Participation of administration
• Protecting staff time for implementation
• Provision of resources
• Ongoing professional development
• Technical assistance, consultation, and coaching
1 2 3 4 5 6
• Use a transparent and systematic, process in all schools for
monitoring the structure and process of school mental health
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21. ...monitor Tier 1 services and
supports in your schools?
promotion services and supports including:
• District observation of school team meetings
• Regular reporting by schools of mental health promotion
services and supports structures, staffing and processes
• Assessment of fidelity to district policies and procedures
1 2 3 4 5 6
22. ... assess and refine district
supports (e.g., policies,
procedures, monitoring,
implementation supports) for
Tier 1 services and supports in
your schools?
• Assess the utility, equity, and effectiveness of district supports via a
transparent and systematic process that includes school feedback
• Ensure that district supports reflect current best practices in mental
health promotion services and supports
• Implement a quality improvement process to refine district
supports
1 2 3 4 5 6
District Support Total (Questions 17-20): ____
District Support Average (Total/4): ____
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Early Intervention and Treatment Services and Supports
(Tiers 2 and 3)
Early intervention services and supports (Tier 2) address the mental health concerns of students who are experiencing mild distress, functional impairment, or are at
risk for a given problem or concern. These students can be identified through needs assessments, screening, referral, or other school teaming processes. When
mental health needs are identified early and culturally responsive, anti-racist, and equitable (CARE) supports are put in place, positive youth development is
promoted, and the chronicity and severity of mental health concerns can be eliminated or reduced. Sometimes these are referred to as “selective” mental health
“prevention” or “secondary prevention” services. Tier 2 services include services provided by all school-based mental health professionals, school-employed and
community-employed.
Examples include small group interventions for students identified with similar needs, transition support groups for newcomers, brief individualized interventions
(e.g., motivational interviewing, problem solving), mentoring, and/or low intensity classroom-based supports such as a daily report card, daily teacher check-in,
and/or home/school note system.
Treatment services and supports (Tier 3) to address mental health concerns are provided for students who are already experiencing significant distress and functional
impairment. Sometimes these are referred to as “indicated” mental health “intervention”, “tertiary” or intensive services and are individualized to specific student
needs. Tier 3 services include services provided by all school-based mental health professionals, including school- employed and community-employed.
Examples include individual, group or family therapy for students receiving general or special education who have been identified, and often diagnosed, with social,
emotional and/or behavioral needs.
Tier 2 Only (Questions 1-2)
1. Of the students who were
identified in schools in your district
(e.g., through screening or referral
processes) as needing mental health
early intervention (Tier 2) services
and supports how many received
them?
1 = Tier 2 services and supports were not received in our school
2 = Tier 2 services and supports were received by 1-25% of the students who needed them
3 = Tier 2 services and supports were received by 26-50% of the students who needed them
4 = Tier 2 services and supports were received by 51-75% of the students who needed them
5 = Tier 2 services and supports were received by 75-99% of the students who needed them
6 = Tier 2 services and supports were received by all students who needed them
2. In schools in your district, to what
extent were all mental health early
intervention services and supports
1 = None of our mental health prevention (Tier 2) services and supports were evidence- informed
2 = 1-25% of our mental health prevention (Tier 2) services and supports were evidenced- informed
3 = 26-50% of our mental health prevention (Tier 2) services and supports were evidenced-informed
4 = 51-75% of our mental health prevention (Tier 2) services and supports were evidenced-informed
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(Tier 2) evidence-informed (based
on research evidence, as recognized
in national registries, and/or
supported by practice-based
evidence of success in local or
similar schools and communities)?
5 = 76-99% of our mental health prevention (Tier 2) services and supports were evidenced-informed
6 = All of our mental health prevention (Tier 2) services and supports were evidence-informed
Tier 3 Only (Questions 3-4)
3. Of the students who were
identified (e.g., through screening or
referral) in schools in your district as
needing mental health treatment
(Tier 3) services and supports, how
many received them?
1 = Tier 3 services and supports were not received in our school
2 = Tier 3 services and supports were received by 1-25% of the students who needed them
3 = Tier 3 services and supports were received by 26-50% of the students who needed them
4 = Tier 3 services and supports were received by 51-75% of the students who needed them
5 = Tier 3 services and supports were received by 75-99% of the students who needed them
6= Tier 3 services and supports were received by all students who needed them
4. In schools in your district, to what
extent were all mental health
treatment services and supports
(Tier 3) evidence- informed (based
on research evidence, as recognized
in national registries, and/or
supported by practice-based
evidence of success in local or
similar schools)?
1 = None of our mental health treatment (Tier 3) services and supports were evidence- informed
2 = 1-25% of our mental health treatment (Tier 3) services and supports were evidenced- informed
3 = 26-50% of our mental health treatment (Tier 3) services and supports were evidenced-informed
4 = 51-75% of our mental health treatment (Tier 3) services and supports were evidenced-informed
5 = 76-99% of our mental health treatment (Tier 3) services and supports were evidenced-informed
6 = All of our mental health treatment (Tier 3) services and supports were evidence-informed
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To what extent did schools in your district use best practices to...
Best Practices
5. ... determine whether early
intervention and treatment (Tier
2 and 3) mental health services
and supports are evidence- informed?
• Create an intervention selection committee with diverse
representation of stakeholders (e.g., school and community mental
health providers, administrators, teachers, students, caregivers)
• Develop an intervention selection process and policy to ensure
evidence-informed services and support are implemented with
fidelity
• Use national evidence-based practice registries (e.g., IES What
Works Clearinghouse, Blueprints for Healthy Youth Development,
California Evidence-based Clearinghouse for Child Welfare (CEBC),
OJJDP Model Programs Guide, Society of Clinical Child &
Adolescent Psychology Effective Child Therapies), research
literature,
• Use resources that center and affirm the identities of individuals
from groups that have been historically marginalized to inform
selection of evidence-informed interventions.
In selecting an intervention consider whether:
• Randomized controlled trials (RCTs) for the intervention
demonstrate effectiveness and positive outcomes with the
intended student population
• The settings (e.g., urban/suburban/rural/frontier;
school/outpatient/inpatient) are comparable to the intended
setting
Never
Rarely
Sometimes
Often
Almost
Always
Always
1 2 3 4 5 6
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• The outcomes are consistent with those valued and prioritized
by members of the school community
• The intervention is culturally responsive, in that it reflects
cultural norms and values of the diverse cultural groups of
students
• The intervention is demonstrated to be effective with diverse
cultural groups and identities
• The intervention is effective at reducing
disparities
• Review of evidence of success (e.g., process or outcome data from
program evaluation or quality improvement efforts, fidelity data)
in schools with similar characteristics and student populations
6. ... ensure mental health early
intervention and treatment (Tiers
2 and 3) services and supports
are equitable and fit the unique
strengths, needs, and
cultural/linguistic consideration
of students and families in your
school?
• Collect data on social and cultural demographics (i.e.,
age, disability, ethnicity, gender identity and
expression, language, national origin, race, religion,
sexual orientation, sex, socioeconomic status, etc.) of
individuals to ensure equitable engagement in Tiers
2/3 services and supports.
• Create an intervention selection committee with diverse
representation (e.g., school and community mental health providers,
school administrators, teachers, students,caregivers)
• Consider intervention fit with unique school considerations through
a review of:
• School’s student body, inclusive of age, disability,
ethnicity, gender identity and expression, language,
national origin, race, religion, sexual orientation, sex,
socioeconomic status
• School’s and community’s mental health needs, and
strengths
• Evaluate fit of existing or prospective interventions with respect to
the strengths, needs and cultural/linguistic consideration of
students, families, and communities to inform adoption,
adaptation, or abandonment of interventions
1 2 3 4 5 6
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• Pilot test new practices with school population to
help inform fit
• Collaborate with diverse stakeholders (including students and
families) to evaluate fit of existing or prospective interventions with
respect to the strengths, needs and cultural/linguistic
considerations of students, families and communities to inform
adoption, adaptation, or abandonment of interventions
• Pilot test new practices with school population to help inform fit.
• As appropriate, adapt the practice to fit school population unique
considerations, and evaluate impact of adaptations
7. ... ensure adequate resource
capacity to implement mental
health early intervention and
treatment (Tiers 2 and 3) services
and supports?
• Evaluate staffing capacity, including staff training requirement and
qualifications and staff time needed to implement services and
supports
• Evaluate staffing capacity in terms of availability of staff with
training and/or expertise in implementing Tier 2/3 interventions
that are culturally responsive, anti-racist and promote equity
• Evaluate implementation supports (ongoing training, coaching, peer
support, supplies) needed to implement services and supports with
fidelity and in a way that promotes cultural responsiveness, anti- racism and equity
• Evaluate costs associated with training and implementation
• Determine whether staffing, implementation supports,
and costs of services and supports are achievable within
current school mental health system
Never
Rarely
Sometimes
Often
Almost
Always
Always
1 2 3 4 5 6
8. ... support training/professional
development, including ongoing
implementation supports such as
coaching for early intervention
and treatment (Tiers 2 and 3)
services and supports?
• Provide interactive trainings (with opportunity for skills practice,
role plays, action planning.
• Provide ongoing support for implementation (by regular coaching,
consultation, or supervision that includes skills practice, role plays,
and corrective feedback, as well as fidelity monitoring and feedback
processes
• Ensure trainings appropriately integrate principles of cultural
responsiveness, anti-racism, and equity considerations relevant to
the topic
1 2 3 4 5 6
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NOTE: Distribution of materials and one-time didactic trainings without
follow-up support are not best practices to support training and
implementation of practices and are generally necessary but insufficient
to support implementation in schools
9. ... monitor fidelity of the
implementation of early
intervention and treatment (Tiers
2 and 3) services and supports?
• Identify fidelity monitoring tools specific to the practice being
implemented or develop a tool specific to the practice and the
implementation context in schools (based on fidelity monitoring
tools for similar evidence-based practices). Tools might involve
reviewing student records or progress, directly observing school
staff who are implementing the practice and/or talking with those
implementing or receiving the practice
• Ensure your fidelity monitoring tool or system measures the
following:
• Adherence to intervention content (what is being
implemented)
• Quality of program delivery (manner in which the facilitator
delivers/implements program)
• Disparities, inequities and disproportionalities related to the
implementation of early interventions and treatment services and
supports
• Logistics (conducive implementation environment,
number/length of sessions implemented)
• Participant responsiveness to and staff engagement in services
and supports by cultural group or identity (i.e., age, disability,
ethnicity, gender identity and expression, language, national
origin, race, religion, sexual orientation, sex, socioeconomic
status) relevant to the program and school community
• Determine frequency of fidelity measurement based on what is
feasible and will yield actionable information
• Establish a benchmark for acceptable levels of feasibility (e.g., not
acceptable, adequate, excellent)
• Monitor and track changes or adaptations to the practice
• Provide feedback to implementers and use the results to
continuously improve, adapt and sustain implementation
Never
Rarely
Sometimes
Often
Almost Always
Always
1 2 3 4 5 6
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10. .... ensure intervention goals are
specific, measurable, achievable,
relevant and time bound
(SMART)? Goals may be documented in
a treatment plan, individualized education
program (IEP), or other charting or
documentation system to track student
response to intervention over time.
• Work with the student, family, and school staff to establish specific
goals for the student’s success. This typically involves standardized
data collection, observation and/or discussion
• Ensure goals are specific (concrete, detailed, and well-defined) and
aligned with student and family’s cultural values, beliefs, strengths,
and needs
• Include strengths-based and person-first language (where
appropriate)
• Establish a measurement plan and set an achievable benchmark
What is achievable will depend on the baseline. For example, if the
student is not currently staying in school any days of the week, an
achievable goal might be to stay in school 2 out of 5 days to start.
Or, if the student is currently referred to the front office once per
day, an achievable initial goal might be to decrease office referrals
from 5 per week to 3 per week
• Ensure goals are time specific, meaning there is a target date
identified and interim steps are included to monitor progress
during a specific timeline for goals to be achieved
1 2 3 4 5 6
11. ... monitor individual student
progress across tiers?
For example, monitoring student
progress or response to an intervention
can inform decisions about needed
services and supports and when to step
up or down between tiers.
• Establish a clear process and logic for students moving from one Tier
to a higher or lower Tier, considering student strengths and progress
on target difficulties
• Use multiple data sources and reporters
• Use validated assessment tool(s) or clearly measured targets that
are trauma-informed and healing-centered for individual
progress/goal attainment
• Use assessment tools that are validated for use with the cultural
groups/identities of the student being served
• Ensure the progress monitoring data is aligned with the purpose of
the service or support the student is receiving
• Provide culturally responsive, healing-centered feedback to the
student, family, and school staff (when appropriate) about progress
monitoring data to inform collaborative decision-making about
changes services and supports
Never
Rarely
Sometimes
Often
Almost
Always
Always
1 2 3 4 5 6
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12. ... implement a systematic
protocol for emotional and
behavioral crisis response?
• Develop a protocol for emotional and behavioral crisis response
based on team (staff, families’, students’, community partners’)
input that includes specific types of behaviors or crises, risk
assessment of harm to self or others, who will respond in each
instance, and how to connect students to the appropriate services
and supports
• Provide training to all school-based staff about the specific types of
behaviors, traumatic events or crises that would warrant a referral
for an emotional and behavioral crisis response
• Include guidelines and procedures for contacting the
caregiver/guardian, providing feedback to teachers and school staff,
and supporting a student’s successful transition back to class.
• Integrate restorative practices when addressing emotional and
behavioral health crises.
• Limit involvement of law enforcement (e.g., School Resource
Officers, community police) in punitive discipline, and eliminate
exclusionary disciplinary practices when possible
• In evaluation of students, use best practices for assessing the
impact of the student’s unique cultural norms and linguistic or
communication styles on the student’s displayed behaviors to
inform decisions about follow-up and/or referral
• Include instructions that identify mental health coverage
considerations if there is different coverage on different days of the
week and offer tips for crisis prevention and de- escalation that are
trauma-informed and healing-centered and/or considerations for
responding to emotional and/or behavioral crises in the event of no
or limited mental health provider coverage in the building
• Get feedback from students, families, school staff involved in a crisis
response incident to inform continuous quality improvement efforts
related to the crisis response system
• Disseminate crisis response protocol and have it readily available
for all school-based staff
• Provide training and ongoing support for protocol implementation
• Provide training and ongoing coaching or support for all school
1 2 3 4 5 6
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staff to use crisis prevention and de-escalation skills, and restorative
practices that are trauma-informed, healing-centered, anti-racist,
and culturally responsive
• Revise protocol as needed based on feedback throughout the year
• Ensure school community, including students and families, is aware
of the behavioral crisis response protocol
Early Intervention and Treatment Services and Supports (Tiers 2 and 3) Total (Questions 1-12): ____
Early Intervention and Treatment Services and Supports (Tiers 2 and 3) Average (Total/12): ____
To what extent did your district use best practices to...
Best Practices
13. ... establish and disseminate
written, standard policies and
procedures for Tiers 2 & 3
services and supports in your
schools?
• Develop policies and procedures to reflect early intervention
and treatment services and supports best practices
• Ensure that the policies and procedures are trauma-informed
and healing-centered
• Ensure that the policies and procedures are culturally
responsive and anti-racist
• Disseminate policies and procedures to all schools in an
accessible format and in first languages of school community
Never
Rarely
Sometimes
Often
Almost Always
Always
1 2 3 4 5 6
14. ... support the implementation of
Tiers 2 & 3 services and supports
in your schools?
• Use comprehensive implementation supports in all
schools including:
• Participation of administration
• Protecting staff time for implementation
• Provision of resources
• Ongoing professional development
• Technical assistance, consultation, and coaching
1 2 3 4 5 6
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15. ... monitor Tiers 2 & 3 services
and supports in your schools?
• Use a transparent and systematic process in all schools
for monitoring the structure and process of school early
intervention and treatment services and supports
including:
• District observation of school team meetings
• Regular reporting by schools of Tiers 2 and 3 structures,
staffing and processes
• Assessment of fidelity to district policies and procedures
1 2 3 4 5 6
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16. ... assess and refine district
supports (e.g., policies,
procedures, monitoring,
implementation supports) for
Tiers 2 & 3 services and supports
in your schools?
• Assess the utility, equity, and effectiveness of district supports via a
transparent and systematic process that includes school feedback
and evaluation
• Ensure that district supports reflect current best practices in early
intervention and treatment services and supports
• Implement a quality improvement process to refine district
supports
Never
Rarely
Sometimes
Often
Almost Always
Always
1 2 3 4 5 6
District Support Total (Questions 13-16): ____
District Support Average (Total/4): ____
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Funding and Sustainability
Funding and Sustainability refers to strategies to optimize financial and non-financial assets needed to maintain and, over time, improve school mental health
systems. Sustainability is always evolving, but the goal is to ensure that the operational structures and capacity of schools is sound and that schools can evolve and
adapt to match the changing needs of all students, families, schools, communities, and other systems in your context
To what extent did schools in your district use best practices to...
Best Practices
1. ... use multiple and diverse
funding and resources to support
a full continuum of school
mental health services and
supports?
• Use multiple and diverse funding sources from different levels (e.g.,
school, local, district, state, and federal), types of funding (e.g.,
grants, third party reimbursement, cost sharing, private foundation
funding, block grants) and different systems (e.g., education,
physical, mental, and public health, substance use, juvenile justice)
• Ensure your funding and resources align to support a full
continuum of services and supports
• Intentionally seek out funding for programming and/or services,
including addressing trauma, well-being, cultural-responsive, anti- racism, and equity, etc., that meet the needs of a diverse school
community
• Establish and use a process to develop and regularly evaluate and
update your financing plan
• Establish and use a process to regularly monitor new funding
opportunities and local, state and federal policies that may affect
funding for comprehensive school mental health systems
Never
Rarely
Sometimes
Often
Almost
Always
Always
1 2 3 4 5 6
2. ... leverage funding and resources
to attract potential contributors?
• Establish and use a formal agreement that specifies
contingent funding and/or non-financial resources
• Regularly seek potential diverse partners who may have funding or
non-financial resources that can be contributed to support the
larger school mental health system
• Foster relationships with diverse agencies and organizations in the
community, that value cultural responsiveness, anti-racism, and
equity, with a goal to create mutually beneficial opportunities that
1 2 3 4 5 6
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will support students and families
3. ... have strategies in place to
retain staff?
• Provide in-person and virtual ongoing professional development
activities such as lectures, didactic presentations, and peer
consultation
• Regularly recognize and celebrate accomplishments (e.g., monthly
awards, recognition, sharing success stories with others) and
personal milestones (e.g., birth of a child, birthdays)
• Practice open, bidirectional communication and provide
opportunities for staff to provide anonymous input if desired
• Offer flexible work schedules
• Recognize and address the impact on staff of secondary traumatic
stress
• Collaborate with staff to provide, monitor and evaluate staff
wellness activities
• Engage diverse staff to provide input on how to optimize staff
retention across diverse groups and identities
• Provide supervision and opportunities for peer support (e.g., new
hire mentor and support group, supervision, buddy program)
• Outline pathways and provide clear opportunities for career
advancement
• Provide incentive-based pay
• Work to ensure salary is fair and equitable and that there are
growth opportunities
• Ensure all staff are aware of the district’s Employee Assistance
Program and behavioral health coverage in insurance benefits.
• Ensure that all policies, procedures, and practices related to staff are
culturally responsive, anti-racist and equitable
Never
Rarely
Sometimes
Often
Almost Always
Always
1 2 3 4 5 6
4. ... maximize the expertise and
resources of all school mental
health partners to support
ongoing professional
development activities?
• Poll school staff members (e.g., teachers, nurses, school social
worker/psychologist, guidance counselors, behavioral specialists,
administrators), community providers and students, family
members and caregivers about expertise in relevant mental health- related content, including expertise in cultural responsiveness, anti- racism and equity and trauma-informed and healing-centered
1 2 3 4 5 6
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Partners may include school- and
community-employed staff, local
community groups or higher
education partners, youth and
families.
approaches
• Offer professional development activities that use the diverse
knowledge and skills of family-school-community partners engaged
in school mental health.
• Have school mental health providers partner with community mental
health providers to train school staff on the signs and symptoms of
exposure to trauma, identifying and supporting students in the
classroom and making referrals for mental health and trauma-related
concerns
• Have school psychologists, social workers and/or counselors to
train community mental health providers on inclusive school
language and policy
• Have professionals with relevant expertise train educators and
school-based clinicians on cultural responsiveness, anti-racism and
equity practices for promoting positive mental health and well- being
• Train school- and community-employed mental health providers on
the same topics, at the same time (such as evidence-informed
services or supports, policies or procedures related to Individualized
Education Programs, etc.) to foster mutuality and collaboration
• Engage youth and family leaders and advocates in professional
development as learners and trainers, offering opportunities for
school staff to hear youth and family perspectives and experiences
• Use diverse professional development mechanisms (in-person and
virtual lectures, presentations, consultation, coaching, mentoring
and written resources)
5. To what extent did schools in
your district have funding and
resources to support Tier 1
(mental health promotion)
services?
1= Funding was not available to support Tier 1 services and supports.
2= Funding was available but only met 1-25% of the cost of needed Tier 1 services and supports.
3= Funding was available but only met 26-50% of the cost of needed Tier 1 services and supports.
4= Funding was available but only met 51-75% of the cost of needed Tier 1services and supports.
5= Funding was available but only met 76-99% of the cost of needed Tier 1 services and supports.
6= Funding was available for all needed Tier 1 services and supports.
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6. To what extent did schools in
your district have funding and
resources to support Tier 2 (early
intervention) services?
1= Funding was not available to support Tier 2 services and supports.
2= Funding was available but only met 1-25% of the cost of needed Tier 2 services and supports.
3= Funding was available but only met 26-50% of the cost of needed Tier 2 services and supports.
4= Funding was available but only met 51-75% of the cost of needed Tier 2 services and supports.
5= Funding was available but only met 76-99% of the cost of needed Tier 2 services and supports.
6= Funding was available for all needed Tier 2 services and supports.
7. To what extent did schools in
your district have funding and
resources to support Tier 3
(treatment) services?
1= Funding was not available to support Tier 3 services and supports.
2= Funding was available but only met 1-25% of the cost of needed Tier 3 services and supports.
3= Funding was available but only met 26-50% of the cost of needed Tier 3 services and supports.
4= Funding was available but only met 51-75% of the cost of needed Tier 3 services and supports.
5= Funding was available but only met 76-99% of the cost of needed Tier 3 services and supports.
6= Funding was available for all needed Tier 3 services and supports.
8. To what extent did schools in
your district maximize
reimbursement opportunities for
eligible services?
1 = Schools in our district did not bill for any eligible services.
2 = Schools in our district billed for approximately 1-25% of eligible services.
3 = Schools in our district billed for approximately 26-50% of eligible services.
4 = Schools in our district billed for approximately 51-75% of eligible services.
5 = Schools in our district billed for approximately 76-99% of eligible services.
6= Schools in our district billed for all eligible services.
Funding and Sustainability Total (Questions 1-8): ____
Funding and Sustainability Average (Total/8): ____
To what extent did your district use best practices to...
Best Practices
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9. ... develop relationships and
collaborate with local leaders to
promote funding and
sustainability for school mental
health?
• Build and sustain a network of diverse district and local leaders that
communicate regularly about district-level funding for school
mental health, including existing and new funding opportunities
• Share disaggregated data documenting school mental health
impact to inform future areas of focus
• Consider potential local “investors” in the expansion and
sustainability of school mental health who have not engaged and
invite them to join the network
Never
Rarely
Sometimes
Often
Almost Always
Always
1 2 3 4 5 6
10. ... develop relationships and
collaborate with state leaders to
promote funding and
sustainability support for school
mental health?
• Build and sustain a network of diverse district and state leaders that
communicate regularly about state-level funding for school mental
health, including existing funding and new funding opportunities
• Share disaggregated data documenting school mental health
impact to inform future areas of focus
• Consider potential state “investors” in the expansion and
sustainability of school mental health who have not engaged and
invite them to join the network
1 2 3 4 5 6
11. ... fairly and equitably allocate
resources across the district?
• Conduct needs assessment and assess resource utilization to inform
equitable resource allocation. Areas of assessment may include
disaggregating data by relevant student demographics (i.e., age,
gender identity, language, race/ethnicity, sexual orientation, etc.)
the following:
• Current school mental health funding and resources
• Available school and community mental health services and
supports that are trauma-informed and healing-centered
• Student mental health needs and strengths
• School mental health teams and capacity
1 2 3 4 5 6
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• Medicaid and private insurance eligibility and coverage
• Social determinants of health (e.g., racism, poverty, housing
and food insecurity, discrimination, access to healthcare
providers)
• When inequities are identified, address root causes of
inequities and develop a corrective plan to ensure equitable
distribution of resources
12... provide guidance and support
to schools on funding and
sustainability?
• Disseminate written guidelines and resources to all schools on:
• Identifying and leveraging funding through school-level
resources, such as principal discretionary funds, parent teacher
association funding, local taxes, and private donations
• Building sustainable infrastructure to support billing and
reimbursement
• Accessing different funding (e.g., Medicaid, private insurance)
• Maximizing the expertise and resources of all partners
Never
Rarely
Sometimes
Often
Almost Always
Always
1 2 3 4 5 6
District Support Total (Questions 9-12): ____
District Support Average (Total/4): ____
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Impact
Impact refers to the long-term effects or changes that occur as a result of the programs, practices, and/or policies implemented within a comprehensive school
mental health system. Documenting and reporting the impact of your school mental health system to a wide range of stakeholders is critical for sustainability. By
having data on the impact of your school mental health systems readily available and accessible, you will be optimally positioned to describe their success and
advocate for ongoing funding, support, and resources, with the support of your district. This domain also asks about best practices for documenting and reporting in
your schools, how your district supports your schools, and best practices for documenting and reporting impact for your entire district. Therefore, there are three
sections in this domain and three impact scores.
To what extent did schools in your district use best practices to...
Best Practices
1. ... document the impact of their
comprehensive school mental
health system’s effectiveness on
educational outcomes?
• Develop a theory of change about how specific mental health
services or supports impact educational outcomes for students
across all identities and backgrounds to decide which educational
outcomes to focus on
• Identify existing and potential educational outcome data (e.g.,
grades, attendance, chronic absence, office discipline referrals,
suspensions and expulsions, performance test scores, achievement,
gifted and talented, college and career readiness, involvement or
leadership in extracurricular activities, or benchmark test scores)
• Develop a plan to collect and document educational outcomes
• Establish data infrastructure that allows for easy collection, analysis,
and reporting
• Examine educational data to understand student progress and
service impact
• Disaggregate data based on demographics (I.e., age, sex, gender
identity and expression, race, ethnicity, national origin, religion,
sexual orientation, disability status, language, and socioeconomic
status) to identify disparities in impact.
• Engage diverse individuals (e.g., students, caregivers, teachers,
other school staff) to provide qualitative feedback (e.g.,
Never
Rarely
Sometimes
Often
Almost Always
Always
1 2 3 4 5 6
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testimonials) about the impact of school mental health services and
supports on educational success
2. ... document the impact of their
school mental health system’s
effectiveness on social,
emotional, and behavioral
outcomes?
• Develop a plan for documenting impact with student
and family input, ensuring representation of diverse
identities and cultural backgrounds
• Develop a theory of change about how specific mental health
services or supports impact social, emotional, and behavioral
outcomes for students across all cultural backgrounds and
identities to decide which outcomes to focus on
• Identify existing and potential social, emotional, and
behavioral outcome data (e.g., social/emotional/behavioral
health screenings and assessments, behavioral observations,
crisis incidents, school climate data, strengths assessments)
• Establish data infrastructure that allows for easy collection,
analysis, and reporting
• Examine social, emotional and behavioral data to
understand student progress and service impact
• Engage individuals (e.g., students, families, teachers, other
school staff) from diverse cultural backgrounds and
identities to provide qualitative feedback (e.g., testimonials,
critiques) about the impact of school mental health services and
supports on social, emotional, and behavioral functioning
Never
Rarely
Sometimes
Often
Almost Always
Always
1 2 3 4 5 6
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3. ... disaggregate student mental
health service and support data
to examine student outcomes
based on various demographic
characteristics?
• Review your current student information or data collection for
variables that capture relevant demographic characteristics of your
student body (e.g., student age, disability, ethnicity, gender identity
and expression, language, national origin, race, religion, sexual
orientation, sex, socioeconomic status)
• Add any variables relevant to demographic groups that are not
represented and develop a plan for data collection, evaluation, and
reporting
• Identify key student outcomes (e.g., receipt of mental health
services and supports relative to referrals, achievement of individual
goals, social, emotional, behavioral and/or functional improvement,
school connectedness, sense of safety at school) that can inform
action steps to improve service provision
• Examine key student outcomes for all students and compare those
results to outcomes for students based on demographic
characteristics of interest.
• Based on findings from data collection, develop trauma-informed
and healing-centered strategies as a team to identify and address
inequities or disparities (and their direct causes/sources) in mental
health access or outcomes
1 2 3 4 5 6
4. ... report the impact of their
CSMHS to a broad and diverse
group of stakeholders (e.g., youth,
families, school and community
partners, district leadership,
existing or potential funders, non- education community partners,
state agencies, local and statewide
representatives)?
• Develop quarterly or semi-annual reports and newsletters or host
meetings to share your data with those who submitted or
contributed to the data or are interested in or help fund school
mental health
• Prepare a compelling and clear 1-2 page document that
communicates the impact of school mental health services, with
terms and graphics that consider the language abilities and
communication styles of the intended audiences of students,
educators, community members, families, etc.
• Prepare a short “elevator” speech that highlights students served
and key indicators of impact to share verbally or in writing with
stakeholders
Never
Rarely
Sometimes
Often
Almost Always
Always
1 2 3 4 5 6
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• Present findings at conferences and other meetings where
individuals and groups that are invested in children’s mental health
and education are present
• Develop a social marketing campaign; this may include creating
published (e.g., fliers) or online (e.g., website) access to your
evaluation findings
• Use news media outlets (write press releases for newspapers,
relevant magazines, online news sources and/or create public
service announcements on radio or local TV) in multiple languages
as a way to disseminate information about your services, supports,
and impact
• Use social media, such as Facebook and Twitter accounts, as well as
columns/blurbs in the school or district newsletter, to communicate
the impact of your work
• Create a website and/or ask the school or district to include
information about CSMHS services and findings on the school or
district website
School Impact Total (Questions 1-4): ____
School Impact Average (Total/4): _______
To what extent did your district use best practices to...
Best Practices
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5. ... document the impact of your
district comprehensive school
mental health system’s (CSMHS’s)
effectiveness on educational
outcomes?
• Develop a theory of change about how specific mental health
services or supports impact educational outcomes for students
across cultural backgrounds and identities to decide which
outcomes to focus on
• Identify existing and potential educational outcome data (e.g.,
grades, attendance, chronic absence, office discipline referrals,
suspensions and expulsions, performance test scores, achievement,
gifted and talented, college and career readiness, involvement or
leadership in extracurricular activities, or benchmark test scores)
• Develop a plan for data collection
• Establish data infrastructure that allows for easy collection, analysis,
and reporting
• Examine educational data to understand student progress and
service impact
• Engage individuals (e.g., students, caregivers, teachers, other
• school staff) across diverse cultural backgrounds and identities to
provide qualitative feedback (e.g., testimonials, critiques) about the
impact of school mental health on educational success
Never
Rarely
Sometimes
Often
Almost Always
Always
1 2 3 4 5 6
6. ... document the impact of your
district comprehensive school
mental health system’s (CSMHS’s)
effectiveness on social, emotional,
and behavioral outcomes?
• Develop a theory of change about how specific mental health
services or supports impact social, emotional, and behavioral
outcomes for students across cultural backgrounds and identities to
decide which outcomes to focus on
• Identify existing and potential social, emotional, and behavioral
outcome data (e.g., social/emotional/behavioral health screenings
and assessments, behavioral observations, crisis incidents, school
climate data, strengths assessments)
• Develop a plan for data collection with student and family input,
ensuring representation of diverse identities and cultural
backgrounds
• Establish data infrastructure that allows for easy collection, analysis,
and reporting
1 2 3 4 5 6
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• Examine social, emotional and behavioral data to understand
student progress and service impact
• Engage individuals (e.g., students, caregivers, teachers, other
• school staff) across diverse cultural backgrounds and identities to
provide qualitative feedback (e.g., testimonials, critiques) about the
impact of school mental health on social, emotional, and behavioral
functioning
7. ... disaggregate student mental
health service and support data
across the district to examine
student outcomes based on
various demographic
characteristics?
• Review your current student information or data collection for
variables that capture relevant demographic characteristics of your
student body (e.g., age, disability, ethnicity, gender identity and
expression, language, national origin, race, religion, sexual
orientation, sex, socioeconomic status)
• Add any variables relevant to demographic groups that are not
represented and develop a plan for data collection, evaluation, and
reporting
• Identify key student outcomes (e.g., receipt of mental health
services and supports relative to referrals, achievement of individual
goals, social, emotional, behavioral and/or functional improvement,
school connectedness, sense of safety at school) that can inform
action steps to improve service provision
• Examine key student outcomes for all students, and compare those
results to outcomes for students in demographic groups of interest
• Based on findings from data collection, develop strategies as a
team to address inequities or disparities in mental health access or
outcomes.
Never
Rarely
Sometimes
Often
Almost Always
Always
1 2 3 4 5 6
8 ... report the impact of your district
CSMHS to a broad and diverse group
of stakeholders (e.g., youth, families,
school and community partners, district
leadership, existing or potential funders,
• Develop quarterly or semi-annual reports and newsletters or host
meetings to share your data with those who submitted or
contributed to the data or are interested in or help fund school
mental health
• Prepare a compelling and clear 1-2 page document that
communicates the impact of school mental health services, with
1 2 3 4 5 6
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non-education community partners,
state agencies, local and statewide
representatives)?
terms and graphics that consider the language abilities and
communication styles of the intended audiences of students,
educators, community members, families, etc.
• Prepare a short “elevator” speech that highlights students served
and key indicators of impact to share with stakeholders
• Present findings at conferences and other meetings where
individuals and groups that are invested in children’s mental health
and education are present
• Develop a social marketing campaign; this may include creating
published (e.g., fliers) or online (e.g., website, Twitter accounts)
access to your evaluation findings
• Use diverse news media outlets (write press releases for
newspapers, relevant magazines, online news sources and/or create
public service announcements on radio or local TV) in multiple
languages to disseminate information about your services,
supports, and impact
• Use social media, such as Facebook and Twitter accounts, as well as
columns/blurbs in the school or district newsletter, to communicate
the impact of your work
• Create a website and/or ask the school or district to include
information about CSMHS services and findings on the school or
district website
District Impact Total (Questions 5-8): ____
District Impact Average (Total/4): _______
To what extent did your district use best practices to...
Best Practices
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9. ...establish and disseminate written,
standard policies and procedures for
documenting and report CSMHS
impact in your schools?
• Develop policies and procedures to reflect impact best practices
• Ensure that the policies and procedures are trauma-informed and
healing-centered
• Ensure that the policies and procedures are culturally responsive
and anti-racist
• Disseminate policies and procedures to all schools in an accessible
format and in first languages of school community
Never
Rarely
Sometimes
Often
Almost Always
Always
1 2 3 4 5 6
10. ...support the implementation of
documenting and reporting
CSMHS impact in your schools?
• Use comprehensive implementation supports to equitably support
all schools including:
• Participation of administration
• Protecting staff time for implementation
• Provision of resources
• Ongoing professional development
• Technical assistance, consultation, and coaching that emphasize
transparency in impact reporting and the inclusion of the
documentation of disparities in mental health access and outcomes
1 2 3 4 5 6
11. ...monitor documenting and
reporting CSMHS impact in your
schools?
• Use a systematic process in all schools for monitoring the structure,
process and outcomes of school early intervention and treatment
services and supports including:
• District observation of school team meetings
• Regular reporting by schools of early intervention and
treatment services and supports structures, staffing and
processes
• Assessment of fidelity to district policies and procedures
1 2 3 4 5 6
12. ... assess and refine district
supports (e.g., policies,
procedures, monitoring,
implementation supports) for
• Assess the utility and effectiveness of district supports via a
systematic process that includes a school feedback and evaluation
process
• Ensure that district supports reflect current best practices in
documenting and reporting CSMHS impact
Never
Rarely
Sometimes
Often
Almost Always
Always
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documenting and reporting
CSMHS impact in your schools?
• Implement a quality improvement process to refine district
supports
1 2 3 4 5 6
District Support Total (Questions 5-8): ____
District Support Average (Total/4): _______
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School Mental Health Quality Assessment—District Version
Score Summary Page
Domain School Average
Score
District Support
Average Score
Teaming
Needs Assessment / Resource Mapping
Mental Health Screening
Mental Health Promotion (Tier 1)
Mental Health Early Intervention and Treatment (Tiers 2 and 3)
Funding and Sustainability
Impact District
Average Score
Emerging Progressing Mastery
1.0-2.9 3.0 – 4.9 5.0 – 6.0