Mental Health Matters

School counselors and psychologists map out an integrated system of support.
With Stephen E. Brock, John Desrochers, Elizabeth Parker, & Robin Zorn.
Principal, March/April 2015
Web Resources

The elementary and middle school years build a strong base for students: skills, habits, and attitudes that will help them succeed in high school and beyond. A supportive mental health program can fortify this foundation. Research backs this up. For instance, a 2011 study by researcher Joseph Durlak and colleagues found that students in schools with universal social and emotional learning programs demonstrated not only better behavior, but also an 11 percent point gain in academic achievement.

Despite this tie, school counselors and psychologists have sometimes been underutilized, says Stephen E. Brock, president of the National Association of School Psychologists. “Today’s school psychologists are trained to do much more than simply administer psychological tests and help determine special education eligibility,” he says. Psychologists and counselors are trained mental and behavioral health providers—and they can be key architects in designing schoolwide systems to ensure that students are healthy and ready to learn.

Brock and three expert mental health professionals sat down with Principal to map out how schools can reinforce and leverage counselors’ and psychologists’ roles.

Principal: What are the common challenges for schools and mental health professionals as they address student mental health and emotional/ behavioral issues?

Elizabeth Parker: School counselors are often the first to recognize and respond to a student’s mental health crisis or need. Failure to identify and address this often impedes academic success. It’s been my experience that this becomes more of a challenge at schools whose counselors have caseloads larger than the 1-250 student-to-counselor ratio recommended by the American School Counselor Association.

Stephen E. Brock: Lack of personnel resources is our biggest challenge. Similar shortages exist for other school-employed mental health professionals, such as school counselors and school social workers. As a result, the needs of many students go unaddressed. Often, we can only work with the students with the most intensive needs and don’t have time to engage in essential prevention and mental wellness promotion efforts.

John Desrochers: There are often very few options for addressing mental health needs in the school setting. This is especially problematic given that the majority of the approximately one in five students with mental illness do not qualify for special education assistance. We need to make services available to students struggling with mental health challenges, even when the problems do not interfere with their ability to access the general education curriculum.

Robin Zorn: The biggest concern schools may have is when a student needs more support than the schools are able to provide. School counselors, school psychologists, and social workers can provide a basic level of support, but we are not set up to provide ongoing therapy or individual, weekly counseling. Many students need that additional support. Ultimately, the school counselor’s role is to decrease any barriers to academic achievement so children can learn. Therefore, it is important for schools to provide outside community resources.

Desrochers: Another issue—and I’m happy to say that this seems to be changing—is that schools have never fully embraced the idea that good mental health and academic achievement are different sides of the same coin. Principals could increase average academic achievement in their schools and at the same time improve school climate, classroom behavior, and overall student performance—just by creating a schoolwide mental health program.

How do you destigmatize mental health issues in schools?

Desrochers: Start by teaching students about mental health in the context of overall mental wellness, and make mental health and wellness a subject on equal footing with math and social studies. Think of the prevention and treatment of mental, emotional, and behavioral issues as simply another part of the school’s curriculum. Students feel far less stigma about these things when they are normal parts of the school day, and when services are provided by school personnel they know and see in hallways every day.

Brock: My approach to this is to recognize and assertively teach the neurobiological basis of mental illness. Mental illness is not simply the result of poor parenting or bad choices—although [these] can make a bad situation worse.

Parker: Building strong rapport and genuine relationships with students and their support systems is a critical component to ensuring that students who need mental health support are able to receive it. Furthermore, school counselors must be knowledgeable about and mindful of cultural and religious beliefs, and public and structural stigma, as potential barriers to students and families seeking the mental health support they need.

What are the elements of a schoolwide mental health program that supports all learners?

Zorn: Schools that implement a comprehensive, data-driven school counseling program provide services to all students. It is proactive instead of reactive, and it is communicated to all stakeholders. School counselors develop program goals based on school data; these are addressed in core curriculum lessons, small group lessons, individual counseling, parent and teacher consultations, and various schoolwide efforts. A comprehensive school counseling program can improve attendance, student achievement, and graduation rates. Discipline referrals and dropout rates may decrease, while students’ problem-solving and decision-making skills increase. Programs such as PBIS (Positive Behavioral Interventions and Supports) support all learners as well.

Desrochers: The most important elements are: 1. A continuum of services starting with a schoolwide prevention program, right to high-intensity services for those with already developed mental health problems; 2. Full involvement by all school staff (especially administrators!); and 3. True collaboration between families, schools, and community. How do you communicate with families about their child’s mental health issues?

Desrochers: The best stance to take is to be compassionate yet professional. My sense is that it’s best to start with an assumption that families love their children and want them to be successful. I also assume that they have done the best they can and may simply have run out of ideas.

Parker: This is one reason that spending the time to proactively build genuine rapport and trust with families and other members of students’ support systems is a critical first step for any school counselor. I work hard to do this with the families of all 650 current students on my caseload through a variety of schoolwide initiatives. It’s easier to share information or concerns about a student’s mental health with family members with whom I have already established a relationship.

Brock: It is important for parents to know that early intervention and treatment presents the best possible circumstances for a positive adult outcome. I often use the analogy of untreated cancer here, and I share this with parents: “I don’t care if it is an untreated cancer or untreated mental illness; the longer we go without treatment, the worse the outcome will be. Conversely, the sooner we provide treatment, the better the prognosis.”

How can schools support students whose family members have mental health issues?

Brock: Given the genetic basis for most mental disorders, this is a fairly common circumstance and can complicate matters. Ideally, the approach to these situations involves ensuring that both the student and the family members get needed treatment, highlighting the need for strong school and community partnerships.

Zorn: For students whose parents or other family members have mental health issues, school counselors should be available to talk through concerns. We often meet with students whose siblings have ADHD, autism, or other mental health issues, to discuss their frustrations at home.

Desrochers: If you have a program where these kinds of issues are routinely discussed, students will talk about them! That at least provides an opening for helping families. We have to work hard at building trust—trust between students, schools, and families.

What’s the connection between physical health and mental health?

Brock: Physical and mental health are connected, and this relationship is bi-directional, which means that physical illness increases the risk of mental illness and mental illness increases the risk of physical illness.

Desrochers: Additionally, there is growing evidence that brief yoga and meditation activities can be incorporated into the school day, even the classroom, to support students’ mental and physical health and their ability to concentrate.

Zorn: In elementary schools, it is important that schools have recess built into the day for every student. Schools can also build in character education programs where random acts of kindness are recognized. It is also important for schools to provide opportunities where all students can feel connected and that they count. If they feel connected, they will feel they belong.

What’s your advice for how principals can maximize the contributions of school counselors and psychologists?

Parker: Today’s school counselors look very different from the guidance counselors of the past. They offer an area of expertise unique to the school setting—that is, their ability to develop and implement a comprehensive school counseling program that ensures the academic development, college- and career-readiness, and social/emotional development of all students. School counselors’ contributions can be easily maximized by protecting their time and limiting clerical/administrative and non-counseling duties, so that most of their time is spent providing direct and indirect services to students. Reducing the student-to-counselor ratio would also maximize a school counselor’s ability to identify and remove any barriers to learning for students on their caseload.

Zorn: Counselors, through the use of data, can support the school’s plan for improvement by developing program goals in the areas of academics, attendance, and behavior. Eighty percent of their time should be spent in direct services to students. School counselors should not be coordinating assessments and testing at school, or handling discipline referrals. They should, however, provide interpretation of standardized tests and provide counseling to students with discipline issues.

Brock: Principals can also include school counselors and psychologists on the school safety and crisis teams to provide expertise, and tap school mental health professionals to do staff development on mental health issues. Not only is this cost-effective, but it also facilitates ongoing consultation and support for school staff helping to promote mental wellness for all students and to support students with mental health problems. Also, assign the school psychologist or counselor as the lead on school-community partnerships related to mental health to help ensure continuity in services and effective communication with families.

Desrochers: I tell everyone that school psychologists are the most underutilized professionals in schools. Many administrators don’t know that they are trained in instructional support, behavior management, individual and group counseling, research and data interpretation, prevention, and assessment and intervention for all kinds of mental, emotional, behavioral, and academic problems. Bring them more fully into the full functioning of the entire school.

Stephen E. Brock is president of the National Association of School Psychologists and coordinator of the school psychology program at California State University, Sacramento.

John Desrochers is a psychologist at Westport (Connecticut) Public Schools, and coauthor of Depression in Children and Youth: Guidelines for School Personnel.

Elizabeth Parker is a counselor at Henrico County Public Schools (Virginia).

Robin Zorn is a counselor at Mason Elementary School in Duluth, Georgia, and the 2014 School Counselor of the Year.


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