School Mental Health Implementation Consultation and Research

Area Description: The Yale Program on School Mental Health Implementation Consultation and Research (SMH-ICR), seeks to promote equitable access to high quality mental health promotion, prevention, early intervention, and treatment services and supports in K-12 schools. We work toward this mission by partnering with and learning from local school and community systems, researchers, and education and mental health leaders nationwide.

Our objective is to close the research to practice gap by leading, contributing to, and learning from evidence-based practice and practice-based evidence in school mental health promotion, prevention, early intervention, and treatment. We are engaged in school mental health research, evaluation, consultation, training, and technical assistance. We strive to inform comprehensive school mental health practice and policy at national, state, regional and local levels through strong school-community-family partnerships. Although we focus primarily on K-12 public schools in the United States, we are actively learning with and from non-public, charter and international school systems.

Equitable access is foundational to our mission due to significant unmet children’s mental health needs in the United States, often based on systemic disparities. At SMH-ICR, we strongly believe that everyone deserves an equal opportunity to succeed in school and life. Our program has a deep commitment to cultural humility and continuous growth and learning to advance diversity, equity and inclusion of thought, individual factors, system characteristics and political climates.

High quality school mental health services and supports are regarded as those which align with the core features of comprehensive school mental health systems (CSMHS). CSMHS provides a full array of supports and services that promote positive school climate, social and emotional learning, and mental health and well-being, while reducing the prevalence and severity of mental illness (Hoover et al., 2019). Optimal performance in all aspects of CSMHS is aspirational for any school system, and every system has unique strengths and opportunities for growth. Therefore, we use methods from quality improvement and implementation science, with national performance measures publicly available in The SHAPE System to help school systems meet their improvement goals.

Specialty areas:

• School-community based mental health provider partnerships
• School-based mental health provider training and ongoing support
• Evidence-based mental health early intervention (Tier 2) and treatment (Tier 3)
• Implementation science in education and mental health
• Continuous quality improvement in education and mental health
• Measurement-based care in education and mental health
• Universal, trauma-sensitive classroom practices for all students
• Title I schools in urban, rural and suburban communities

The SMH-ICR Team also includes undergraduate and graduate trainees in psychology. Please reach out to Dr. Connors if you are interested in training opportunities on our team.

Despite high and rising rates of adolescent depression and suicidal thoughts and behaviors, racial and ethnic minoritized (REM) youth are significantly less likely to remain in mental health services than their White peers. This is due in part to poor therapeutic alliance and concerns about treatment relevance and acceptability. Existing engagement interventions are limited, with few addressing treatment retention for REM youth at risk for depression and suicide. Measurement-based care (MBC) is the use of patient-reported progress data throughout mental health treatment to promote collaborative, patient- centered treatment plan adjustments. MBC is an outstanding candidate to improve treatment engagement due to its focus on personalized treatment and is also highly effective when integrated in depression treatment. In collaboration with the SMILE Lab at Teachers College Columbia University, we developed Strategic Treatment and Assessment for Youth (STAY), a culturally-tailored MBC approach to improve treatment retention, depression symptoms and suicide outcomes through better therapeutic alliance and treatment relevance and acceptability. We are refining STAY with user centered design methods with youth, caregivers, and providers, prior to a subsequent pilot effectiveness-implementation trail of STAY as compared to MBC As Usual (R34MH134915).

The Maryland Community Health Resources Commission approved 129 grant awards totaling $111 million to expand access to comprehensive behavioral health services for K-12 students in every jurisdiction in Maryland. Funding to support these new programs was made available by the Maryland General Assembly under the Blueprint for Maryland’s Future (Ch. 36 of 2021). Dr. Connors is partnering with the University of Maryland National Center for School Mental Health team which provides training, technical assistance, and evaluation to the CHRC grantees who are delivering evidence-based practices in the context of school-community-family partnerships. Dr. Connors is leading a statewide Measurement Based Care Learning Community (MBC LC) for CHRC grantees to engage in shared learning to advance the adoption and implementation of measurement-based care in schools throughout the state. More information about the MBC LC can be found on the Maryland Consortium on Coordinated Community Supports Grantee Page.

Learn more on the CCERC website.

Our team is partnering with Dr. Carolyn Lin at the University of Connecticut to evaluate quality improvement efforts of seven identified school districts in Connecticut who will use BHP funds to develop and pilot test new systems to meet the behavioral health needs of students, families, and staff. This project is supported by the Center for Connecticut Education Research Collaboration and in partnership with Child Health and Development Institute and the Connecticut State Department of Education, with whom we work closely to align implementation consultation and evaluation in support of our dedicated district partners.

School District Partners: Chaplin Public Schools; Griswold Public Schools; Highville Charter School; Manchester Public Schools; New Hartford Public Schools; Norwalk Public Schools; Killingly Public Schools

Measurement-based care (MBC) in schools is the routine use of student- and caregiver-reported progress data throughout mental health early intervention (Tier 2) and treatment (Tier 3) services and supports for students. FOCUSS is an NIMH-funded pilot trial of MBC implementation in schools that applies the most promising implementation strategies identified in our prior work and augments and tailors those strategies to school district-specific challenges, resources and contextual factors. The primary goal of FOCUSS is to improve school mental health clinician adoption and implementation of MBC with students served throughout the school year.

School District Partners: West Haven Public Schools (West Haven, CT); Stamford Public Schools (Stamford, CT)

Our team partners with the University of Maryland National Center for School Mental Health (NCSMH) to provide continuous quality improvement consultation on comprehensive school mental health to improve learning and promote success for America’s youth. Dr. Connors is an Adjunct Assistant Professor and core faculty member at the NCSMH, as well as a developer of The SHAPE System. In this collaboration, our team provides training and technical assistance/consultation to local, state and national partners of the NCSMH related to advancing comprehensive school mental health system quality. This includes national dataset management, execution of learning collaboratives, and content development and consultation on products and strategies to optimize the reach of NCSMH activities.

The Trauma Sensitive Classrooms (TSC) Project was developed in partnership with 7-Dippity for school districts requesting practical, evidence-based, trauma-sensitive strategies for teachers to use with all students to promote resilience and reduce barriers to learning. TSC strategies are intended to improve student success by 1) promoting positive student-teacher relationships; and 2) teaching students skills to self-regulate their emotions and behavior at school using healthy choices. TSC includes proactive (Universal/Tier 1) and responsive (Early Intervention/Tier 2) strategies, customized to the specific needs of a school or district using an SEL Kernels approach (Jones, 2012). TSC training also includes basic mental health literacy for teachers including the impact of trauma and stress on the brain, learning, and classroom behavior. TSC focuses on ongoing implementation support by providing in-depth coaching and mentoring to support educators’ immediate and effective use of strategies with their students. We prefer to work with local coaches and mentors to build long-term capacity at the building and/or district level. The initiative also seeks to positively support mental health and wellbeing of teachers and administrators themselves.

School District Partners: Escambia County School District (Pensacola, FL); Bay District Schools (Panama City, FL)

SMH-ICR proudly partners with researchers, practitioners, intermediary organizations, and school systems who share our mission to advance high quality school mental health services and supports for all students, families, and schools. Some partners include the following:

• 7-Dippity
• American Institutes of Research
• Center for Connecticut Education Research Collaboration (CCERC)
• Centre for School Mental Health (Western University)
• Child Health and Development Institute (CHDI)
• Data Science for Dynamic Decision-Making Center (D3C, University of Michigan)
• Escambia County Public Schools
• Greenspace Health
• Massachusetts School Mental Health Consortium (MASMHC)
• National Center for School Mental Health (NCSMH, University of Maryland)
• School Mental Health Minoritized Youth and Families (SMILE) Lab, Teachers College, Columbia University
• University of Connecticut
• University of Lincoln, Nebraska
• West Haven Mental Health Clinic
• Yale Measurement Based Care Collaborative (YMBCC)