The Provision of School-based Mental Health Services within a Multi-Tiered Systems of Support Framework (with Dr. John Kelly)

This article is part of a series highlighting the presentations given at the 2021 eLumaNation Summit, held virtually September 30 – October 1, 2021.

Administrators and educators are becoming acutely aware of the mental health needs of students and the impact that these issues have on learning and students’ ability to thrive in school. However, the good news is that schools are uniquely positioned to facilitate the development, delivery, and monitoring of prompt, effective, and culturally responsive mental and behavioral health services, on a preventive and intervention basis. At eLumaNation 2021, we had the opportunity to hear from Dr. John Kelly about implementing services in school to not only address mental health needs, but also improve school climate, behavioral adjustment of students, and individual achievement in the classroom.

All schools recognize that students’ mental health impacts their ability to learn. The key is integrating mental health supports into what schools are already doing to enhance learning.

KEY TAKEAWAYS

  1. Understanding the Multi-tiered System of Support (MTSS) Framework and how this applies to the provision of mental health services in school.  
  2. Identification of the roles at different “tiers” or levels within this framework.  
  3. Recommendations for specific interventions at the different “tiers” which can be applied within their school setting.

Dr. Kelly’s presentation started with a profound story, “Moving Upstream: A Story of Prevention and Intervention.” The story begins at a small village located on the banks of a very large river. One day, one of the villagers, who is standing next to the river, sees a child drowning. Without hesitation, he jumps into the water, swims to the child and rescues him. He is alarmed that this could happen but feels good that he is able to save the child.  

The very next morning this same villager goes down to the river, and is again stunned to see, not one, but two children struggling in the river.  So he calls out to another villager and says, “come help, come help. I need some help saving these children.” So he and another villager swim out to bring the children back to safety. The next day the situation repeats, but now it’s three children. Then the next day, it’s four. The problem keeps escalating. And before long, the village has formed a rescue team to monitor the river, to watch for children floating downstream. 

After several days, the village elder says, “This is silly. Let’s take a walk upstream and see if we can discover why we keep finding kids in the river.”  And so the group heads upstream. Eventually they come across a dilapidated bridge that’s spanning the river. Unfortunately, it’s the only bridge in the vicinity and it is used frequently by the local children even though it’s missing many of its planks. While some of the kids are able to make their way across the dangerous gaps, others aren’t so lucky and fall down into the river. And those are the ones that the villages downstream are in fact, saving on a daily basis. Dr. Kelly then goes on to liken this to the mental health situation in schools.

“I started out with this story because essentially this is what we do each and every day within our schools.  There are times where we feel we’re jumping into that river, saving the kids in a crisis situation, providing the intensive services, when in fact, there are other types of critical situations that are going on upstream as well.”

So many of our kids are facing all kinds of different kinds of challenges that a presenting real barriers to learning including:

  • Divorce
  • Financial difficulties
  • Homelessness
  • Sickness
  • Violence
  • Food Insecurity
  • Death
  • Unemployment
  • Bullying
  • Academic difficulties.

And these things have been greatly compounded by the COVID-19 pandemic and all of the unrest around it. The need for a strengthened Multi-Tiered Support System has never been greater — yet there are many planks on this bridge that are missing or must be repaired.

While the primary objective of schools is to promote learning, the data shows that our schools have also become the de facto mental health care system for kids and adolescents in the US — and perhaps this is not by accident. Dr. Kelly went on to reference a study by CASEL (2003) which explored the relative influence of 30 different categories of education, psychological and social variables on learning. The ultimate findings showed that the social and emotional variables exerted the most powerful influence on academic performance. So not only does MTSS help distressed students with mental, social and emotional issues, it makes them better students.

But like the broken bridge in the story, our system is in dire need of repair and improvement. With this Dr. Kelly recommended the following:

  1. Creating a refocused role of mental health services, which includes:
    • supporting teachers as the Primary Change Agents,
    • designating the mental health providers as the “Educational enhancers,”
    • serving the core function of schools: promoting learning,
    • understanding that social and emotional development are critical parts of this core function.
  1. Providing early identification, screening and progress monitoring with the following:
    • creating an early identification system,
    • developing procedures to flag students who need additional mental health supports — including using teacher identification to identify the students with the greatest challenges,
    • using existing school data on these students to determine the most beneficial supports.
  1. Establishing prevention and universal interventions through:
    • Trauma sensitive practices
    • Classroom guidance lessons
    • Social Emotional Learning
    • Positive behavior interventions and supports
    • Effective discipline policies and practices
    • Bullying/Violence Prevention
    • Crisis prevention and intervention teams
    • Fostering positive relationships among students and staff.
  1. Implementing targeted interventions through:
    • Co-Planning Session
    • Wellness Plans
    • Check-In Check Out
    • Group Counseling
    • Behavior Plans
    • Mentoring.
  1. Ensuring intensive school & community supports with:
    • Intensive School Interventions
    • Individual Counseling 
    • Functional Behavioral Assessment
    • Special Education Consideration
    • Individualized Behavior Plan
    • More restrictive environment
    • Intensive Community Interventions
    • Long Term Therapy
    • Family Counseling
    • Involvement with Social Services
    • Community Mentoring.

Dr. Kelly concluded his fabulous presentation with the recommendation and a visual model of the Continuum of School Mental Health Services — as recommended by the National Association of School Psychologists (NASP).

A screenshot of a social media post

Description generated with very high confidence

About Dr. John Kelly

Dr. John Kelly is a school psychologist in the Commack School District and an Adjunct Professor at St. John’s University in the School Psychology program. He earned his Ph.D. in Clinical and School Psychology from Hofstra University.  Dr. Kelly has publications and book chapters and presented at numerous national and international conferences on topics that include mental and behavioral health services for children, advocacy training for school psychologists, legislative issues related to education and children, leadership development, violence and bullying prevention, and suicide awareness. Dr. Kelly is on the Executive Board of the New York Association of School Psychologists (NYASP) and is a Past President of the National Association of School Psychologists (NASP). Dr. Kelly has received numerous state and national awards, including the NYS School Practitioner of the Year in 2001 and the NASP School Psychologist of the Year in 2003.

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George Dayton

George Dayton

George Dayton is the Director of Marketing & Business Development at eLuma Online Therapy. He earned a Bachelor's degree from Brigham Young University as well as a Master's Degree in Business Administration from the Woodbury School of Business. Mr. Dayton has spent the larger part of his career developing, producing and distributing filmed content for kids and families ( including the award-winning remake of the film Where the Red Fern Grows for Buena Vista Home Entertainment). In more recent years, he has worked on ventures more closely related to children's welfare and education. He served as one of the founding members of Kidnected World, the Student Orphan Aid Program, and also helped launched the Autism Initiative for Vivint Gives Back. Mr. Dayton is passionate about eLuma and its cause, and hopes to help find new ways in which the company can partner with schools to maximize student outcomes!