School Self-Reported Implementation of Mental Health Policies and Practices: An Exploration of School- and State-Level Predictors

Mental health plays a fundamental role in child development and can impact interpersonal relationships and the ability to live a healthy and productive life. A wide variety of individual and environmental factors are associated with poor mental health and not all racial, gender and socioeconomic groups are equally exposed or affected. Prevalence of mental health disorders among adolescents are common and simultaneously represent a potential barrier to learning. Since most youth attend school regularly, these institutions are in a unique position to improve access and availability of mental health services, but may not have prioritized mental health due to competing demands placed on the school day, lack funding and/or support for such efforts. Federal education policy has the potential to shift state-level support and funding to secondary schools and alter the local school and state-level environments. Anticipating the potential impact of such legislation requires an understanding the relationship between school- and state-level factors and schools’ implementation of mental health policies and practices.

This study used three national datasets, Youth Risk Behavior Survey, School Health Policy and Practices Survey, and the School Health Profile survey. Multi-level modeling techniques were applied to examine the relationship between both school- and state-level predictors and school self-reported implementation of mental health policies and practices at secondary schools across the United States.

Results indicated that the following were all positively associated with school self-reported implementation of mental health policies and practices: Lead health teacher certification to teach health education, (r= 0.56, p<0.001), School use of data when writing the School Improvement Plan (SIP) (r=0.32, p<0.001), presence of a health and safety coordinator (r= 0.24, p <0.001), and presence of a health council (r=0.36, p <0.001). States where agency personnel provided professional development in mental health and suicide prevention to health educators in schools had a positive association with school self-reported implementation of mental health policies and practices (r=0.26, p= 0.02).

Results support school use of data when writing the SIP, presence of a health and safety coordinator, or a health council and use of educators certified to teach health education. Finally, despite state agency efforts to provide assistance in support of school mental health policies and practices, only professional development in mental heath to health educators was significant in the implementation of policies and practices. Future research is necessary to understand what form of assistance may motivate schools adoption of mental health policies and practices.