Findings from National Scan, Survey, and Synthesis of Reviews in School-Based Mental Health and Substance Use
Policy Briefing Note
Since 2009, the Mental Health Commission of Canada has funded a national project assessing the status of school-based mental health and substance use practices and programs. This project was carried out by the School-Based Mental Health and Substance Abuse Consortium, a team of 40 researchers and practice leaders from across Canada. On May 31, 2012, the findings from this initiative will be released.
This Briefing Note has been prepared to provide policy officials with information about the findings in advance of the public release, so that governments can be prepared for any resulting media queries.
Overview of Findings:
1. Methodology. Three information-gathering techniques were used to develop a snapshot of the state of school-based mental health and substance use in Canada.
a. National survey of Canadian schools and school districts on school mental health practices, infrastructure, needs, enablers and barriers to service delivery
b. National scan of nominated best practices currently in use in Canadian schools, and c. Synthesis of systematic research reviews
These methods yielded many consistencies, and a few areas of divergence. Together, the findings offer a rich summary of school mental health and substance use programming in Canada.
Key Recommendation: Ensure that leaders in school mental health in your jurisdictions are aware of this initiative and its’ key findings.
2. Importance of a Framework. Findings from the survey, scan and review are reported using the Evergreen Framework, which highlights the continuum of mental health promotion, prevention, intervention and ongoing care. Organizing programs and services using a Framework can be a helpful way to consider service delivery in schools within a larger system of care. Other helpful models, like the Comprehensive School Health Framework (Joint Consortium for School Health, 2010), the Expanded School Mental Health model (Weist & Albus, 2004) and the Pathways to Care model (Wei, Kutcher, & Szumilas, 2011) serve a similar purpose.
Key Recommendation: Consider existing frameworks for understanding school mental health and substance use when planning services in your jurisdiction.
3. Review of Systematic Studies in School Mental Health and Substance Abuse. The Review indicates that there is sufficient evidence to suggest practice and policy directions in Canada. For example:
Investments in mental health promotion appear to be warranted. In particular, class-wide instruction that includes social emotional learning / social skill building for all students has a solid basis in research.
There is compelling evidence to support the use of cognitive behavioral approaches for prevention and intervention with students exhibiting internalizing (e.g., anxiety, depressed mood) and/or externalizing symptoms (e.g., oppositional behavior, impulsivity, aggression).
In the area of substance use, the literature is mixed, but there is support for interactive approaches that highlight resistance education and skill-building.
Note that school mental health intervention with special populations is an area for which the body of systematic reviews is insufficient to make clear recommendations.
Key Recommendation: Schools are particularly well-positioned to provide mental health promotion support to all students. Assess the degree to which social-emotional learning / social skill building is in place in your jurisdictions. Consider enhancing support in this area. Check the evidence for the effectiveness o f prevention and intervention programs currently in use.
4. Scan of Nominated Best Practices in Canada. The Scan revealed exemplar programs that align well with findings from the Review and have been evaluated locally. There are also research-informed programs that have not been tested in Canada, and would benefit from rigorous evaluation. At the same time, however, there are a number of programs currently in use that have been created in response to a local need that don’t align clearly with the evidence and have not been evaluated systematically. There is a strong need for identification and scaling up of exemplar programs, rigorous evaluation of untested but research-informed approaches, and careful re-consideration of the continuation of programs that appear to be inconsistent with the evidence-base.
Key Recommendation: There are evaluated exemplar programs available in the Canadian school context. Locally developed programs that are inconsistent with the evidence-base and untested should either be subjected to evaluation or discontinued.
5. National Survey of Schools and School Districts. The Survey findings suggest that there are many areas of need to be addressed before systematic, evidence-based programming along the service continuum can be effectively placed in Canadian school boards. District and school teams report that they are very concerned about student mental health, but the necessary infrastructure for coordinated school mental health is lacking (e.g., leadership, alignment with board policy and strategic directions, protocols for decision-making and integrated service, systematic professional development, implementation support). The survey findings suggest that organizational conditions are foundational to ensuring a sustained and systematic approach to school mental health.
Key Recommendation: Work with leaders in your jurisdictions to identify and implement critical organizational conditions for effective school mental health.
6. The Importance of Partnership. Across information sources, findings were consistent in highlighting that school mental health and substance use programs and practices are most successful in the context of collaborative, cross-sectoral, systems of care.
Key Recommendation: Engage in meaningful collaboration across Ministries to create shared language, establish role clarity, ensure optimal use of resources, and develop protocols for efficient pathways to care.
Contact Us:
School Mental Health and Substance Abuse Consortium SBMHSA Consortium Lead, Ian Manion, Ph.D., C.Psych.
Ontario Centre of Excellence for Child and Youth Mental Health manion@cheo.on.ca
Visit us on-line:
https://kec.mentalhealthcommission.ca/partners/sbmhsa
