Key Findings from the National Scan, Survey, and Synthesis of Reviews
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. Key high-level findings are listed below.
1. Methodology. Three information-gathering techniques were used to develop a snapshot of the state of school-based mental health and substance use practices and programs in Canada. The national scan of nominated best practices, survey of Canadian schools and districts, and synthesis of research reviews yielded many consistencies, and a few areas of divergence.
2. Framework. Findings from the survey, scan and review are reported using the Evergreen Framework (McLuckie & Kutcher, 2010), which highlights the continuum of mental health promotion,
prevention, intervention and ongoing care. Organizing services using a Framework can be a helpful way to consider service delivery in schools within a larger system of care.
3. Synthesis of Systematic Reviews. 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, whole school approaches that highlight resistance education and social 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.
4. Scan of Nominated Best Practices. 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 do not 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 consideration of the continuation of programs that appear to be inconsistent with the evidence-base.
5. National Survey of Schools and School Districts. The Survey findings suggest that there are many areas of need that must 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 needed 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). These organizational conditions are foundational to ensuring a sustained and systematic approach to 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.
7. Limitations. It was difficult to recruit participation in the Scan and Survey. The scan findings should be understood as a sampling of programs, rather than an exhaustive list. It is recommended that the searchable database created by the SBMHSA Consortium be updated as programs continue to be nominated. The survey findings were very consistent across respondents, but it is possible that those who chose to respond were systematically different than those who did not participate. The review included only systematic reviews (i.e., review of reviews, rather than review of individual studies) completed prior to January 2010, in the area of school-based programming for internalizing and externalizing disorders and substance use. Coverage of organizational and implementation issues was limited. The KTE Team has provided additional reference to reputable resources that might be helpful for decision-makers.
8. The Power of Networks. The SBMHSA Consortium learned that there are many strong national, provincial, and regional networks in place in Canada that are designed to support research, practice and policy in school mental health. As knowledge and momentum grows, these groups can be further mobilized to bridge research and practice/policy in school mental health in Canada.
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 [email protected]
Visit us on-line:
https://kec.mentalhealthcommission.ca/partners/sbmhsa
