Improving School Workforce Capacity to Address Youth Mental Health
September 26, 2022 | Ioana Ungureanu
The youth mental health crisis has created a need for state public health officials to work collaboratively to improve workforce capacity and strengthen prevention systems for youth. In 2021, according to a CDC mental health surveillance report of adolescents ages 12-17, 15% of youth had a major depressive episode, 37% had persistent feelings of sadness or hopelessness, and 19% seriously considered attempting suicide.
Youth mental health is deeply rooted in the social determinants of health, with trauma, poor access to services, community violence, housing instability, parental unemployment, food insecurity, and unsafe physical spaces contributing to worsening mental health outcomes. In 2022, the ASTHO School Behavioral Health Advisory Committee explored ways to improve youth mental health outcomes and found that the school system offers opportunities to strengthen systems of care.
Experts in the field indicate that a comprehensive school mental health system includes components such as data, screening, workforce training, and family and community partnerships. Building a comprehensive workforce response to this crisis requires educators and school administrative staff, school-based mental health professionals, and communities to work collaboratively.
The success of this work depends on our ability to build support systems for staff members’ mental health and well-being, so they are themselves better equipped to support students. Recent data on school staff and educators shows that 88% of public schools are concerned about staff burnout and stress. Given the important role of school staff in addressing youth mental health, states can focus on three strategies to improve workforce capacity.
- Develop pre-service recruitment and training.
- Increase school staff mental health literacy.
- Improve school staff resiliency.
Pre-Service Recruitment and Training
School workforce recruitment is critical now more than ever, as staff stress and shortages put students’ educational attainment and health at risk. Evidence-based strategies to improve recruitment efforts include recruiting workforce from the local community, improving teacher compensation, and increasing service opportunities for high school and college students interested in entering the education field. These are key components of creating a more diverse and equitable workforce. Administrators can also use this workforce diversity assessment tool to ensure that the workforce they recruit is diverse and reflects the community they will support.
While studies have found that pre-service certifications in mental health are inconsistent and limited in the United States, teacher preparation programs are increasingly focusing on mental health support for aspiring teachers. For example, in Iowa, the Scanlan Center for School Mental Health—a partnership between the Iowa Department of Education and the University of Iowa—aims to improve access to mental health resources and training for pre-service school educators.
States are also incorporating pre-service training best practices to improve access to behavioral health providers in school settings. For example, Alaska’s Rural Human Services (RHS) is a statewide partnership between the Alaska Mental Health Board, Alaska Department of Health and Human Services, and the University of Alaska, which was created to expand access to behavioral health services for rural residents. The RHS program at the University of Alaska College of Rural and Community Development is a 34-credit certificate program developed for village-based human service providers. It is intended for rural residents who are natural helpers and healers in their communities, and is designed to help residents further develop skills and credentials. Skill development, education, and training are provided in services such as crisis intervention, suicide prevention, community development, and counseling in mental health, substance abuse, interpersonal violence, grief, and healing. Students are often employed full-time and supported by their employer to attend classes.
Increase School Staff Mental Health Literacy
School staff, including administrators and educators, have an important role in supporting student mental health, including by creating safe and supportive environments, promoting positive behaviors and social emotional learning skills, and referring students to mental health professionals.
Mental health literacy is broadly defined as knowledge and beliefs about obtaining positive mental health. Mental health literacy should be paired with peer-to-peer support for educators and organizational well-being policies within the school system. Some examples of existing mental health literacy training modules for the school workforce that public health can lift up include Classroom WISE and MHTTC National School Mental Health Best Practices: Implementation Guidance Modules for States, Districts, and Schools.
North Carolina is pursuing multiple strategies, including $5 million in additional funding to expand Youth Mental Health First Aid training in schools and communities. In 2020, the North Carolina General Assembly required the state board of education to develop a school-mental health policy, and required that K-12 schools adopt mental health training programs for staff. The North Carolina Department of Public Instruction, in collaboration with the North Carolina Department of Health and Human Services, developed a model training plan for schools, which includes criteria for selecting trainings and a list of eligible trainings. These and other related efforts to support the emotional well-being of school staff and students will be included in a Unified School Behavioral Health Strategic Plan that is being developed collaboratively between the two North Carolina Departments.
The Oklahoma State Department of Health (OSDH) has incorporated information on trauma and adverse childhood experiences into educator training programs. In partnership with the Potts Family Foundation, OSDH has delivered the NEAR Science - Beyond ACEs training to 1,000 teachers, which is focused on how toxic stress and trauma affect the brain and strategies to build resiliency. OSDH is also training teachers with two evidence-based programs, Trust-Based Relational Intervention and Mindfulness Based Stress Reduction through a grant received from National Association of County and City Health Officials (NACCHO).
Improve School Staff Resiliency
School workforce stress is creating high turnover rates for educators and school staff. State cross-sector agencies can work collaboratively to improve resiliency. Research shows that strategies to increase teacher retention include promoting teacher well-being, encouraging engagement in decision-making, creating a supportive school organizational climate, and monitoring retention. School employees' well-being should be included in organizational practices and policies. In addition, workforce retention includes considerations of loan reimbursement, mentoring, and additional compensation for staff. Policy makers and administrators can consider reducing demands to allow space for wellness activities as focusing on increasing positive resources and supports for school workforce is not enough.
Resilient Wisconsin is an initiative that connects with community partners across the state, including partnerships between state education and health authorities, to promote workforce resilience. Wisconsin leveraged work on previous initiatives, as well as the CDC Overdose Data to Action funding, to start the initiative. Resilient Wisconsin is now focused on comprehensive prevention efforts, resource development, partnership building, and trainings. The Wisconsin Department of Health Services and Department of Public Instruction are also fielding a survey to school staff on capacity and resource availability and will use the results to continue improving school staff well-being.
Policymakers and state health officials can support school workforce capacity and resiliency, which ultimately should improve the mental health of both students and staff. State health agencies should work in collaboration with the education sector to improve supports and resources for school workforce efforts. A public health approach to mental health promotion is necessary now more than ever, and state public health agencies can act as coordinating bodies for furthering these efforts.