Comprehensive School Mental Health: An integrated “School-Based Pathway to Care” model for Canadian secondary schools

Abstract

Adolescence is a critical period for the promotion of mental health and the treatment of mental disorders. Schools are well-positioned to address adolescent mental health. This paper describes a school mental health model, “School-based Pathway to Care,” for Canadian secondary schools that links schools to primary care providers, mental health services, and the wider community, enabling them to address youth mental health in a collaborative manner. The model highlights the fundamental role of mental health literacy, gatekeeper training, and education/health system integration in improving adolescent mental health, and enhancing learning environments and academic outcomes.L’adolescence constitue une période critique pour la promotion de la santé mentale ainsi que le traitement des désordres mentaux. En ce sens, les écoles sont bien placées pour s’attaquer aux problèmes de santé mentale vécus par les adolescents. Cet article trace le portrait d’un modèle de santé mentale en milieu scolaire, le modèle “School-based Pathway to Care”, modèle déployé au sein d’écoles secondaires canadiennes. Celui-ci met en lien les établissements scolaires avec les institutions fournissant des soins de santé de base et des services de santé mentale. Ce faisant, il permet aux différents intervenants de collaborer, s’attaquant ainsi ensemble aux problématiques de santé mentale des jeunes. Ce modèle souligne l’importance de la littérature portant sur la santé mentale, de la formation des surveillants et de l’intégration des systèmes d’éducation et de santé dans l’amélioration de la santé mentale des adolescents, des environnements scolaires et des résultats académiques

Successful Application of a Canadian Mental Health Curriculum Resource by Usual Classroom Teachers in Significantly and Sustainably Improving Student Mental Health Literacy

“…18,21,[23][24][25][26][27][28] Schools provide the ideal location in which to implement interventions that can be demonstrated to improve MHL. [14][15][16]23,[29][30][31][32][33][34][35] Early definitions of MHL, as "knowledge and belief about mental disorders which aid their recognition, management, and prevention," 19, p 182 have evolved concurrently with advances in understanding of health literacy, [36][37][38][39] including incorporation of constructs pertaining to stigma, advocacy, and help seeking, 20,21 and empowerment. 40 Similarly, stigma theory has evolved to acknowledge the importance of knowledge in stigma reduction.…”

Enhancing mental health literacy in young people

“…It is fundamental that schools not only promote positive mental health, but also enable students to differentiate normal mental distress from mental health problems/disorders, reduce stigma against mental illness, and promote helpseeking behaviors of students and mental health self-care if they need mental health care. The concept of MHL has been developed to fill this gap in the education system [2,13]. Our literature search identified one school MHL intervention in Norway [15] that embedded MHL into schools that demonstrated impact on student knowledge for identification of certain mental disorders and attitude changes; however, these approaches have often been input into schools by external providers and, therefore, may not lead to sustained and enhanced MHL capacity embedded into educational systems.…”

“…When applied through enhancing capacity of classroom teachers to integrate evidence-based MHL curriculum resources (http://teenmentalhealth.org/curriculum/) into existing curriculum, as demonstrated by numerous Canadian studies, such interventions can concurrently result in positive MHL outcomes for both students and teachers alike [21][22][23][24]. Additionally, this approach can facilitate the development of an horizontally integrated school-based pathway to youth mental health care that links education and health systems, enhances identification, and facilitates triage and referral of students with mental disorders to local mental health care providers, thus functionally integrating educational and health care delivery systems, even in the absence of specific policies designed to do so [13,25].…”

Strategies for Integrating Mental Health into Schools via a Multitiered System of Support

“…In particular, early identification and intervention of mental illness have been linked to an array of positive outcomes, including higher academic achievement, less intensive services, higher social and occupational functioning, less psychological distress, and fewer costs/burdens to the larger system of care. Increasing amounts of research results support the positive impact of early universal interventions, including mental health literacy for teachers and students, 22 social emotional learning, 21 and classroom behavior management strategies. 20 …”