Roles and Functions of School Mental Health Professionals Within Comprehensive School Mental Health Systems

Abstract

Mental health concerns are on the rise among youth, contributing to a growing need for school-based mental health services. However, challenges to service provision arise due, in part, to workforce shortages, service fragmentation, and inefficient allocation of staff time. The current study describes the professional competencies and time allocation of four school-based mental health professions (i.e., school counselors, school psychologists, school social workers, and school nurses) in order to demonstrate how schools can leverage the skills of their existing staff to coordinate a comprehensive approach to support student mental health. First, we identified the core clinical competencies needed to implement the key features of comprehensive school mental health systems. Then, we crosswalked these clinical competencies with the training standards of the four professions. Finally, we conducted a systematic review of the literature to understand how these professionals’ time is allocated, as well as their responsibilities related to the provision of mental health services. Results demonstrated that, although all four professions receive training in most of the core competencies needed to implement comprehensive school mental health services, their skillsets are often underutilized in day-to-day practice. Thus, we concluded that there are at least two untapped opportunities for school leaders to support student mental health—first, maximize the use of school mental health professionals through task-shifting (i.e., reassigning tasks less central to mental health service delivery to other staff), and second, implement an integrated model of school mental health services to efficiently leverage the mental health training of professionals. Supplementary Information The online version contains supplementary material available at 10.1007/s12310-022-09535-0.

Applying the extension for community healthcare outcomes (ECHO) model to promote collaborative and effective school mental health services.

“…Despite the promise of SMH services, persistent barriers exist in the delivery of evidence-based mental health services (Kern et al, 2022; Weist et al, 2019). Although SMH staff have specialized training in mental health interventions, workforce shortages and routine work assignments often mean that these staff have little opportunity to deepen skills for supporting students with mental health needs in ways that are culturally relevant and integrated with other activities in the school (Atkins et al, 2010; Langley et al, 2010; Zabek et al, 2023). Thus, SMH supports are often provided in relative isolation and there is a lack of coordination and role clarity among SMH providers, resulting in inefficient and inadequate service delivery (Weist et al, 2012).…”

Theory‐informed school counseling: Increasing efficacy through prevention‐focused practice and outcome research

“…To address these mental health and equity concerns, there has been a growing interest in providing prevention services in school (Zabek et al, 2023). Schools provide a unique setting where socially just, prevention-focused counseling can occur developmentally over time and across various contexts, which could further address existing inequalities in access to preventive and systemic care for children and adolescents (Johnson et al, 2023b;Lemberger-Truelove & Bowers Parker, 2023;Whitaker et al, 2018).…”

“…In their effort to promote interdisciplinary collaboration, scholars and educators have begun to focus on the variations in roles, definitions, and training related to preventive practices (National Center for School Mental Health, 2019; Zabek et al., 2023). Lack of role clarity and coordination among prevention providers could cause service fragmentation, especially when prevention services are delivered in isolation (Weist et al., 2012).…”

Adolescents’ perspectives on SSWs’ counselling practice in Swedish elementary schools: “plumb the depths and navigate to shore”

“…SSWs in Sweden have a combined profession of counselling and social work (cf. Zabek et al , 2023), which also includes a safeguarding perspective/position (cf. Beddoe, 2018; Rafter, 2022; British Association of Social Workers BASW 2023b).…”