Supporting Student Mental Health: The Role of the School Nurse in Coordinated School Mental Health Care

Abstract

School nurses play a critical role in the provision of mental health services in the school environment and are valuable members of the coordinated student mental health team. They possess expertise to navigate in today's complicated educational and health care systems, and it is estimated that school nurses spend 33% of their time addressing student mental health issues. Despite their role and expertise, school nurses are often not recognized as part of the school mental health team and, thus, their role in student mental health care and the full collaboration and coordination with other education and mental health professionals in the school has yet to be fully realized. This article reviews school nurse mental health expertise, models of mental health service provision, and current mental health practices as reported by national stakeholders. In addition, it highlights school nurse barriers and additional training needs related to student mental health care and provides concrete recommendations for building strong collaborations between school nurses and other education and mental health professionals to support student mental health.

Mental health work in school health services and school nurses’ involvement and attitudes, in a Norwegian context

“…This may be one of the reasons why the school nurses feel alone in their work related to adolescents’ mental health problems as some also report that they felt less competent and confident in this respect. This is consistent with other studies demonstrating that school nurses report a need for additional training in relation to mental health screening and assessment (Bohnenkamp, Stephan, & Bobo, ; Pryjmachuk et al., ). A lack of knowledge becomes a barrier to giving young people adequate first aid for mental health problems.…”

Collaborative care in schools: enhancing integration and impact in youth mental health

“…In addition, the table details documented constraints of the education sector that are likely to drive modifications of the CC model. These include the characteristics of students, who tend to present with a wide range of developmental and behavioral/emotional problems (Lyon, Bruns, et al, 2014; Walker, Kerns, Lyon, Bruns, & Cosgrove, 2010); the need for health and mental health interventions in schools to align with the educational mission and educational outcomes (Prodente, Sander, & Weist, 2002); tradeoffs between service accessibility and ease of facilitating parental engagement (Langley, Nadeem, Kataoka, Stein, & Jaycox, 2010); variability in medical staff availability in schools, as well as the appropriateness of a central role for medical providers (Bohnenkamp, Stephan, & Bobo, 2015; Power, Blum, Guevara, Jones, & Leslie, 2013); and opportunities to involve a range of educational personnel in mental health interventions (Owens et al, 2014). …”

“…Furthermore, prior research has documented that a modularized, common elements paradigm demonstrates good fit for groups of school-based mental health providers (Lyon, Ludwig, et al, 2014; Lyon, Charlesworth-Attie, Vander Stoep, & McCauley, 2011; Stephan, Wissow, & Pichler, 2010; Weist et al, 2009), with some studies including medical providers as well (Stephan, Connors, Arora, & Brey, 2013). Building on these findings, faculty from the University of Maryland’s Center for School Mental Health have developed an innovative initiative, the Mental Health Training Intervention for Health Providers in Schools (MH-TIPS; Bohnenkamp et al, 2015), which includes training for school nurses in common elements of evidence-based practice.…”

Shared responsibility: school nurses' experience of collaborating in school‐based interprofessional teams

“…In other words, there seem to be certain condition in order for collaboration to be effective for countries recognise collaboration as important considering such conditions may be valuable. For example, lack of a availability might explain why SNs partnership with other professions is not realised despite being recommended .…”

“…In other countries, such as the United States, school‐based health centres, initially developed to provide primary care and prevent teen pregnancy, are growing in number, but more collaboration with school staff and school personnel, such as school psychologists, has been called for . Other school‐based interprofessional teams, such as prereferral teams, or student study teams, with the aim of preventing referrals to special education by early interventions , or school mental health teams, seldom include school nurses . Thus, to our knowledge, few countries include SNs in interprofessional teams with psychologists, school social workers and special‐education teachers in the way now proposed in Sweden; however, school nurses partnering with other school mental health and special‐education specialists have been highly recommended .…”