Abstract:

Background:
Between 2015 and 2019, the greater Houston area experienced a series of traumatic events, from the devastation of Hurricane Harvey to the Santa Fe school shootings, affecting over 525,000 children between the ages of 9-17. During this time, student behavioral health concerns escalated, and neurodevelopment research re-emerged regarding the effects trauma, toxic stress, and social determinants of health on student behavior. In 2020, the COVID-19 pandemic and ongoing racial and political unrest further exacerbated student mental health concerns, adding to the 5% of students who already had a Serious Emotional Disturbance. In response, a workgroup was convened to review and revise the 2012 Consensus Recommendations to improve school-based mental health supports.

Perspective:
The multidisciplinary collaborative, composed of school district educators and administrators, community-based child-serving organizations, mental/behavioral health providers, equity experts, community advocates, and students, used the collective impact model to assess and update recommendations that identify and address educational trends around students' growing mental and behavioral health needs.

Objective:
The diversity in stakeholders allowed differing perspectives to surface, leading committee members to take on a holistic understanding of the current challenges and converge around an overarching goal to improve schools' mental health support systems and encourage inclusive policies and practices.

Methods:
The Multi-Tiered System of Supports (MTSS) framework guided the work. MTSS was used to organize and categorize the 2012 recommendations and workgroups into the three-tier groups - promotion and prevention, early intervention and identification, and treatment. These recommendations were assessed for relevance to current school climate, feasibility of implementation, and impact on student outcomes. The revised list of recommendations (2021) was generated and went through a 4-step process that includes research, engagement, determination, and prioritization. Two workgroup members were designated to complete background research, identify best practices, and develop corresponding measures for the new list.

Results:
This work resulted in a revised list of recommendations to improve the healthy psychological development of students, enhance the prevention of behavioral issues, and provide appropriate and timely intervention for students exhibiting behavioral health concerns. The list includes recommendations for state-level policy, school districts, mental health providers, and community advocates. The 37 recommendations are discussed in the 2021 Consensus Recommendations report – the culminating outcome from the collaborative's work.

Conclusions:
These efforts successfully engaged stakeholders to create and agree on recommendations that would improve the mental health system for students. Through this convening, these constituents discussed challenges, policies, and practices and exchanged solution-driven ideas to contribute to best practices within the education system. Although conducted in the Greater Houston area, other communities can replicate it with slight modifications for a successful partnership.

Keywords:

Collaborative engagement, school mental health, children's mental health, school discipline, educational policy, child trauma, school community partnerships.