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Several national organizations are developing a joint statement that defines and describes how schools can promote mental health. An initial draft (posted below) was discussed on conference calls in December 2009 and January 2010. Participating organizations are invited to edit the text directly on this page using the "EasyEdit" tool found at the top of this page. Comments on the draft can also be made using the "thread" tool at the bottom of the page.
Note: Anyone visiting this web page can make changes and comments anonymously but participants are encouraged to join the wetpaint system (Select "Sign Up" from the top navigation bar) we are using for this wiki, then select "join" to enter this wiki-community. By doing this, you will be able to control the email that you receive from this web site by adjusting the "email notifications in your profile. As well, others participating in this process will be able to know which suggestions have been made by you.
The consensus statement below is being developed by several national organizations in Canada in order to clarify and describe the actions that can be taken through schools to support mental health. We hope that this statement can be used as a basis for developing ministry, agency and school policies and long-term plans as well as a reference point encouraging concerted inter-sectorial actions at all levels.
Schools acting with the direction and support of government ministries, school boards and working collaboratively with other agencies and professionals as well as parents and young people, can make a substantial contribution to enhancing the mental health of youth. This may include but not be limited to the following: developing mental health awareness, knowledge, skills and beliefs among students, educators and parents; creating supportive social and physical school environments; helping to deliver programs that can assist in the identification, triage and referral of young people at risk of mental disorder; providing "on site" services to address mental health problems; providing on-going liaison with health care providers to meet the needs of youth receiving care for mental disorders; promoting staff wellness and more.
While teachers are not mental health professionals and cannot be expected to assess children or address their specific mental health problems, they can provide a a supportive environment, be aware of community-based services and refer children in need to others.
The potential roles of the school in addressing youth mental health can be conceptualized as a pathway. The first component of which is mental health promotion. The International Alliance for Child and Adolescent Mental Health and Schools (INTERCAMHS) has suggested this definition of school mental health promotion:
The above definition moves beyond traditional concepts of health promotion and includes a number of components often conceptualized as different stages on a pathway to care. In Canada, with a health care system substantially different from that in other countries, schools may play different roles in this pathway to care, particularly in the domain of mental health service provision. An essential component of the INTERCAMS approach however is its emphasis on the critical role of evidence to guide training, policy, research and practice in addressing the following:
Proponents of school-based and school-linked mental health programs and approaches should be careful to not duplicate the work that has been done by other sectors that overlap with mental health concerns. The safe and caring schools movement has and is describing comprehensive approaches to preventing crime, violence and bullying with a focus on offenders, bystanders and victims. The inclusive schools movement has defined much of what works in integrating students with physical, intellectual, learning and emotional disabilities. The social and emotional learning movement is already well-established in many school systems. Anti-racism and diversity programs have addressed other behaviours that have mental health consequences. Consequently, school mental health programs and approaches should be positioned with these other efforts as well as the ongoing and constant efforts of schools to provide good student discipline, appropriate, supportive relationships between students, staff and parents and moral, principled guidance to their students,
A considerable body of research evidence (including systematic reviews, replicated controlled trials) and professional experience has accumulated suggesting that multiple intervention programs developed and delivered as part of comprehensive approaches (linking MH to other issues, multi-level, multi-systems/agencies), coordinated agency, mental health professional and school programs and whole school strategies can have an impact on mental health as well as positive and negative aspects of mental health (e.g. attachment, resiliency, depression, suicide) as well affect or offset other health behaviours and conditions (e.g addiction, aggression, abuse, disability, chronic disease). These interventions can include:
Further, it is recommended that:
The above statement on how schools, agencies, communities and governments can promote mental health includes four broad actions that can be taken at different levels in several systems. It is very important that implementation, capacity-building and program sustainability be considered as a primary step in any action planning. Further, it is suggested here that:
Note: Anyone visiting this web page can make changes and comments anonymously but participants are encouraged to join the wetpaint system (Select "Sign Up" from the top navigation bar) we are using for this wiki, then select "join" to enter this wiki-community. By doing this, you will be able to control the email that you receive from this web site by adjusting the "email notifications in your profile. As well, others participating in this process will be able to know which suggestions have been made by you.
Canadian Consensus Statement on School Mental Health Promotion (October 30 draft)
The consensus statement below is being developed by several national organizations in Canada in order to clarify and describe the actions that can be taken through schools to support mental health. We hope that this statement can be used as a basis for developing ministry, agency and school policies and long-term plans as well as a reference point encouraging concerted inter-sectorial actions at all levels.
Schools acting with the direction and support of government ministries, school boards and working collaboratively with other agencies and professionals as well as parents and young people, can make a substantial contribution to enhancing the mental health of youth. This may include but not be limited to the following: developing mental health awareness, knowledge, skills and beliefs among students, educators and parents; creating supportive social and physical school environments; helping to deliver programs that can assist in the identification, triage and referral of young people at risk of mental disorder; providing "on site" services to address mental health problems; providing on-going liaison with health care providers to meet the needs of youth receiving care for mental disorders; promoting staff wellness and more.
While teachers are not mental health professionals and cannot be expected to assess children or address their specific mental health problems, they can provide a a supportive environment, be aware of community-based services and refer children in need to others.
The potential roles of the school in addressing youth mental health can be conceptualized as a pathway. The first component of which is mental health promotion. The International Alliance for Child and Adolescent Mental Health and Schools (INTERCAMHS) has suggested this definition of school mental health promotion:
"Promoting mental health through schools supports a whole school approach involving effective mental health promotion, intervention and treatment. This approach is supported by policies, skills for social emotional learning, a healthy psycho-social school environment and access to services in the school or in the broader community. The full participation of teachers, students, families and community agencies is encouraged with informed dialogue and collaboration among people and programmes throughout all phases of the continuum. This action is supported by principles that value diversity and inclusiveness, and practice that creates conditions for empowerment and school organizational development."
The above definition moves beyond traditional concepts of health promotion and includes a number of components often conceptualized as different stages on a pathway to care. In Canada, with a health care system substantially different from that in other countries, schools may play different roles in this pathway to care, particularly in the domain of mental health service provision. An essential component of the INTERCAMS approach however is its emphasis on the critical role of evidence to guide training, policy, research and practice in addressing the following:
- Universal mental health promotion, which seeks to improve school psychosocial environments, skills-based health education for social, emotional learning and brings resources and programs to all students to promote health, successful teaching and learning and academic success;
- Selective interventions, which provide prevention programs for young people presenting risk factors for problems;
- Indicated interventions, which provide early interventions to young people exhibiting emotional and behavioural problems; and
- Treatment, which provides more intensive services to youth presenting established emotional/behavioural problems.
Proponents of school-based and school-linked mental health programs and approaches should be careful to not duplicate the work that has been done by other sectors that overlap with mental health concerns. The safe and caring schools movement has and is describing comprehensive approaches to preventing crime, violence and bullying with a focus on offenders, bystanders and victims. The inclusive schools movement has defined much of what works in integrating students with physical, intellectual, learning and emotional disabilities. The social and emotional learning movement is already well-established in many school systems. Anti-racism and diversity programs have addressed other behaviours that have mental health consequences. Consequently, school mental health programs and approaches should be positioned with these other efforts as well as the ongoing and constant efforts of schools to provide good student discipline, appropriate, supportive relationships between students, staff and parents and moral, principled guidance to their students,
A considerable body of research evidence (including systematic reviews, replicated controlled trials) and professional experience has accumulated suggesting that multiple intervention programs developed and delivered as part of comprehensive approaches (linking MH to other issues, multi-level, multi-systems/agencies), coordinated agency, mental health professional and school programs and whole school strategies can have an impact on mental health as well as positive and negative aspects of mental health (e.g. attachment, resiliency, depression, suicide) as well affect or offset other health behaviours and conditions (e.g addiction, aggression, abuse, disability, chronic disease). These interventions can include:
- adjustments to the core operations of schools such as student/staff conduct policies, student evaluation, promotion/failing/retention procedures, student recognition programs, programs to support transitions into primary school, between primary and secondary school and onto further studies or the workforce
- policy interventions including school and youth policies of health authorities and social service agencies as well as school boards
- instructional interventions including improved curriculum design and content, effective MH promotion and prevention programs and materials, teaching methods, parent involvement in take home activities and peer instruction
- health, mental health, social and other services including early identification, screening, support for students in treatment or managing an illness, support for reintegration after treatment, brief counseling interventions and the roles played by several professionals and their employing agencies including school psychologists, social workers, pediatricians, public health nurses, police officers, guidance counsellors, classroom teachers and others
- a variety of social support programs including peer helper programs, student friendship programs, mentoring programs, parent involvement, education and support programs, school activities, participation in community awareness programs, working with self-help and community-based organizations, staff wellness programs and more
- changes to the physical environment of schools such as stress-reducing modifications to school grounds, attention to light, air ventilation, and more.
- preparing new and experienced teachers to address mental health issues through university-based teacher education programs and ongoing staff development
Further, it is recommended that:
- The Mental Health Commission of Canada (MHCC) , the Public Health Agency of Canada (PHAC), Health Canada (HC), Justice Canada (JC) and other relevant federal departments and knowledge/research agencies (such as the Canadian Population Health Initiative and CIHR Institutes) ensure that school mental health policies, programs and research are explicitly included and funded in their respective strategies and initiatives.
- Education, health, law enforcement and other ministries in the provinces and territories develop and implement inter-ministry policies, agreements, programs, guidelines and funding mechanisms to support and require inter-agency and inter-disciplinary cooperation to promote the mental health of young people through school-based and school-linked initiatives.
- Local school boards, health authorities, police departments and mental health agencies/professionals develop and maintain partnerships, programs and collaborative actions on mental health, integrating them within broader strategies on healthy schools, safe & caring schools or similar policy/action frameworks.
- Existing national and regional initiatives, networks, university centres and other organizations be brought together to develop a collaborative and coherent knowledge development, synthesis and exchange strategy. These existing mechanisms include the MHCC Knowledge Exchange Centre, the PHAC Canadian Best Practices Initiative, the CPHI Mental Health initiative, the MHCC Evergreen initiative on youth mental health, the national Community of Practice on School Mental Health, provincial/territorial centres of excellence in MH, annual conferences in the education, health and mental health sector and more. This KDE strategy should build on current PHAC and MHCC initiatives that are taking local programs to national scale in areas such as positive mental health and stigma. As well, the KDE strategy should make use of new web-based technologies to access expertise and experiences from other countries as well as facilitate ongoing exchanges across Canada.
The above statement on how schools, agencies, communities and governments can promote mental health includes four broad actions that can be taken at different levels in several systems. It is very important that implementation, capacity-building and program sustainability be considered as a primary step in any action planning. Further, it is suggested here that:
- programs should address the needs of the whole child over the life course. This includes attention being paid not only to the ends of the continuum (positive MH and mental illness) but also to the mid-range concerns and problems such as loneliness, stress, divorce, bereavement as well as the intersections with other health and social problems.
- programs should be based on relevant and proven behavioural theories and approaches such as social intelligence, attachment theory, health and normative beliefs and others
- programs should not only seek to prevent or reduce problems but also build strengths, resilience and assets
- the needs of specific populations (children of families living with a mental illness, FASD, special needs and others) as well as local community conditions (aboriginal, rural, multi-ethnic, religious and others) need to be addressed
- ministries, agencies and schools should strive towards multi-intervention programs delivered through comprehensive approaches (multi-issue, multi-level, multi-system), coordinated agency-school programs (on mental health or aspects of MH) and whole school (engaging educators only)
- interventions should be based on the highest possible research evidence and be tested and adapted through data-based experience and reflection
- evidence-based implementation models and theories about systems change should be used to plan program development, delivery and evaluation
- school-based and school-linked mental health programs must fit within the primary mandates of schools as well as be cognizant of their constraints, organizational cultures and professional norms/preoccupations
- baseline capacities such as minimum instructional time/learning objectives, maximum waiting times for delivery of assessment and treatment services, staffing ratios for school and clinical staff and other aspects need to be defined and them monitored
- system and organizational capacities such as coordinated policy, assignment of coordinators, formal and informal mechanisms for cooperation, ongoing knowledge exchange and workforce development, regular monitoring and reporting, strategic issue management and explicit sustainability planning need to be developed and monitored
- policy-makers, researchers, officials and advocates need to consider how school mental health programs fit with and within the large, complex systems and the ecology of local community/agency/school so that their plans and programs are more apt to be adopted, implemented and sustained.
