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School-based Mental Health Programs Proving Effective


Just as children across the country head back to school, new research shows that the growing number of school-based mental health programs are effective in helping students.

Most mental illness starts early in life, about 90 percent of people who develop a mental disorder showing warning signs during their teen years. An estimated 13 percent of youth under 18 have significant mental health problems.* Anxiety, depression, attention-deficit/hyperactivity disorder (ADHD), disruptive behavior disorders are among the more common disorders. If mental health problems go untreated, they can continue into adulthood and contribute to ongoing problems.

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Because most children spend much of their time at school, it offers an opportunity to reach many children with mental health-related prevention, resilience and early identification initiatives.

According to a recent review in Harvard Review of Psychiatry, the number of school-based mental health programs is increasing and so is the evidence that they are working, providing benefits both in short-term and the long-term.

The researchers, led by J. Michael Murphy, Ed.D., with Massachusetts General Hospital, looked at school-based mental health programs that have been implemented on a large scale and that measure specific mental health outcomes. The program they examined reached an estimated 27million students over the last decade. Research has linked these programs to such benefits as reducing anxiety, improving reading scores, reducing bullying at school, and lowering rates of substance abuse in young adulthood.

What do these programs look like?

The majority of the programs focus on all students but some target students at high risk of mental health problems. For most of the programs the content is provided to the students in specific daily or weekly sessions over a period of weeks or over the entire school year. For some of the programs the intervention is incorporated into the existing school curriculum and daily activities and support is ongoing.


Classroom teachers are trained to provide most of the programs. Two interventions looked at by the researchers were carried out by mental health professionals.

Program Examples

Positive Behavior Interventions and Supports (PBIS) — focuses on positive social culture and behavioral support for all students. PBIS is not a specific curriculum, but an approach that emphasizes the use of the most effective and most positive approach to address even severe problem behaviors.

FRIENDS – focuses on reducing anxiety and teaching skills for managing emotions and coping with stress among students, parents and teachers. It addresses six core topic areas, including identifying feelings, understanding one’s physical responses, learning to relax, linking thoughts and feelings, developing plans for coping and practicing emotion management.

Positive Action (PA) – focuses on self-management skills, social skills, character building and mental health. It has six primary units encouraging positive actions such as getting along with others and actions for improving oneself.

Promoting Alternative Thinking Strategies (PATHS) – focuses on self-control, emotional understanding, positive self-esteem, relationships and interpersonal problem-solving skills. The PATHS curriculum also seeks to reduce problem behaviors and it uses role playing and storytelling lesson activities.

Cognitive-Behavioral Intervention for Trauma in Schools (CBITS) – focuses on reducing trauma symptoms among at-risk primary school children (for example children exposed to violence or natural disasters). The intervention is provided by mental health professionals.

“The available research supports the long-held belief that such school-based programs continue to be one of the most promising types of preventive mental health interventions available for children,” the authors concluded.

APA’s School Mental Health Program: Typical or Troubled?®

The APA and its Foundation is also active in this space.

The Typical or Troubled?®® School Mental Health Education Program educates and encourages adults (such as parents, teachers and other school personnel) to notice the warning signs of mental health problems, to be prepared with intervention strategies, and to know where to refer teens for help in addressing these issues.

Typical or Troubled?®, developed by the American Psychiatric Association Foundation, is an evidence-based program that has been successfully working with school communities to improve student mental health through early recognition, intervention, and treatment. The program involves presenting an evidence based school curriculum that educates the school community to take three important steps: Notice. Talk. Act.

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Reference and Resources


AnxietyDissociative DisordersADHDBipolar DisordersIntellectual DisabilitySleep DisordersDepressionAutismPatients and FamiliesHoarding DisorderGender DysphoriaOCDPersonality DisordersEating DisordersSpecific Learning DisorderSomatic Symptom DisorderSchizophreniaPostpartum depressionAddictionPTSD


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  • Jeremy Searle

    "Most mental illness starts early in life, about 90 percent of people who develop a mental disorder showing warning signs during their teen years" Read this slowly


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