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Unified Mental Health Teams

By Tracy L. Jackson | October 2020

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Despite prevalent youth mental health concerns and teen suicide, there is hope for students when school districts play a large part in assisting school counselors with mental health issues, suicide prevention and education.

After a student suicide in Loudoun County Public Schools, a suburb of Washington, D.C., stakeholders cried out for more help. A willing school board listened and developed a plan to better meet student needs. With the support of our superintendent and under the direction of an assistant superintendent, we created a unified mental health team approach.

Aligned with multitiered systems of support (MTSS), these teams systematically deliver a range of interventions based on demonstrated levels of need to students in grades six through 12. To meet  all students’ needs, the district hired additional school counselors and assigned a full-time school social worker and school psychologist to each of the county’s 33 comprehensive middle and high schools. The district also implemented evidence-based programming and resources for all stakeholders to help students build better coping skills.

The Unified Model

Loudoun County Public Schools’ unified mental health teams are made up of school counselors, school social workers, school psychologists, school nurses, student assistance (drug and alcohol prevention) specialists, special education deans, administrators and school resource officers. Our school-based teams meet monthly to review data and discuss Tier 1 programming interventions. School-based teams may discuss Tier 2 and Tier 3 interventions within this meeting; however, separate meetings are encouraged. Schools are tasked with annual team training, creating a Tier 1 action plan and completing a self-assessment or inventory based on plan completion and implementation.

Our central office Mental Health Collaboration Team includes the supervisors of each of the areas and the supervising directors. This team meets monthly to discuss what is occurring at the schools, share outcomes of biannual site team visits, brainstorm solutions for any concerns that arise and plan professional development opportunities. An unexpected outcome has been enhanced collaboration efforts between school-based and central office mental health personnel.

How It Works

High school counseling directors serve as coordinators of the site-based teams – all teams are housed in the school counseling office. School counselors serve as a kind of general practitioner, referring students out to Tier 2 supports (small-group counseling, check-in/check-out, peer mentoring) or Tier 3 supports (individual counseling, restorative conferences, reentry support and wrap-around services) when needed. At the middle school level, school counselors share this duty with administrators, as they are divided into “houses” or “teams.”

Students with suicidal ideation are screened at each school by a member of the team. The results of the screening determine the level of supports needed. Students returning from a mental or physical health absence are placed into a re-entry protocol. This protocol ensures that parents and members of the unified mental health team provide extra care for the student during the transition back to school.

Tier 1 Supports

Our school counselors on the Tier 1 system planning teams provide classroom instruction and presentations to promote healthy social and emotional understanding and skills for all students. The school counseling program exposes students to bullying prevention, stress, anxiety and depression topics.

Other members of the Tier 1 system planning team provide presentations addressing depression awareness and suicide prevention to ninth graders at each high school, with booster sessions given to upperclassmen. The goals are to:
  • decrease suicide and suicide attempts by increasing student knowledge and adaptive attitudes about depression
  • encourage personal help-seeking and/or help-seeking on behalf of a friend
  • reduce the stigma of mental illness and acknowledge the importance of seeking help or treatment
  • engage parents and school staff as partners in prevention through “gatekeeper” education
  • encourage schools to develop community-based partnerships to support student mental health
We implement restorative practice in the form of circles to strengthen relationships between individuals. Many teachers have started to hold weekly circles in their classrooms to form social connections within their class and school community.

Our school division also uses two student programs that engage students as peer mentors. One program increases help-seeking behaviors and promoting connections among peers and caring adults. In the other program, specially trained and supervised peer helpers provide outreach services to students who need assistance with individual or school problems. The groups may focus on specific areas such as bullying, healthy relationships, crisis management, conflict resolution, substance use, mental health, suicide, special needs populations, child abuse and community outreach efforts. The helpers also act as liaisons between the school’s student body, teachers and administration and serve as positive role models.

Our schools have invented their own mental health and wellness fairs – all-day events run for and by students in the building. Students and student groups showcase their mental health awareness games and/or activities, ranging from walking on the track to shooting free throws, from mood rings to painting rocks for the school’s rock garden. While old favorites like yoga and bracelet making still draw big crowds, the students appreciate new and innovative ways to engage with positive mental health and wellness activities. The mental health collaboration team has also created a parent and community symposium that brings together public and private mental health providers, school-based personnel and other community.

Tier 2 and Tier 3 Supports

Our Tier 2 and Tier 3 planning and problem-solving teams are led by school social workers, school psychologists and student assistance specialists. At the Tier 2 level, these members of the Unified Mental Health Team ensure that students are using the small groups, progress reports, peer mentoring and peer tutoring programs. On the Tier 3 level, team members provide individual counseling, incentive charts and attendance and behavioral contracts.

Lessons Learned

One challenge we’ve experienced is working through changes in school leadership. New administrators and school counseling directors may require additional training or support from districtwide mental health collaboration teams. New school counselors, school social workers and school psychologists also need training in unified mental health team protocol –they are the school-based mental health professionals who really drive the teams.

It is also important to recall that everyone moves at a different pace. Each school has its own culture, and all administrators have their own leadership style. Some schools will progress faster and some will need more support. If your district does not follow MTSS, you will need to think about how a unified mental health team could fit into your existing model. The backing and support of your stakeholders and your school board are essential. Their support can move your initiative and program exponentially. Hiring additional staff and reducing school counselor ratios were key to our district’s vision for this team.

Finally, note that new initiatives may equate to more data collection. It comes with servicing students in this time of accountability and fiscal responsibility.

The biggest gains from our Unified Mental Health Teams include openness with students about mental health and wellness and awareness of the ways these teams support the ASCA National Model. Most students now know how to recognize signs of anxiety and depression in themselves and others. They are no longer afraid to seek help for themselves or let a trusted adult know a friend needs help. Mental health and wellness are becoming accepted terms in our students’ vocabulary as they become integrated into a lifestyle.

These teams have opened the door for greater conversation and dialogue among school-based mental health experts. A better understanding of disciplines and a shared understanding of roles have emerged. This is a professional shift and a huge benefit for our students, as we can accomplish more together. Remember, there are no finish lines in developing strong mental health and wellness habits. We should all work on positive mental health and model it for our students.

Tracy L. Jackson, Ph.D., is supervisor, school counseling services, for Loudoun County (Va.) Schools. She can be reached at