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Briefly describe MTSS and the process of integrating behavioral health support into an existing academic framework.
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Integrating Behavioral Health Support into an Existing Academic Framework: Assessment and Data Collection: Start with a comprehensive assessment of current academic and behavioral systems. Gather data on student performance and behavior to identify needs and gaps in support. Building a Collaborative Team: Form a multidisciplinary team including teachers, administrators, school psychologists, counselors, and behavioral specialists. This team will guide the integration process. Professional Development: Train staff on MTSS principles, behavioral health strategies, and the importance of integrating academic and behavioral supports. Developing the Tiered Support System: Tier 1: Incorporate universal behavioral health practices into the school culture. This can include [social-emotional learning (SEL)] curricula, positive behavior interventions and supports (PBIS), and school-wide expectations. Tier 2: Identify students needing additional support through data analysis and provide targeted interventions like small group counseling, peer mentoring, or behavioral contracts. Tier 3: Offer individualized and intensive behavioral health support. This may involve one-on-one counseling, wraparound services, or collaboration with external mental health providers. Data-Driven Decision Making: Use continuous progress monitoring and data analysis to evaluate the effectiveness of interventions at each tier. Adjust strategies based on student responses. Family and Community Engagement: Involve families and community resources in the support process. This can enhance the effectiveness of interventions and provide additional resources for students. Sustainability and Fidelity: Ensure that the integration of behavioral health support is sustainable over time. Regularly review and refine processes to maintain fidelity to the MTSS framework. By systematically incorporating behavioral health supports within an MTSS framework, schools can create a more comprehensive approach to student well-being, leading to improved academic and behavioral outcomes.
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School_Admin
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none
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Discuss the importance of integrating behavioral health into a tiered academic support framework.
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Behavioral health concerns can greatly impact a student’s ability to be successful in school and yet we continue to work in silos. Schools play a crucial role in the overall development of children and youth and are in a unique position to detect problems early, preventing more serious concerns later in life. School communities that interconnect academic and behavioral health focus on establishing healthy environments where everyone feels a sense of connection and belonging. Using a multi-tiered approach, content experts, families, work together on one team. They use data to determine that the majority are experiencing success. At the first sign of need, teams are prepared to increase support for students, staff and families. Unaddressed SEBMH issues represent barriers to student learning; when they are addressed effectively, students do better overall, including academically. Sometimes academic challenges can also precipitate or perpetuate student mental and behavioral health difficulties. By working together, academic and behavioral health teams can support a student more holistically. All domains are necessary to address simultaneously as they all contribute to whole human development-they are connected and cannot be separated
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School_Admin
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none
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Discuss the barriers to implement an integrated MTSS framework.
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Variability in programming across schools and districts, too many teams, failure to organize one team using core MTSS practices and focusing on SEBMH, limited school administrator buy-in and leadership for effective MTSS. Lack of investment from district and school leadership ; too many initiatives. Confusion about what MTSS is. Leadership not trained in behavioral health. Need to move from an individual focus to population focus (healthy environments with majority are health and teams making decisions together to prioritize care and align resources). Expert model with expectation that the behavioral health /mental health leaders will fix. The magnitude of need requires systemic changes in how the system is designed Set up the system that perpetuates academic health is somehow separate from health. Lack of effective teaming/leadership. Lack of skills and confidence in data interpretation. Staffing shortages, turnover. Expectations to work within the system, not in a position to change the system (one reason for turnover). “Coaches” become middle managers, don’t feel supported.
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School_Admin
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none
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What are the key concepts in implementing an effective integrated MTSS?
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Co-creating with all school community members and meaningful relationships are the foundation for any key concepts that various organizations define as essential for this work- teaming, data-informed decision making, etc. Effective teaming with commitment to MTSS at district and school levels. Investing enough time in the process to build effective systems for your school and district.
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School_Admin
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none
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We are just starting with MTSS. What are the core features of the framework. Where should we begin?
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Core features: Effective teams, using data, having formal processes for selecting evidenced based practices, using data to actively uncover strengths and needs, rigorous progress monitoring for fidelity and impact and coaching at the system and practice level. Getting Started: Start by talking with members of your school community. What is working, what is not? Look at data, what is going well, what is not going well. Ask students, families and educators if they feel a sense of connection and belonging, if they have a trusted person, if they feel like they have the skills they need to be successful. We have a tendency to do big sweeping initiatives and skip the basics. All roads lead to connection and belonging, so we start that work first...and we do this with community members. This is a team sport!! Conduct resource mapping. Find out what supports are already in place. What is missing? Ws needed? What are next steps? Develop leadership team if one does not already exist. Start with a self-assessment/readiness survey at district level (e.g. DSFI) and school level (e.g. TFI, SBHA Inventory, SAM) to identify strengths and needs at both district and school level. Survey staff parents and students to gauge school climate and engagement, create goals based on data analysis (note: it may be best to begin with 3 priorities and create a plan to reach these goals. Implementation is ongoing and fluid,
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School_Admin
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none
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I need family voice that represents our diverse school community. I have lots of input from a vocal but small minority of parents expressing concerns about integrating positive health and wellness (SEL) in our Tier 1 curriculum. I believe most families are in favor of this, but they are not as vocal. What can I do to get more diverse voices especially around positive health and wellness (SEL)?
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Make connections with families naturally! Talk with parents and families at school events (back to school events, roller skating night, events at local restaurants) and during pick school pick up. Ask teachers to nominate families to join committees and extend them invitations. Host information nights (in person and virtual) to answer questions families might have about participating. Consider a virtual participation option for families to accommodate those with young children, variable work schedules, etc. For in person meetings, create a welcoming environment with food and time to socialize. Get to know the school community. Be present at community events. Get to know parents/families at school and in the community. Work to build authentic events. Family voice can be included informally and formally. Ask parents (at the beginning of each year) how they want to be involved, use their input to create opportunities and follow-up!
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School_Admin
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none
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We have seen an uptick in students coming to the school counselors expressing issue related to anxiety and depression. We currently refer to a community-based clinic for support but the students are not making it to their appointments for various reasons. We would like to hire a clinician to work in the building. However, there is a group of parents in our district who are resistant to our school providing mental health services. Can you tell me why it is important to deliver mental health services in schools? How can we increase buy in from the parents in our district?
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It can be hard to detect issues like anxiety and depression in students. For young people, these issues can often manifest as irritability or physical complaints like headaches or stomachaches. It’s easy to mistake anxiety and depression for work avoidance or grouchiness. However, anxiety and depression are very real and very treatable. Even if anxiety and depression are not immediately obvious to us, they are standing in the way of our students learning. That’s why it’s important to address mental health in schools. Students can’t learn if they don’t feel psychologically safe. Be mindful also of the impact of screen time and social media use on students’ mental health. More and more studies are showing that anxiety and depression are on the rise for youth who spend a lot of time online. This can be a good place to start asking students and families questions about their daily lives and their emotions. Recognize that gaining buy-in from students and families for school mental health services may not happen right away. Having multiple conversations and meeting families where they are can go a long way. Some families may prefer to discuss mental health issues with people they trust (e.g., other family members, faith leaders, family doctors) before discussing further with the school. Talking with families in person is often the most effective way to communicate the value of mental health services in schools. Persuasive conversations are more likely to happen when the outreach is connected to school events and one-on-one meetings with teachers and staff and between parents/guardians. It’s helpful to be prepared to describe what the available services actually are, how they fit into the normal school day, how to access them, and how they connect to children’s well-being and success. Being thoughtful and compassionate when responding to hesitation from community members goes a long way. You can make a plan to ensure concerns are addressed and invite them to review and contribute to the plan over time. You can offer many opportunities to voice suggestions and concerns, verbally and in writing, and identify and connect community members willing to talk personally with those who have questions. When done well, expanded school mental health services, with clinicians from community mental health centers joining school employees for the work, barriers to student learning are reduced, and there is a large literature on a number of other benefits, including improved school climate, reduced teacher stress, and improved student SEBMH and academic functioning. Discuss the range of supports the school currently provides—academic, behavior...integrating positive health and wellness across the tiers facilaites prevention and early intervention for issues of anxiety, depression, etc....issues we all feel at times. Goal—normalizing the need for support.
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School_Admin
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none
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Why do schools struggle to integrate school behavioral health services into their MTSS
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Academic and SEBMH agendas treated separately, with separate teams and leadership, devaluing of SEBMH relative to academic performance, concern about learning loss related to the pandemic and over-prioritizing academic subjects. Schools and school leaders are often unfamiliar with the mental health system and its resources. There should be efforts to build relationships between leaders and staff of these systems to understand the many mutual benefits (e.g., significantly enhanced resources for schools, significantly improved accessibility and relevance of the mental health system). A critical part of this work is for there to be formal memoranda of agreement (MOAs) between the schools and the mental health system enabling mental health clinicians to be viewed as school employees and involved in all aspects of the MTSS, including team meetings, and some involvement in Tier 1 and Tier 2 programming. Optimally, these MOAs include some funding for clinicians to enable more than just Tier 3 involvement (e.g., to pay one day a week of their salary for full-time presence in the building). There can additionally be financial or billing-related barriers. Some behavioral health agencies have strict guidelines for their behavioral health providers to only provide billable services or have a high demand on billable hours, limiting the amount of time that providers spend doing non-billable services such as collaborating on MTSS teams or providing Tier 1/Tier 2 support. School communities often think of mental health supports as relating to DSM diagnoses only---thus refer to community partners---not a school issue Schools often don’t know where to start when addressing student behavior issues. Some schools also tend to be reactive when problem behaviors occur, rather than taking a preventative approach. Addressing behavior problems is not as straightforward as a reading or math issue, which can be daunting. When faced with student behavior problems, school staff and families may focus on what peers without behavior issues “should” be doing (e.g., attending school regularly, completing work and turning it in on time, etc.). Instead, we may need to back up and meet a student where they are and slowly work towards what is expected of typically performing peers.
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School_Admin
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none
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Can you share with me, in a simple way, what RTI (Response to Intervention) is? How is it different than MTSS?
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RTI and MTSS represent very similar processes. RTI was developed primarily on academic interventions, MTSS is broader and emphasizes academic and SEBMH programming. RTI was developed in response to static test and re-test models, versus continuously assessing student functioning and fluidly adjusting programming related to data on students’ response to it.
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School_Admin
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none
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What type of data should I be pulling to inform our MTSS? Where can I find that data?
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There are many relevant data sources, including annual assessments of school climate being collected in almost all school districts, and academic record variables including student attendance, grades and discipline encounters. Ideally, these data are augmented with systematic screening for student SEBMH issues, with all sources of data reviewed in the lead team for SEBMH meeting, with these data facilitating progress monitoring (and the appropriate adjustment of prevention, early intervention and intervention strategies) and outcome monitoring to determine if programs are actually leading to improved student outcomes. That’s a great question. I might start by mapping all the data resources in my school, including what data is collected, how it is stored, and who can access it. Student outcomes that are usually identified as most important to monitor schoolwide include attendance, grades and test scores, office discipline referrals and actions, and more and more school climate surveys. These are good starting points because most schools have this data in a central system already. In South Carolina, that’s typically PowerSchool. PowerSchool has the capacity to track MTSS intervention data, too. Some features to look for are customizable and standardized cut points and disaggregation capabilities (e.g., by Grade, by classroom, by level of concern, and by any population you are monitoring concerning equity). I-Ready is a popular computer diagnostic and adaptive instructional intervention software for reading and math that can produce reports. Screening data may be in a separate data system or integrated. There are many more that may be in use at your school. You may also be able to access reports on child welfare visits, hospital and crisis center visits, and other community health service data through a Data Sharing Agreement (DSA) that specifies the terms of use in accordance with organizational, state, and federal regulations.
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School_Admin
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none
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We do not have a significant amount of funding in our district and we need a data management system. Can you share with me what data management systems are available as well as how to create one if we cant afford existing systems?
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Most schools use a systematic data system to track student progress (e.g., PowerSchool), which will include data on student academic progress, attendance and discipline issues. These data should be augmented with screening data, and progress monitoring/outcome data using a range of measures that have strong psychometric qualities, and are free, in the public domain. Ideally, there is standardization of data collected and data collection procedures across schools within a district, and ideally across districts within a state. Districts and schools will need to build data management and evaluation infrastructure and there are many relevant examples through the national Center on Positive Behavioral Interventions & Supports (PBIS, see www.pbis.org ).
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School_Admin
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none
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We have a ton of data on our students, but we don’t know how to analyze it to support our MTSS. What patterns and trends should we be looking for?
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Data can be segmented by tiers, including tracking all programming at Tier 1, Tier 2, and Tier 3, and assuring there are data specialists evaluating these data at each tier (for progress monitoring and student impacts) and these data and data specialists are also used in the lead team meeting for SEBMH to assure the effectiveness of programming. Data can also be segmented by grade level, involving grade level teams looking at all available relevant data, and adjusting programming based on these data.
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School_Admin
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none
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We already use MTSS for academic support for our students. We are trying to add mental health as a function of the MTSS. What steps do we take to get this started?
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Start with a thorough review of Tier 1 practices which should include all core functions of the MTSS, e.g., team functioning, data-based decision making, implementation of evidence-based practices, aligning practices across tiers, assuring adequate coaching supports, emphasizing cultural responsiveness and equity, and other. Evaluate potential programs that support positive student mental health functioning at each tear, empower the lead team for SEBMH, and with district support and from relevant resources (e.g., Center on PBIS, www.pbis.orgNational Center on School Mental Health, www.schoolmentalhealth.org; Southeastern School Behavioral Health Community, www.schoolbehavioralhealth.org), choose programs from the public domain to support student mental health. Begin with Tier 1 installation and then rapidly move to Tier 2 and Tier 3 intervention selection, purposefully attending to the alignment of these programs across tiers.
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School_Admin
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none
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What is the best way to collect mental health data on our students? What types of data should we be looking at?
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It is best to start with natural data sources that school communities are already collecting. Stay focused on trends and patterns at the population level. Look at attendance patterns, academic health, office referral rates, survey data that provides information related to sense of connection and belonging. It is also important to look at data beyond the school environment. What do we know about the lives outside of school that may directly impact student success? Look for % of families with stable food, housing and transportation, calls to crisis centers, rates of unemployment, military deployment. It is also helpful to look for areas of strengths like access to green spaces and connection to faith-based centers. Libraries, art and culture for children, youth, and families; athletics/leisure; special interest groups
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School_Admin
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none
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How do we know if a student needs Tier 2 services or Tier 3 services?
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Any changes in MTSS services are up to the MTSS team to decide. It should be noted that behavior changes tend to happen more slowly and incrementally than academic changes. We want to implement minimally sufficient interventions; that is, we want to give enough support to our students but not too much to address their current problem. So we would usually attempt Tier 2 interventions before moving to Tier 3. Exceptions to this would include students with severe behavior problems requiring immediate, intensive intervention. Examples include, but are not limited to, being a danger to self or others, leaving the school building, or using drugs at school.
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School_Admin
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none
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We have a team in our school that looks at Tier 2 and Tier 3 supports. Multiple teachers have reported that they have identified students with social skills challenges that are negatively impacting the classroom environment. What next steps should we take?
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At your next MTSS team meeting, look for patterns in the data together. Are there particular students that multiple teachers are concerned about? Are there a few teachers who are reporting most of the concerns? Are there patterns according to environment or time of day? Is there an uptick in school-wide problem behaviors before and after school breaks? Once you have a better understanding of what is happening in your school, you can begin to address the behavior. Depending on your data, you may need to go back to your Tier 1 services and shore up those interventions. From there, behaviors in need of further support can be addressed.
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School_Admin
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none
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What are the types of student mental health needs that indicate Tier 2 support would be a sufficient resource? What kinds of services should they receive? Where and when do they receive them? Who can provide them?
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Some mental health needs that can be addressed with Tier 2 supports are mild to moderate mood disorders like depression and anxiety, as well as ADHD and difficulty with social skills. School-based services can include small group counseling, social skills groups, check in/check out, and evidence based interventions designed for specific issues (like anxiety or depression). Skill building can also occur in vivo in the classroom or other school environments. For example, students with difficulty making friends may receive coaching at recess on how to initiate play with peers. Small groups can be seen at school during the instructional day. Depending on the availability of staff and families, groups can also be arranged before and after school. Tier 2 providers can include counselors, social workers, psychologists, and school-based community mental health providers. Teachers and other staff may be trained to assist students in natural environments where they are practicing skills, as in our recess example above.
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School_Admin
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none
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I am an administrator on an MTSS team. The team members are sharing that they feel overwhelmed with balancing their roles on the MTSS Team and their responsibilities in the building. What can I do to support reducing this stress?
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Start with a clear understanding of “what is overwhelming.” Then focus on strategies that may include-Defining roles and clear expectations of all team members—not just a few. Coordinating. Limiting meetings. Making meetings productive. Have an agenda for each meeting to stay focused and productive. In meetings, clearly define who is responsible for each task. Follow up on these tasks at the next meeting to keep team members accountable and make sure students are getting consistent, timely support. Appoint a team member to lead the agenda and take notes. Share notes with the team so team members can refer back to them and any tasks they are assigned.
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School_Admin
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none
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What types of Tier 1 programs and initiatives support Mental Health. What do we need to do to get parents and youth involved in these efforts?
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Mental health literacy programs, school-wide guidance lessons, character education, community building in classrooms, school-wide behavior incentives, restorative circles. To involve parents, provide options for participation with multiple modalities and varying degrees of engagement (in-person, virtual, surveys, focus groups, etc.). Specifically invite parents and caregivers who have not historically been involved. Start by building community with families and youth around fun events (such as fundraiser nights at local restaurants, skating rinks, etc.).
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School_Admin
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none
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When a school is beginning to use their MTSS to integrate mental health supports what tools can they use for progress monitoring for each tier, fidelity, and overall implementation?
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Meet with your MTSS team to review implementation and fidelity at each tier. Review each intervention (including numbers of students served in each Tier 2 and Tier 3 intervention). Also examine school-wide behavior data, including attendance rates, office discipline referrals, in school and out of school suspensions, and recommendations for expulsion. School-wide fidelity tools, like the SAM or DSFI, can also help organize your school's MTSS performance by domains.
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School_Admin
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none
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Our teachers are busy but we need classroom level data. What other strategies can we use to get classroom level data that don’t add more to the teachers?
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Think of the data you already have. Do teachers use ClassDojo or similar software to track classwide behavior? Your school should also have attendance and discipline referral data readily available. You can break down this data by class and grade level and look for trends. Defining the need for the data and how the data will be used to enhance classroom efforts and overall school climate.
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School_Admin
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none
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How do we get our MTSS team members to meet regularly?
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This starts with school leaders setting clear expectations around regular MTSS meetings and attendance by team members. At the beginning of the school year, the team should meet and agree on a standing meeting time that does not conflict with other commitments (drop off/dismissal, faculty meetings, grade level meetings, etc.). Efficiency also helps here! Having an agenda and sticking to it makes your time together more effective and can make meetings shorter. Leaders need to be invested and MTSS needs to be linked to the strategic planning/school improvement process Meetings are more likley to happen when they have meaning and are meaningful.
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School_Admin
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none
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How do we follow up on all our students so no one falls through the cracks?
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Taking good notes, assigning specific tasks to specific people, and following up regularly! Having an MTSS team leader to track students and follow up with team members on tasks is helpful here. All about data (qualitative and quantitative)
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School_Admin
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none
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Are there evidence based protocols that exist in the schools to support referral for mental health services as both tier 2 and tier 3? if so can you please describe as well as share links for exemplars?
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Referrals to mental health should be the exception, not the rule...referral by definition means to transfer responsibility to another person and that perpetuates the expert model (magic fairy dust approach) When we add community employed experts, build capacity of everyone in the system and focus on creating healthy environments we set up a system that enables this to occur. What if we used request for assistance instead of “referral” and we not only increased support for students, but we also increased support for staff and families. The trick is that we make the request for assistance process easy, clear and we provide quick response time.
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MTSS_Coach
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none
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Why do schools struggle with creating functional MTSS teams?
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There has to be an investment in prevention at the district community level. Union, board and leaders across disciplines need to have a clear understanding of what it is and what it takes to develop .
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MTSS_Coach
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none
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Give examples of functional, effective MTSS teams and how they balance their responsibilities.
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I am working with a school district who has multiple MTSS teams that do not communicate. What are some strategies I can use to help them? Leadership at the district and school level needs to be involved with agreement about how MTSS is useful. There needs to be a leadership team that includes people who can make decisions around consolidating teams, data, changing policy, job descriptions, professional development and coaching support. They need to see the value in using MTSS to achieve their goals.
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MTSS_Coach
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none
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Suggest and help define an MTSS coordinator role.
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A coordinator can start the communication and collaboration process, then develop it with feedback from implementers.
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MTSS_Coach
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none
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My district would like to include youth voice on their MTSS Teams. How can they go about identifying students for this role and what are appropriate expectations of them?
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Make diversity the rule—get input from a range of students that represent the school community. Formal and informal avenues work.
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MTSS_Coach
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none
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How can I simply explain fidelity and implementation measures to a district who is just beginning to develop their MTSS?
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Implementation inventories are just that, inventories! You take stock of where you are and make short- and long-term plans based on what you learn from doing them. Fidelity and implementation inventories are created by researchers who have identified what they think are all the most important elements of a functioning MTSS. There is always room for growth, and updates are made over time, but overall you can count on the latest inventory to help you consider all the ways to make sure your MTSS functions efficiently and effectively, making your lives easier and leading to better outcomes! Completing an inventory is also a great way to keep a written historical record for your school as staff move in and out of the district and you learn what works best to optimize your system. Think of fidelity as a way to measure the implementation process. Your programmatic efforts will shape/direct how to monitor fidelity.
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MTSS_Coach
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none
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What is MTSS, PBIS, ISF, RTI? All these acronyms are floating around. I need succinct answers. My next meeting is in 15 minutes.
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Ok let’s look at your question from a high level and then I will share brief specifics about each. MTSS, PBIS, ISF, and RTI are all frameworks and approaches to meeting the diverse needs of the student population in your school or district. All of these function to organize resources-the adults, programs, and practices- needed to meet the social, emotional, behavioral, and academic needs of the students. They all share similar foundations but have unique scopes of practice and outcome targets. The features true to each model are teaming, a tiered delivery system, evidence-based practices, data-informed decision-making, screening, and progress monitoring. Multi-tiered System of Supports (MTSS) is a broader framework that illustrates the core features of this organizational process, serving as a key resource to facilitate integration, cohesion, and efficiency of all practices that enhance academic, behavioral, and social-emotional support. Positive Behavior Intervention and Supports (PBIS) is a proactive approach that works to positively impact all students by improving the school climate through strategies that define, teach, and support appropriate student behaviors. Interconnected Systems of Framework (ISF) offers a roadmap that supports the integration of mental health services into the school setting through collaboration between school and community mental health professionals throughout the tiered delivery system. Response to Intervention (RTI) is a process to help schools focus on high-quality interventions that are matched to academic and behavioral student needs and monitored frequently. Your school or district may have elements all, some, or Pending Privacy Clearance of these systems in place, but the good news is, given your question it sounds like they are beginning the process of building or enhancing these structures. After your meeting, it may be helpful to review the “Core MTSS” course from the SBHA LMS.
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Clinical_Staff
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none
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I am new to my district and have been invited to join an MTSS team. I am not clear on what they mean when they say I am an MTSS Team member. What is expected of me on this team?
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So MTSS teams are made up of leaders in the district who have the responsibility of creating and managing the practices and procedures that support students. Essentially this group of adults looks at the “who”, “what”, and “how” of the game plan to support all students (universal/Tier 1), some students (targeted/Tier2), and individual students (Intensive/Tier 3) for the district. At the district level, you will be sharing this responsibility with district administrators, lead educators, community representatives, MTSS coach, and other professionals with a vested interest in promoting the academic, behavioral, and health outcomes of students. At the most foundational level, you would be expected to be an active member of the team by attending scheduled meetings, coming prepared to those meetings, and completing assigned action items that result from MTSS meetings. Working with the assumption that you are the individual who is representing the provision of mental health services for the district you would be engaging with the core features of MTSS through your professional lens- providing feedback on evidence-based practices and programs that can be deployed at each tier to enhance mental health and well-being of students (and staff), supporting the collection, analysis, and reporting of mental health data, and supporting the progress monitoring of mental health interventions at each tier. You can think of yourself as both a mental health provider and consultant in this role. An effective way to understand expectations as a new team member would be to ask your other team members directly. You can always reach out to an MTSS Coach through the SBHA as well!
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Clinical_Staff
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none
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I work in a large school district. It seems like every student who has an issue, behavior, emotion, and/or mental health is immediately referred to me. I can’t keep up. What can I do to inform a more preventative approach in my school?
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When the majority of students seem like they have a concern, chances are they aren’t learning or living in a healthy environment, so it is important to focus on Tier 1 and have a team that can quickly triage students who may be in crisis and connect to intensive supports.
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Clinical_Staff
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none
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My school does not use a universal screening system. What screeners can I recommend for use that capture internalizing and externalizing behavior? Can you give me a list of all available screening tools and a description of each.
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Installing a screener is much more than providing a list to choose from. It requires having systems in place across tiers of support with teams who can quickly connect students with elevated risk to be connected to someone who can provide a diagnostic assessment and provide more support.
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Clinical_Staff
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none
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Discuss the most prominent universal social emotional behavioral health screeners used by school districts. Compare and contrast.
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Believe it or not there are hundreds of empirically studied screeners out there! For routine practice, there are a handful that stand out based on research in schools. Some of these cost money to use, some are free, and some only cost if you need a full data system to conduct screening. Most schools are so big that they do need a data system to quickly tabulate and communicate information to users. The Student Risk Screening Scale – Internalizing and Externalizing (SRSS-IE) can be freely accessed, as can the SAEBRS Social, Academic, and Emotional Behavior Risk Screener (SAEBRS) and Strength and Difficulties Questionnaire (SDQ) paper versions. The electronic versions have a cost. The Behavior Assessment System for Children (BASC) and Behavior Intervention Monitoring Assessment System (BIMAS) are also commonly used screeners with a cost. The Early Identification System (IES) is available to some predominately rural states for free and includes links to evidence-based intervention matched to student needs. These systems often have a demonstration site or coordinator that can show you what the product actually looks like, how it functions, and any associated training and support needs.
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Clinical_Staff
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none
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Can you describe what PCOMs is and how clinicians use it in schools?
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Sure! I would describe PCOMS as a student-centered approach to therapy. The PCOMS system gives clinicians access to common measures of student well-being and a session rating scale, which lets a student indicate if they are finding the therapy experience supportive each time they meet. The student completes the surveys and then the clinician and student discuss them together to make sure they agree on therapy goals, that treatment is effective, that progress is made, and that the student has independence in directing their own life. Clinicians can use this information to build and maintain a therapeutic relationship and make clinical decisions such as treatment adjustments. PCOMS can be used regardless of diagnosis.
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Clinical_Staff
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none
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Please give examples of effective Tier 1 mental health strategies for schools experiencing community trauma (insert examples of community trauma)
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There are several ways to universally promote mental health in schools experiencing community trauma. Teachers and staff can foster supportive relationships first and foremost. Good relationships help students manage difficult emotions. Teachers and staff can greet, smile at, and call students by name. They can listen to them, call attention to their strengths, and offer students choices around school activities and routines. Routines help establish safety by creating classroom environments that are predictable. These routines can include time for movement and developmentally appropriate mental health promoting activities such as mindfulness, art, music, and time in nature. Older students may benefit from being given the opportunity to spend time on meaning-making activities such as community service, writing, and activism. Most of these activities can be embedded in the school’s academic curricula and support the development and activation of personal strengths, social skills, and coping skills. Schools must also resist re-traumatization. Discipline policies and procedures should be restorative, not punitive. School mental health clinicians can offer suggestions about what might be best depending on the nature of the trauma and SAMHSA’s guiding principles for being trauma informed.
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Clinical_Staff
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none
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My services fall into tier 2 and 3 of our MTSS. I am wondering how I can be more involved at Tier 1.
|
MTSS teams are ideally set up to maximize everyone’s skills and talents. It’s likely that your specialized skillset inclines team members to think of you at advanced levels of support, but you also have a great deal to offer at Tier 1. You can ask to be included in Tier 1 meetings, especially for planning and implementation support for Tier 1 practices and curricula. Based on the concerns you are seeing among students receiving Tier 2 and Tier 3 services and your knowledge of Tier 1 mental health supports, you can make professional suggestions on which are likely to be most effective. As teachers and staff implement, you can serve as a go-to support person. Your role will have to allow for meeting and consultation time, so you might need to negotiate that with your supervisor and team. It might also require shifting some responsibility or a change in funding structure. Don’t give up if there are a few hoops to jump though first! It might be helpful to connect with someone who has done this in another school or district.
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Clinical_Staff
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none
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List the responsibilities of an LPC, LMSW, LMFT within a school building integrated MTSS framework.
|
As a mental health provider you will have impact across all tiers of support, MTSS implemenation for School behavioral health, and teamining. You will provide mental health support at Tier 3 to indiviudla clients and families, you will provide small group support at tier 2. For teamining you will act as a consultant and collaborator playing an active role in MTSS team meetings, providing data and insight for the students/families under your care, and support the development of universal strategies for mental health promotion and wellness at tier 1. You wull lead, or a minimum, be included in crisis response planning and teaming, support conducting assessments and safety planning, and connecting to community based resources (think case managment). You may also lead professional develpment for mental health associated content, vulnerable population, and refferral processes.
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Clinical_Staff
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none
|
I am worried that my district’s protocol for suicide prevention is not good. Can you tell me what things should be in the suicide protocol and who should be involved? Can you also provide me examples of safe protocols?
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Prevention protocols should include screening and assessment of suicide risk, safety planning, clear guidelines for what to do at each desingated level of risk, parental notification guidelines, resources to share with parents to aid in their ability to create safety. The protocol should reduce vicarious trauma and reactivity, while increasing protective faccors and safety. The protocol should also include key personnel involved (i.e. crisis response team lead and contact information and subsequent team members). Roles should be clearly identified an start with asking about suicide (whole school staff), and then what to do after a student responds yes- a flow chart is great for this effort as it simplifies the process into a visual framework. AFSP and SAMHSA offer great examples for best practices.
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Clinical_Staff
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none
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List and describe evidenced based strategies for de-escalation in a classroom setting.
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First and foremoste, ensure immediate safety first, get support from an admin or sro if need be. Remain calm and regulate yourself first, be mindful of "how" you are communicating use open and supportive body language and a calm, slow paced tone, breathe. Offer space, standing too closely can feel like escalation- you may even offer to change the environment, especially if other students are around. Act with empathy (even if it is challenging in he moment), validate and reflect the feelings you are aware of. Dont over complicate the conversaton, your focus is on getting the student back to baseline and navigating the moment- use simple neutral language that is focused on bringing the student out of the reactive mindset. You can offer choises so the student has a sense of agency- would you like to take a short walk with me or go take some time to talk with your school counselor. You can engage clinical coping tools like breathing and grounding techniques. If the associated behavior is violent or aggressive, you must follow your schools protocol, it is best to review these processes prior to the situationns arising.
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Clinical_Staff
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none
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My district recently experienced a death by suicide of a student. This is impacting the students, teachers, and the staff. What resources are available? What is my role?
|
The National Association of School Psychologists has resources for children experiencing grief at https://www.nasponline.org/resources-and-publications/resources-and-podcasts/school-safety-and-crisis/mental-health-resources/addressing-grief. On that page, you will also find links to assist teachers, administrators, and caregivers.
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Clinical_Staff
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none
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When is the best time for me to pull students for their sessions? Are there other ways that I can monitor them in between sessions?
|
The best way to make sure students receive their intervention time is to build dedicated time for interventions in the school master schedule. If this is not currently available in your school or district, try to avoid pulling the student during a fun activity or preferred subject, or during a test. If you can accommodate the request, ask the student when they might prefer to work with you. Also ask teacher(s) in advance about upcoming tests or events that might change the schedule. In between sessions, create a quick way to get information from families and teachers on the student's progress. An electronic form with a few questions is easy to email to parents and teachers. If you are asking for progress updates on a regular basis, a calendar reminder along with an electronic form can prompt parents and teachers to complete the form. Keep the form brief and to the point.
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Clinical_Staff
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none
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My school is asking for me to share data on the students I see for Tier 3 services. I am not sure how to remain compliant with HIPPA and FERPA while also providing the MTSS team what they need for progress monitoring and information to support program identification at Tier 1 and Tier 2, can you advise.
|
You are correct in prioritizing confidentiality and student privacy. However, you can still share this necessary data so long as it is deidentified. You can speak at an aggregate level about the trends you are seeing in the population you serve- whether they are associated demographic characteristics or common themes in session (bullying etc.). You can also share skills and practices that support protective factors. You can also have end of session surveys where you ask your student clients for feedback on both the session and the school climate.
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Clinical_Staff
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none
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I want to start a peer support program in my district. I am not sure where to start or how to communicate the need to other MTSS team members. What programs do you recommend and what things should I consider before and during implementation.
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Pending Privacy Clearance
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Clinical_Staff
|
none
|
I am a mental health provider interested in working within the school district. Please provide a list of professional development options so that I may become more familiar with mental health practices within the schools.
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Pending Privacy Clearance
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Clinical_Staff
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none
|
I am a school social worker. What are some ways I can assist educators with Tier 1 interventions and implementation?
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If you are not a part of the MTSS team already, speak with your school's leadership about becoming part of the team. If you serve more than one school, ask to join virtually if you are off-site on MTSS meeting days. Ask your school leadership how you can support Tier 1 interventions. Also reach out to teachers to ask what support they need with Tier 1 implementation.
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Clinical_Staff
|
none
|
What are some non-profit organizations near me? (for social worker to partner with for donations for backpack program, clothing, etc. for students and families in need)
|
hmm I would need to know where you are located but there is national support available like Volunteers of America's Operation backpack, The Salvation army also participates in a backpack program, as does Feeding America and the Kids in Need Foundation. Cradles to crayons can provide essential items for youth up to age 12. Teacher can connect to adoptaclassroom.org to get donations for their setting.
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Clinical_Staff
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none
|
I am a school counselor in a small school in rural area. The teachers in my school are really overwhelmed with behaviors that they are experiencing in the classroom. Students are acting out, being rude to each other and the teachers, and not listening. How can I help support the teachers and the students? Generally, most teachers have not been given proper training to support behavioral concerns in the classroom, but the good news is that we know what to do and have the research to prove what to focus on. We start by talking with our students about their experience and what they would like to see change and co-design approaches together. One of the most impactful things we can do is to make sure that everyone feels a sense of connection and belonging and that includes staff. Small things like welcoming students each day and learning their name and something personal about them, setting the stage for a nurturing environment.
|
Generally, most teachers have not been given proper training to support behavioral concerns in the classroom, but the good news is that we know what to do and have the research to prove what to focus on. We start by talking with our students about their experience and what they would like to see change and co-design approaches together. One of the most impactful things we can do is to make sure that everyone feels a sense of connection and belonging and that includes staff. Small things like welcoming students each day and learning their name and something personal about them, setting the stage for a nurturing environment.
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School_Counselor
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none
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I have a student who is experiencing significant issues in the home, they are already receiving Tier 3 services from our contracted mental health professional. I want to support the student, what can I do?
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Talk with the mental health professional about stratgies you can implement in the classroom or school environment to support the student. These might include taking a break in the classroom or offering more teacher support during non-preferred tasks or those the student perceives to be difficult.
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School_Counselor
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none
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I am a school counselor and have been asked to provide student level data on the kids in our building for our next MTSS meeting. What type of data are they looking for?
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Pending Privacy Clearance
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School_Counselor
|
none
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Discuss the role of a school counselor within the integrated MTSS framework.
|
Pending Privacy Clearance
|
School_Counselor
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none
|
What are the best practices for integrating mental health supports into each tier of the MTSS framework?
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Pending Privacy Clearance
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School_Psychologist
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none
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How can we ensure that mental health interventions are evidence-based and aligned with academic goals within the MTSS framework?
|
Pending Privacy Clearance
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School_Psychologist
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none
|
What screening tools or assessments should we use to identify students who may need mental health support within the MTSS framework?
|
Pending Privacy Clearance
|
School_Psychologist
|
none
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How can we effectively collaborate with school counselors, social workers, and other mental health professionals to provide comprehensive support within the MTSS framework?
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Pending Privacy Clearance
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School_Psychologist
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none
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What can I do to support the mental health of students that come into my office?
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Pending Privacy Clearance
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School_Nurse
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none
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I am seeing many students coming in with symptoms that are somatic in nature. How do report this to my school and what are the next steps that should be taken?
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Pending Privacy Clearance
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School_Nurse
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none
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I know so much about kids at this school, but no one asks about their health status—mental or physical. How do I get added to these school teams to share what I know?
|
I’m so glad you want to join the MTSS team, school nurses are often champions of student
health, including mental health. School nursing standards of practice include leadership,
community/public health, care coordination, and high-quality care. Educators might not
know how familiar you are with the MTSS model already! Introduce yourself to the MTSS
team leadership and let them know you would like to attend a meeting. Be sure to connect
what you know about student health needs and academic success to the conversation.
Reach out to your principal. Explain your interest in supporting the MTSS efforts at the
school. Meet with MTSS coordinator to discuss your interests.
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School_Nurse
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none
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What is my role in the MTSS, how can I best support the team as a school nurse?
|
Your exact responsibilities will be developed together with the MTSS team and should
follow local and national policy on parental consent and health plan sharing. You can help
identify the data needed to make decisions and monitor student progress across all tiers of
support. You may deliver brief mental health interventions with training and support and/or
serve on an individual student support team. School nurses are often trained in motivational interviewing and can help students create their own individual mental health plans.
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School_Nurse
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none
|
How can the school nursing staff collaborate with other members of the MTSS team to address students' mental health needs effectively?
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Pending Privacy Clearance
|
School_Nurse
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none
|
I saw a student in my office today who has clearly not showered in some time and seems to be wearing the same clothes for multiple days in a row. Is this an issue I should share during an MTSS team meeting? I am hoping to get her some additional help. Is it even ok for me to share this information because it is about a specific student?
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Pending Privacy Clearance
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School_Nurse
|
none
|
I am seeing a lot of students that seem very depressed. What training can I get to better understand how to help? Are there other staff at my school who should receive this training? Where would it be situated in the MTSS?
|
Pending Privacy Clearance
|
School_Nurse
|
none
|
What role can school nurses play in identifying students who may be struggling with mental health issues within the MTSS framework?
|
Pending Privacy Clearance
|
School_Nurse
|
none
|
How can school nurses provide mental health education and resources to students, families, and staff as part of the MTSS framework?
|
Pending Privacy Clearance
|
School_Nurse
|
none
|
What strategies can school nurses use to promote mental wellness and resilience among students within the MTSS framework?
|
Pending Privacy Clearance
|
School_Nurse
|
none
|
How can school nurses ensure that students' mental health needs are addressed with their physical health needs within the MTSS framework?
|
Pending Privacy Clearance
|
School_Nurse
|
none
|
What resources and supports are available to help school nurses connect students and families with community mental health services as part of the MTSS framework?
|
Pending Privacy Clearance
|
School_Nurse
|
none
|
How can school nurses contribute to the data collection and analysis process to inform decision-making related to mental health interventions within the MTSS framework?
|
Pending Privacy Clearance
|
School_Nurse
|
none
|
What protocols and procedures should school nurses follow to ensure confidentiality and privacy when addressing students' mental health needs within the MTSS framework?
|
Pending Privacy Clearance
|
School_Nurse
|
none
|
How can school nurses advocate for the importance of integrating mental health into the overall school wellness program and MTSS framework?
|
Pending Privacy Clearance
|
School_Nurse
|
none
|
I’m worried about a student who comes to the health room often. How do I know if the teacher/counselor/social worker/psychologist has already reached out to the family?
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Pending Privacy Clearance
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School_Nurse
|
none
|
What is MTSS, and how does it differ from our current practices?
|
MTSS is an approach adopted from the public health prevention framework that helps us identify the continuum of whole human needs (cognitive, social emotional, behavioral) , organize our resources by what we will do for All, Some, and a Few. This supports organizations to be more efficient with resources and supports. Data-informed decision making is used to design and progress monitor the approach, making organizations more effective.
|
Teacher
|
none
|
How will the integration of mental and behavioral health practices into MTSS impact our existing systems and routines?
|
It will allow us to break down silos among teams and integrate and align supports and data-informed decision making routines. Through implementation, organizations can identify what they will stop doing (de-implement ineffective practices) and any gaps in what they are doing (continuum of supports). It should improve efficiency and effectiveness.
|
Teacher
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none
|
What training will be provided to educators to ensure they are equipped to implement the MTSS framework effectively?
|
Professional learning efforts should be organized within a MTSS as well. What will all staff be engaged with (e.g., skill of the month to support classrooms), some staff (e.g., small group struggling with routines to support transitions during the day) , and a few staff (one to one coaching). Data can be used to design on-going professional learning opportunities. The organization of teams should focus on how to design bi-directional communication and learning to support implementation with fidelity. The SBHA LMS is a great professional development resource. Your SBHA district coach can help your school/school district strategize the use the LMS resources.
|
Teacher
|
none
|
How will educators learn about evidence-based mental and behavioral health practices and interventions?
|
Professional learning efforts should be organized within a MTSS as well. What will all staff be engaged with (e.g., skill of the month to support classrooms), some staff (e.g., small group struggling with routines to support transitions during the day) , and a few staff (one to one coaching). Data can be used to design on-going professional learning opportunities (e.g., all staff identify a need to learn about the impacts of trauma on teaching and learning). The organization of teams should focus on how to design bi-directional communication and learning to support implementation with fidelity.
|
Teacher
|
none
|
What is the role of educators in addressing students' mental and behavioral health needs within the MTSS framework?
|
All staff in education systems have a role in addressing students’ mental and behavioral health needs within the MTSS framework. For example, classroom teachers use evidence-based practices to establish positive, predictable environments which are part of an approach to support social emotional, mental, and behavioral health needs.
|
Teacher
|
none
|
How will educators collaborate with other school staff, such as school counselors, psychologists, and nurses, to support students' mental and behavioral health?
|
The role of clinicians might shift with an interconnected system of support. Clinicians may provide more indirect support, in addition to direct support. This may include being part of teams across tiers, including tier 1 to enhance the preventative and protective nature of tier 1 for all students. It may mean co-teaching between educators and clinicians to provide modeling of non-clinical approaches to supporting students –e.g., explicit instruction to develop social emotional skills.
|
Teacher
|
none
|
What resources, including staffing, time, and funding, will be allocated to support the implementation of MTSS with a focus on mental and behavioral health?
|
Pending Privacy Clearance
|
Teacher
|
none
|
How will we ensure equitable access to mental and behavioral health supports for all students, regardless of their individual needs or backgrounds?
|
Pending Privacy Clearance
|
Teacher
|
none
|
What data will be collected to monitor the effectiveness of mental and behavioral health interventions within the MTSS framework?
|
Pending Privacy Clearance
|
Teacher
|
none
|
How will educators use data to make informed decisions and adjustments to support students' mental and behavioral health needs?
|
Pending Privacy Clearance
|
Teacher
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none
|
How will parents and families be informed about the implementation of MTSS with a focus on mental and behavioral health?
|
Parents and families should be invited to be co-design the MTSS. So, perhaps a more accurate question begins with how do we build a foundation to engaged in a co-design process and build a bi-directional communication plan that informs all school community members along the way and invites on-going input to design the MTSS.
|
Teacher
|
none
|
What resources and supports will be provided to parents and families to help them support their child's mental and behavioral health at home?
|
Pending Privacy Clearance
|
Teacher
|
none
|
How will we address stigma surrounding mental health and promote a positive school culture that prioritizes student well-being within the MTSS framework?
|
Addressing stigma is so important! Adults in the school building can lead by example by not using MTSS or diagnostic “labels” (e.g., tier 2, ADHD) when talking about students. Even when students are not around, communication shortcuts like these can become habits that affect how we think about young people, colleagues, and ourselves when we experience challenges. Explicit training and professional development on this topic can help make sure that everyone understands why it’s important and feels confident in new communication practices. Practice using and self-correcting to non-stigmatizing language on your own and together. Sometimes it takes time to unlearn a habit. Another way to address stigma is to normalize the fact that we all need help sometimes and should always feel like we can ask for it at school. To normalize mental health, students, staff, and families can join together to host mental health education activities at school and school-sponsored events. This can include handouts with information on school services and practices, as well as hosting speakers with lived experience and providing general mental health support materials. You may be able to partner with a local mental health advocacy group and free food can make it an extra-special event. Lots of media and books that are part of school curricula directly address mental health and can be curated by your librarian. Books that represent the experiences of the students in your community are most likely to address stigma in a way that connects to their lived experiences.
|
Teacher
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none
|
What strategies will be implemented to create a safe and supportive learning environment for all students?
|
Pending Privacy Clearance
|
Teacher
|
none
|
My child has an IEP due to auditory challenges. She benefits from needed accommodations and is doing well academically in school? Why am I being asked to sign her up for a social skills support group? She has lots of friends.
|
If the system were designed through co-creation with students and families, this question might not arise. There shouldn’t be any surprises when we do this work with others and not for others.
|
Parent
|
none
|
How can I join a planning team at my son’s school? No one from my neighborhood seems to be on any committees or teams. I asked to join the School Improvement Council but wasn’t selected to be a parent representative.
|
This would not be an issue in a well designed system that includes bi-directional communication, trust, and co-creating approach.
|
Parent
|
none
|
If my child’s behavior is fine at home, why should they need a behavior group at school?
|
Behavior is often related to the context or environment. Humans adapt different behaviors for different contexts. As a parent, I would want to know about the context in which behaviors are occurring to support problem solving that examines the environment.
|
Parent
|
none
|
What goes on in the behavior group? Who leads it? Will my child pick up on other kids’ poor behavior?
|
Full transparency and communication with school community members would alleviate questions like these. As a parent, I would want to know exactly what is happening in the group to support my child, what decision rules identified the need for the additional support and when will we know when we can begin to fade the additional layer of support. Knowing helps parents extend any necessary support as well.
|
Parent
|
none
|
Is the behavior group special ed? We don’t want our child to be labeled.
|
Tier 2 and 3-additional layers of support for academic, social emotional, and behavioral needs are for all students. These are not special education services. This should be part of open bi-directional communication among all school community members. Parents are essential partners for supportive services for their children. School leadership, MTSS leadership, School counselors, School clinicians, etc. should engage parents in the planning and implementation of services and supports for their children. If this happens, parents will not be surprised. But if surprises happen, honest and open discussion is the way to respond.
|
Parent
|
none
|
What additional data is needed to inform Jamal's Tier 3 plan, and how will we gather it?
|
Pending Privacy Clearance
|
Expert Coach
|
cf03_t3
|
How can we address Jamal’s resistance to counseling and reluctance to participate in interventions?
|
Pending Privacy Clearance
|
Expert Coach
|
cf03_t3
|
What role should Jamal’s grandmother play in the intervention process, and how can we support her more effectively?
|
Pending Privacy Clearance
|
Expert Coach
|
cf03_t3
|
Should the team proceed with a referral for a special education evaluation, despite the grandmother’s hesitations?
|
Pending Privacy Clearance
|
Expert Coach
|
cf03_t3
|
How will the team monitor Jamal's progress across both academic and behavioral goals, and what would trigger a need for further escalation or adjustment to the plan?
|
Pending Privacy Clearance
|
Expert Coach
|
cf03_t3
|
What specific coping skills should be prioritized in Ava’s small-group intervention?
|
Pending Privacy Clearance
|
Expert Coach
|
cf02_t2
|
How can we balance the need for Ava to step away when overwhelmed without reinforcing avoidance behaviors?
|
Pending Privacy Clearance
|
Expert Coach
|
cf02_t2
|
What role can Ava’s parents play in helping her apply the coping strategies at home?
|
Pending Privacy Clearance
|
Expert Coach
|
cf02_t2
|
How can we assess whether Ava’s needs can be met with Tier 2 interventions, or if a more intensive approach is necessary?
|
Pending Privacy Clearance
|
Expert Coach
|
cf02_t2
|
How can the team promote Ava’s re-engagement in peer activities while respecting her current discomfort with social interactions?
|
Pending Privacy Clearance
|
Expert Coach
|
cf02_t2
|
End of preview. Expand
in Data Studio
MTSS School-Based Behavioral Health QA Dataset
This dataset contains a curated collection of real-world questions and corresponding expert responses related to Multi-Tiered Systems of Support (MTSS) and school-based behavioral health integration. Questions vary in style—ranging from open-ended reflections to specific, context-based prompts—and are often rooted in realistic school scenarios, with some referencing external case files.
Dataset Summary
The dataset is designed to evaluate large language models (LLMs) on nuanced, domain-specific question-answering tasks. It captures authentic school-based inquiries around integrating behavioral health practices into academic systems.
Each entry includes:
- A question posed by a school professional (e.g., administrator, counselor, MTSS specialist)
- A gold standard answer, written by subject matter experts
- The role of the participant
- A reference to case files (when applicable)
This dataset enables fine-grained assessment of LLM performance on educational, behavioral health, and systems-level implementation topics.
Dataset Structure
| Column | Description |
|---|---|
questions |
Real-world queries about MTSS and school-based behavioral health practices |
gold_answers |
Human-validated answers providing expert guidance or reflection |
roles |
Role of the person involved (e.g., School_Admin, Counselor, etc.) |
case_files |
Linked case information or placeholder (none if not applicable) |
Example Entry
{
"questions": "We are just starting with MTSS. What are the core features of the framework? Where should we begin?",
"gold_answers": "Core features: Effective teams, using data... (full structured response)",
"roles": "School_Admin",
"case_files": "none"
}
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