Nursing Role in Managing Mental Health Needs of Students
The mental and behavioral health needs of students are wide and varied. The school nurse is an essential member of the school mental health team. In June 2023, the National Association of School Nurses (NASN) released Elevating the Role of School Nurses in School-Based Mental and Behavioral Health. School nurses support student mental and behavioral health by:
- Providing direct care including coaching, counseling, and medication management.
- Managing referrals and care coordination with school-based and community providers.
- Conducting screening to identify student needs.
- Supporting emergency preparedness and crisis response.
Nurses have a foundation in the Health Prevention Model for Disease Prevention.
Tertiary prevention provides care to those with disease to prevent complications.
Secondary prevention screens for those at risk to prevent disease.
Primary prevention provides health promotion and education to the whole population.
NASN’s position statement The Behavioral Health and Wellness of Students clearly outlines the importance of school nurses as frontline care who so often are the first to recognize the mental health needs of students.
Many schools in are using the Minnesota Multi-tiered Systems of Support to support the mental and behavioral needs of students. Tier 1 is the promotion of positive social, emotional, and behavioral skills and overall wellness for all students. Tier 2 are supports and early intervention for students identified through needs assessments as being at risk for mental health concerns. Tier 3 provides targeted interventions for students with serious concerns that impact daily functioning.
Examples of school nursing in Tier 1 include:
- Provide school-wide mental health promotion.
- Provide classroom education on mental health literacy.
- Participate in school based mental health teams.
- Implement social, emotional learning techniques into the health office environment/experience.
Examples of school nursing in Tier 2 include:
- Early identification of mental health needs through the nursing process with individual students.
- Teaching student self-guided practices such as relation breathing, distraction, or journaling.
- Participating in resource and referral mapping for school and community mental health resources.
Examples of school nursing in Tier 3 include:
- Develop and implement Individual Health Plans (IHP) or Emergency Care Plans (ECP) for students.
- Coordinate care such as student’s post-discharge from hospitalization or partial day programs.
- Intentional, specific planning to assist students in reaching goals to manage their health condition such anxiety symptoms.
- Provide referrals and resources to specialty care, mental health, or space for virtual mental health appointments at school.
If students or staff need free and confidential support
Call the 988 Suicide & Crisis LIfeline
Resources
- CDC: What is Children’s Mental Health
- CDC: Promoting Mental Health and Well Being in Schools an action guide school and district leaders.
- FastTrackerMN.org is a dynamic behavioral health search tool that gives Minnesotans access to real time information and availability for mental health care in MN.
- National Center for School Mental Health provides resources and education specific to mental health needs of students.
- National Alliance on Mental Illness (NAMI) provide information, education, training, support for those with mental illness, families, and the public.
- Psychiatric Assistance Line (PAL) provides education and training for nurses and resources including several videos for teachers, parents, and students.
- MDH Mental Health Promotion provides resources for school and the community to promote health and well-being.
- MDH Suicide Prevention provides resources, education, community prevention trainings and MN data on suicide.
- School Health Assessment and Performance Evaluation System (SHAPE) is a public-access, web-based platform that offers schools, districts, and states a workspace and targeted resources to support school mental health quality improvement. SHAPE houses the National School Mental Health Profile and the School Mental Health Quality Assessment (SMH-QA). These measures are designed for team completion at the school or district level to document the school mental health system components, assess the comprehensiveness of a SMH system, prioritize quality improvement efforts and track improvement over time.