Why this is important

• 70% of mental health problems begin during childhood or adolescence. Early identification and intervention can improve mental health outcomes and reduce the need for more intensive services later on.
• 18% to 22% of children and youth in Ontario meet the criteria for a mental illness, but less than one-third of those children and youth have contact with a mental health provider.
• If children and youth do have contact with a mental health provider, school is the most common place where they access support.
• Every school board has funded positions at secondary schools for school mental health professionals. These individuals are trained and equipped to provide excellent tier 2 prevention and early intervention services. Making appropriate referrals for this level of support helps to ensure that students receive helpful services early, often preventing the need for more costly intensive services in community or hospital settings.

The school’s role in early identification

Between tier 1 and 2, early identification takes place. Often, the classroom teacher is the first to notice a concern; however, any staff member in the school or a parent/caregiver or the student themselves may identify the need for more support. All school staff need some level of mental health literacy and awareness, as any staff member could be the one a student chooses to connect with for support.

• While classroom educators are often the first to notice changes in emotions or behaviour that may signal a mental health concern, specialized knowledge focused on early identification and support of mental health problems can benefit staff who support students in a special capacity, such as child and youth workers, coaches, guidance teachers, special educators, gender and sexualities alliance leaders, and grad coaches.
• Along with learning to recognize signs of mental health concerns, school staff, as they grow in confidence, become aware that these signs may vary among students and that not all students show visible signs of distress when they are struggling. Noticing a change in behaviour or emotion happens best within the context of a caring staff–student relationship.

How to detect signs of possible mental health problems

In general, if school staff notice a change in how a student is expressing behaviour, emotions, or thoughts, they should also take note of how often, how intensely, and for how long the concerns have been present. It is also important to pay attention to how distressing it is for the student and how it’s affecting their day-to-day activities.  

Here are a few important reminders for school administrators and staff when identifying signs of a possible mental health concern:

• Reflect on any beliefs and biases that may negatively influence your perception of a student’s emotions and behaviours and how mental health is perceived and addressed.
• Avoid assumptions and stereotypes, remembering that each student is unique and that mental health problems manifest differently for everyone. Base your observations on specifics rather than generalizations.
• Gather information from the school adults in the student’s life to develop a comprehensive understanding of changes you’re noticing. Documenting and consulting with other staff regarding these concerns will help to create a full picture before addressing the worries with the student and/or their parents/caregivers. It is possible the noticed changes are appropriate responses to a student’s experiences and not indicative of a mental health concern.
• Remain curious and open to school factors that may be affecting a student’s mental health. Be prepared to address these factors swiftly and effectively, if uncovered.  

Common mental health concerns and support strategies

Challenges with anxiety, attention and mood are common mental health concerns in youth. These concerns may be long-term and diagnosed conditions. Or they may be acute reactions to a tragic event or other life situation. Learn more about common concerns and support strategies.

Dealing with emergency concerns

If your concern for a student is urgent (e.g., suicide risk or risk to others/imminent danger), act immediately to activate board protocols and never leave the student alone. See youth suicide prevention, intervention, and postvention for more information.

How to support students in the moment

Many students will feel worried, unsettled, irritable, or stressed at different points in their lives. Although there are no “good” or “bad” emotions, some emotions can make us feel more comfortable than others.  

Validation is a skill that can be helpful when supporting students and others who are experiencing intense emotions (Ontario College of Teachers, 2018). It offers a way to acknowledge their point of view, thoughts, emotions, and experiences, without trying to solve, fix, or judge the situation. Like other skills, learning to validate others takes regular practice and reflection.

• Seek to understand by remaining curious, giving time for a student to express themselves, listening more, and speaking less. The goal is to help students feel genuinely heard and seen, not to minimize or change their feelings, provide opinions, fix the situation, rush to create a silver lining, or jump to explanations or problem-solving.
  • During interactions, some students may readily share their feelings; others might benefit from open-ended questions, prompts, or visuals.
  • Refrain from labelling feelings for students because when we name or identify feelings for others, we introduce our bias.
  • Teach students how to use tools to identify their emotions/feelings when they are not feeling intense emotions or in crisis, as this creates better conditions for learning.

• Once you’ve actively listened for the range of feelings that a student may be experiencing and checked for understanding using a posture of curiosity and cultural humility, validate the emotion(s). Validation is best done when it comes out authentically (rather than from a script).  Here are some examples of validating phrases:
  • “Thank you for sharing that with me.”
  • “I can see how you would feel ____.”
  • “It makes sense that you’d feel ____.”
  • “I can only imagine how ____ you’d feel.”
  • “No wonder you’re feeling _____.”
  • “That sounds really _______.”

• Students can often sense inauthenticity. Drawing on empathy and really trying to imagine what the situation may be like for a student can help you to provide validation sincerely. We will likely never fully understand someone else’s experiences, but we can still strive to empathize with them.

How to talk with students and/or parents/caregivers about mental health

As a school administrator, you may either speak directly with students and their parents/caregivers when mental health concerns arise or provide support to staff members in addressing these concerns. As appropriate, depending on the age and maturity of the student, students should be part of the decision to engage their parents/caregivers as caring adults within their circle of care. Consult your mental health leadership team for age-of-consent guidelines that are followed at your board.

Here are some general guidelines to keep in mind when talking with students and parents/caregivers about mental health concerns:

How to respond when a parent/caregiver approaches the school about a mental health concern

A parent/caregiver may reach out to the school with concerns about their child’s mental health. Staff members may not have noted any concerns, or they may be able to round out the concerns noted with observations about the student’s behaviour or emotions in the school context.  

In the same way that you would validate the student’s concerns, it is helpful to listen carefully and attentively to the worries of parents or caregivers, knowing that they may feel quite anxious about their child’s well-being. A caring, compassionate connection can make all the difference to a family who is facing the challenges and worry of a child or young person’s emerging or escalating mental health problems.  

Note that at times, the worry and fear that a parent/caregiver feels may come across as anger or intolerance. Though they may not be at their best, parents/caregivers of children who struggle with their mental health may be walking a difficult path, so it is best to lend calm and grace to the interaction.

When parents/caregivers are considered the main expert and navigator in their child’s mental health care, they are empowered to lead the coordinated treatment planning, with caring support from all partners. In contrast, when students come back to school from hospital or community treatment without this sort of discharge planning and support, continuity of care suffers. Whenever possible, try to set the stage so that parents/caregivers engage with the school and share information to facilitate seamless care across settings. School administrators may want to regularly review and role-play situations with the staff to help team members prepare for unscheduled conversations about mental health concerns and to receive the information in a good way. The WE CARE resource provides guidance to school staff on how to listen, respond, and connect with parents/caregivers when a concern is shared.

Prevention and early intervention services available in Ontario schools

While educators and student support staff provide ongoing support to students in the classroom to assist with learning and wellness, psychotherapeutic prevention and early intervention services are offered within the school setting by regulated mental health professionals, like social workers, psychologists, and psychotherapists.  

Knowing the protocols and procedures for accessing mental health supports within your school board is essential to efficiently connect students with mild-to-moderate mental health problems to brief, school-based early interventions.

The Circle of Support and System Pathways Flowchart resources are designed as a guide for staff when they are concerned about a student and wondering if additional mental health support might be required. The text boxes in the worksheet may be populated to include local or specific board information.

Modifications and accommodations to support student mental health

Educators are very familiar with modifying and accommodating in the classroom based on the unique strengths and needs of students. The same approach can be taken when modifications or accommodations are required for mental health problems.  

Accommodations can start right away when the educator or other school staff notice that a student may be experiencing a mental health concern – they don’t need to have a diagnosis or be receiving treatment to benefit from more focused support in the classroom. See common student mental health concerns for guidance.   As with teaching and learning, what works for one student may not work for another. Mental health needs can also change over time. Be sure to review supports to ensure they’re still effectively supporting the student.

Student mental health concerns and attendance

Some students may miss school because of mental health concerns. This is sometimes called school avoidance. When anxiety is the cause of an absence, best practice is to encourage attendance, even for short periods, every day. Avoiding school only makes it harder to return. Students may also avoid school because a situation at the school is affecting their well-being, such as bullying or experiences of racism. It’s important to pinpoint the reason for avoidance in order to support the student effectively. PPM 169: Student Mental Health outlines requirements for boards to follow regarding mental health absences. If a student is unable to attend school because of a mental health concern, their absence must be excused under s. 21(2)(b) (“by reason of sickness or other unavoidable cause”) of the Education Act. Emphasizing the importance of self-care and prioritizing mental health can allow for more open conversations among students, parents/caregivers, and teachers.

Working with community partners at tier 2

At times, partners like community mental health organizations, youth wellness hubs, public health or cultural/faith groups approach schools and school districts with offers to provide tier 2 prevention and early intervention services.  

While additional support may be welcome, alignment with the board mental health and addictions strategy, and relevant partnership protocols, is an important step. This includes consideration of agreements with board employee groups, as well as clarity about which services will be provided within the school setting and who carries responsibility for supervision, record-keeping, communication, etc.

Before entering into arrangements for the provision of prevention and early intervention services with an external partner, like public health or a cultural/faith organization, review PPM 149 and your board’s procedure regarding external partnerships and partnership agreements to ensure that protocols are followed.

Resources to support tier 2 prevention and early intervention