Understanding the role of schools  

Schools are where students spend most of their time, learning, socializing and developing important life skills. They are also the most common place where young people in Ontario access mental health supports. This means that school staff play an essential role in noticing early signs of emerging or escalating mental health concerns, offering initial and ongoing support and connecting students and families with the help they need. In Ontario, school mental health professionals (e.g., psychologists, registered psychotherapists, social workers) are available to provide prevention and early intervention services, so that students who seem to be experiencing a mental health problem can be referred seamlessly for assessment and early intervention at school. Those with more significant needs can be referred to community mental health or hospital care. Schools play a critical role in ensuring that students who need mental health services are identified and supported early, before symptoms escalate. 

What the research tells us

According to the 2019 Ontario Child Health Study : 

• 18 to 22% of children and youth in Ontario meet the criteria for mental illness  
• 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 

It is widely accepted that early detection of mental health problems means that students who need additional mental health support, beyond universal mental health promotion and literacy, are directed to appropriate assessment and treatment services. There is compelling research that early intervention can positively influence an individual’s life course, relative to those with mental health disorders who do not receive timely treatment. Studies show that young people find early intervention to be acceptable and helpful to them. 

Why this is important

Given that schools are uniquely positioned to support student well-being through early identification, it is important to help school staff to be equipped for this important role. School staff develop supportive relationships with students and, with information and support, can learn to effectively notice changes in student mental health when they occur.

How to notice and respond to potential mental health concerns

Although school staff are not mental health professionals, they have an important role to play in identifying possible mental health concerns for students and guiding young people toward needed supports.  

It’s not unusual for children and youth (and adults) to feel worried, unsettled, irritable or stressed. To determine if these feelings are a concern and if more support with mental health is needed, consider: 

• Frequency: How frequently are the concerns observed? 
• Impact: Do concerns interfere with daily activities? 
• Intensity: Do concerns cause the student distress? 
• Duration: Have concerns been present for longer than two weeks? 

Above all, school staff should be noting whether the behaviours and emotions they are observing represent a change for the student. This can mean a change from their everyday manner, which possibly signal an emerging mental health problem, or it could be an escalation of concerns for students who have already been diagnosed with a mental health disorder.

It is important to note the student’s age, stage of development and lived realities as aspects of the observed behaviours and emotions are considered. For instance, temper outbursts for kindergarten students would be understood differently than the same behaviour in an older child. At the same time, it is important to consider that anger may be an appropriate response for students who are enduring harms associated with marginalization, bullying or racial trauma. Context is important when determining if a young person could be experiencing a mental health problem and the nature of supports that could be helpful. 

Paying attention to changes in a student’s behaviours and emotions helps you notice and recognize when support may be needed. Consulting with the student and those in their circle of support can provide additional context and information for consideration. 

IMPORTANT: Thoughts of suicide and suicidal expressions and behaviours are signs that should be addressed immediately by following your school board protocols. These signs do not need to persist to warrant following up. For more information about warning signs of suicide and what to do if you think a student is having thoughts of suicide, please read the Prepare; Prevent; Respond: Suicide Prevention/Life Promotion Literacy for School Staff Quick Reference Guide for School Staff. It is important that every school staff member knows the process for accessing mental health services because students may choose any caring adult for support when they are seeking help. Support for students is most effective when it is done in continued collaboration with others in the student’s circle of support. Never leave a student who has expressed suicidal thoughts or behaviours alone while you are seeking help for them.

Noticing common mental health concerns

There are many specific subtypes of anxiety disorders, but the following are some common signs of concerning anxiety: 

• attendance concerns 
• difficulty speaking in groups or in class 
• exaggerated need to be perfect 
• excessive worry 
• fears 
• performance on tests doesn’t match ability 
• recurring physical symptoms without medical explanation (stomach aches) 
• refusal and avoidance of tasks 
• separation issues (younger students) 
• social issues, such as extreme shyness around peers 

Notice signs of attention concerns 

School staff are well-positioned to observe early signs of attention concerns. For some students, signs of difficulty with attention are obvious and noticeable from a young age. For others, concerns can be hard to notice but can be just as impactful, particularly when they are not identified until later grades. 

Here are some signs that may be linked to attention concerns. While signs may typically be present in either elementary or secondary students, always consider the student’s individual profile, including their developmental stage.

Notice signs of a mood concern 

Many signs of a mood challenge are also typical components of adolescent development and don’t necessarily indicate a mental health disorder. Knowing a student’s usual way of being and recognizing changes is a good place to start.

Important: Take all disclosures of suicidal thoughts or behaviours seriously. Follow your school protocols for response and support. Never leave a student who has expressed suicidal thoughts alone without support. For more information about warning signs of suicide and what to do if you think a student is having thoughts of suicide, please view Prepare; Prevent; Respond: Suicide Prevention/Life Promotion Literacy for School Staff Quick Reference Guide for School Staff. 

There are everyday, class-wide strategies as well as targeted strategies that can be helpful for students experiencing mental health concerns. Learn about what you can do to support students experiencing mental health concerns in the school environment.

The ONE CALL approach

To help school staff notice and respond with care, School Mental Health Ontario developed a simple framework called ONE CALL.

Observe – Observe and reflect on your own thoughts, beliefs and biases. Consider doing your own self-reflection using this cultural humility tool. 

Notice – Notice changes in a student that are different from their usual way of being. Reflect on frequency, intensity, duration and impact.  

• For examples of some signs that may indicate a mental health or addictions concern, view our ONE-CALL Desk Reference. 

Explore – Explore whether the student is open to talking to you about the changes you have noticed. If not, offer to connect them with another trusted adult of their choice.  

• To learn more about validating a student’s emotional experiences, view our Emotional Validation Quick Reference Sheet. 

Connect – Connect with the student (or connect them with another trusted adult) and discuss your observations. In many cases, school staff may also wish to connect with a student’s parent/caregiver to share what they have noticed.

Our Talking with Parents and Families about Mental Health tip sheet may help.

Ask – Ask the student what they need (if anything) and/or how you can support them, rather than making assumptions. This demonstrates caring, honours their knowledge, limits the introduction of bias and respects a student’s autonomy.

Listen – Listen actively, trust and validate students’ emotions. Do not expect students to be resilient in situations requiring school action (e.g., racism, bullying, transphobia, or any other experiences of discrimination). Consider using the Listen, Believe, Act framework when appropriate.

NOTE: If you have reasonable grounds to suspect that a student has experienced abuse or neglect, or that the student is likely to suffer abuse or neglect, you have a duty to report and must follow your school board’s reporting procedure. Similarly, if the student is disclosing suicidal thoughts or behaviours, or intentions to harm others through violence, action must be taken following your board protocols. 

Link – Link students (and parents/caregivers when appropriate) to other supports in the school, board or community when needed.

Communicating with parents and caregivers about student mental health concerns

School staff may need to speak directly with parents/caregivers when mental health concerns arise. It is also possible that a parent/caregiver will reach out to you to discuss some concerns they may have. As appropriate, students should be part of the decision regarding engagement with parents/caregivers as caring adults within their circle of support.  

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

• Before the conversation build relationships and trust through ongoing communication, frequent check-ins, celebrating accomplishments, etc.  
• Be mindful that not all families have the same experience or relationship with schools, education or mental health supports. Consider what the barriers may be and how you can acknowledge and address them. 
• Plan the conversation: determine who is best positioned to connect with the family. Whenever possible, it should be someone who the family knows and has a relationship with.  
• Consider the time and place offer a mutually convenient time and place, limiting the possibility for interruptions and allowing sufficient time. 
• Share the student’s strengths and what they are doing well. Where appropriate, recognize that/how those strengths can be used to support their mental health and well-being. 
• Find neutral and non-judgmental ways of describing and discussing the changes you are noticing (e.g., “I’ve noticed that Miguel is having a hard time settling in class. He is easily distracted and often has difficulty focusing. I’m wondering if you’ve noticed this at home.”) 
• Reduce stigma associated with mental health concerns and mental illness by shifting the narrative away from labelling and judgment. 
• Allow parents/caregivers time and space to fully share and reflect, as their experience may be different from what is being shared with them. 
• Avoid labels or mental health terms (e.g., depressed, anxious) to describe the concerns. Instead, describe in clear terms what you are observing (e.g., “Quinn appears sad in class lately. I have been curious about that, as it is impacting his friendships.”)
• Centre the expertise of families by learning about what works at home to support their child and what they believe would be helpful at school, while listening to and validating their concerns about their child. 
• Learn about any supports and services the family may already have in place, and who else may need to be consulted about the mental health plan. 
• Work alongside students and their parents/caregivers to swiftly identify and address issues related to oppression and/or discrimination. 
• Offer support in navigating complex systems by addressing barriers to mental health support. 

Responding in ways that are identity-affirming

Students’ experiences of mental health are shaped by their identities, cultures, and communities. Recognizing this helps school staff respond in ways that are inclusive and affirming.

When noticing and responding to mental health concerns, it’s important to: 

• Understand and acknowledge the way students navigate and express emotions, stress or mental health concerns. 
• Be aware of how identity-specific biases may impact how student actions are interpreted.  
• Consider systemic factors such as oppression, racism, discrimination or marginalization that may impact a student’s well-being and access to care.  
• Engage families and community partners to better understand each student’s context and strengths. 

Culturally-responsive and identity-affirming approaches, supports and services centre the identities, knowledge, strengths and lived experiences of each student. 

Schools and systems that support noticing and responding with care: 

• Understand that supporting a student’s mental health is a shared responsibility. 
• Provide a supportive and identity-affirming environment for every student.  
• Prioritize relationships and connection, to foster open conversations and help-seeking. 
• Provide training and professional learning for school staff on mental health, reconciliation and equity. 
• Partner with students and parents/caregivers to centre their perspectives, experiences and expertise. 
• Establish clear pathways and protocols responsive to each student. 
• Encourage open communication and collaboration among staff, families and mental health professionals.

In a coordinated approach: 

• Students, families and caregivers are seen as partners and contribute valuable insight and expertise.  
• Educators and school staff support mental health promotion and the early identification of emerging mental health concerns.  
• School mental health professionals provide targeted interventions and guidance. 
• School administrators create structures and conditions for mentally healthy learning environments.  

Remember, school staff are not alone in supporting a student with signs of mental health concerns. When everyone in the school community plays a role, students are more likely to get the help they need, when they need it. 

Resources

• Tip sheet

Cultural Humility Self-Reflection Tool for School Staff

• Guide/tool

ONE-CALL Desk Reference

• Tip sheet

Talking with Parents and Families about Mental Health

• Info sheet

Listen, Believe and Act: Support for Students Who Have Been Disproportionately Impacted in Schools

• Guide/tool

Prepare; Prevent; Respond: Suicide Prevention/Life Promotion Literacy for School Staff Quick Reference Guide for School Staff

• Available in print
• Guide/tool

My Circle of Support – Student Help-Seeking Resource