Roles and Functions of School Mental Health Professionals Within Comprehensive School Mental Health Systems

Abstract

Mental health concerns are on the rise among youth, contributing to a growing need for school-based mental health services. However, challenges to service provision arise due, in part, to workforce shortages, service fragmentation, and inefficient allocation of staff time. The current study describes the professional competencies and time allocation of four school-based mental health professions (i.e., school counselors, school psychologists, school social workers, and school nurses) in order to demonstrate how schools can leverage the skills of their existing staff to coordinate a comprehensive approach to support student mental health. First, we identified the core clinical competencies needed to implement the key features of comprehensive school mental health systems. Then, we crosswalked these clinical competencies with the training standards of the four professions. Finally, we conducted a systematic review of the literature to understand how these professionals' time is allocated, as well as their responsibilities related to the provision of mental health services. Results demonstrated that, although all four professions receive training in most of the core competencies needed to implement comprehensive school mental health services, their skillsets are often underutilized in day-to-day practice. Thus, we concluded that there are at least two untapped opportunities for school leaders to support student mental health-first, maximize the use of school mental health professionals through task-shifting (i.e., reassigning tasks less central to mental health service delivery to other staff), and second, implement an integrated model of school mental health services to efficiently leverage the mental health training of professionals.

Supplementary information: The online version contains supplementary material available at 10.1007/s12310-022-09535-0.

Keywords: Interprofessional collaboration; Professional competencies; Roles and functions; School mental health professionals; Service coordination; Time allocation.

Fig. 1

Flow diagram of systematic review

Fig. 2

Time allocation of SMH professionals. Note. SC school counselors. SN school nurses. SP school psychologists. SSW school social workers. Due to variability in the inclusion and operationalization of time outcomes across studies, synthesized time allocation results should be considered in context. The delineation of how individual study time outcomes were organized can be found in the Supplemental Materials.*Study did not measure activities in the miscellaneous category