How Districts are Bringing Social, Emotional, and Behavioral Health Supports to Schools and Classrooms

In Massachusetts and across the nation, we are facing a crisis in children’s behavioral health care. Too many of our young people are not getting the support they need because of a shortage of available and accessible services, a lingering stigma around mental health care, and insufficient parity in insurance coverage between physical and behavioral health care. More than 20 percent of children in the United States experience a mental health condition. Yet 70 percent of children who need services are not able to access them. Most wait years before receiving intervention, inhibiting their progress in school and in life.

As one place where most children can be reached daily, schools have the potential to help address this issue. In fact, the majority of children who receive behavioral health services do so in schools. By creating an environment that prioritizes social and emotional well-being for all students and offers interventions for those who need additional support, schools can provide one local solution to begin to address this nationwide crisis. 

Our latest report, A Supportive School for Every Student: How Massachusetts Districts are Bringing Social, Emotional, and Behavioral Health Supports to Schools and Classrooms, looks at how schools in Boston are doing just this through an approach called the Comprehensive Behavioral Health Model (CBHM). The model—which is grounded in a belief that students who are mentally healthy will be able to access rigorous academic content—is designed to prioritize social and emotional well-being with the same intentionality as reading and math. Through a partnership between Boston Public Schools, Boston Children’s Hospital, and UMass Boston, 70 schools are putting in place a Multi-Tiered System of Supports to reach every student.

Through this approach, all students in CBHM schools receive “Tier 1” supports, which includes social-emotional learning curriculum and positive behavior interventions and supports. At the Harvard-Kent School in Charlestown, for example, students earn “PRIDE Bucks” for displaying the school’s core values of Purpose, Responsibility, Individuality, Determination, and Engagement. Grade levels, classrooms, and students can be recognized for earning the most bucks. Staff members say this has strengthened peer interactions and helped make the school a more fun and supportive environment for every student.

Even in schools with a strong foundation of prevention, there are students whose needs require a higher level of support. “Tier 2” provides this support, which may include intervention by a classroom teacher or group counseling with a behavioral health specialist. At the McKay School in East Boston, for example, teachers noticed a third grader was often alone on the playground and had difficulty engaging with his peers because of a hearing impairment. The school’s psychologist referred him to a sports-based therapeutic program called Doc Wayne that leads small group sessions in schools to strengthen personal development and social relationships. This program proved to be transformative for the student, helping him gain confidence to connect with other students.

For the highest-need students, “Tier 3” often includes individualized counseling from the school psychologist or a clinician from a community-based organization. Brighton High School, for example, implemented the evidence-based Check & Connect Model to provide wraparound support for students who show warning signs of dropping out. Students in need of intervention meet weekly with a mentor to discuss behavior, attendance, and grades. Mentors also connect with the student’s family and, as specific needs emerge, connect them with school and community-based supports. In its first year, this program contributed to a 7-percentage point increase in student attendance.

In its early stages, the CBHM is working. Principals and school psychologists say it has transformed school culture and improved the school experience for students with a range of needs. Across all CBHM schools, students saw meaningful improvements in social and academic competence during the 2017-18 school year, with particularly large gains for the highest-risk students. These students also exhibited the greatest growth in positive behaviors throughout the year.

We know children cannot learn at their full potential unless they are safe and healthy. Yet education and both physical and behavioral health needs are often addressed by different sectors, policies, and in separate settings. By making students’ social, emotional, behavioral, and mental health needs a priority in school, districts like Boston are creating the conditions for every child to learn and thrive.