Promoting Mental Health in Schools: Evidence-Based Strategies for a Stepped, Collaborative Approach

Schools play a central role for children and adolescents not only in terms of education but also by providing structure, continuity and social connection. These factors significantly contribute to emotional wellbeing. A substantial proportion of young people experiencing mental health difficulties do not access specialist services yet continue attending school (Wolpert et al., 2019). This places schools in a unique position to offer early support reduce barriers to care and promote wellbeing through structured, evidence-informed frameworks.

Recent research has highlighted the advantages of comprehensive school mental health (SMH) systems, particularly those organised around Multi-Tiered Systems of Support (MTSS). MTSS provides a coherent structure integrating prevention, early intervention and intensive support to meet diverse student needs (Barrett et al., 2018) acknowledging the interdependence of academic outcomes, mental health and social-emotional development.

Why School Mental Health Matters

Mental health difficulties among children and adolescents are increasingly recognised as influential factors in academic engagement, peer relationships, attendance, and long-term outcomes (Ford et al., 2020). Within this context, schools contribute to mental health support in several ways: 1. Early identification: Educational staff often observe behavioural or emotional changes before they escalate into acute difficulties. 2. Accessibility: School-based provision can reduce stigma, logistical barriers, and waiting times commonly associated with external services (Loades & Mastroyannopoulou, 2010). 3.Consistency and stability: School routines can support children experiencing stress, trauma, or fluctuating mental health needs.

Effective school-based support requires structured systems, shared responsibility, and reliance on evidence-informed practice — the core features of MTSS.

Understanding Multi-Tiered Systems of Support (MTSS)

MTSS is a prevention-oriented, whole-school framework integrating academic, behavioural, and mental health support. It is typically organised into three tiers that together provide a continuum of care.

Tier 1: Universal Support

Universal supports aim to strengthen wellbeing and social–emotional competencies across the entire student population. Evidence suggests that universal programmes, such as social and emotional learning (SEL), whole-school climate initiatives, and wellbeing curricula, are associated with improved academic outcomes, reduced behavioural difficulties, and enhanced social functioning (Durlak et al., 2011).

Common universal strategies include classroom-based SEL instruction, positive behaviour support systems, teacher training to enhance mental health literacy, and school-wide policies that promote belonging, safety, and inclusion. These approaches embed mental health within everyday school practice rather than positioning it as an isolated intervention.

Tier 2: Targeted Support

Targeted Support interventions are designed for students who require more focused support than universal strategies can offer. These may include young people displaying emerging emotional, social, or behavioural needs.

Evidence-based Tier 2 interventions include small group social–emotional programmes, targeted behavioural interventions, and brief cognitive–behavioural techniques to address anxiety or mood difficulties, as well as early intervention for attendance or engagement concerns.

Data-informed identification processes, such as early warning indicators, teacher referral pathways, and systematic screening, are essential to ensure equitable access and timely support. Research suggests that targeted early intervention can reduce escalation and improve functioning (McGorry et al., 2018).

Tier 3: Intensive, Individualised Support

Intensive, Individualised Support interventions address the needs of students with significant or complex mental health conditions, comprising individual, evidence-based therapeutic interventions, collaboration between school-based mental health staff and external clinical providers, and coordinated planning for students requiring multi-agency involvement.

Effective Tier 3 implementation depends on strong communication between educators, counsellors, psychologists, and community mental health teams to ensure effective, personalised care (Weist et al., 2017).

Core Processes Strengthening School Mental Health Systems

Research signals several processes that underlying effective and sustainable implementation of school mental health systems. 1. Teamwork and collaboration: multidisciplinary teamwork is central to SMH. Collaboration between educators, school psychologists, counsellors, and external partners reduces fragmentation and promotes coherence across tiers (Nadeem et al., 2011). 2. Data-based decision making: Schools increasingly rely on academic, behavioural, and wellbeing data to identify emerging needs, select interventions, and monitor progress. Data-driven decision making promotes equity, consistency, and responsiveness (Sugai & Horner, 2020). 3.Evidence-based practices: Using interventions with demonstrated effectiveness remains a key principle of high-quality SMH. Evidence-based approaches are associated with improved outcomes and more efficient use of resources (Chorpita et al., 2011). 4. Progress monitoring: Regular monitoring enables schools to evaluate intervention effectiveness and make timely adjustments. This prevents drift, supports accountability, and fosters continuous improvement. 5. Supportive relationships: Robust relationships between students and trusted adults in school settings serve as protective factors, particularly for those experiencing adversity or psychological stress (Roffey, 2017). Relationship-centred approaches enhance engagement and willingness to seek help. 6. Youth and family engagement: Actively involving students and families in planning and decision making improves relevance, acceptability, and treatment adherence. Family–school partnerships are consistently linked with better attendance, behaviour, and academic outcomes (Sheridan & Kim, 2015).

Conclusion

Comprehensive, multi-tiered systems of support are increasingly being recognised as potentially beneficial to promoting mental health in school settings. Universal, targeted, and intensive interventions, when grounded in collaboration, data-informed practice, strong relationships, and family engagement, provide a robust foundation for effective support.

As the mental health needs of children and adolescents continue to evolve, stepped care models offer a flexible and scalable approach, transforming schools into proactive environments for early intervention, resilience building, and long-term positive outcomes.

Where next?

Mental Health in Schools: Practical Strategies for a Stepped, Collaborative Approach is a three part webinar series brings together leading experts to share practical, evidence-based strategies for strengthening student mental health within schools through comprehensive, multi-tiered systems of support (MTSS). Attendees will learn how to implement prevention and early intervention strategies, foster stronger collaboration among schools, families, and communities, and build sustainable systems that ensure student well-being and academic success.

References

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Chorpita, B. F., Daleiden, E. L., & Weisz, J. R. (2011). Identifying and selecting the common elements of evidence-based interventions: A distillation and matching model. Mental Health Services Research, 13(1), 3–17.

Durlak, J. A., Weissberg, R. P., Dymnicki, A. B., Taylor, R. D., & Schellinger, K. B. (2011). The impact of enhancing students’ social and emotional learning: A meta-analysis of school-based interventions. Child Development, 82(1), 405–432.

Ford, T., John, A., & Gunnell, D. (2020). Mental health of children and young people in the UK: Patterns and trends. The Lancet Psychiatry, 7(4), 303–304.

Loades, M. E., & Mastroyannopoulou, K. (2010). Teachers’ recognition of children’s mental health problems. Child and Adolescent Mental Health, 15(3), 150–156.

McGorry, P., Mei, C., Chanen, A., Hodges, C, Alvarez-Jimenez, M., & Killackey, E. (2018). Designing and scaling up early intervention for mental disorders. World Psychiatry, 17(3), 372–383.

Nadeem, E., Saldana, L., Chapman, J., & Miranda, J. (2011). School-based mental health interventions: A systematic review. Journal of School Psychology, 49(1), 1–39.

Roffey, S. (2017). The ASPIRE principles and the role of leadership in creating a mentally healthy school. Educational & Child Psychology, 34(2), 103–115.

Sheridan, S. M., & Kim, E. M. (2015). Foundational aspects of family–school partnerships. In APA Handbook of Human Systems Integration. American Psychological Association.

Sugai, G., & Horner, R. (2020). Sustaining PBIS: Implementation drivers, capacity building, and scaling. Positive Behavioral Interventions & Supports Center.

Weist, M. D., Lever, N., Bradshaw, C., & Owens, J. (2017). Handbook of School Mental Health (2nd ed.). Springer.

Wolpert, M., Dalzell, K., & Cortina, M. (2019). An evidence-based approach to mental health support in schools. Journal of Child Psychology and Psychiatry, 60(4), 327–328.