On 22 January 2026, ACAMH will host a webinar Mental Health in Schools: Practical Strategies for a Stepped, Collaborative Approach.
We caught up with the presenter – Professor Mark D Weist, Professor in the School of Community Health Sciences at the University of South Carolina and Director of the South Carolina School Behavioral Health Academy – to talk about the topic itself, his career, and his hopes for the event.
What first got you interested in school mental health, and how did you come to specialise in it?
I certainly didn’t plan it this way. I finished my PhD in 1991, the job market was tough, and I applied to about 12 positions and got just one – at the University of Maryland School of Medicine in Baltimore.
Honestly, it wasn’t really what I wanted to do or where I wanted to live, but Baltimore was actually a leader in developing school-based health centres, and then in 1995 there was an opportunity to apply for a National Centre for School Mental Health. We got that grant, and that really launched my career.
What in your view are some of the key top-line challenges in creating effective mental health support for children and young people – both in and outside of school settings?
One is the pathologising that occurs. Western medicine operates on this mode of: I’m the expert, you’re the patient, you have this disorder, here’s what to do. Instead, we need to realise that it’s all based on the relationship. The therapeutic alliance should be the foundation, and to have someone positioned as the ‘expert’ often compromises that alliance. We need to be in a collaborative mode, really valuing the voice and leadership of youth and families.
Alongside that, we need to be very reticent about putting some what can be highly stigmatising diagnostic labels on students. They can really be self-fulfilling prophecies which set the youth on a negative trajectory where they experience self-stigmatisation and reduced expectations from others.
What is the Multi-Tiered System of Support (MTSS), and what are the key principles behind it?
With some other colleagues, I created MTSS in the late 2000s, borrowing elements of two separate existing models that had gained traction in the US during the 1990s.
MTSS has three tiers: promotion and prevention at Tier 1, for all students; early intervention at Tier 2, for those beginning to show signs of problems or experiencing risk; and then more intensive intervention at Tier 3. Then you have all of the key processes that go along with that – having the right team, using data for decision-making, screening, selecting evidence-based practices, progress monitoring, evaluating impacts, and a focus on continuous quality improvement.
If you provide mental health within that framework, it’s going to be more systematic and coherent. The alternative, which we often see, is the hodgepodge approach, a co-located strategy where you have the mental health system coming into the building maybe two or three days a week, but working independently, and it just can’t achieve the same results.
Budget and prioritisation must be barriers to implementing that more strategic support – how do you address those and other barriers?
Exactly – school leaders often feel overrun with the charge they already have, and then we’re saying “you want us to add mental health to this? We don’t have the capacity for that.”
That’s where you have to come back with the counter-argument: if you enable this collaboration, we’re going to be reducing and removing barriers to learning and helping you with the outcomes that you want to achieve.
Another big issue is what we call “initiativeitis”, especially if there’s a lot of turnover in school leadership. Staff get jaded because some new priorities are put in place and they think: “Should I even invest in this because it’s probably going to be gone in a year or two?”. With MTSS, you have everyone in the system co-creating and improving the work together – including families in leadership roles, which we’ll discuss in the webinar – there’s more buy-in and more fertile ground for innovation.
Who do you hope will attend this webinar?
We believe in advancing interconnected research, policy and practice. At our own conferences, we’re open to anyone that’s interested, including family members and other community partners. So definitely if we had researchers, practitioners and policy makers, government officials, that would be great – and most definitely it will be inclusive of family and youth advocates.
To have impacts in interconnected research, practice and policy, we need to be open to working with any group that’s interested in the work.
And what is it that you hope attendees will be empowered to do or achieve as a result?
I hope attendees will understand how to build that strong organisational framework for school mental health – moving beyond the hodgepodge approach to something systematic and sustainable. And I really want people to see the value of co-creation with families and youth.
I want attendees to feel equipped to advocate for and implement the MTSS in their own contexts- and to understand how this framework reduces barriers to learning and helps achieve the outcomes everyone cares about.
Interested in more?
This short course,Mental Health in Schools: Practical Strategies for a Stepped, Collaborative Approach, consists of three live online sessions delivered byProfessor Mark D. Weist, Professor Brian P. Daly, and Associate Professor Joni Williams Splett.
Speakers
Mark D. Weist received a Ph.D. in clinical psychology from Virginia Tech, and is a Professor at the University of South Carolina. In 1995, with other leaders from the University of Maryland, he established the National Center for School Mental Health, now in its 30th year (see www.schoolmentalhealth.org). He has published and presented widely in areas of mental health-education system partnerships, school behavioral health (SBH), trauma, evidence-based practice, and advancing policies that support children and youth at local, state, regional, national, and international levels of scale. He currently leads the Southeastern School Behavioral Health Community, and co-chairs the School Mental Health International Leadership Exchange.
