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Supporting Mental Health in Schools: The Value of Dual Perspectives

June 17th, 2021

Universal screening to evaluate social-emotional behavior (SEB) functioning is important in determining if students are on track to meet their developmental goals and whether or not they may benefit from additional supports, including mental health services. 

We know that one in five students will exhibit symptoms of a mental health problem, yet upwards of 80% of those students will not receive timely treatment. Schools must rethink how to facilitate early intervention and prevention services. Universal screening can be a valuable tool in ensuring all students receive timely and effective social-emotional and mental health support. 

Understanding the Dual Factor Model of Mental Health

The dual factor model of mental health recognizes that students exhibit not only symptoms of psychological problems or problem behaviors, but they might also be displaying a lack of prosocial skills or resilience. This is a big shift away from a traditional deficit-focused view of mental health.

The dual factor of mental health recognizes that the incorporation of positive psychology and resilience is just as important to consider when looking at a students’ complete mental health. With that in mind, an effective social-emotional behavior (SEB) screener should not only focus on problem behaviors but it should also be able to identify if a student is not displaying prosocial or resiliency skills. 

We know that many existing tools are solely focused on the presence of psychopathology, which can lead to a number of problems such as the over-identification of a certain student group or certain types of behavioral or mental health issues. Those students that are aggressive in class or who might have attentional challenges are much easier to spot and, therefore, are more likely to be referred to services than the student in the back of the classroom, disengaged with their head down.

With universal screening from a dual factor model of health as well as multiple perspectives, we get a more complete picture of every student in your classroom. That is why the best screeners include not just a teacher report, but also a student self-report. 

The Value of Having Dual Perspectives

Ask any educator and they will most likely agree that more data doesn’t necessarily mean better decisions, especially when those data are discrepant or disagree with each other.  But when it comes to mental health, having too little data about a student’s mental health can create a narrow window into their overall need. A student’s behavior in one context might be very different from their behavior in another context. For example, middle or high school students might have upwards of six or seven teachers in different subject areas. 

So if we are only asking one educator to report on a child’s needs, we might only be getting a small slice of that student’s behavior within one specific context. However, seven screenings (or even eight if the student is self-reporting) is simply not feasible. So how do we incorporate multiple perspectives?

First Ask: What Are Our Objectives for Using the Data?

I always ask schools to really consider the overall purpose and goals of the screening process. This starts with understanding what their specific objectives are with the data that they hope to get. Even more specifically, it’s important to ask: 

  • What is the referral question?
  • How will we use these data to support our students?

Many of the schools that I’ve worked with have specific protocols to ensure that their connection to data use is clearly identified prior to conducting screening:

  • Which SEB screening scores will be used?
  • What other indicators should also be considered?
  • What levels should be reviewed prior to intervention planning?

It’s also really important to understand the contextual appropriateness of your screening tool. At what ages and grades will we be screening and what kind of informants should we be using?

By identifying objectives for using screening data, schools can determine the perspectives needed to gain a complete picture of a student’s mental health. It likely won’t be necessary to have eight different informants, but having more than one is often the best way to gain a complete picture of students’ SEB functioning. 

Supporting Equity with Quality Data

Lastly, it’s crucial that schools incorporate an equity lens. Schools can apply this lens by asking:  Are we using screening instruments and data to ensure equitable SEB outcomes for all kids? 

I would encourage schools to be sure that the quality of the information going into their system is directly related to the quality of data that’s produced, as well as the decisions that follow. In our world, we have a saying that says junk data in is junk data out. Junk data results from:

untrained raters and different perceptions of socially acceptable behavior.

From an equity lens, this is particularly important given the long history of disproportionate outcomes, suspensions, and expulsions for children from minority backgrounds. Screening can be a very important tool if your teachers are trained to approach the process with the perspective that data can reveal important differences and drive informed decisions that ensure that the school services that we provide facilitate equitable, educational, and SEB outcomes for students.

What to Do with Discrepant Data

As mentioned before, student SEB data varies depending on context, which is why it’s valuable to have multiple perspectives. That said, correlation among raters on specific universal screening tools tends to be low. And at first glance that might be highly problematic for a school–though in reality, this can be highly useful for the decision-makers. 

For example, if Mrs. Jones rates a student very high in their ability to appropriately engage with their peers, but Mr. Lincoln rates the same student very low in the exact same area, the school-based decision makers reviewing that data might really struggle to understand which teacher’s score is correct And the answer could be: both.

Let me explain. 

How to Address Rater Discrepancy

There are a couple of strategies that I would recommend to address rater discrepancies: 

  1. Understand the type of behavior to be identified. Teachers can sometimes have difficulty in reliably identifying students with internalizing concerns – it is important to then get that student’s self perspective on how they’re experiencing those concerns.
  2. Understand that discrepant raters are OK. Teachers rating students very differently could be an important clue as to the emotional or behavioral response in one academic setting versus a different one.
  3. Consider access to a particular behavior. Students are not as accurate at identifying their own social or externalizing problem behaviors and teachers are not as accurate when it comes to identifying internalizing concerns.

Approaches for Reconciling Discrepancies

Moving forward, how do we synthesize and reconcile some of those discrepancies? 

One method I recommend is called the “trait score approach.” Using this approach, a decision maker purposely selects informants who are expected to vary due to the differences in context. For example, schools may select a rater based on a subject area where the student struggles or is more likely to display problematic behavior and another in which a student excels.  Knowing or expecting those differences to occur can also lead to some consistency in that a child might be more likely to express risk or need in a very specific context and not in another. This approach expects differences and allows schools to consider multiple perspectives rather than just comparing different scores on certain items or subtests. 

Key Takeaways

  1. Universal screening can be an important tool to facilitate critical early intervention services, including those that support mental health.
  2. The use of multiple perspectives is not necessarily a problem when discrepant data occur. In fact, having differing viewpoints is a signal that more conversations are needed. 
  3. Having access to perspectives of different raters offers educators more complete pictures of their students’ mental health.

 

To learn more, you can view my SEB Master Class: Leveraging Dual Perspectives in SEB Universal Screening here.

 

 

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Illuminate Education equips educators to take a data-driven approach to serving the whole child. Our solution combines comprehensive assessment, MTSS management and collaboration, and real-time dashboard tools, and puts them in the hands of educators. As a result, educators can monitor learning and growth, identify academic and social-emotional behavioral needs, and align targeted supports in order to accelerate learning for each student. 

Ready to discover your one-stop shop for your district’s educational needs? Let’s talk.

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