A Guide for Intermediate and Long-term Mental Health Services
After School-related Violent Events

Establishing a Community Infrastructure

School crisis intervention includes the concepts of readiness, response and recovery supported by the U.S. Department of Education and Project SERV.

School and community readiness includes development and implementation of safety policies and plans, including the development and maintenance of partnerships with key agencies and organizations such as community health and mental health agencies, local religious institutions, law enforcement and emergency responders. The more solidly that schools develop parallel structures and common methods of communication, well in advance of a crisis or disaster, the more likely that the physical and emotional needs of students and staff will be promptly and adequately met. The important work of the school and community partners is the identification of service or policy gaps prior to the development of a crisis, filling these gaps, and evaluating effectiveness.

"There are many legal issues that impact school response including children as witnesses, crime scene preservation, documentation of clinical impact, maintenance of records, school and mental health provider liability, etc."
-RADM Brian W. Flynn Ed.D., Assistant Surgeon General

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School Calendar, Climate and Culture

The school is a complex, living organism, a system of people, programs and facilities within a community. Not all schools are alike. Some experts in school crisis response have theorized that schools are much like families. Some are open and inclusive. Others are closed to "outsiders" and to students who do not conform to formal or informal standards of behavior.

For example, the climate of the school can be positive and supportive, with clear, equitable, and enforceable standards of behavior among students and staff, reducing threats and violence in the environment. On the other hand, the culture of the school may promote the interests of a few to the detriment of many, ignoring bullying and permitting favoritism.

The school calendar is an important factor in response and recovery efforts. Because each school year begins and ends within a period of 180 instructional days, students are highly attuned to signpost school events such as Homecoming, winter and spring formals, religious holidays, graduation events, SATs and other testing dates that become charged with negative or highly emotional responses to violent events on or near campus. Mental health recovery efforts must always be aware of traditional school activities that become traumatic reminders of loss, such as the birthday of a student killed on campus or the first Christmas spent without a childhood friend.

The school is a microcosm of society. Within its walls are especially vulnerable students, such as those with pre-existing mental disorders or histories of neglect, trauma or violence. Also vulnerable and highly at-risk to violence exposure and stress are students in communities of poverty, ethnic minorities and gay and lesbian students, who may benefit from additional mental health support in the aftermath of an act of school-related violence.

The school is also part of a larger community, and just as that community shares in the effects of school-related violence, it also shares in the recovery process. The diagram below serves as a conceptual framework for understanding the interacting relationships of all school-related groups with each other and within the context of the larger community. Even though a crisis occurs on the school campus and immediately affects those in the inner circle of school-related groups, there is an ongoing need for the school system to link to groups in the outer community circle as they begin to meet the mental health needs of the school community.

For example, school-community linkages may be especially important for those students who may be at higher risk for mental health problems such as juvenile offenders, children in foster care, and those with a history of receiving mental health services. Likewise, a good working relationship between the school and the media can potentially play a pivotal role not only for the affected school and community but also for schools and communities nationwide.

An infrastructure of relationships among all stakeholders must be maintained, so that if a school-related violent event does occur, recovery can take place as seamlessly as possible.

While phases of response and recovery may have common features, the specifics of the infrastructure, providers, and services are locally determined. In general, the organization of services is best served by establishing three groups, each having a specific task.

Figure 1: The School in the Community

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The Immediate Services Working Group

The first step in planning for school recovery services is to assess the overall needs of a school and articulate those needs within the Project SERV Immediate Services Grant (ISG) application. School stakeholders may include the following individuals from the school and district:

• Superintendent or his/her representative
• Chief fiscal officer or his/her representative
• School police or school resource officer
• District health and mental health administrators
• School board member
• Principal/school site administrator
• Teacher representative
• Parent representative
• Head school site counselor, school psychologist or school social worker
• School office manager
• School custodian

At the ISG planning meeting, the school/district should invite established partners from public and private non-profit community mental health agencies that are currently providing services to the school or have provided school-based services and programs.

From the ISG working group, a Community Advisory Working Group will be formed, comprising individuals who are committed to shepherding the project through immediate, intermediate and long-term phases of recovery.

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The Community Advisory Working Group

The Community Advisory Working Group includes selected representatives from both the school and community who serve as key informants about mental health needs. The group should meet weekly during the ISG and monthly during the RSG. It may include representatives from the following groups but should not exceed 15 or 20 individuals:

• School administrators and supervisors
• School mental health providers and teacher representatives
• Community-based service providers and organizations
• Parent representatives
• Student representatives

Subgroups of the Community Advisory Working Group can assist with specific tasks such as planning a memorial or making decisions about monetary and other donations made to the school. With adequate support and sensitivity, a smaller group of family victim representatives might be given the opportunity to meet with the principal and one or two selected school and community mental health representatives on a regular basis to ensure that their needs are met and that any actions taken by the school are made in consideration of their feelings and responses. An alternative to meeting with victim representatives is periodically to use program evaluation surveys to capture the feedback of all the stakeholders.

"Input that conveys a school's culture, individual temperaments of key players, and a school's access to resources prior to crisis - input that is inclusive (e.g., students, parents, school staff), from the very beginning, is key to successfully meeting intermediate and long-term goals."
-Angela Oddone M.S.W., NEA Health Information Network

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The Mental Health Provider Working Group

The Mental Health Provider Working Group is composed of mental health professionals, case managers, and other school site service providers. This group combines the information from the Community Advisory Working Group, first hand experiences in the school, and professional expertise to plan and implement the mental health recovery program. The school and community mental health service providers who compose this group should be in daily communication with each other and meet as often as needed during the ISG period to identify and staff the types of mental health services available to meet the specific needs of students, staff and communities.

The tasks of the Working Group include the following:

• Charting the infrastructure
• Crafting organizational agreements
• Mutual aid
• Training
• Mapping chronological services - identifying immediate, intermediate and long-term mental health needs of students, staff, parents and administrators
• Identifying and mobilizing resources
• Defining working relationships of school and community service providers
• Clarifying roles, expectations and parameters of service
• Identifying organizational legal mandates and limitations
• Identifying immediate interventions and assignments, e.g, who will provide psychological first aid for students, teachers, parents
• Identifying potential training/mental health education needs for school staff, parents, administrators, providers, etc., during immediate, intermediate and long-term phases

The Community Advisory Working Group and The Mental Health Provider Working Group continue to work through the intermediate and long-term phases of recovery, re-assessing needs and modifying services to students and staff as appropriate, with the goal of developing multi-level school-based and community mental health approaches and services for preventing, responding, and recovering from trauma.

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