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

Checklists for Organizing Intermediate and Long-Term Mental Health Services After a School-Related Act of Violence

Guidelines for Superintendents

At the highest levels of leadership in schools and community mental health agencies, the Superintendent of Schools and the Director of Public Mental Health Services (County or other regional entity), are instrumental in establishing the overarching collaborative organization agreements that permit and encourage collaborative mental health services in schools. Their agreement provides important institutional sanction and the recognition that students and staff may be in need of assistance after an act of violence at the school.

Delegation of authority for the specific program details is usually given to the division or department which is responsible for student health and human services or student operations and safety in larger school districts or to the school site administrator in smaller districts. In the public mental health system, the authority is often delegated to the child mental health professionals.

SCHOOL SITE CRISIS TEAM CHECKLIST

The chart below is a list of crisis team positions that can be designated from among existing local school staff in preparation for immediate crisis response. In addition to the person with the lead responsibility for each function, two alternates with similar capabilities should be identified in the event that the lead person is not available when needed.

When the chart is completed at the beginning of each school year, it should be distributed to all staff so that every adult will be aware of who is responsible for specific crisis response functions. Provide an updated list if personnel or designated assignments change during the year. Individual checklists for the intermediate and long-term phases are listed in the pages that follow.

POSITION	RESPONSIBILITY/FUNCTION*
Principal or Site Administrator	Acts as Incident Commander, officially convenes the school site team; requests additional support, if needed; keeps central office informed
Assistant Principal	Assesses the extent of physical and emotional impact on the school; serves as logistics coordinator (identifies rooms for media, counseling, parent meetings, etc.)
Teachers	Maintains calm and supports students in the classroom; refers students as needed
School Counselor, School Psychologist and School Social Worker	One is designated a leader of crisis counseling team; remainder provide individual and group counseling and psychological first aid to students/staff
School Nurse	Monitors health problems and somatic complaints initiated by crisis event
Attendance Counselor	Monitors student attendance and organizes outreach to parents and students to return fearful students to school
Plant Manager/Custodian	Responsible for hazard mitigation

*Source: Jane's School Safety handbook, 2001

PRINCIPAL CHECKLIST

Primary Role: The principal is the instructional and operational leader of the school who gives final approval for all personnel and programs implemented on the school campus. S/he sets the tone for recovery, conveying concern and support for all recovery efforts, with an eye to reducing or eliminating stigma for those who seek additional services and care.

TASKS

Identify an "in-house" mental health program coordinator/director or "point person" who can provide leadership and technical expertise:
__________	Delegate authority to a school counselor, school psychologist or school social worker to assist with the organization, implementation, coordination and maintenance of the intermediate and long- term mental health services in the school
Convene school and community meetings to review interventions and gather information from the immediate phase of crisis response:
__________	A. Meet with all staff and review the first 45 days since incident occurred
__________	B. Meet with parents and community to review the first 45 days
__________	C. Meet with district personnel to review the first 45 days
Assess current information:
__________	A. Identify the intermediate and long-term recovery needs as expressed by staff community, and district
__________	B. Review roles and responsibilities of Health and Human Services personnel at the school; adjust job roles and responsibilities as needed to meet the needs of students and staff
__________	C. Assign staff to review school records to help identify "at-risk" students who may need further mental health assistance _____1. Academic records _____2. Attendance records _____3. Health records
__________	D. Make logistical arrangements for a comfortable, quiet location on campus or off campus where school and community mental health professionals can provide mental health recovery services for students
__________	E. Authorize intermediate and long-term recovery awareness training for: _____1. Teachers _____2. Health and Human Services personnel _____3. Nurses _____4. Staff _____5. Community mental health personnel
Communication:
__________	A. Focus on positive messages to the media: _____1. Students and staff are cared for and services are available on campus or in the community (specific location is important) _____2. The best place for students is at school; calm routine and social activities are stabilizing and supportive environments conducive to healing/recovery _____3. Although services are confidential, the principal wants to know when any member of the school family is facing new challenges or difficulty because of the traumatic event
__________	B. Keep staff informed via regular meetings and communication: _____1. Give regular updates to describe on-campus and community services _____2. Authorize procedures for assessing and referring students _____3. Allow for question and answer periods in staff meetings
__________	C. Provide leadership and support in establishing a working relationship with community and in-school mental health professionals.
__________	D. Meet with district-level staff to review the regular services grant to Project SERV and any other funding/in kind services.
__________	E. Meet regularly with all mental health staff to check needs of students and faculty.

TEACHER CHECKLIST

Primary Role: The teacher is the instructional leader of the classroom who gives consent for students in his/her classroom to be excused from class for mental health services. S/he sets the tone for recovery, conveying concern and support for all recovery efforts, with an eye to reducing or eliminating stigma for students who seek additional services and care.
TASKS
__________	A. Re-establish classroom routine and maintain the teaching and learning environment of the classroom
__________	B. Help identify the changes in student behavior or life circumstances that may indicate impairment of health, mental health or problems of living that are secondary adversities resulting from the traumatic event
Participate in Training: Intermediate and long-term mental health challenges may be unlike those of the immediate aftermath of a disaster or crisis. Each child and adult recovers at a different rate depending upon the level of exposure and other risk factors. Training in intermediate and long-term recovery will help increase understanding of the behavior of students. Staff development for teachers should include the following components
__________	A. Honing observation skills
__________	B. Understanding symptoms
__________	C. De-stigmatizing mental health referrals
__________	D. Importance of sensitivity to changes of students
__________	E. Procedures for referring students
__________	F. Self-care and stress reduction
Communication:
__________	A. Keep open communication with students, staff and administration
__________	B. Expect regular updates describing campus services
__________	C. Insist upon question and answer time during faculty meetings
__________	D. Convey an open invitation for students to talk about how they are doing

SCHOOL MENTAL HEALTH PROVIDER CHECKLIST

Primary Role: The school counselor, school psychologist, and school social worker represent the "in-house" mental health professionals of the school. One of these individuals may be identified as the leader or coordinator or director of the school-based mental health program during the intermediate and longer-term phases of recovery. S/he may identify additional mental health resources in the community, negotiate and oversee the overall mental health recovery program and the role of community providers in the school. S/he sets the tone for recovery, conveying concern and support for all recovery efforts, with an eye to reducing or eliminating stigma for students who seek additional services and care.
TASKS
__________	A. Provide support, technical assistance and advice to the principal
__________	B. Provide support and consultation as needed to faculty and staff
__________	C. Provide mental health recovery information and support to parents
__________	D. When authorized by the principal, acts as liaison with community-based agencies and oversees the work of community mental health professionals providing services to students on campus
__________	E. Provide training to faculty and staff, as appropriate
Participate in Training:
__________	A. Receive specialized training in issues related to intermediate and long-term mental health including phases of recovery, effective interventions, child trauma, depression, etc.
__________	B. Translate technical aspects of mental health information to staff as appropriate
__________	C. Give attention to self-care and stress reduction techniques using community resources
Communication:
__________	A. Work closely with principal to develop and maintain the on-site mental health program
__________	B. Maintain close contact and open communication with students, staff and parents

SCHOOL NURSE CHECKLIST

Primary Role: The school nurse is the school-based professional who represents health and medical services to students. As such, his/her role is to support the long-term recovery of students and staff by providing information and consultation about the effects that psychological trauma and depression may have on health outcomes. S/he is a team member with the school counselor, school psychologist and school social worker, assisting with the identification of students who are at risk for long-term mental health challenges because of the traumatic event. S/he sets the tone for recovery, conveying concern and support for all recovery efforts, with an eye to reducing or eliminating stigma for students who seek additional health and mental health services and care.
TASKS
__________	A. Oversees health and well-being of students
__________	B. Assists in identifying children and staff who may need additional mental health services and support
__________	C. Provides training, as appropriate, to students and staff about the interplay of health and mental health factors
Training:
__________	A. Honing observation skills
__________	B. Understanding symptoms
__________	C. Monitoring high risk students
__________	D. Coordinating referrals from staff and students
__________	E. Establishing open communication with staff and students
__________	F. Self-care and stress reduction
Communication:
__________	A. Meet regularly with mental health professionals
__________	B. Receive regular updates describing campus services
__________	C. Be available for question and answer time during faculty meetings
__________	D. Encourage students and faculty to share concerns

COMMUNITY MENTAL HEALTH PROFESSIONAL CHECKLIST

Primary Role: The community mental health professional serves as a supplemental service provider and consultant to the school. His/her role is to support, not supplant the mental health services that are provided by the school counselor, school psychologist and school social worker. S/he sets the tone for recovery, conveying concern and support for all recovery efforts, with an eye to reducing or eliminating stigma for students who seek additional services and care. The community mental health professional also helps the school site administrator to recognize and plan for intermediate and long-term services for staff and may play a primary role in responding to unforeseen crises may arise during successive phases of recovery.
TASKS
__________	A. Understand special role in the school _____1. Support not supplant, existing services _____2. Work within the context of the mission of the school, i.e., restore and help to maintain a positive learning environment
__________	B. Work in concert with school-based mental health professionals
__________	C. Provide training consultation and support to faculty and staff, as appropriate
Training: Because community mental health professionals are not school employees, they may be carefully screened for experience and training in child trauma treatment. This may include pupil personnel credentials, licensure or evidence of special coursework.
__________	A. Possess or receive technical training in intermediate and long-term recovery child and adult treatment issues
__________	B. Self-care and stress reduction techniques
Communication:
__________	A. Work collegially with school-based mental health staff
__________	B. Prior to any additional referrals or recommendations for other services, confer with school counselor, school psychologist or school social worker designated as the "in-house" leader or program coordinator and /or principal
__________	C. Provide a monthly service report
Prepared by Arlene Fink Associates, 1562 Casale Road, Pacific Palisades, CA 90272 under contract for the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration

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

Checklists for Organizing Intermediate and Long-Term Mental Health Services After a School-Related Act of Violence

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