Effectiveness of an online suicide prevention program for college faculty and students.

Objective: Suicide prevention programs help college staff and students identify students at-risk for suicide. Kognito is an online, simulation-based suicide prevention program. The purpose of the current study was to evaluate Kognito's effectiveness in changing suicide prevention attitudes and behavior. Participants: 170 college students and 140 college staff completed the training module and three surveys. Methods: College staff and students from 24 public, private, and community colleges and universities in Maryland completed Kognito modules and pre-, post-, and 3-month follow-up assessments. Results: Both college staff and students exhibited significant improvements in reported Preparedness, Likelihood, and Self-Efficacy in gatekeeper attitudes. Students reported significant gains in gatekeeper intervention behaviors. Conclusions: The current results suggest that Kognito is associated with attitudinal change for college staff and students, but only college students demonstrated statistically significant behavioral impact for both being more likely to ask about suicide and refer peers to counseling.

Impact of a School-Based, Multi-Tiered Emotional and Behavioral Health Crisis Intervention on School Safety and Discipline.

Schools across the United States are struggling with how to formulate comprehensive and effective programs to address the mental health needs of students and to promote school safety. This study, funded as part of the National Institute of Justice Comprehensive School Safety Initiative, employed a randomized controlled study design to evaluate the impact of a multi-component package of crisis prevention and response interventions on school safety and discipline outcomes, including suspensions, office discipline referrals, bullying reports, juvenile justice referrals, threat assessments, and follow-up procedures. Forty schools participated, all in a culturally diverse Mid-Atlantic, US school system spanning urban, suburban, and rural areas. The Emotional and Behavioral Health-Crisis Response and Prevention (EBH-CRP) intervention is a comprehensive training, organizational, and support protocol for school and community stakeholders aimed at increasing competence in preventing and responding to student EBH crises using multiple evidence-informed strategies that address emotional and behavioral health concerns across the continuum of supports. Results indicate that the EBH-CRP intervention had a significant positive effect on suspensions, office discipline referrals, and juvenile justice referrals for secondary schools. In addition, the intervention had positive effects on the number of bullying reports overall, with a particularly strong impact on primary schools. The intervention also had positive effects in maintaining more use of threat assessment and follow-up procedures. Although the intervention had a significant positive effect on secondary school-level suspensions, there was no impact on racial/ethnic disproportionality rates for this outcome. Implications for school safety prevention are discussed.

Between-teacher variance of students' teacher-rated risk for emotional, behavioral, and adaptive functioning.

As schools increasingly adopt universal social, emotional, and behavioral screening, more research is needed to examine the effects of between-teacher differences due to error and bias on students' teacher-rated screening scores. The current study examined predictors of between-teacher differences in students' teacher-rated risk across one global and three narrow domains of behavioral functioning. Participants included 2450 students (52.1% male, 54.2% White) and 160 teachers (92.1% female, 80.3% White) from four elementary schools in one Southeastern U.S. school district. Teachers rated student behavior on the Behavior Assessment System for Children (Third Edition) Behavioral and Emotional Screening System (BESS)-Teacher Form and completed a survey about their training and perspectives of common behavior problems. Results of multilevel linear regression found between-teacher effects to be greater for internalizing risk scores (intraclass correlation = 0.23) than for externalizing risk scores (intraclass correlation = 0.12) or adaptive behavior scores (intraclass correlation = 0.14). Statistically significant student predictors in most models included student grade, gender, race and/or ethnicity, office discipline referrals, and course grades. We also detected effects of several teacher-level variables in one or more of the models, including teacher gender, teacher ratings of problem severity and concern for hypothetical children displaying behavior problems, and the covariance of random teacher intercept and teacher random slopes for students' office discipline referrals. Although these factors explained some teacher-level variance in students' risk scores, a notable amount of variance between teachers remains unexplained. Future research is needed to fully understand, reduce, and account for differences between teacher ratings due to error and bias.

Can We Move the Needle on School Mental Health Quality Through Systematic Quality Improvement Collaboratives?

Learning collaboratives (LCs) have often been used to improve somatic health care quality in hospitals and other medical settings, and to some extent to improve social services and behavioral health care. This initiative is the first demonstration of a national, systematic LC to advance comprehensive school mental health system quality among school district teams. Twenty-four districts representing urban, rural, and suburban communities in 14 states participated in one of two 15-month LCs. Call attendance (M = 73%) and monthly data submission (M = 98% for PDSA cycles and M = 65% for progress measures) indicated active engagement in and feasibility of this approach. Participants reported that LC methods, particularly data submission, helped them identify, monitor and improve school mental health quality in their district. Qualitative feedback expands quantitative findings by detailing specific benefits and challenges reported by participants and informs recommendations for future research on school mental health LCs. Rapid-cycle tests of improvement allowed teams to pursue challenging and meaningful school mental health quality efforts, including mental health screening in schools, tracking the number of students receiving early intervention (Tier 2) and treatment (Tier 3) services, and monitoring psychosocial and academic improvement for students served.