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School Mental Health Referral Pathways

Introduction

School mental health referral pathways are the processes and procedures used to identify student mental health needs and connect students with the appropriate mental health supports and resources. These pathways exist in the context of an equitable, multi-level system of supports, which provides a conceptual model for organizing mental health supports in schools. Clearly defined referral pathways are an essential part of meeting the needs of every learner because they:

  • Provide next steps for staff when they identify a student in need;
  • Coordinate supports within schools and between schools and outside organizations
  • Improve student outcomes through early identification and intervention

Although the word “referral” can mean connecting a student to external service providers, a highly functional referral pathway includes pathways to both school and community supports, with strong relationships and sustained collaboration between both systems.  

Referral Pathway Action Steps

In order to create an effective pathway, schools must consider the specific needs and resources of their school and community. Schools can utilize the Referral Pathways Self-Assessment to assess the current functioning of referral procedures. After identifying gaps in the pathways, schools can utilize the following action steps to address gaps in the system.

 

School Mental Health Referral Pathways Module Series

new View the School Mental Health Referral Pathways Module Series for more information, tools, and local examples. This module series can be utilized by schools that are at any point in the process of building and improving their mental health referral pathways.

Building or strengthening existing pathways to mental health support: Refer to DPI’s Mental Health Referral Pathways document

Comprehensive look at school mental health referral pathways: Refer to SAMHSA’s School Mental Health Referral Pathways Toolkit

Tools and Resources

For more tools and resources, use the dropdown menus below to explore each step in building a school mental health referral pathway.

Mental Health Teaming

The school mental health team is responsible for the oversight and implementation of a school’s mental health referral pathway. Mental health teams include a variety of school staff, community members, and student and family representatives. This team should be integrated with the school’s established PBIS/MLSS teams to promote alignment across the system.

Procedures for Managing Referral Flow

An effective referral pathway proactively identifies student needs and matches students to evidence-based interventions and supports that best fit those needs. Referral procedures are clearly defined, accessible to everyone, and communicated to staff, students, community partners, and families. Staff understand their role in collecting referrals, expanding upon initial referral information, making decisions about interventions and supports, and documenting the process.

A System for Information Gathering

Mental health teams establish processes and procedures for expanding on initial referrals. Direct student observation, interviews, and assessments are examples of approaches teams may use to increase their understanding of the student’s strengths and challenges. The results of these information-gathering processes can also provide important information about the adult behaviors and school and district policies and procedures that may be contributing to the student concern. This information is used in conjunction with existing data to inform team decisions about how to best support the student, and should be shared with consideration for confidentiality and information sharing and privacy laws.

A Secure Student Record Management System

Mental health referral pathway procedures generate referral forms, observation, interviews, releases of information, and other paperwork that need to be securely stored. Teams will determine appropriate levels of access for team members that best maintain student confidentiality.

Needs Assessment and Resource Mapping

School Mental Health teams engage in needs assessment to gather, analyze, and share information on student risk and protective factors. Existing student data, screener results, and broader community data are examples of useful indicators of strengths and risks. Resource mapping, on the other hand, is a process of identifying available supports and evaluating the breadth and quality of those supports. Engaging in these complimentary processes ensure that appropriate interventions are available when student needs arise.

  • School Mental Health Quality Guide: Needs Assessment and Resources Mapping- From the National Center for School Mental Health, this guide provides background information on needs assessment and resource mapping, best practices, possible action steps, examples from the field, and resources.
  • Resource Mapping Checklist- This template provides a list of possible resources to be included in the resources mapping process.
  • Gap Analysis Worksheet- From the National Center for School Mental Health, this worksheet helps schools identify gaps between needs and available resources.
  • Screening Resource Guide- From Wisconsin DPI, this resource guide provides information on selecting, implementing, and action planning around screening results.
  • SHAPE Quality Assessment- This assessment is used to improve the quality of school mental health systems. Needs assessment/resource mapping is one of the quality domains included in this tool.
Decision Rules for Determining Appropriate Intervention

A major role of the School Mental Health Team is to ensure that students are paired with the most appropriate and helpful interventions available. To ensure efficient and effective triage, teams create decision rules for determining when a student needs a level 2 or 3 intervention, if an intervention is complete or should be discontinued, and possible sources of positive outcome data.

Systems for School-based Monitoring of Intervention Effectiveness

School mental health teams should establish and utilize a system for monitoring the effectiveness of the interventions and supports provided to students. This includes gathering both process and outcomes data on interventions delivered in school, effectiveness data from community partners, and feedback from the student and their family.