Building Partnerships to Support Mental Health Needs in Diverse Rural Schools: The National Center for Rural School Mental Health

Children lined up in a school hallway

Written by Wendy M. Reinke, Director of National Center for Rural School Mental Health 

Prior to the pandemic, 1 in 5 school-age youth experienced serious mental health issues. During the pandemic, these numbers grew, with emergency room visits for mental health issues increasing by 24 percent among children and 31 percent among adolescents. Given this rise in mental health problems, the U.S. Surgeon General released an advisory in December 2021, outlining ways to prevent and treat the mental health challenges facing youth. School-based prevention and intervention supports are part of this solution, but in rural schools, geographic isolation and limited resources make it difficult to access these services. The U.S. Department of Education’s Institute of Education Sciences-funded National Center for Rural School Mental Health (NCRSMH) is working to address this challenge.

This National R&D Center builds on a coalition partnership in Missouri and is supporting new partnerships with rural school districts in Missouri, Virginia, and Montana. Each state provides a unique geographical context that has informed the tools and interventions we are developing for wide use in rural schools. For example, Missouri sits in the middle of the country, where half of the school districts are considered rural and another third are considered small towns. Virginia encompasses central Appalachia, which struggles with issues of underemployment, mental health, and school dropout. In Montana, rural residents are scattered across 56 counties, 30 of which are classified as “frontier” counties with three or fewer persons per square mile. To address these diverse conditions, our team has built an Intervention Hub and Cost Calculator to help rural schools easily access tools they can afford and that will work for their local context to support their students’ mental health needs.

A cornerstone of the Center is the use of an assessment tool that allows schools to gather data to determine their needs for school-level prevention, group-based interventions, and individualized interventions. The tool, called the Early Identification System (EIS), allows schools to collect information from teachers and students themselves in a feasible and efficient fashion across seven areas of risk that we know are directly linked to mental health issues: peer relationship problems, attention and academic problems, emotion dysregulation, externalizing problems like aggression, internalizing problems like depression and anxiety, school disengagement, and bullying behaviors.

Recent data from students in our rural schools indicates that 20 percent of youth always or often felt sad in the past month, and 15 percent felt worried, with this being more likely for girls than boys. Teachers reported that 36 percent of students were easily distracted, 13 percent have poor social skills, and 19 percent have poor academic performance. Identifying early indicators of later mental health problems, like internalizing symptoms and poor social skills, allows schools to intervene early and help prevent larger concerns later.

The EIS provides schools with reports using a red, yellow, green format. This way, schools can quickly identify areas of concern (red) and areas where students are doing well (green). Then, schools have access to the EIS Intervention Hub, which allows them to link the information from the EIS directly to a menu of options of evidence-based interventions that we know have been shown to support improvement in the area of concern. Most of the interventions available are free, easy to use, and have all the information needed for schools to implement them -- in most cases without external support.

Over the next three years, we will be recruiting 100 rural school partners across our three geographic regions to evaluate the impact of using the EIS tools on students’ mental health and academic achievement.

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