O2127: Building Resilient Minds: Mental Health and Substance Use Curricula, Programs, and Policies in US Schools, 2008-2020

Background: Youth with mental health concerns are more likely to seek help from peers or trusted adults than mental health professionals. Schools have therefore been deemed an ideal setting to provide mental health and substance use (MHSU) services for young people. The overall purpose of the study was to examine trends in MHSU services, curricula, programs, and policies in US middle and high schools from 2008 to 2020.

Methods: Data were collected from seven cycles (2008-2020) of the School Health Profiles (SHP), a national surveillance system operated by the Centers for Disease Control and Prevention (CDC). The survey involves two self-administered questionnaires for the principal and lead health education teacher at randomly sampled schools that serve students from grades 6-12 across the US, covering 44-50 states during the study period. Descriptive statistics were compiled, including percentages (%) and counts (n) of schools that had implemented various MHSU-related services, curricula, programs, and policies. Data from states with a participation rate of 70% or higher for each survey year were adjusted through weighting to accurately reflect the characteristics of schools within those states. Weighted prevalence estimates were then calculated for middle and high schools teaching MHSU topics and integrating school-based MHSU services.

Results: A total of 2718 schools were included in the analytic sample. Between 2016-2020, the provision of counseling, psychological, and social services within schools increased from 46.1% (95% CI: 45.1-47.2%) to 57.9% (95% CI: 56.8-59.0%). Between 2008-2014, the representation of mental health or social services staff on any school health council, committee, or team also increased substantially, from 53.7% (95% CI: 50.6-56.8%) to 74.4% (95% CI: 73.2-75.6%). Furthermore, between 2008-2020, interprofessional collaboration between health educators and psychologists, counselors, or social workers on health education activities increased from 60.2% (95% CI: 59.1-61.2%) to 69.0% (95% CI: 67.8-70.2%). The prevalence of teacher professional development on emotional and mental health, as well as suicide prevention topics, increased drastically, with the latter doubling from 29.4% (95% CI: 28.4-30.3%) to 61.1% (95% CI: 60.0-62.3%) from 2008-2020. Minimal changes were observed over time for the integration of alcohol or other substance use prevention into curricula, school-based services, family and parent education, or teacher professional development.

Conclusion: Although certain MHSU services, curricula, programs, and policies increased between 2008 to 2020, others remained stagnant, with lingering gaps in the availability of family and parent education. Considering the growing MHSU needs of young people, further research is needed on the quality of and time for MHSU curricula and the effectiveness of implementation.