Student mental health: a guide for school staff

Young children may not yet have the words to say “I’m scared” or “something is wrong at home.” Distress often leaks out through their bodies, behaviour and play instead.

You might notice

• Clinging to a parent at drop-off or trouble separating
• Losing skills they had (toileting accidents, baby talk)
• Repetitive play that acts out a scary event
• Headaches and stomach aches with no clear cause
• Trouble concentrating, or sudden reckless or aggressive behaviour
• Worry about their own safety or their family’s
• Talk of guilt or shame about something that happened

What helps

• Calm, predictable routines and warnings before changes
• Simple words for feelings, and a feelings chart on the wall
• Drawing, play and quiet time to settle
• Patience if some skills slip back for a while
• A quick, warm check-in each morning

Middle school brings puberty, new friend groups and more time online. Fitting in matters enormously, so bullying, exclusion and online conflict can hit hard. Many students hide struggles because they don’t want to look different.

You might notice

• Eating alone or sudden loss of a friend group
• Avoiding certain places: hallways, bathrooms, the bus, the cafeteria
• Lost or damaged belongings, unexplained injuries
• Dropping grades, missing work or skipping class
• Moodiness that seems bigger than “normal” for this age
• Reluctance to come to school on certain days

What helps

• A trusted adult the student can go to without needing a reason
• Clear, enforced anti-bullying expectations
• Teaching students how to be “upstanders”
• Clubs and activities that build belonging

Teens often feel self-conscious about their emotions and worry about being seen as “abnormal.” After a hard experience they may withdraw from family and friends, feel shame, or take more risks.

You might notice

• Withdrawing from friends, teams or activities they loved
• Chronic absences, sleeping in class, or falling behind
• Reckless, self-destructive or accident-prone behaviour
• Sudden anger, revenge talk or fights
• Writing, art or posts about death, hopelessness or being a burden
• Covering skin in hot weather, or unexplained cuts and burns

What helps

• Respecting their growing independence while staying close
• Explaining “acting out” as possibly anger or pain looking for a voice
• Offering choices and a say in their support plan
• Connecting them with counselors, mentors and peer groups

Good times and places

• A quiet minute after class, not in front of peers
• Walking together, or side by side on a task
• At the start of a free period, not right before a test
• A note or a quiet word if talking face to face feels too much

You could say

• “I’ve noticed you’ve seemed quieter this week. How are things?”
• “You usually love art, and lately you’ve been sitting out. I wondered if something’s up.”
• “I care about how you’re doing, not just your grades.”

Try to avoid

• Guessing at a diagnosis (“I think you’re depressed”)
• Lecturing or problem-solving straight away
• Comparing them with other students
• Promising to keep anything secret

Helpful habits

• Let silences sit; many students need time
• Reflect back what you hear: “That sounds really hard.”
• Thank them for telling you
• Ask what would help, and offer a choice of next steps

• Explain honestly who you will talk to, and why
• Offer to walk them to the counselor rather than just giving a name
• Write down what you noticed (see the “Student observation note” worksheet)
• Check in again in a day or two

NCTSN’s framework includes students and families as full partners in planning support, which builds trust and acceptance. Families often know what helps at home, what has worked before, and what is going on in the child’s life.

Tips for a good meeting

• Start with something positive about the student
• Share specific observations, not labels (“She’s put her head down in 4 of 5 classes this week”)
• Ask: “What do you see at home? What helps?”
• Offer an interpreter if a family prefers another language
• Agree on one or two next steps and a date to check in
• Avoid diagnosing — suggest a check with their clinical provider or school psychologist

School counselors hold at least a master’s degree in school counseling and a state certification or license. They design a counseling program for all students covering academic, career and social-emotional development.

Their core work (ASCA)

• Classroom lessons based on student standards
• Academic planning and goal setting
• Short-term counseling for individuals and small groups
• Referrals for long-term support
• Using attendance, discipline and achievement data to spot needs
• Advocating for students at IEP and other student meetings

School counselors do not provide therapy or long-term counseling in school. They recognize and respond to mental health needs and connect students and families to ongoing care.

How teachers can partner

• Invite them to co-teach a lesson on stress, friendship or study skills
• Refer early, with specific observations
• Share patterns you see across a class, not just single students
• Ask for strategies to use in class after a student has seen them

School psychologists have specialist-level or doctoral graduate training and state certification or licensure. They apply expertise in mental health, learning and behaviour, and many serve more than one school.

What they bring to a team

• Psychological and educational testing, and explaining the results
• Gathering information about a student’s behaviour and learning conditions
• Helping design positive behaviour strategies and plans
• Consulting with teachers on teaching and classroom approaches
• Counseling for students and parents
• Crisis prevention and response

School social workers are trained mental health professionals with a social work degree. They focus on how outside-of-school life affects learning, and they help families and staff work together.

How they help staff

• Sharing cultural, economic, family and health factors that affect a student
• Assessing students with mental health concerns
• Training staff and helping with behaviour management
• Advising on school policy, including IDEA and Section 504
• Coordinating community and mental health agencies
• Managing cases for families who need several services

School health and school nurse services are among the related services a student can receive under IDEA.

Working together

• Know which of your students have health plans and what to do in an emergency
• Tell the nurse when a student often complains of aches before certain classes
• Ask the nurse to share repeated-visit patterns with the counselor
• Brief substitutes on health plans

Special education teachers and related service providers, such as speech-language pathologists and occupational or physical therapists, carry out specialized parts of a student’s IEP. They are also a resource for classroom teachers.

Ask them

• “What does this goal look like in my class?”
• “Which strategy from your sessions can I reinforce?”
• “What data do you need from me?”
• “Can you observe and give me feedback?”

In 2023, 65% of LGBTQ+ high school students felt persistent sadness or hopelessness, compared with 31% of heterosexual peers. CDC finds that when schools put LGBTQ+-supportive practices in place, all students show less emotional distress, less violence and harassment, and fewer suicidal thoughts and behaviours.

Practices CDC recommends

• Student clubs such as Gender and Sexuality Alliances (GSAs)
• Safe spaces where students know they are welcome
• Anti-harassment policies that are enforced
• Staff professional development on inclusion

CDC notes that the more of these practices a school uses, the better student health outcomes tend to be.

Everyday actions

• Interrupt slurs and teasing every time
• Use the name a student asks you to use, following your school policy
• Keep what students share about identity private
• Show visible signs of welcome

The U.S. Department of Education’s Newcomer Toolkit highlights a welcoming environment and social-emotional support as key needs of newcomer students and families. Being welcomed by culturally aware staff who communicate in a language the family understands makes a real difference.

Some newcomers have experienced war, displacement, loss or long journeys. Others are adjusting to a new language, culture and school system all at once. Belonging should be built together — not left as the student’s job alone.

What helps

• A buddy or peer guide for the first weeks
• A tour, visual signs and a simple map of the school
• Interpreters for families
• Patience with silence while learning a new language
• Trauma-sensitive classroom practices
• Connecting families with community organisations

Signs to notice

• Dreading work, or feeling numb
• Thinking about students’ stories when you’re trying to rest
• Irritability, poor sleep, or feeling hopeless
• Pulling away from people you love

What helps (NCTSN)

• Build self-awareness about your stress
• Keep a work-life balance
• Move your body, eat well, rest
• Stay connected with people
• Use your Employee Assistance Program or counseling if needed
• Pair up with a self-care “buddy” to keep each other accountable

NCTSN says education, skills training and supervision together are the most important ways to prevent secondary traumatic stress. Its trauma-informed schools framework includes staff self-care as a core area.

Ideas for schools

• Reflective supervision or regular debriefs
• Balancing caseloads where possible
• Staff wellbeing groups
• Flexible time after a crisis
• Checking in on staff resilience regularly
• Training on trauma and secondary stress

Feeling isolated raises the risk of secondary stress, and staying connected lowers it. A staff community that checks in on each other, shares the load and celebrates small wins helps everyone last longer and care better.

Try

• A weekly “one good thing” moment at staff meetings
• A quick “How are you, really?” to a colleague
• Covering a class so a colleague can take five minutes after a hard moment
• Peer support or wellbeing circles

Free, confidential, 24-hour support from trained crisis counselors for anyone in suicidal crisis or emotional distress. That includes students, families and staff.

Free, confidential support by text with a trained crisis counselor, any time of day or night.

Counselors can talk through a worry about a child and help you work out how to make a report. The hotline is not connected to 911, so call 911 if a child is in immediate danger.

Reports usually go to your state or local child protective services. Many states have their own toll-free reporting number, listed by the Child Welfare Information Gateway.

Find A Helpline is a free directory of verified helplines in over 150 countries, reachable by phone, text, chat or WhatsApp. The International Association for Suicide Prevention shares it as a way to find support.

Places to turn

• A trusted colleague, supervisor or peer support group
• Your Employee Assistance Program (EAP), if your school has one
• Your own clinical provider or a counselor
• 988, by call or text, if you are struggling