NUR416- Article 1 – school nurse article

Find and read a nursing scholarly article that relates to your clinical practice (school Nurse) and is found in a peer-reviewed journal.

· What is the research question?

· What research method is being used?

· How are the subjects chosen (explain the parameters, sample size, & how many)

· What are the results of the study?

· What are the recommendations?

· What are your opinions?

Submission Instructions:

· lose points for improper grammar, punctuation, and misspellings.

· It must be a research article. Write a 1-page summary using an outline of the steps of the research process, and discuss the study type, purpose, and research question(s) above.

· current APA style and references should be current

· The purpose of these article summaries is for you to educate me on the study – NOT the topic.

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DOI: 10.1177/1942602X241295803
For reprints and permission queries visit http://www.sagepub.com/journalsPermissions.nav.
© 2024 The Author(s) November 2024 39(6) | NASN School Nurse 301

Mental/Behavioral Health

School nurses are members of the school-
based mental and behavioral health
support team. This consensus document
was developed by school nurses and
school nurse leaders in collaboration
with leaders from national associations
and organizations with a vested interest
in K-12 mental and behavioral health.
The document is also publicly available
on the National Association of School
Nurses website.

Keywords: Collaboration;
Multidisciplinary Teams; Mental Health;
Behavioral Health; School-based
Mental Health

Introduction

According to a recent report from the
Centers for Disease Control and
Prevention (CDC), the number of
adolescents experiencing poor mental
health is growing, especially among
LGBTQ+, female, and Black students
(CDC, 2023). In 2021 alone, 70% of
LGBTQ+ students reported persistent
feelings of hopelessness, and 25% of
female students had made a suicide plan.
Youth who have mental health problems

are more likely to experience violence,
engage in risky behavior, and struggle
with school. However, CDC notes that
when youth have strong feelings of
connectedness with school and family,
those bonds can protect their mental
health. Given the rise in poor mental
health among students—and the role
school connectedness plays in protecting
mental health—it is critical that schools
be equipped to provide a safe
environment with mental health
supports.

To identify key priorities and
opportunities in this area, we gathered
evidence from the literature and
interviewed school health care
providers and experts in school-based
health services. Ultimately, our goal was
to help schools build strong
connections with students and deliver
school-based mental and behavioral
health (SBMH) supports to meet the
growing need for them. SBMH care
teams manage mental and behavioral
health supports in their schools,
addressing student needs ranging from
stress management, safety planning,
and substance use to suicide prevention
and coping skills.

Supporting Youth Mental and
Behavioral Health in Schools

Schools play a vital role in preventing
mental health problems among youth, as
well as in identifying and supporting youth
who do have mental health problems.
SBMH providers—including social workers,
psychologists, counselors, and school
nurses as specialized instructional support
personnel—lead the way in helping
schools fulfill this role. Multi-tiered systems
of support (MTSS) is a common framework
used by SBMH providers to assist students
and match them to appropriate supports.
Another framework, positive behavioral
interventions and supports, provides a
similar tiered approach to organizing and
delivering services. Regardless of the
framework, many schools have launched a
student mental health program, and
research shows that these programs help
students achieve academically and build
social and leadership skills, self-awareness,
and positive connections to adults in their
school (Youth.gov, n.d.).

1295803 NASXXX10.1177/1942602X241295803NASN School Nurse / MonthMonth XXXX / NASN School Nurse
research-article2024

Elevating the Role of School
Nurses in School-Based
Mental and Behavioral Health
A Consensus Document

National Association of School Nurses

Adolescents say they are more comfortable
accessing health services through school-
based clinics

302 NASN School Nurse | 39(6) November 2024

The rising number of students who
have mental health concerns means that
schools must prioritize time and
resources when considering a student
mental health program. Whether schools
are just beginning to develop such a
program or are seeking to expand an
existing one, the SBMH providers we
interviewed identified several key areas
that schools can focus on to better
support students (Box 1).

How School Nurses can Support
SBMH Programs and Teams

School nurses have tremendous
potential to work with other SBMH
providers to implement school mental
health programs, yet they often do not
get the opportunity. Although individual
school nurses and education systems
have different levels of readiness or
capacity to support SBMH programs,
school nurses are most successful when
the SBMH care team, principals, and
superintendents engage with them and
understand their role.

School nurses can build their SBMH
team’s capacity to deploy a multitiered
system of supports that is responsive to
student needs. As members of
interdisciplinary teams, school nurses can
collaborate with school personnel—
including teachers, psychologists, social
workers, counselors, and principals—to
assess, identify, conduct interventions for,
refer, and follow-up with children who
need behavioral health services (Reaves
et al., 2022; Substance Abuse and Mental
Health Services Administration & Centers
for Medicare & Medicaid Services, 2019).

School nurses are key members of
SBMH care teams and support mental
and behavioral health (see Image 1).
They [school nurses] also have regular
access to students in school clinics and
are well-positioned to identify students
with potential mental health concerns,
especially for “frequent visitors”—
children who often present with a
physical complaint, such as an upset
stomach, but could have an underlying
mental health issue. This touch point can
increase the speed at which problems
are identified and treatment can begin.

School nurses promote health by
helping students access physical, mental,
and behavioral health care in school and
in the community (Hoskote et al., 2023).
These emerging practices can help
policymakers, school administrators and
teachers, and SBMH providers think
about what school nurses can contribute
to their own schools and how they can
advance key SBMH priorities (Box 2).

Opportunities for Advancing
SBMH Programs

The protective effects of school
connectedness on youth mental health
firmly place SBMH providers, school
nurses, and other school personnel on
the front lines of responding to the
growing crisis (CDC, 2022). However,
SBMH providers including school nurses

Box 1. Priority Areas for Advancing SBMH Programs for Students

Image 1. Ways School Nurses Serve as Members of the SBMH Care Team

November 2024 39(6) | NASN School Nurse 303

current efforts to address students’
mental and behavioral health needs, and
improve systems of care. Box 3 shows
opportunities for administrators and
policymakers to make substantive
changes at the state and regional levels,
as well as actions providers and
educators at the local and community
level can take to support student mental
health. We acknowledge that each
school nurse and education system
might have different level of readiness or
capacity to support mental and
behavioral health. Nevertheless,
adopting some or all the following
recommendations can increase system-
wide capacity and create a more
capable, integrated, holistic, and
interconnected system of care.

Methods and Approach

We completed a literature scan to
identify (1) current SBMH models and (2)
descriptions of the school nurse’s role in
supporting student behavioral and mental
health. We analyzed data for common
themes, existing programs, opportunities,
and challenges to integrating school
nurses into SBMH teams.

We held two meetings to discuss the
role of school nurses in SBMH care
teams and opportunities for further
support and integration. The first
meeting included school nurses in K–12
schools and school nurse leaders from
regional and state-level educational
entities. The second meeting involved
leaders from national organizations with
a vested interest in K–12 mental and
behavioral health, including alliances,
associations, and councils representing
stakeholders from health- and education-
based organizations. We analyzed data
from these meetings to identify
opportunities at the system, community,
and school levels to strengthen how
school nurses work with other providers
to support students’ mental and
behavioral health, with an eye toward
further integrating school nurses in
existing structures.

Note: In this document, the terms
mental health and mental and behavioral
health are used interchangeably to refer
to the supports that school nurses

Box 2. Additional Opportunities for School Nurses to Support SBMH
Programs

Box 3. Considerations for Leaders in Health and Education Fields

require the broader support of federal
and state policymakers, local educational
entities, families, and communities to
fully realize their opportunity to help
students who have mental health
problems and those at risk.

The data we gathered from literature
reviews and interviews highlight
opportunities for state, regional, and
community stakeholders to further
embed school nurses into existing
student support structures, amplify

304 NASN School Nurse | 39(6) November 2024

provide in mental health and behavioral
health, including substance use.

This document is publicly available on
the NASN website at: http://
higherlogicdownload.s3.amazonaws.
com/NASN/8575d1b7-94ad-45ab-808e-
d45019cc5c08/UploadedImages/PDFs/
Advocacy/CDC-03_SBMH_Consensus_
Document_edited_6-14-23-2

Acknowledgments

NASN contracted with Mathematica to
engage school nurses and other valuable
partners in discussions on enabling school
nurses to help provide SBMH supports.
The following individuals participated in
these discussions and contributed to the
content of this consensus document. They
shared their lived experiences supporting
student mental health and identified
policy and structural opportunities to
further integrate school nurses into SBMH
delivery models.

Thank you to our school nurse
participants

Alaska: Wendy DeGraffenried, BSN, R.N,
NCSN, HN-BC.
California: Dawn Anderson, MA, BSN, RN,
PHN & Katie Nilsson, MSN, RN, PHN, CPN,
RCSN.
Colorado: Stephanie Faren, MSN, MPH, RN,
NCSN & Kelli Mueller, MS, BSN, RN, NCSN.
Connecticut: Mary Emerling, RN, MPA.
District of Columbia: Elizabeth McDermott,
BA, BSN, RN, NCSN.
Florida: Amy Ponce, MSN, RN.
Hawaii: Abbie Neves, PhD, APRN-Rx,
PMHCNS- BC; Bobbie Jo Beyerle, MSN,
APRN-Rx, NP-C; Jamie Boling, MPH, MSN,
APRN- Rx, FNP-BC, PMHNP-BC & Deborah
Mattheus, PhD, APRN-Rx, CPNP, FAAN.
Kansas: Paula K. Bunde, MS ED, BSN, RN.
Maine: Pat Endsley, PhD, MSN, RN, NCSN &
Tammy Diaz, MPH, RN, NCSN.
Minnesota: Magen Borkenhagen, BSN, RN,
PHN, LSN & Denise Herrmann, DNP, RN,
CPNP, FNASN.
New Jersey: Shelia Caldwell, BSN, RN,
CSN-NJ, FNASN.
Nevada: Breana Taylor, RN, MSN.
Ohio: Ann Connely, MSN, RN, LSN, NCSN &
Jean McGraw, RN, BSN.

Pennsylvania: Rebecca Kilfoy, MSN, ACNP,
NCSN & Jennifer McCulloch, MEd, BSN, RN,
CSN.
Virginia: Angela Knupp BSN, RN; Karen
Mask, RN, BSN, MPH; Rachell Myhr, RN;
Joanna Pitts, BSN, RN, NCSN, CNOR &
Heather Shea Pugh, BSN, RN.
Washington: Annie Hetzel, MSN, RN, NCSN;
Tessa McIlraith, MS, BSN, RN & Lynn Nelson,
MSN, RN, NCSN.
Wisconsin: Louise Wilson, MS, BSN, RN,
LSN, NCSN.

Thank you to our participants from
national organizations

American Academy of Pediatrics: Sonya
O’Leary, MD, FAAP, American Academy of
Pediatrics Council on School Health.
American Federation of Teachers:
Katherine Duncan, MBA, Senior Director,
Strategic Partnerships.
The JED Foundation: Katherine Duncan,
MBA, Senior Director, Strategic
Partnerships.
Kaiser Permanente: Niti Kadakia, MBA,
Director, Student Behavioral Health.
Mental Health America: Em Skehill, BS,
Director of Public Awareness and
Education.
Mental Health School Professional Grant
Program: Tawanda Avery, MEd-SPED,
Program Lead.
National Alliance for Medicaid
Education: Jenny Milward, Ed.D, Executive
Director.
National Association of Elementary
School Principals: David Griffith, M.Ed.,
Associate Executive Director, Policy and
Advocacy.
National Association of School
Psychologists (NASP): Nick Affrunti, PhD,
Director of Research & Kathleen Minke, PhD,
NCSP, Executive Director.
National Association of Secondary School
Principals (NASSP): Ronn Nozoe, MEd,
CEO, Chief Executive Officer.
National Center for School Mental
Health: Jill Haak Bohnenkamp, PhD,
Assistant Professor.
National Education Association: Karuna
Antani, MPH, Senior Health & Safety
Specialist.
National Parent Teacher Association:
Emily Smith, LICSW, Manager, Programs &
Strategic Initiatives.

School Social Work Association of
America: Maria Badillo Diaz, DSW, LCSW,
Board Member.
School-Based Health Alliance (SBHA):
Robert Boyd, MCRP, Mdiv, President and
CEO; Andrea Shore, MPH, CPO; and Katy
Stinchfield, MS, LPC, Director of Behavioral
Health Programs.
State School Nurse Consultants: Susan
Acosta, BS, RN, NM State SN Consultant, New
Mexico.
The School Superintendents Association
(AASA): Kayla Jackson, MPA, Project
Director.

References
Centers for Disease Control and Prevention.

(2022). Toolkit for schools: Engaging
parents to support student mental health
and emotional well-being. https://www.
cdc.gov/healthyschools/connectedness/
connectedness_toolkit.htm

Centers for Disease Control and Prevention.
(2023). Youth Risk Behavior Survey: Data
summary & trends report 2011–2021. https://
www.cdc.gov/healthyyouth/data/yrbs/pdf/
YRBS_Data-Summary-Trends_Report2023_508.
pdf

Hoskote, A. R., Croce, E., & Johnson, K. E.
(2023). The evolution of the role of U.S.
school nurses in adolescent mental health
at the individual, community, and systems
level: An integrative review. The Journal of
School Nursing, 39(1), 51–71. https://doi.
org/10.1177/10598405211068120

Reaves, S., Bohnenkamp, J., Mayworm, A.,
Sullivan, M., Connors, E., Lever, N., Kelly,
M. S., Burns, E. J., & Hoover, S. (2022).
Associations between school mental health
team membership and impact on service
provision. School Mental Health, 14(3),
672–684. https://doi.org/10.1007/s12310-021-
09493-z

Substance Abuse and Mental Health Services
Administration & Centers for Medicare &
Medicaid Services. (2019, July 1). Guidance to
states and school systems on addressing mental
health and substance use issues in schools.
SAMHSA Publications and Digital Products.
https://store.samhsa.gov/product/guidance-
states-and-school-systems-addressing-mental-
health-and-substance-use-issues

Youth.gov. (n.d.). School-based mental health.
https://youth.gov/youth-topics/youth-mental-
health/school-based

http://higherlogicdownload.s3.amazonaws.com/NASN/8575d1b7-94ad-45ab-808e-d45019cc5c08/UploadedImages/PDFs/Advocacy/CDC-03_SBMH_Consensus_Document_edited_6-14-23-2

https://www.cdc.gov/healthyschools/connectedness/connectedness_toolkit.htm

https://www.cdc.gov/healthyyouth/data/yrbs/pdf/YRBS_Data-Summary-Trends_Report2023_508

https://doi.org/10.1177/10598405211068120

https://doi.org/10.1007/s12310-021-09493-z

https://store.samhsa.gov/product/guidance-states-and-school-systems-addressing-mental-health-and-substance-use-issues

https://youth.gov/youth-topics/youth-mental-health/school-based

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