Beyond Silos: Optimizing The Promise Of School-Based Mental Health Promotion Within Integrated Systems Of Care

Schools have a critical role to play within the broader system of care supporting children, youth, and families. For 6 h each day, 10 months of the year, schools have the opportunity to support social emotional skill development, enhance mental health literacy, encourage help-seeking, and provide daily classroom support to students who are struggling with mental health problems. Many school districts also have the capacity to provide evidence-based preventive services, crisis response, assessment, and brief intervention services. However, when school-based mental health promotion and prevention services are not offered within the context of a comprehensive local/regional system of care, students requiring more intensive supports may not receive needed intervention. Further, best and emerging practices across contexts may not get evaluated or shared, and responses to acute needs that transcend geography may be disjointed and confusing. Using a broader system lens, there are policy and practice opportunities for cross-sectoral integration that, when leveraged using system science principles, can lead to more efficient and high-yield service delivery for children, youth, and families as well as system-wide responses to emerging issues or acute circumstances (e.g., suicide cluster, influx of child refugees, high profile media events). Drawing on the modified interactive systems framework and highlighting examples from the provincial rollout of Ontario's Comprehensive Mental Health and Addictions Strategy, a number of system-scale implementation science principles are shared with a view to optimizing the promise of school mental health, beyond silos.