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0-07: Staff training for health/safety emergencies
0-08: Partnerships with community service providers
1-02: Communication among school, home, and health providers
4-06: Mental health problems: capacity to identify, refer, manage
4-11: Crisis response team and plans
4-23: Students with symptoms of poor health
8-05: Employee assistance programs
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American Association of Suicidology
Center for Effective Collaboration and Practice
Supports and promotes a reoriented national preparedness to foster the development and the adjustment of children with or at risk of developing serious emotional disturbance.
Center for Mental Health in Schools.
Resources, technical assistance, and continuing education on topics related to mental health in schools, with a focus on barriers to learning and promotion of healthy development.
Center for School Mental Health Assistance
Supports schools and communities in the development of programs and provides leadership and technical assistance to advance effective interdisciplinary school-based mental health programs.
National Association of School Psychologists
National Institute of Mental Health
Click onto "For the Public" to retrieve publication materials relating to mental health for children and adolescents, including materials on violence and suicide, including surgeon general reports.
National Mental Health Information Center
A web site for the United States Department of Health and Human Services' Substance Abuse and Mental Health Services Administration (SAMHSA); Links to the National Strategy for Suicide Prevention and other mental health resources.
US Department of Education
US Department of Education - Individuals with Disabilities Education Act (IDEA)
US Department of Education - Office of Safe and Drug-Free Schools
Includes publications on effective violence and substance abuse prevention programs.
US Surgeon General Reports
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7-03 - Recognition and referral of students under stress

Implement prevention programs that focus on recognition of stressful life situations and interventions to help students deal with these stresses.


Early detection of the most common psychosocial and educational stresses can lead to fewer problems with learning and school performance when these issues are dealt with expediently at school. Engagement in high-risk behavior may be decreased if prevention programs are designed for early identification of and interventions for students needing support.


Research has identified a variety of commonplace educational and psychosocial problems and external stressors that interfere with students' learning and teachers' teaching.

A variety of problems affect the ability of many students to be successful in the classroom. Examples of stresses that affect achievement are: school adjustment difficulties, language problems, school and life transitions, substance and alcohol use and trauma. Social, interpersonal and family stresses also affect learning. They include recent loss, isolation, psychological reactions to sexual activity, concerns with sexual identity, abuse and neglect (physical, mental, and sexual), other forms of victimization, and exposure to various forms of violence, including witnessing or learning about a violent situation or suicide. Difficulties with learning or attention are also stressors.

School staff members are often in a position to learn of such life stresses that affect students soon after they occur. They may present to school staff as high risk behaviors (e.g., poor attendance, delinquency, gang-related activities, conduct and behavior problems). School staff can help assure that students who might need assistance are referred to school mental health professionals for further assessment. Some students may require referral outside of the school setting for additional assessment and/or intervention. Provide staff development so that all staff members are aware of the potential consequences of such stresses. Staff must also know where to refer students and how to approach a student who requires a referral. Appendix F lists stressors that are often associated with violence and suicide.


American Academy of Pediatrics, Committee on Substance Abuse. The role of schools in combating substance abuse. Pediatrics. 1995;95:784-785.

Bell CC, Clark DC. Adolescent suicide. Pediatr Clin North Am. 1998;45:365-380.

Carnegie Council on Adolescent Development. Great Transitions: Preparing Adolescents for a New Century. New York, NY: Carnegie Corporation of New York; 1995.

Drug Strategies. Making the Grade: A Guide to School Drug Prevention Programs. Washington, DC: Drug Strategies; 1999. .

Friesen BJ, Poertner J. From Case Management to Service Coordination for Children With Emotional, Behavioral, or Mental Disorders: Building on Family Strengths. Baltimore, MD: Paul H. Brookes; 1995.

Gilliland BE, James RK. Crisis Intervention Strategies. 3rd ed. Pacific Grove, CA: Brooks Cole; 1997.

Hooper K, Lawson HA. Serving Children, Youth and Families Through Interprofessional Collaboration and Service Integration: A Framework for Action. Oxford, OH: The Danforth Foundation and the Institute for Educational Renewal at Miami University; 1994.

Mazza J. School-based suicide prevention programs: are they effective? School Psychology Review. 1997;26:382-396.

National Institute on Drug Abuse. Drug Abuse Prevention: What Works. Rockville, MD: US Department of Health and Human Services; 1997.

O'Carroll PW, Mercy JA, Steward JA. CDC recommendations for a community plan for the prevention and containment of suicide clusters. MMWR. 1988;37(S-6):1-12.

Pumariega AJ, Vance HR. School-based mental health services: the foundation for systems of care for children's mental health. Psychology in the Schools. 1999;36:371-378.

Ross JG, Eihaus KE, Hohenemser LK, Green B. School health policy prohibiting tobacco use, alcohol and other drug use, and violence. J Sch Health. 1995;65:333-338.

Tobler NS, Stratton HH. Effectiveness of school-based drug prevention programs: a meta-analysis of the research. J Primary Prevention. 1997;18.

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