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4-01: Student assistance teams at each site
4-06: Mental health problems: capacity to identify, refer, manage
4-17: Behaviors with underlying health causes
4-23: Students with symptoms of poor health
5-10: Foods as marketed items, rewards, punishments
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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
US Department of Education
US Department of Justice, Office of Juvenile Justice and Delinquency Prevention
Information and resources (conferences, funding opportunities, publications) about juvenile justice, delinquency, and combating youth crime.
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7-08 - Policies on student discipline

Utilize disciplinary actions that do not jeopardize students' physical health or safety, that do not harm emotional well-being, and do not discourage physical activity or other healthful behaviors. Prohibit use of food as a reward or punishment.


Corporal punishment increases chances for violent behavior in susceptible youth. When suspended or expelled students are out of school, they are often exposed to safety and health risks. Denial of recess or forced physical activity (running laps, doing extra push-ups) as a disciplinary action can send a message that physical activity is a luxury or a punishment. Both can discourage enjoyment in life-long physical activity.


Acceptable forms of disciplinary actions include time out, staying after school, performing services, and reduction in grades. Unacceptable forms include verbal abuse, corporal punishment, and actions likely to humiliate students. When a student's actions threaten injury to the student or someone else, physical restraint is sometimes necessary. Schools can use incentives (or their withdrawal) as behavior management tools. Examples of incentives are: stars on a chart hung on classroom wall, extra free-time, extra recess, participation in special events (e.g., field trips), points students can use to purchase books or merchandise, student's name in the school newspaper, featuring a "student of the week", and choosing student to make public announcements.

Proponents of expulsion and suspension find that these actions not only punish students, but alert parents and protect other students and school staff. But there are unintended health, mental health, and safety consequences. Suspension and expulsion are often reserved for students who use illicit substances, commit crimes, disobey rules, and threaten violence. These students are most likely to be victims of abuse or to be depressed or otherwise mentally ill. For students with major home-life stresses, suspension compounds current stresses and predisposes them to even higher risks of behavioral problems. Adolescents are more likely to smoke, use alcohol and other drugs, commit crimes and engage in sexual intercourse when out of school. Suicidal ideation and behavior may be expected to occur more frequently at such times of isolation among susceptible youth. Students face greater risks of dropping out permanently and becoming entangled in the courts when they are excluded from school.

Students who are suspended or expelled should have immediate professional support and continuous adult supervision during school hours. Suspension and expulsion should always be accompanied by a referral to a health and/or mental health professional to identify any underlying problems. Innovative disciplinary actions schools have taken include: immediate transfer of students to supervised "suspension classrooms" (until they are either moved to an alternate setting or re-admitted to regular school site), having parents accompany students to school for a portion of the school day, and having students provide community service on school grounds during non-school hours.

Schools are required to provide educational services to students receiving services under the Individuals with Disabilities Education Act, even when they are expelled, if the offending behavior is related to their disability. School must do pre-expulsion assessments and demonstrate reasonable efforts to minimize the risk of harm in these students' educational placement. Modifications of these students' Individualized Education Programs (IEPs) are often specifically re-designed to address and prevent recurrence of inappropriate behavior. This is a promising model for managing disciplinary problems of all students (i.e. both regular and special education).


American Academy of Pediatrics, Committee on School Health. Corporal punishment in schools. Pediatrics. 2000;106:343.

Centers for Disease Control and Prevention. Guidelines for school health programs to prevent tobacco use and addiction. MMWR Recomm Rep. 1994;43(No. RR-2):1-18.

Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). Where we stand: school discipline. Landover, MD: CHADD; 2001. Available at:

Cotton K. Schoolwide and classroom discipline. School Improvement Research Series, SIRS 2001; IClose-Up #9; Available at:

National Association of School Nurses. Position Statement: Corporal Punishment in Schools. Scarborough, ME: National Association of School Nurses, 1996. Available at:

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