Strengthening Supports for Teen Mental Health in San Mateo County

A Q&A with Gardner Center Researchers

The Gardner Center has released a research brief on a study conducted to understand the mental health needs of public school students in San Mateo County and identify promising supports and interventions. Gardner Center researchers Kendra Fehrer and Kristin Geiser collaborated to share their perspectives on the issues and the findings.

Can you give us some background on teen mental health in San Mateo County and the partnership that came together to study the issues?

This project emerged in response to growing concerns about students’ mental health in the County. Catalyzed by several tragic student losses over the span of just a few years, the San Mateo Union High School District (SMUHSD) developed a partnership to enhance supports for student well-being across all its high schools.

The district’s partners in this endeavor include Stanford Department of Psychiatry & Behavioral Sciences’ Center for Youth Mental Health and Well Being (Youth Mental Health), as well as the Peninsula Health Care District (PHCD).

The partnership’s efforts included establishing wellness centers on multiple campuses, new practices to better detect students who may be in need of mental health support, and several other initiatives.

As the partners began to consider additional investments, they realized that they wanted their next steps to be informed by a deeper understanding of students’ mental health needs across the K-12 continuum. They also wanted to know where the opportunities might be to dramatically improve the way we support student mental health in the County.

So, the partnership expanded to include the five K-8 districts that feed into SMUHSD (Burlingame, San Bruno Park, San Mateo-Foster City, Millbrae, and Hillsborough). And it also invited the Gardner Center in as a research partner to conduct the inquiry they needed to inform their next steps.

What were the partnership’s research questions and how was the study designed to address them?

The partners were interested in developing a more nuanced understanding of students’ mental health needs and the strengths and limitations of the strategies schools currently employ to meet those needs.

They were also interested in finding out if there were any predictive factors that could help signal which elementary students might be more likely to experience mental health challenges as they transition into and moved through high school — and, in turn, be candidates for some kind of earlier intervention or support.

And lastly, they were interested in seeing if the findings connected to the first two questions would highlight strategic opportunities for effectively supporting student mental health across the K-12 schools and districts.

To address these questions, our interdisciplinary research team conducted a mixed methods study. We collected longitudinal administrative data from SMUHSD and its K-8 partner districts which allowed us to trace students from the high school district in the 2017–18 and 2018–19 school years back to their K-8 records.

In addition, our team conducted interviews and focus groups with 96 individuals (including teachers, site and district administrators, mental health counselors, parents, family liaisons, guidance counselors, wellness staff, and front office staff). Participants represented eight schools and three districts (SMUHSD and two K-8 partner districts).

What were the study’s key findings? Was there anything that surprised the partners?

One important finding is that schools are experiencing increased prevalence and greater complexity of student mental health needs across all ages (K-12) and across the socio-economic spectrum.

This struck us as important because the public discourse around student mental health often frames it as an adolescent issue connected to academic pressure and the pursuit of admission to a prestigious colleges or university.

While this may be the case for some students, our data remind us that student mental health is inextricably linked to a wide range of school and non-school factors — for example, family economic pressures or immigration concerns. It affects students of all ages and all demographics, and often reflects a confluence of variables rather than one specific issue.

How are schools supporting students with such needs? It varies. We found a number of promising strategies; however, we also found that within schools and across districts they are typically not yet connected in ways that create a comprehensive or integrated system of support.

We also found that most resources dedicated to mental health support tend to go to what participants described as “crisis management” — reacting and responding to students who present with the most acute mental health needs — rather than proactively cultivating the mental health and well-being of all students.

In terms of next steps, the findings indicate that in addition to bolstering schools’ immediate capacity to serve students who need mental health support, there is also a need to develop a more systemic approach to promote the mental health and well-being of all students and strengthen continuity of care across grades, schools, and districts. Our research brief highlights many opportunities for advancing this work and we are already seeing participating districts use the findings to inform their thinking and their planning.

We know from our interviews that those who work with and on behalf of students care deeply about students’ mental health, and we witnessed the urgency that they feel to make sure schools are settings that support student well-being.

While schools cannot meet students’ needs alone, they are an important part of the ecosystem serving children and youth, and so it makes sense that we would invest in strengthening the system of support provided within and across districts. We look to advancing this work with our district and community partners, and discovering together how it will unfold.

Kendra Fehrer and Kristin Geiser are senior research associates at the John W. Gardner Center for Youth and their Communities at Stanford University.