Impact of a School-Based Program to Improve Mental Health on Student Outcomes

• In Event: Mental Health in Education: Risks, Interventions, and Access to Care

Abstract

Lack of access to effective adolescent mental health treatment in the United States presents a significant public health concern, with nearly half of adolescents experiencing symptoms of a mental illness (Merikangas et al., 2010; Whitney & Peterson, 2019) and one in five experiencing a major depressive episode (Reinert et al., 2024) and seriously considering suicide (CDC, 2024). This study investigates the effects of TRAILS Early Intervention program (TRAILS-EI), which is designed to increase student access to effective mental health services by training School-based Mental Health Professionals (SMHPs) in cognitive behavioral therapy (CBT). This study took place in 84 schools a large urban school district in the Midwest, and the final sample included 130 SMHPs, and approximately 24,000 students. Schools were randomly assigned to one of two cohorts. Cohort A started TRAILS-EI implementation during the 2023-24 academic year and Cohort B started implementation during the 2024-25 academic year. Prior to conducting random assignment, we stratified on geographic location within the city, and baseline rates of depression/anxiety in the school.

The study team utilized both administrative data and data from surveys to measure key outcomes including student coping skills, rates of depression and anxiety, and GPA. The administrative data (annual student mental health screener data and academic records) were provided by the school district and used to assess the impact of the program on student behavioral health and academic outcomes. We estimated differences in outcomes between Cohort A and Cohort B schools in a regression framework. School-level covariates include the proportion of black students, school type, and school attendance rates. Student-level covariates include grade level, race/ethnicity, gender, homelessness status, limited English proficiency status, free or reduced-price lunch status, and special education status, all coming from the 2023-24 academic year.

At the end of the first year, there was a statistically significant reduction in rates of severe disciplinary experiences of two percentage points, representing a 22% decrease over the control group’s rate. However, there were no statistically significant impacts on rates of depression/anxiety or year-end GPA. Preliminary analyses of follow-up data from the 2025-2026 school year indicate that these impacts on school discipline are sustained and that the program may also cause additional, delayed improvements in the rates of depression and anxiety among students. These findings highlight the potential effectiveness of school-based CBT interventions, and training for SMHPs, as a way to address the widespread and urgent challenge of adolescent mental health.

Author

• Catherine Armstrong Asher, University of Michigan
  Presenting Author