What is your school’s protocol for referring students to behavioral health services? How is that different if a student is in crisis?
PIC 19: An icon of a school building appears. Question text “What’s your school’s protocol” and “What if it’s a crisis?” appears.
Each school is different, so you need to become familiar with the process and resources in your school, and review your school’s referral process and crisis plan, so you’re prepared when one of your students needs you to intervene.
PIC 20: Text “Become familiar with the process & resources” appear below the school building icon.
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Here’s what the referral process and crisis plan should look like:
The first step is to identify the student in distress.
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This identification might come from a teacher or staff member, from a parent, or from a student.
Some Tier 1 programs, such as the At Risk and Resilient Together simulations you may have already completed, are designed to help school personnel identify, approach, and refer students who may benefit from Tier 2 or Tier 3 services.
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Next, determine whether the situation is a crisis.
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A crisis situation is one in which you suspect the student or someone else may be in immediate danger, for example if the student may be self harming, considering suicide, or planning to harm others. Other crisis situations might involve family emergencies, like abuse or neglect.
PIC 25: Next to “YES,” an exclamation point appears along with the text, “Immediate Danger: Danger of harming self or others,” in a red background.
While general behavioral concerns, such as disruptive behavior, withdrawal or isolation, or suspicion of substance use are serious and do warrant exploration and follow up, they’re considered non crisis because the danger is not immediate. Remember, signs of distress look different across age groups and in each child. Trust your instincts.
PIC 26: Next to “NO,” the following text appears, “No Immediate Danger: General behavior concerns” in a green background.
If you notice worrisome behaviors or worrisome changes in behaviors, err on the side of referral, allowing mental and behavioral health professionals to make the assessment.
If the situation is a crisis, contact the first available clinician and the school leader, so they can respond immediately.
PIC 27: The header “Crisis” appears on top of a red background, along with an icon for two speech bubbles and the text, “Contact clinician and school leader. If in danger of harming self or others, DO NOT leave alone.”
If you think the student is in danger of harming themselves or others, do not leave the student alone while you seek help. Crisis teams are available to provide students with emergency support. Know and immediately implement your school’s crisis protocols.
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In a non crisis situation, the next step would be to document any attempts you’ve made to resolve the issue and complete a referral form. Referral forms may be submitted by teachers, staff, school nurses, parents, or students. The form should be turned in to your school’s student support team.
PIC 29: The header “Non Crisis” appears on top of a green background. A series of icons appear one at a time: “Document attempts to resolve” is represented by an icon of a sheet of paper icon with three bullet points. “Complete referral form” is represented by another icon of a sheet of paper with a pencil. “Submit to student support team” is represented by three people icons grouped together.
This is a small group of staff and parents or guardians who develop individualized strategies to support students in distress. At your school, this team may be known as the Student Support Team, the Whole Child Team, the MTSS Team, or the Early Intervention Team. Most schools have a School Behavioral Health Coordinator who serves as the point of contact for this team and receives completed referral forms.
PIC 30: Underneath the “Submit to student support team” icon, text appears saying, “Point of contact: School Behavioral Health Coordinator.”
This team will complete a screening assessment and, with your participation, determine the appropriate services and next steps. Team members then typically observe the student’s classroom behavior for several weeks and decide whether to maintain the strategies, modify them, or refer the student for special education assessment.
PIC 31: A few more icons appear one at a time. “Screening assessment” is represented by a magnifying glass icon. “Determine and implement appropriate services and next steps” is represented by an icon of a check mark. “Observe behavior over time” is represented by a teacher icon behind a podium. Finally, “Decide on the next steps” is represented by two overlapping arrows pointing right.
So what about parents and guardians? How do we involve them in this process?
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It’s best practice to constantly seek and integrate caregiver perspectives. By the time a referral form is completed, the parent or guardian should already be aware of previous strategies you’ve attempted. They should continue to be a part of the process by joining referral discussions and helping determine which clinician on the team is best suited to provide services for their child.
PIC 33: A white colored teacher icon is shown talking to two gold colored parent icons who all have speech bubbles. The text “Seek & integrate caregiver perspectives” is shown on the right.
Remember, each school may have its own protocol for referring students to behavioral health services. Get familiar with your school’s process.
PIC 34: The school building icon appears in the center, with the text “Get familiar with your school’s process” shown underneath.
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