Policy Action Plan: Ensuring Mental Health Support in School Aged Children

April N. Wright

Delaware Technical Community College

NUR 420: Nursing Policy

Bonita Blackman

February 18, 2024

Mental Health is such an important part of a child’s overall well-being. Society tends to

forget this sometimes, especially in the population of our school aged children. As children are

growing into adults, they all struggle with personal issues, family struggles, peer pressure,

academic pressures etc. When mental health issues are added to that, the effects are

overwhelming for a child. The mental health crisis has hit an all-time high in society today and

the COVID 19 pandemic has a lot to do with that. Our school aged children are struggling

physically, emotionally, mentally, and academically due to this crisis. Their mental health is just

as important as their physical health. In healthcare, there are guidelines, policies, and regulations

that must be followed to ensure safe and successful outcomes. I believe that promoting mental

health importance in our school systems early on will help in decreasing the number of students

that suffer from mental health illness related problems and providing them the support they need

in and out of school. As they say, “it takes a village”. It certainly does. Mental illness and mental

health issues is like sex education, it needs to be talked about. I get the impression that some

think of it as a subject that does not need to be discussed. “If we discuss it, then it will bring

attention to it and it will become a problem”. It is a problem because it is not discussed. The

importance of mental health education should be stressed as soon as the children start school, and

most importantly as they are becoming a teenager and growing into adults.

The Importance of Policy Promotion in School Setting

A health policy “frames our professional roles. It defines nursing practice and knowledge

and prioritizes and targets resources. A health policy directly impacts our patients’ day to day

lives” (Annesley, 2019). Clinicians can collaborate and form a team, rather than providing care

individually. It is more effective for the patient and each part of the team can bring something
different to the table, including skills, knowledge, and opinions. “Health policy means different

things. It relates to content: improving the population’s health, but it also relates to process: how

things are done; to power: who influences and drives it” (Annesley, 2019). If a policy was

developed in our school systems to promote mental health education in our schools to students as

well as staff, I feel that we may see a decrease in the depression, anxiety, physical symptoms,

and suicidal ideations that is seen in our youth. School staff and administrators need to be

educated in mental health first and foremost so our students can learn from those that are

educated in the subject. A mental health education class should be placed in the agenda and

schedules of students as well as a policy in place that regulates this along with ensuring follow

up by the school nurse and parent/guardian compliance if outside referrals are recommended.

Our goal is to make sure our student’s health is improved. The results can be shown by the

student’s behavior, physical health, hygiene/appearance, academic progress/grades, and their

attendance. Schools have an attendance policy and if a student misses so many days, a truancy

charge can be placed on the parent, resulting in court. Are we getting to the cause of the

attendance issue? Is it the student’s mental health that is causing behavior changes, grades

falling, behavior issues, and their reactions to all this. If mental health is the problem, are

resources being made available? Are the parents and school staff being held accountable

themselves for making sure there is follow up? If there is a truancy or attendance policy in the

school system, what is wrong with having a policy related to mental health education and an

accountability regulation related to follow up care after resources have been recommended. The

school nurse is an excellent advocate for staff, students, and parents/guardians. The school nurses

see students for medical issues during the day and for mental health issues that may present

initially as a physical ailment. If we were to look at acuity of students’ vs numbers of students,

emotionally, mentally, and physically. The Wellness Centers that some high schools have

available are a plus as the staff can assist a student with more in-depth problems and as a team,

can provide continuity of care for that student. This continued care and follow up provides the

student/family with support and the results is more likely to be a positive one. The House Bill 3:

An Act to Amend Title 14 Relating to School Attendance is a bill involving school attendance.

“The bill provides for excused absences for the mental and behavior health of a student that

requires that any student taking more than 2 such excused absences will be referred to a

behavioral health specialist. The bill makes it clear that mental and behavioral are a priority in

Delaware. This bill provides a tool to identify students struggling with mental and behavioral

health issues” (Legislature, Delaware General Assembly 2023). From the time the bill was

introduced in 04/25/23 until the time it was approved and made a law on 08/16/23, the bill took a

path through the House/Senate for discussion. In this bill, it is stated that the student should not

be penalized for any excused absences for the mental or behavioral health of the student and

must be given the opportunity to make up any schoolwork missed during these absences. After

the second and subsequent excused absence for the mental and behavioral health of the student,

the student must be referred to a school-based mental or behavioral health specialists.

(Legislature, Delaware General Assembly 2023). On 06/30/23, the bill was passed by the Senate

after it was added/amended that DOE was to provide reports related to these absences. This is all

fine and good but are we seeing any follow up from these reports. We should be focusing also on

if there is attendance improvement after students provided with added support by a specialist and

if there is compliance of using the resources after recommended. If not, parent/guardian should

be held accountable just like they are for truancy issues. There should be no issues with
compliance if the resources have been available, grant funding is given to help finance these

services, and follow ups have been completed within a certain time frame.

I have developed an action plan related to mental health education and promotion of

continued care of students during school as well as providing follow up and accountability after

referrals are made.

Mental Health Accountability Action Plan in the School Setting

Problem: The rise in mental health issues in our school aged children resulting in

physical complaints, poor behaviors, and poor attendance. Mental Health Education is not

present in school curriculum.

Long Term Goal: Provide mental health education in the schedules of all middle school

and high school students along with continued support throughout their educational years.

90 Day Goals:

 Decrease in school nurse visits by 30%.

 Increase in school building attendance numbers. Improvement in individual

student attendance.

 Improvement in grades and state testing results in comparison to beginning of

school year and by end of 2nd semester.

 Decrease suspensions and in behavioral issues by 50%.

 Provide staff training for all employees during Professional Development

Days prior to start of each school year- updating as needed.

 School nurses, Counselors, and Administrators must be involved with

trainings/competencies.

Action: Students

 Assigned a Mental Health Class during the school year. and student can pick a

support person in the school that they would like to have.

 Meet with school nurse and counselor together twice during year, along with a

risk survey at beginning of year and recheck at end of 3rd marking period.

 Follow up with any referrals/recommendations as necessary.

Action: Parent/Guardian

 Follow up with all recommendations and referrals.

 Will be held accountable if any referrals are not followed up with.

Nurses and counselors must meet monthly to discuss number of visits and look for

any signs of mental health struggles, as well as address them, refer, and follow up while

offering support to the student and their family.

Conclusion

Teamwork, collaboration, and communication are all keys in providing care for

students/patients. Children/students that experience mental health disorders/issues and how they

are treated have a significant effect on overall health and relationships throughout a child’s life.

The earlier the problem or issue is identified or recognized, the better chance of getting the
needed support so the child can learn how to deal with how they are feeling about fears, worries,

disruptive behaviors and how they handle it during their daily routine. Our children are our

future. We must support them in every way possible so they can grow into successful people of

society. I have witnessed over the years that making a student feel loved and cared for even the

short time that they are with us in a school day, goes a long way. If we can help their mindset,

and their hearts, the academics and success will come.

Bill Detail - Delaware general assembly. (n.d.-a). https://legis.delaware.gov/BillDetail?

How to write An action plan (with template and example) | indeed.com. (n.d.-b).
https://www.indeed.com/career-advice/career-development/how-to-write-an-action-plan

SH;, A. (n.d.). The implications of Health Policy for Nursing. British journal of nursing (Mark
Allen Publishing). https://pubmed.ncbi.nlm.nih.gov/31002553/

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