ABOUT THE COVER ART
On February 14, 2018, a 19-year-old former student at Marjory Stoneman Douglas High School entered the building and open fired with a semiautomatic rifle, killing 17 people and injuring 17 others. At that time, Joey Digilio was in the 10th grade at Marjory Stoneman Douglas. One year later on the anniversary of the tragedy, students were given the option of attending school that day or commemorating the event in their own way. Joey met up with five friends at the home of Olivia Feldman and they went to the art supply store, bought paints and canvases, and expressed their feelings through their art. On the front cover is Joey’s art; it is his first and only painting to date. Joey graduated from Marjory Stoneman Douglas High School in spring 2020 and plans to become a firefighter. May this work be a tribute to the resilience of all our young people, and a reminder of the work we all need to do to foster the emotional well-being of our youth.
The cover was designed by Queenie Dong and Philip J. Lazarus in collaboration with OUP.
CONTENTS
Contributors xi
Introduction: Are Our Youth All Right? 1
Philip J. Lazarus, Shannon M. Suldo, and Beth Doll
1. Conceptualizing Youth Mental Health Through a Dual-Factor Model 20
Shannon M. Suldo and Beth Doll
2. Framing School Mental Health Services Within a Dual-Factor Model of Mental Health 40
Beth Doll, Evan H. Dart, Prerna G. Arora, and Tai A. Collins
3. Building Culturally Responsive Schools: A Model Based on the Association for Supervision and Curriculum Development’s Whole Child Approach 61
Janine Jones and Antoinette Halsell Miranda
4. Implementing Positive Behavior Interventions and Supports: A Framework for Mental Health Promotion 79
Donald Kincaid and Natalie Romer
5. Adopting a Trauma-Informed Approach to Social-Emotional Learning 96
Maurice J. Elias, Erica R. Powlo, Ava Lorenzo, and Brian Eichert
6. Promoting School Safety, School Climate, and Student Mental Health: Interdependent Constructs Built Upon Comprehensive Multidisciplinary Planning 117
Amy Jane Griffiths, Elena Diamond, Zachary Maupin, James Alsip, Michael J. Keller, Kathryn Moffa, and Michael J. Furlong
7. Preventing School Violence and Advancing School Safety 137
Dewey Cornell and Brittany Crowley
8. Cultivating Student Engagement and Connectedness 163
Christopher Pinzone and Amy L. Reschly
9. Creating Resilient Classrooms and Schools 183
Beth Doll and Hong Ni
10. Strengthening the Quality of Preschool, Childcare, and Parenting 204
Soo-Young Hong, Holly Hatton-Bowers, and Lisa Knoche
11. Building Family–School Partnerships to Support Positive Parenting and Promote Healthy Families 224
S. Andrew Garbacz and Linda M. Raffaele Mendez
12. Promoting Physical Activity, Nutrition, and Sleep 243
Ellyn M. Schmidt, Tessa N. Hamilton, and Jessica A. Hoffman
13. Teaching Emotional Self-Regulation to Children and Adolescents 264
Philip J. Lazarus and Annela Costa
14. Promoting Students’ Positive Emotions, Character, and Purpose 282
Shannon M. Suldo, Jenni Menon Mariano, and Hannah Gilfix
15. Building a Foundation for Trauma-Informed Schools 313
Philip J. Lazarus, Stacy Overstreet, and Eric Rossen
16. Preventing Bullying in Schools 338
Amanda B. Nickerson and Timothy Parks
17. Supporting the Well-Being of Highly Mobile Students 355
Michael L. Sulkowski
18. Enfranchising Socially Marginalized Students 375
Amanda L. Sullivan, Andy V. Pham, Mollie Weeks, Thuy Nguyen, and Quennie Dong
19. Preventing School Failure and School Dropout 395
Robyn S. Hess and Cynthia E. Hazel
20. Providing Evidence-Based Supports to Students in the Aftermath of a Crisis 413
Philip J. Lazarus, Franci Crepeau-Hobson, Kathy Sievering, and Cathy Kennedy-Paine
21. Raising the Emotional Well-Being of Students With Anxiety and Depression 435
Diana Joyce-Beaulieu and Brian Zaboski
22. Implementing Statewide Practices That Promote Student Wellness and Resilience 459
Amity Noltemeyer, Cricket Meehan, Emily Jordan, and Michael Petrasek
23. Using Universal Screening to Monitor Students’ Social, Emotional, and Behavioral Health 481
Katie Eklund, Stephen P. Kilgus, Lauren Meyer, and Alexandra Barber
24. Accessing Targeted and Intensive Mental Health Services 503
Tammy L. Hughes and Maggie B. Mazzotta
Afterword: We Must Be Champions for the Emotional Well-Being of Our Youth 523
Philip J. Lazarus and Ralph Eugene Cash
Index 533
James Alsip, EdS
Chapman University Orange, CA, USA
Prerna G. Arora, PhD
Teachers College, Columbia University
New York, NY, USA
Alexandra Barber, MS University of Wisconsin-Madison Madison, WI, USA
Ralph Eugene Cash, PhD
Nova Southeastern University College of Psychology Davie, FL, USA
Tai A. Collins, PhD, BCBA-D University of Cincinnati Cincinnati, OH, USA
Dewey Cornell, PhD University of Virginia Charlottesville, VA, USA
Annela Costa, PhD Florida International University Miami, FL, USA
Franci Crepeau-Hobson, PhD University of Colorado, Denver Denver, CO, USA
Brittany Crowley, MEd
University of Virginia Curry School of Education and Human Development Charlottesville, VA, USA
CONTRIBUTORS
Evan H. Dart, PhD, BCBA-D University of South Florida Tampa, FL, USA
Elena Diamond, PhD Lewis & Clark College Portland, OR, USA
Beth Doll, PhD University of Nebraska—Lincoln Lincoln, NE, USA
Quennie Dong, BA Florida International University Miami, FL, USA
Brian Eichert, PsyD South Brunswick School District Edison, NJ, USA
Katie Eklund, PhD University of Wisconsin-Madison Madison, WI, USA
Maurice J. Elias, PhD
Rutgers University New Brunswick, NJ, USA
Michael J. Furlong, PhD University of California Santa Barbara
Santa Barbara, CA, USA
S. Andrew Garbacz, PhD University of Wisconsin-Madison Madison, WI, USA
Hannah Gilfix, MA University of South Florida Tampa, FL, USA
Amy Jane Griffiths, PhD Chapman University Orange, CA, USA
Tessa N. Hamilton, PhD Northeastern University Boston, MA, USA
Holly Hatton-Bowers, PhD University of Nebraska—Lincoln Lincoln, NE, USA
Cynthia E. Hazel, PhD University of Denver Denver, CO, USA
Robyn S. Hess, PhD University of Northern Colorado Greeley, CO, USA
Jessica A. Hoffman, PhD Northeastern University Boston, MA, USA
Soo-Young Hong, PhD University of Nebraska—Lincoln Lincoln, NE, USA
Tammy L. Hughes, PhD, ABPP Duquesne University Pittsburgh, PA, USA
Janine Jones, PhD University of Washington Seattle, WA, USA
Emily Jordan, MSW The Ohio Department of Education Columbus, OH, USA
Diana Joyce-Beaulieu, PhD University of Florida Gainesville, FL, USA
Michael J. Keller, EdD Laguna Beach Unified School District Laguna Beach, CA, USA
Cathy Kennedy-Paine, MS/Specialist University of Oregon Springfield, OR, USA
Stephen P. Kilgus, PhD University of Wisconsin-Madison Madison, WI, USA
Donald Kincaid, EdD University of South Florida Tampa, FL, USA
Lisa Knoche, PhD University of Nebraska—Lincoln Lincoln, NE, USA
Philip J. Lazarus, PhD Florida International University Miami, FL, USA
Ava Lorenzo, PsyD Rutgers University New Brunswick, NJ, USA
Jenni Menon Mariano, PhD University of South Florida Sarasota, FL, USA
Zachary Maupin, EdS Chapman University Orange, CA, USA
Maggie B. Mazzotta, PsyD Duquesne University Pittsburg, PA, USA
Cricket Meehan, PhD Miami University Oxford, OH, USA
Linda M. Raffaele Mendez, PhD Fairleigh Dickinson University Teaneck, NJ, USA
Lauren Meyer, PhD University of Wisconsin-Madison Madison, WI, USA
Antoinette Halsell Miranda, PhD The Ohio State University Columbus, OH, USA
Kathryn Moffa, PhD
Boston Children’s Hospital Boston, MA, USA
Thuy Nguyen, BA University of Minnesota—Twin Cities Campus Minneapolis, MN, USA
Hong Ni, PhD California State University—Fresno Fresno, CA, USA
Amanda B. Nickerson, PhD University at Buffalo, The State University of New York Buffalo, NY, USA
Amity Noltemeyer, PhD Miami University Oxford, OH, USA
Stacy Overstreet, PhD Tulane University
New Orleans, LA, USA
Timothy Parks, MA University at Buffalo, The State University of New York Buffalo, NY, USA
Michael Petrasek, EdD
The Ohio Department of Education Brunswick, OH, USA
Andy V. Pham, PhD Florida International University Miami, FL, USA
Christopher Pinzone, PhD Eanes Independent School District Austin, TX, USA
Erica R. Powlo, PsyD Rutgers University
New Brunswick, NJ, USA
Amy L. Reschly, PhD University of Georgia Athens, GA, USA
Natalie Romer, PhD WestEd Tampa, FL, USA
Eric Rossen, PhD National Association of School Psychologists Bethesda, MD, USA
Ellyn M. Schmidt, PhD Northeastern University Boston, MA, USA
Kathy Sievering, MA Jefferson County School District Golden, CO, USA
Shannon M. Suldo, PhD University of South Florida Tampa, FL, USA
Michael L. Sulkowski, PhD University of Arizona Tucson, AZ, USA
Amanda L. Sullivan, PhD University of Minnesota—Twin Cities Minneapolis, MN, USA
Mollie Weeks, MA University of Minnesota—Twin Cities Campus Minneapolis, MN, USA
Brian Zaboski, PhD Yale University North Haven, CT, USA
Are Our Youth All Right?
PHILIP J. LAZARUS, SHANNON M. SULDO, AND BETH DOLL ■
Less than a decade ago, the emergency department at Rady’s Children’s Hospital in San Diego would see one or two psychiatric patients per day, noted Dr. Maxwell, the hospital’s interim director of child and adolescent psychiatry. He stated, “Now it is not unusual to see 10 psychiatric patients in a day and sometimes even 20” (cited in Reese, 2019). Most adolescents who come into the emergency room are considering suicide, have attempted suicide, or have harmed themselves. Moreover, in 2018, California emergency rooms treated 84,584 young patients aged 13 to 21 who had a primary diagnosis involving mental health. That is up from 59,705 in 2012, a 42% increase in only six years. This trend corresponds with another alarming development: A rate of 7.5 per 100,000 of all young people in California died by suicide in 2017. This is up from a rate of 4.9 per 100,000 in 2008 and a nationwide rise in youth suicide rates from 7.2 to 11.3 per 100,000 from 2008 to 2017 (Centers for Disease Control and Prevention, 2018). Moreover, Twenge et al. (2019) draw from the National Survey on Drug Use and Health and report that, compared to the mid-2000s, more adolescents in the late 2010s experienced serious psychological distress, major depression, and suicidal thoughts and took their own lives. These trends are weak or nonexistent among adults 26 years old and over. These data suggest a generational shift in mood disorders and suicide-related outcomes rather than an overall increase across all ages. These results suggest that for a significant number of our school-aged youth, they are not all right, and we as a society need to make significant investments in research, funding, training, and school-based mental health services to foster the emotional wellbeing of our youth.
The purpose of this book is to provide school-based mental health professionals (i.e., school counselors, school psychologists, school social workers, and child/adolescent mental health practitioners) with the knowledge and tools to help promote students’ emotional well-being and mental health. The intent is to describe how to implement new models of mental health service delivery in schools and provide practical strategies to bolster the likelihood that our youth will be better off tomorrow than today. In this text, we recommend conceptualizing student mental health through a dual-factor model that encompasses both promoting wellness and reducing pathology. Moreover, we advocate for a change in educational priorities—one that supports the whole child, in mind, body, and spirit.
Chapters in this text integrate the multitiered systems of support (MTSS) model with the dual-factor model of mental health. Chapter authors emphasize the promotion of wellness as well as prevention and intervention to ameliorate emotional and behavioral problems in children and adolescents. Authors highlight evidence-based research on prevention science accumulated over the past two decades. This text can also serve as a stepping stone for future research that can be conducted to make school climates more supportive and welcoming.
THE ORIGINS OF THIS TEXT
My Story, by Phil Lazarus
In 1997, I was asked to be a founding member of National Association of School Psychologists (NASP) National Emergency Assistance Team. This team was founded after the bombing of the Alfred P. Murrah Federal Building in Oklahoma City on April 19, 1995, that killed at least 168 people and injured more than 680 others. Our intention was to have a national emergency assistance team in place that could respond to large-scale tragic events that impacted children, youth, and families. We anticipated that most of our responses would be related to helping children in the aftermath of natural disasters, and I was selected to be part of this five-member team due to my experience responding to Hurricane Andrew in South Florida. However, soon after the team was founded, our nation was struck by a spate of high-profile mass school shootings in 1997 and 1998 (e.g., Pearl, MS; Padukah, KY; Edinboro, PA; Springfield, OR; Craighead County, AR), and our team responded on site. Then on April 20, 1999, in Littleton, CO, the Columbine High School massacre occurred. This changed everything. I was asked to consult with the Federal Bureau of Investigations in 1999 along with many other participants to determine how we could potentially identify school shooters before they wreaked havoc on school campuses. As a result of these tragic shootings, I was interviewed multiple times. Before one of these shows, the Glenn Beck Show, I only had about 90 minutes before taping, and I was trying to think of the message
to get across to the public. The one message I came up with was “Children are safe in school. The actual chance of being killed at school is less than one in a million. Send your children to school.”
During the first part of the interview, Glenn Beck asked me reasonable questions. I gave him facts, warning signs, advice for parents and statistics, such as “We are losing 25 students every three days to violence in America. That is the equivalent of losing a classroom of children every three days to violence.” Then he asked, “So, Dr. Lazarus, What’s going on with our society? Why all this violence? Are we like the Romans, feeding our kids to the lions?” Wow! How do you answer a question like that? For a moment I felt like a deer in the headlights but eventually talked about how we, as a society, glorify violence and provided facts and commentary. Yet, the next day after the interview, I could not get Glenn Beck’s question out of my mind. And I wished I had said, “The reason this all is happening is because our society is out of whack. We have neglected the emotional well-being of our nation’s youth. We can do better. We must do a lot better.”
I saw school shooters as the canary in the coal mine. Canaries warn miners if there is a gas leak or if the air in the mine is becoming toxic. When the canaries die, the miners get out of the mine. These school shooters were telling us that something is wrong. Get out. Go in a new direction. As a result, I refocused my energy on helping schools prevent crises and helping young people respond to crisis. I coedited Best Practices in School Crisis Prevention and Intervention (Brock, Lazarus, & Jimerson, 2002) with the hope of improving the emotional lives of children. I later ran and was elected president of NASP, under the theme Advocating for the Emotional Well-Being of Our Nation’s Youth, and co-wrote Creating Safe and Supportive Schools and Fostering Students’ Mental Health (Sulkowski & Lazarus, 2017). Then I used my powers of persuasion to convince two highly respected scholars to agree to tackle the project of this book—one being Shannon Suldo, an expert of children’s emotional well-being and happiness, and the other being Beth Doll, an expert on transforming the delivery of mental health services in schools and creating resilient classrooms.
My Story, by Beth Doll
Forty years ago, after finishing my doctoral coursework, I worked as a school psychologist in a rural Kentucky county. One of my early referrals was Dustin1; his teacher described him as a serious behavior problem, constantly acting out and interrupting the other students. None of his peers liked him, she explained, because Dustin made their days so very difficult. And so I dutifully observed Dustin at recess and quickly learned that he was one of the most popular second graders on the playground. The playground supervisors agreed and even said that they relied on him to step in and mediate the other students’ disagreements. The first
1. As is the case for all children described in this text, Dustin is a pseudonym.
few times this happened, I was taken aback: Nothing in my coursework had prepared me for the fact that students’ presenting problems can disappear (or at least be strikingly different) when they move to different places or settings in the school. I quickly realized that sometimes, instead of “change the kid” interventions, it was important to “change the setting.”
Years later, another second grader explained this phenomenon to me. Johnny was working with me on writing a picture book, “How I drive my teacher crazy!” And he was an expert on the topic. One day, while illustrating his book, he shared a small bit of kid-wisdom: “I should be in Mrs. Tylee’s room. I’d do a lot better in her room.” And I didn’t say it out loud, but I agreed with him because Mrs. Tylee was a consummate teacher who dearly loved her students. Then, Johnny went on to explain, “The problem is, Daniel is the baddest kid in her class, and I’m the baddest kid in my class. And I don’t think they can have two baddest kids in the same class.” That is how Johnny framed my challenge: to figure out how to make more classrooms like Mrs. Tylee’s so that fewer students were baddest.
A first impression might be that the important characteristic of successful settings is the teacher, and it is true that teachers’ relationships with their students are powerful predictors of students’ success in school. Still, other examples from my experiences showed me that teachers are not the only important facet of schooling settings. In a low-income, urban middle school, the number of eighthgrade suspensions and expulsions dropped dramatically when more games and activities were made available during the lunchtime break. In an urban elementary school, previously isolated students were fully included in their classmates’ play when the games were more fun with more students participating. In a fifthgrade classroom, bickering and arguing diminished once students established a fair and simple routine for choosing recess soccer teams. Passing scores on state standards tests rose strikingly when an eighth-grade class began to graph and monitor their progress toward mastering the standards.
The important questions, then, were these: What are the characteristics of classrooms and schools that predispose students to success? What factors, if present, significantly increase the likelihood that students will succeed academically, socially, and behaviorally? How could I tell when these aspects of classrooms were present? And, how could I strengthen these factors in classrooms where they did not already dominate? These are the questions that I sought to answer in Resilient Classrooms: Creating Healthy Environments for Learning (Doll, Brehm & Zucker, 2014), Resilient Playgrounds (Doll & Brehm, 2010), and Transforming School Mental Health: Population-Based Approaches to Promoting the Competency and Wellness of Children (Doll & Cummings, 2008). Questions such as these are uniquely compelling for school mental health professionals who witness the daily interactions of children and youth as they transition between varying ecosystems of the school and community. Fortunately, the very rich scholarship of developmental resilience, effective schools, and psychological well-being has emerged alongside my efforts, and this book calls upon these scholarly traditions in making an argument for fostering the well-being of children.
My Story, by Shannon Suldo
I entered graduate school at the University of South Carolina intending to study features of families and parent–child relationships that influenced adolescents’ mental health—presumably for the worse, as at the time most discussions of mental “health” focused on psychological problems and forms of illness such as eating disorders, depression, and emotional crises. But while reading journals in the library one evening, I came across a recently published study that examined family functioning in relation to youth life satisfaction, an indicator of wellness. It was serendipitous that I was at perhaps the only university where a school psychology faculty member—Scott Huebner—had an interest in life satisfaction. It was 1999, prior to the widespread use of the term positive psychology and prior to much empirical work on correlates of life satisfaction among youth. Scott was a trailblazer, and in the 1990s laid the foundation for how to measure life satisfaction among school-aged students using reliable and brief tools he developed and validated. I quite literally owe all of my subsequent academic accomplishments to Scott’s research ideas, mentorship, and support. In 2000, Scott came to campus excitedly waving the millennial issue of the American Psychologist, a special issue devoted to positive psychology that stemmed from Martin Seligman’s 1998 presidency of the American Psychological Association. In the introduction, Seligman and Csikszentmihaly (2000) offered the following prediction about psychology in the 21st century: “We believe that a psychology of positive human functioning will arise that achieves a scientific understanding and effective interventions to build thriving in individuals, families, and communities” (pp. 13).
As my research on adolescent life satisfaction continued, from 2003 to 2006 I was fortunate to attend some of the early gatherings of pioneers in positive psychology at the annual International Positive Psychology Summits hosted by Gallup in Washington, DC. At these meetings, I shared findings from my studies conducted in South Carolina and then Florida that demonstrated the protective nature of high life satisfaction for adolescents who experienced numerous major life stressors; associations between teenagers’ life satisfaction and their schooling experiences; and the existence and utility of a dual-factor model of mental health in middle school students. And, I learned from researchers conducting experiments with adults that it was possible to cause increases in subjective wellbeing (SWB) through strategies intended to build gratitude, kindness, hope, goaldirected behavior, optimism, use of character strengths, and savoring of positive emotions, as well as nurturing relationships.
Energized by findings with adults that lasting gains in happiness were possible, since 2007 I have worked with my graduate students at the University of South Florida to develop, evaluate, modify, and disseminate evidence-based programs and practices that have increased SWB among children, adolescents, and educators in elementary, middle, and high schools throughout the Tampa Bay area. I wrote Promoting Student Happiness: Positive Psychology Interventions in Schools (Suldo, 2016) to provide school mental health providers and educators
with a guide for how to assess and promote SWB through increasing positive emotions about one’s past, present, and future, and strengthening relationships. I am so grateful that I’ve had 20 years to apply Seligman and Csikszentmihaly’s (2000) charge to building thriving students, teachers, and schools—as well as in my own family. When my preteen gets about three demands into the “but I really want [this 100th oversized stuffed animal; a social media game she is too young for; sushi for dinner again, etc.],” she is successfully redirected by prompts to write in her gratitude journal and returns to a pleasant/tolerable state. And when my perennially happy eight-year-old son had a tough day and scored relatively low on a life satisfaction survey he found on my clipboard and self-administered, he asked “Don’t you teach lots of kids how to feel happier?” [Yes! I teach kids your age about 10 things they can do!] and continued, “Give me just one or two of those ways, okay?” Empowering youth, teachers, and parents with tools that evoke positive emotions and foster the best in life is a blessed career path for sure.
THE SCOPE OF THE PROBLEM: PREVALENCE OF PSYCHOLOGICAL DISTRESS IN YOUTH
About 22.2% of adolescents in the United States suffer from mental illness according to epidemiological studies (Merikangas et al., 2010). Thus, about 444 youth will display clinically significant mental health disorders in a high school of 2,000 students. Sadly, this rate has increased significantly from a major previous study conducted 12 years earlier that found that 17% of youth suffer from mental illness (National Research Council & Institute of Medicine, 2009). Two of the most common and debilitating disorders are anxiety (with prevalence rates of 31.9%) and depression (with prevalence rates of 14.3%) among 13- to 18-yearolds. These two disorders alone affect millions of children and adolescents in the United States (Merikangas et al., 2010). Furthermore, in addition to being prevalent, mental health disorders exert a markedly negative impact on students' functioning. A study by the World Health Organization indicates that mental disorders account for nearly half of all disabilities among individuals between the ages of 10 and 24 (Gore et al., 2011). In the United States, about 7.5 million children are estimated to have an unmet mental health need (Kataoka, Zhang, & Wells, 2002), and half of adolescents with severely impairing mental disorders have never received mental health treatment (Merikangas et al., 2011).
According to the New Freedom Commission on Mental Health (2003), between 5% and 9% of students meet eligibility criteria for emotional disturbance. As a consequence, many of these young people will experience negative life outcomes such as not graduating from school and having a diminished quality of life (Sulkowski & Lazarus, 2017). Furthermore, the Report of the Surgeon General’s Conference on Children’s Mental Health (U.S. Department of Health and Human Services [DHHS], 2000) concluded that 10% of U.S. children suffer from a mental disorder severe enough to limit daily functioning in their family, community, and school settings with few affected youth receiving adequate mental health care.
Recent research demonstrates that mental disorders emerge early in life, that is, while individuals are still students in school. Among affected children and adolescents, 50% of disorders had their onset by age 6 for anxiety disorders, by age 11 for behavior disorders, by age 13 for mood disorders, and by age 15 for substance abuse disorders (Merikangas et al., 2010). Moreover, given that half of all children with anxiety disorders had their onset by first grade, there is a significant need for transitioning from the common focus on treatment in U.S. youth to a focus on prevention and early intervention.
Children and youth may have significant emotional distress even if they do not display mental health problems resulting in a psychiatric diagnosis or special education classification. Results of the Center for Disease Control and Prevention’s (CDC) bi-annual Youth Risk Surveillance Survey showed that 31.5% of U.S. high school students felt so sad or hopeless that they stopped engaging in usual activities almost every day for at least two consecutive weeks in the year prior to the survey (CDC, 2018). Even more concerning, 17.2% of high school students reported that they had seriously considered suicide at some point during the 12 months prior to completing the survey and 7.4% of students had made a suicide attempt (CDC, 2018). Stated differently, 3 out of 10 youngsters felt so sad or hopeless during the prior year that they were not able to lead fully productive lives, and one out of six students had seriously considered ending their own life.
In addition to displaying mental health problems that warrant acute care, millions of students fail to develop important social and emotional skills that can protect their emotional well-being (Lazarus & Sulkowski, 2012; Sulkowski & Lazarus, 2017). In this regard, fewer than half of students (19%–45%) develop competencies such as empathetic responding, conflict resolution, and problemsolving skills prior to graduation (Klem & Connell, 2004). Moreover, many of these same students are poorly bonded to supportive educational communities and less than a third of 12th graders reported that their schools provide an encouraging and supportive learning environment (Benson, 2006). The problem may be even more severe than is reported because the population sampled by Benson did not include students who had dropped out of the school.
Numerous surveys have indicated that coping with excessive stress was a major concern of high school students (Vella-Brodrick, 2016), not just in the United States but also in other countries. For example, in a large Australian survey of individuals aged 15 to 19 (Bullot, Cave, Fildes, Hall, & Plumer, 2017), 43% of young people reported dealing with stress was a prime concern and a large focus of their stress revolved around school life. In a sample of high school dropouts, only 41% of students reported that there was someone at school with whom they could discuss a personal problem (Bridgeland, DiIulio, & Morison, 2006). This perception that no one at school truly connects with or cares for the student presents a significant barrier to graduating and future success and is the most frequently cited reason that students drop out (Kostering & Braziel, 2002). Clearly, schools need to do more to support at-risk and disenfranchised students, and youth with mental health challenges. All school personnel should create a welcoming culture to help all youth succeed in school and beyond.
We have known about the problems facing children and adolescents for a long time. For example, the opening sentence of the Surgeon General’s Conference on Children’s Mental Health states that “the nation is facing a public crisis in mental health care for infants, children and adolescents” (DHHS, 2000, p. 15). Unfortunately, this knowledge has not prompted significant changes in public policy or in the number of school psychologists and other mental health providers hired by the schools. In fact, with the increase of charter schools in the United States, it can be argued that comprehensive and integrated school mental health services for our nation's students in some schools have actually decreased. The reason is that charter schools typically only contract for psychoeducational assessments and not for comprehensive and integrative services as recommended by NASP (2010). School-based mental health professionals understand the scope of this problem and, despite our limited numbers, are well-equipped to share our concerns regarding this public health crisis and develop innovative and evidencebased solutions to address it (Lazarus, 2012).
RISK AND RESILIENCE RESEARCH
In 1955, Werner (2013) began a longitudinal study monitoring the impact of various biological and social risk factors for that year’s birth cohort on the Hawaiian island of Kauai: 698 children of whom 30% were living with four or more risk factors such as chronic poverty or parental psychopathology. She was interested in learning which factors best predicted the children’s subsequent needs for special educational services upon entering kindergarten. Werner’s was not the only ambitious longitudinal study. A similar study was begun in Great Britain three years later, and by 2013, Werner identified over a dozen large-scale longitudinal studies that included at least of 100 participants who were followed since childhood at several points in time, had low attrition rates, and used multiple measures of risk and adaptation. Several of the studies sought to predict which children would develop mental disorders. Two very compelling attributes characterize these studies. First, because the earlier years of some studies predated personal computer technology, many of the early records were kept in paper files. Risk factors were collated by placing red dot stickers on the file’s tab. It was a monumental undertaking. Second, although the dozen studies were conducted on four different continents and by independent research groups, their findings were remarkably consistent (Garmezy, Masten, & Tellegen, 1984). The original intent of the researchers had been to identify which risk factors predicted particular problematic outcomes, but that is not what they found. Instead, across multiple independent studies, it became apparent that it was the number of risk factors that best predicted later problems, and outcomes for children living with four or more risk factors were particularly distressing (a phenomenon described as “four-dot children”). Results demonstrated that children could tolerate some adversity but at a certain point, multiple risk factors accumulated to overwhelm the developmental system.
Beginning in the 1970s (Masten, 2018), developmental risk researchers began to turn their attention to another phenomenon that was evident in their various research studies: in every study, there were some four-dot children who, by virtue of their multiple adverse risk factors, ought to be failing—but they weren’t. Because of their rich, longitudinal data sets, each research team was able to identify the critical assets or protective factors that characterized these resilient children. Once again, the various independent studies identified a similar array of factors predicting successful coping in high-risk children (Werner, 2013): characteristics of the community (e.g., parental competence, other supportive adults, peer friendships, successful schools, prosocial organizations) and characteristics of the child (e.g., sociable, engaging, intelligent, achievement motivated, positive selfconcept, planning, and foresight). It was quickly apparent that these descriptions of developmental resilience could be powerful tools for strengthening the success of children even if they were struggling against overwhelming risk and adversity. Masten (2001) captured the power of this shift in her iconic publication, Ordinary Magic. Developmental risk and resilience research was the basis for the Adverse Childhood Experiences study (Felitti et al., 1998) which was also prompted by several previous well-known intervention studies including the Abecedarian Project (Ramey & Campbell, 1984), the Seattle Social Development Project (Hawkins et al., 1992), and the Fast Track (Bierman, 1996). Importantly, the resilience factors identified in the developmental risk and resilience research mirror the prominent characteristics of thriving identified in the positive psychology research.
In many respects, the developmental risk and resilience research elevated the importance of schools in promoting the emotional and psychological well-being of children and youth. Risks and protective factors accumulate and interact over time in developmental cascades, emerging across the 13 years that children spend in schooling. These factors—both positive and negative—impinge on children’s capacity for accomplishing important developmental tasks, including the very striking task of succeeding in school. Moreover, most risk and protective factors are not characteristics of the child per se, but instead represent characteristics of the social and self-regulatory systems of child-rearing. Schools are uniquely poised to recognize and manipulate such systemic variables. Finally, it is very apparent that dramatic shifts in pathways or developmental trajectories occur more readily when children are younger; schools’ access to young children is more extensive than that of many other cultural institutions. Thus, schools’ status as critically important contexts for development is now broadly recognized, and the importance of school-based mental health services is undisputed.
A DUAL- FACTOR MODEL OF MENTAL HEALTH— BROADENED ATTENTION TO WELL- BEING
For most of the 20th century, psychological functioning was defined by the presence of symptoms of disorders and associated negative outcomes. If criteria were
not met for a disorder, an individual was viewed as subclinical and not provided psychological services. However, it is increasingly recognized that psychopathology and well-being are related but distinct; the absence of psychopathology is correlated with but not equivalent to the presence of well-being (Keyes, 2005). A complete mental health status may best be defined by few symptoms of mental illness and the presence of positive indicators such as happiness, commonly operationalized as SWB. High SWB reflects an overall appraisal of satisfaction with life—either on the whole (global life satisfaction) or with specific areas of life (such as yourself, school, or family life)—and a positive affect balance wherein one experiences positive feelings more frequently than negative feelings. As detailed in Chapter 1 of this volume, a growing body of research with children and adolescents demonstrates the necessity of considering psychopathology and SWB in tandem, in line with a dual-factor model of mental health (Suldo & Shaffer, 2008). Students with average to high SWB in addition to minimal psychopathology (i.e., have complete mental health) demonstrate superior functioning across developmental domains that span academic, social, identity, and physical health outcomes. Further, there are sizable proportions of students for whom elevated psychopathology co-occurs with high SWB, or, conversely, minimal psychopathology exists with low SWB. It is our contention that viewing mental health only through the lens of psychopathology is incomplete as adjustment appears to be a function of students' level of both SWB and psychopathology symptoms. What do we know about the happiness levels of people in the 21st century?
HAPPINESS STUDIES
In line with calls for national accounts data for SWB, the past 15 years have brought impressive initiatives to monitor happiness and life satisfaction in representative samples across the world as societal interest in wellness expands beyond economic conditions to include perceived quality of life. International data collections like Gallup World Poll (see Gallup, n.d.; Children’s Worlds, n.d.) have revealed developmental and national trends in happiness. In the Gallup World Poll (conducted annually since 2005), residents of over 160 nations report their SWB along with numerous other indicators of quality of life. From each country, about 1,000 individuals aged 15+ participate. Diener and Tay (2015) examined national trends in SWB from 2005 to 2013 and found that despite an increase in stress during that period (which included the global economic downturn in 2009), overall the average world levels of well-being did not change significantly on any indicator of SWB during the seven-year period. Comparisons of SWB at the nation level found that citizens in a few countries (Greece, Egypt, Syria) that experienced marked upheaval during that time also reported a marked decrease in life satisfaction, but there was marked stability in SWB including among Scandinavian nations that always have the highest levels with Denmark at the top. In many countries—including the United States and other industrialized nations—most adults report positive appraisals of life satisfaction; but there is
substantial variability within and between nations (Diener, Diener, Choi, & Oishi, 2018). In particular, countries marked by poverty, war, and health crises, and individuals in any nation who experience a multitude of adverse childhood events coupled with few social supports are likely to experience low SWB (Diener et al., 2018). In the most recent World Happiness Report (data from the 2016–2018 Gallup World Polls), Finland, Denmark, and Norway still had the happiest citizens, and the United Stated ranked 19 of 156 countries (Helliwell, Layard, & Sachs, 2019). A 2020 Gallup report indicated that while the vast majority of Americans report feeling fairly to very happy, the percentage at this high level has dipped to the lowest in over 70 years of Gallup’s periodic surveys (McCarthy, 2020). Such trends in adult wellness are critical to keep in mind as we charge teachers, administrators, and other adults in schools with fostering emotional well-being in youth.
In Children’s Worlds, the International Survey of Children’s Well-Being measures life satisfaction, happiness, and quality of life among representative samples of 8-, 10-, and 12-year-olds (about 1,000 children per age group, per country) in up to 40 countries. Analysis of multiple indicators of SWB completed by children aged 7 to 14 in 14 countries participating in Children’s Worlds uncovered a developmental phenomenon wherein SWB starts to decline around 10 years of age in most countries, a downward trend not attributable to school transitions such as the start of middle school, which varied across countries (Casas & GonzalezCarrasco, 2019). Earlier cross-national assessments of life satisfaction indicated that as youth age, average levels of life satisfaction tend to decrease linearly from elementary to middle school to the high school years (Cavallo et al., 2015). Taken together, global monitoring of youth happiness indicated relatively high levels of happiness throughout the childhood years, followed by declines during the adolescent years.
Regarding the well-being of adolescents within the United States in particular, the Monitoring the Future (MtF) survey has monitored the happiness of students in grades 8, 10, and 12, and life satisfaction in 12th graders annually since 1991 (see MtF, n.d.). Twenge, Martin, and Campbell’s (2018) report of MtF trends in average levels of SWB from 1991 to 2016 revealed that global life satisfaction trended upward from 1991 to 2009 and then decreased and leveled off in 2011. Happiness ratings peaked in 2007, dipped in 2009, and then trended upward until 2012. Alarmingly, multiple indicators of SWB (happiness, global life satisfaction, and satisfaction with one’s self) were all lower in 2013 and continued to decline substantially through 2016, the time period the researchers noted followed widespread ownership of smartphones and increased Internet time. Even after considering economic variables, Twenge et al. concluded, “The most likely culprit for a cultural force leading to lower well-being among adolescents since 2012 is the increase in electronic communication” (p. 776). Plausible causes for psychologically harmful side effects of moderate to heavy social media use include its associations with cyberbullying and social upward comparisons, which result in negative self-appraisals, as well as loss of time spent in activities that undergird happiness such as face-to-face social interactions and healthy behaviors such as
