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Teach By Design
Assessment
Mental Health
Fidelity
Evaluate
May 13, 2025
Your PBIS Action Plan for Mental Health Starts Here
Once you know the mental health statistics in our schools, you can’t help but take action. If you’re implementing PBIS, the Tiered Fidelity Inventory gives you a few places to start.
By
Megan Cave
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May 13, 2025
Every year, Mental Health America (MHA) encourages us all to spend more time educating ourselves about mental illness and strategies for improving our own mental health and wellness. This year, in addition to that education, MHA wants us to take action. As they announced this year’s theme, MHA said, “In a world where mental health challenges affect millions, awareness is just the beginning. This year, we’re taking a bold step forward with our theme: ‘Turn Awareness into Action.’ It’s time to transform understanding into tangible support, compassion into concrete steps, and intentions into real-world impact.”
If action items are what you’re looking for, you’ve come to the right place.
Let’s start with what we know about mental health in schools.
Current Mental Health Statistics in Schools
Every two years, the Centers for Disease Control and Prevention (CDC) conducts the Youth Risk Behavior Survey (YRBS) to understand the health, behaviors, and experiences of high school students in the United States. In 2023, the YRBS found:
4 in 10 (40%) students had persistent feelings of sadness or hopelessness.
2 in 10 (20%) students seriously considered attempting suicide and nearly 1 in 10 (9%) attempted suicide.1
The goal is to decrease our exposure to risk factors and increase our access top rotective ones.
When breaking these data out by demographic groups, we learn just who is most vulnerable to negative mental health outcomes in our schools— female students, LGBTQ+ students, and students of color:
More than half of female students experienced persistent feelings of sadness or hopelessness during the past year.
More than 3 in 5 LGBTQ students experienced persistent feelings of sadness or hopelessness during the past year and more than half had poor mental health during the past month.
1 in 5 LGBTQ+ students attempted suicide during the past year.
Almost a third of the students surveyed said they experienced racism at school.
Risk and Protective Factors for Mental Health
When something is known to affect us negatively, we call it a risk factor. Alternatively, the things that protect us from risk factors are called (shockingly enough) protective factors. Common risk and protective factors for mental health include:2
Risk Factors
Protective Factors
Bias & discrimination
Positive coping skills
Insecure housing, healthcare, or education
Secure employment, housing, education
Childhood trauma
Safe living spaces
Social isolation
Strong social circles & positive relationships
Medical conditions
Preventative care, mental & physical health services
The goal is to decrease our exposure to risk factors and increase our access to protective ones. Having access to these protective factors won’t prevent negative things from happening, but they can decrease the effects.
We know mental health statistics in our schools are worrisome. We also know the risk and protective factors affecting mental health. The last detail we know is: mental health supports work best within a multi-tiered system of support (MTSS)!3 These frameworks establish tiers of support where we offer foundational skills to everyone and increased support for those who need it most. It’s time to talk about the action we can take…and this action plan starts with an MTSS: Positive Behavioral Interventions and Supports (PBIS).
Embedding Mental Health Support in a PBIS Framework
Access to data systems and information regarding the topics above
Community members like social workers, school psychologists, and counselors contribute their expertise to your team and ensure mental health supports are included in the systems and practices you implement.
Item 1.3 Schoolwide Expectations
The schoolwide expectations you reflect who you areas a community and represent the social, emotional, and behavioral skills you want to teach. The TFI 3.0 asks you to align those expectations with your district’s or state’s social, emotional, behavioral standards or curriculum…which makes a lot of sense. If your schoolwide expectations reflect the skills you want to teach, the social, emotional, behavioral learning curriculum you use should align with your expectations. It’s a natural partnership.
Item 1.8 Crisis and Emergency Response Plan Linked to Schoolwide Supports
What do you do before, during, and after an emergency happens at your school? It’s all outlined in your school’s crisis and emergency response plan. The TFI 3.0 calls this plan to our attention by explicitly linking it to your schoolwide systems and building in considerations for student and staff wellness along the way.
What coping skills can you teach now in the event of an emergency?
How will you support student/staff/family mental health in the midst of a crisis?
What can you do to make sure your response centers mental health when the emergency is over?
Bonus points to you if you can name multiple strategies to support a variety of social, emotional, behavioral needs.
Item 1.18 Using School and Community Data to Inform Tier 1
Elevating your schoolwide community’s voices by asking for their feedback promotes a sense of community, improves fidelity, strengthens your implementation, and makes everything you do more meaningful, relevant, and valued.4 The TFI 3.0 asks you to consider two things related to these community data:
Do you have access to information like nurse/counselor visits, universal screening, and community resource profiles?
How often do you use those data to inform your decisions?
PBIS implementation is iterative, so if you have access to these data, but haven’t incorporated them into your decision-making process, set a goal to make that part of your quarterly routine!
Item 1.20 Evaluation Plan
Your school’s annual evaluation plan is your opportunity to review the actions your team took, the outcomes you achieved, and how those efforts compare to previous years. Once you create the plan, you have to share it! “By sharing data frequently with school staff, the school team may…strengthen perceptions that implementation leads to valued outcomes.”5 As part of the evaluation plan, the TFI 3.0 asks your team to include how you used community data to inform your work this year. Be sure to share your annual evaluation with your community partners so they can see how their efforts impacted your school’s outcomes.
The first step to improving mental health outcomes in your school is being able to define the problems you want to solve. Equipped with that information, it’s time to take action. Your PBIS implementation offers a few places to start. As a team, ask yourself:
Are there community members like school psychologists or social workers who can add mental health expertise to our schoolwide team?
How do our schoolwide expectations help us meet district or state social, emotional, and behavioral standards?
How many of our emergency response strategies center student, staff, and family mental health and wellness?
Which community data do we include in our team’s decision-making process and how often do we share those data with everyone?
These PBIS systems, data, and practices are just a few ways to achieve better mental health outcomes within your larger community. Take action now by making a plan for the coming school year!
1. Centers for Disease Control and Prevention. (2024). Youth risk behavior survey data summary & trends report 2013–2023, U.S. Department of Health and Human Services.
2. Centers for Disease Control and Prevention, About Mental Health, https://www.cdc.gov/mental-health/about/index.html.
3. Eklund, K., Kilpatrick, K. D., Kilgus, S. P., & Haider, A. (2018). A systematic review of state-level social–emotional learning standards: Implications for practice and research. School Psychology Review, 47(3), 316-326.
4. Freeman, J., Robbie, K., Simonsen, B., Barrett, S., & Goodman, S. (January 2021). Integrated TFI Companion Guide. Eugene, OR: Center on PBIS, University of Oregon. www.pbis.org.
5. McIntosh, K., Kim, J., Mercer, S. H., Strickland-Cohen, M. K., & Horner, R. H.(2015).Variables associated with enhanced sustainability of school-wide positive behavioral interventions and supports. Assessment for Effective Intervention, 40(3), 184–191. doi:10.1177/1534508414556503.
Megan Cave is a member of the PBISApps Marketing and Communication team. She is the writer behind the user manuals, scripted video tutorials, and news articles for PBISApps. She also writes a monthly article for Teach by Design and contributes to its accompanying Expert Instruction podcast episode. Megan has completed four half marathons – three of which happened unintentionally – and in all likelihood, will run another in the future.
