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We don’t provide mental health advice, counselling, or treatment. If you or someone you know is in crisis, contact your local community crisis team. You can also reach out to the Indigenous Hope for Wellness Help Line 1-855-242-3310, the Black Youth Helpline 1-833-294-8650, or Kids Help Phone 1-800-668-6868.

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Our approach

Everything we do is evidence-informed, student-centred and aligned with the Ontario curriculum.

About Ontario’s approach to school mental health  

  • Ontario has a comprehensive and systematic multi-year School Mental Health and Addictions Strategy that follows scientific research and responds to student needs and service trends. 
  • Each school board across the province has a mental health leadership team that uses this provincial strategy to guide the development of their local School Mental Health and Addictions Strategy, that reflects the needs, context, strengths and resources of their community. 
  • Every school board has an implementation support coach from School Mental Health Ontario to help them roll out their strategy. 
  • School boards across the province have access to a range of evidence-informed, identity-affirming programming, resources, professional learning and training to support excellence in school mental health service delivery. This suite of supports is routinely updated as new identity- affirming, culturally relevant, evidence informed programming is identified.
  • Ontario educators, school/system leaders, student support staff, school mental health professionals, and students themselves are involved in the development of mental health resources, learning, and programming used in Ontario schools. 
Cover photo of the School Mental Health Strategy 2022-25

School Mental Health Strategy 2022-2025

Download a PDF of the 2022-2025 School Mental Health Strategy

Ontario’s multi-tiered system of support for school mental health 

Across the globe, a multi-tiered system of support approach is seen as foundational for school mental health service delivery. This structure helps to establish priorities, clarify roles, and ensure service coordination and quality within a complex and evolving field. Broadly, it includes a continuum of services: mental health promotion, early identification, prevention and early intervention, and service pathways / clinical support for more intensive mental health needs.  

The Aligned and Integrated Model or AIM is a triangle with three equal sides that shows the three levels of student mental health support in Ontario. The bottom of the trangle is the Foundation and includes school and classroom leadership. It’s divided into the following five sections:

Welcome – school and classroom physical environments

Include – student engagement and belonging

Understand – Mental health literacy and knowing your students

Promote – Curriculum, teaching and learning

Partner – Home, school, community partnerships

The second level is Notice and represents early identification. It’s divided into the following three segments:

Prevent – Provide early intervention services

Support – Offer ongoing classroom support

Bolster – Build skills and resiliency

The third level is the top of the triangle. It is Bridge and represents mobilizing board and community supports. It includes one segment:

Intervene – Assessment and treatment services The words equity, engagement and evidence appear around the graphic.

Tier one

A multi-tiered system of support approach begins with and prioritizes mental health promotion, highlighting the critical role that schools play in everyday wellness and to enhance student mental health literacy and leadership. This is often referred to as tier one support and is universally offered at the school and classroom level.

Educators, in particular, have tremendous opportunity to strengthen wellness as part of everyday practice, and to notice and support when students show signs of a mental health problem. Consistent, high-quality educator mental health literacy is a foundational part of the multi-tiered system of support approach at tier one. School and system leaders have a key role in creating the conditions for effective student mental health promotion.

Although classroom educators are often the first to note a change in emotions or behaviour that might signal a mental health disorder, any member of the school staff could be the one that a student chooses to connect with for emotional support. As a result, all school staff need some level of mental health awareness, and some, particularly those who support students in a special capacity (e.g., child and youth worker, coach, guidance teacher, special educator, GSA leader, grad coach) can benefit from specialized mental health literacy focused on early identification and support. In addition to learning how to recognize signs of a mental health problem, in a multi-tiered system of support model, student support staff are equipped with identity-affirming resources, tools, and programming that can be used to help students who might benefit from additional support and allyship.

Tier two

When students are showing signs of an emerging or escalating mental health problem, tier two school-based prevention and early intervention services can be introduced. In Ontario, school mental health professionals who are registered with a professional college, such as school social workers and psychologists/psychological associates, are available to provide brief, evidence-informed interventions to help students with mild-to-moderate mental health problems.

Tier three

Some students with significant, acute, or complex mental health needs require more intensive or urgent mental health services, referred to as tier three or tier four support. In these cases, school mental health professionals help with service pathways and clinical support. The collaborative vision for the system of care outlined in Right Time, Right Care highlights the critical need for clear and seamless transitions to, from, and through more intensive or specialized services when Ontario students require this level of support.

School mental health professionals can assist with these transitions, supporting students and their families with access, navigation, and care plans. When students are unable or unwilling to receive these services within community mental health, cultural/faith, or hospital settings, assessment and intervention is provided by school mental health professionals.

School Mental Health Strategy 2022-2025 

The School Mental Health and Addictions Strategy is visually depicted in the wheel graphic below. It follows the multi-tiered system of support approach, with tier one supports noted in green, tier two supports in blue, and tier three supports in purple. The school mental health supports and services included in the strategy are meant to wrap around every student, as noted in the centre of the figure. Also at the centre, noting the primacy of its importance, is a focus on the intersection of equity, identity, and student mental health.

2022 Strategy Infographic - see full description below

The graphic is a circle or wheel. The very centre says every student.

A ring around the centre circle says commitments to Truth and Reconciliation, and equity.

The next ring out has the words dismantle, engage, amplify and respond.

The next ring is broken into equal sections for the multi-tiered system of support. There are five sections for Tier 1, two sections for Tier 2 and one section for Tier 3.

Tier one includes:

  • Parent, caregiver, and community connections and support
  • System, school, classroom mental health leadership
  • Strength-based mental health promotion
  • Mental health literacy and stigma reduction
  • Student leadership, participation and agency

Tier 2 includes:

  • Early identification and student support
  • Prevention and early intervention

Tier 3 includes:

  • Intensive supports and service pathways

The outside frame says mentally healthy learning environments, teaching and learning, student engagement and allyship, partnerships and services.

Below the wheel is a heading that says foundations with seven equal rectangles that say:

  • Leadership commitment
  • Engagement & collaboration
  • Vision & strategy
  • Infrastructure
  • Processes & protocols
  • Evidence monitoring
  • Internal and external communication

At the centre

Video opens with text on screen:

At the centre of Ontario’s school mental health strategy is every student and their unique strengths, identities, needs and natural supports.

A graphic of the strategy unfolds:

The graphic starts with a circle. The very centre says every student.

A ring around the centre circle says commitments to Truth and Reconciliation and equity.

The next ring out has the words dismantle, engage, amplify and respond.

The next ring is broken into equal sections for the multi-tiered system of support. There are five sections for Tier 1, two sections for Tier 2 and one section for Tier 3.

Tier one includes:

Parent, caregiver, and community connections and support

System, school, classroom mental health leadership

Strength-based mental health promotion

Mental health literacy and stigma reduction

Student leadership, participation and agency

Tier 2 includes:

Early identification and student support

Prevention and early intervention

Tier 3 includes:

Intensive supports and service pathways

The outside frame says mentally healthy learning environments, teaching and learning, student engagement and allyship, partnerships and services.

The centre of the circle that says every student then expands to take over the screen and is replaced by a series of diverse student photos, each appearing one at a time.

The circle then changes back to the words every student and shrinks. Text appears:

Differentiated and identity-affirming supports wrap around every student across the tiers of intervention.

But how? The Identity-Affirming School Mental Health Frame offers guidance related to places for reflection and action.

The screen changes to show a graphic with the title The Identity-Affirming School Mental Health Frame.

The graphic is a circle or wheel. The very centre says every student.

A ring around the centre circle says commitments to Truth and Reconciliation, and equity.

The next ring out has the words dismantle, engage, amplify and respond. Each section opens one at a time starting on the bottom left:

Respond with differentiated and Identity affirming mental health supports

Then the top right:

Engage and partner with students, parents/caregivers and community with cultural humility.

Then the bottom right:

Amplify diverse student, parent/caregiver and community perspectives by decentring whiteness

Then the top left:

Dismantle and remove oppression and racism with anti-oppressive and anti-racist policies and practices.

The graphic disappears and words appear:

School mental health done well is grounded in Truth and Reconciliation

School mental health done well is grounded in equity

Those words transition to say:

School mental health done well is identity affirming.

The video ends as the screen becomes a purple, blue and green gradient and the School Mental Health Ontario logo appears in white in the very centre.

Every student

At the centre of the strategy is every student, and their unique strengths, identities, needs and natural supports. The strategy considers the whole child, as well as their family and community and experiences. Putting a focus on every student, rather than “all students” encourages strong consideration of each student’s unique identity when planning relevant mental health supports and services. 

Commitments to Truth and Reconciliation, and equity

The strategy emphasizes that school mental health supports must be grounded in commitments to Truth and Reconciliation, and equity to truly meet the needs of every student.

Equity, culture and mental health

The next layer of the strategy highlights the embedded Identity Affirming School Mental Health Frame. This has been co-developed with a diverse provincial working group to help describe and prioritize the intersection of equity and mental health. Using this Framework, Mental Health Leadership Teams reflect on and dismantle colonial systems and structures that provide uneven access to, and outcomes for, mental health services; to engage with culture/faith/community leaders and groups to learn more about available and needed identity-affirming mental health supports; to amplify perspectives of young people and communities who are racialized and marginalized in co-developing mental health services and supports; and to respond to student mental health needs through identity-affirming and culturally responsive approaches. The strategy prioritizes resources and professional learning in support of these actions. 

Tier one

Parent, caregiver, and community connections and support

Students have a range of natural supports and protective influences in their lives, at home, school, and in their communities. Working together, the strength of these natural supports can be optimized. This aspect of the strategy focuses on explicit and intentional parent, caregiver, and community connections and support, with a view to strengthen relationships, build mental health literacy, co-develop collaborative mental health promotion initiatives, and reinforce common understandings and messaging for young people.

System, school, classroom mental health leadership

Effective and sustainable school mental health practice is dependent on system, school, classroom mental health leadership. Educators need the support of school leaders to confidently introduce identity-affirming classroom mental health resources and programming, in the same way that school leaders depend on the support of system leaders to lead mentally healthy schools. Strategy work in this area helps to ensure that leaders at all levels understand their role in supporting school mental health and have the tools and resources they need to perform this role.

Strength-based mental health promotion

Strength-based mental health promotion, as part of daily classroom practice, is a key cornerstone for the MTSS. This includes, for example, a warm welcome for every student each day to create a strong sense of belonging at school, everyday mental health practices that reinforce a sense of wellness and a range of culturally responsive ways of coping with stress, and reminders about individual gifts, strengths and the power of self-love. In this 3-year strategy, more wellness-promoting classroom resources will be shared and supported.

Mental health literacy and stigma reduction

When students have accurate and current information about mental health, they gain a sense of agency for their own well-being and are better equipped to help themselves, or a peer, when mental health problems arise. In addition, knowledgeable young people can be ambassadors for stigma reduction, as they normalize the experience of mental health distress and help-seeking. Findings from #HearNowON 2021 indicate that students want to learn about mental health at school. Participants also highlighted the need to ensure strong mental health literacy for educators who support this instruction. In response, the strategy focuses on greater roll-out of MH LIT for educators and associated classroom resources, alongside implementation support for Student MH LIT secondary student mental health learning.

Student leadership, participation and agency

Through #HearNowON 2021, students expressed a strong desire to become more engaged in mental health initiatives in their school and board so that they can play a more active role in wellness promotion. Young people have a unique perspective and powerful voice in this work. Strategy work will continue to focus on ways to support student leadership, participation, and agency, safely, effectively, and authentically. The ThriveSMH reference group will continue to provide input to SMH-ON activities and will continue to co-lead the development of student-facing resources. Particular emphasis will be placed on encouraging the participation of “quiet leaders” through a range of diverse opportunities and on magnifying the reach of student-facing resources and forums through web and social media platforms.

Tier two

Early identification and student support

Although classroom educators are often the first to note a change for a student that might signal a need for mental health support, other student support staff often have a key role in early identification and student support (e.g., coach, guidance teacher, special educator, gay-straight alliance leader, grad coach). The 3-year strategy includes expanded role-specific learning opportunities and resources, so that more caring adults at school can be equipped to support students with emerging or escalating mental health needs.

Prevention and early intervention

School mental health professionals in Ontario schools provide prevention and early intervention services when students have mild-to-moderate mental health needs that would benefit from brief, targeted intervention. Over the next 3-year period, through the Innovation and Scale Up Lab at Western University, more identity-affirming evidence-informed protocols will be selected for testing and potential scale up. At the same time, work with the Offord Centre for Child Studies / McMaster University will help with the development of measurement-based care tools for SMH clinicians to help guide therapeutic decision-making. Training on brief protocols will continue (e.g., Brief Intervention for School Clinicians, Brief Digital Interventions, Supporting Transition Resilience of Newcomer Groups), and professional learning for front-line clinicians and supervisors will be expanded in key areas (e.g., substance use prevention, eating disorders prevention). An updated Culturally Affirming CBT module will be piloted and scaled out over this period, in collaboration with colleagues at CAMH Health Equity Office.

Tier three

Intensive supports and service pathways

Over the past two years, School Mental Health Ontario has partnered with the Lead Agency Consortium, the Knowledge Institute on Child and Youth Mental Health, and Children’s Mental Health Ontario to develop a shared vision for an integrated and coordinated system of care for child and youth mental health. This work culminated in a vision paper, Right Time, Right Care: Strengthening Ontario’s mental health and addictions system of care for children and young people that summarizes the relative roles of schools and community mental health organizations with respect to service delivery. While schools have a primary focus on mental health promotion, prevention, and early intervention, community mental health organizations take a lead role in more intensive service delivery when young people are experiencing more severe, complex, or acute mental health problems. The strategy includes support for the Right Time, Right Care implementation plan, as well as collaboration related to other key partners in the system of care.

Outside frame

The outside framing of the strategy references the recently released Canadian Healthy Schools Standards led by the Canadian Healthy Schools Alliance. The language is slightly adapted to highlight a focus on the Standards for (Mentally) Healthy Schools: Mentally Healthy Environments, Teaching and Learning, Engagement and Allyship, and Partnerships and Services.

Foundations for effective, scalable, and sustainable school mental health practice

Implementation of the multi-tiered system of support approach is complex and requires a comprehensive approach that highlights both “what” (evidence-informed interventions across the tiers of intervention) and “how” (strong emphasis on foundational infrastructure and implementation supports to promote scalability and sustainability). 

Interventions + infrastructure + implementation support = effective, scalable and sustainable school mental health practice.

Leadership commitment is demonstrated when system and school leaders are active in modelling, communicating and supporting decisions and activities that provide a mentally healthy experience for every student. When ministry, system and school leaders show that they are committed to a focus on mental health and well-being – by what they say, and by what they do and prioritize – board and school staff echo this commitment and feel valued for their work in this area. Working alongside the ministry, CODE Advisory Team, Superintendent Associations, and School Leader Associations, the strategy continues to focus on supporting those who champion student mental health within the education sector.

Promoting student mental health within a district, and within a school, truly takes a village. Early engagement of those who are most involved as initiatives are introduced, and in an ongoing way, helps to build shared ownership and leads to more impactful outcomes. Collaboration with students, parents/ caregivers, and community partners in the selection and shaping of mental health initiatives is an important way to ensure that practices are identity-affirming, relevant, and culturally responsive. The strategy builds on successful past engagement efforts to grow new partnerships and platforms for collaboration.

A clear and focused vision, that is created collaboratively and is aligned with board priorities and initiatives, is a key foundation for school mental health. The vision guides the mental health and addictions 3-year strategy and action plan, and mental health service delivery model within the board. System strategic goals align with the provincial school mental health strategy and local mental health priorities. School leaders echo the provincial and board mental health strategy within their local plans and initiatives, prioritizing resources and supports that meet local needs and draw on community strengths. System and school leaders have a critical role in establishing and reinforcing the board vision for mental health and well-being, and reflecting this within the wider strategy and daily work of the board or school.

Bringing effective mental health and well-being to life in schools requires a dedicated infrastructure and support. In Ontario, this infrastructure has been supported by funding from the Ministry of Education which allows for dedicated leadership roles within each school district. In addition, SMH-ON provides implementation coaching support to every board in the province so that initiatives can be rolled out systematically, with a view to sustainability over time. Strategy work in this area is focused on “getting to uptake” of high-yield classroom resources, programming, and professional learning and training through the use of coaching, decision support tools, consistent protocols, and communities of practice.

Protocols provide documented guidance and system clarity in supporting student mental health promotion, prevention, and early intervention. Clearly described implementation processes to support the dissemination, implementation, use of, and monitoring of all mental health resources and practices are required for all protocols, resources, and services. In Ontario, every board is expected to have a number of clearly articulated protocols related to mental health practice. Clear protocols for collaboration with community mental health and hospital partners are needed to ensure role clarity and seamless service pathways within the local context.

Sound implementation and outcome indicators, and measurement tools that inform needs and monitor uptake and effectiveness, are essential for making decisions in supporting student mental health. Continuous quality improvement cycles with progress monitoring help in understanding the success of implementation, of both outcome and process indicators. Examining data supports analysis of effectiveness and illuminates disproportionate impact for students who are Black, Indigenous and marginalized. System and school leaders, with support of the Mental Health Leadership Team and equity partners, share a critical role in monitoring, evaluating and responding to indicators that demonstrate progress in school mental health and well-being.

Communication related to mental health needs to be dynamic, multidirectional, research-informed, and accessible for all internal and external stakeholders. Given the potential for misinformation and misunderstanding in this area, evidence-informed, common messaging is needed, and stakeholders need a clear path towards high-quality, made-in-Ontario resources that align with the strategy and board action plans. The strategy prioritizes the development and expansion of a variety of communication platforms designed to reach intended audiences with key messages and supports.

Expected outcomes of the 2022-2025 strategy

The vision for the current School Mental Health and Addictions Strategy is that by 2025 every student will have access to differentiated and responsive, evidence-informed mental health promotion, prevention and intervention services at school. To achieve this goal: ` 

  • Resources, protocols/programming, professional learning, training, and supports will need to continue to be developed/selected. 
  • System and school leaders, school staff and SMH professionals throughout the province will need to be aware of these evidence-informed, identity-affirming, made-in-Ontario resources, professional learning, training and supports. 
  • System and school leaders, school staff and SMH professionals will need to be supported to use these mental health supports and services in an ongoing manner. 
  • Students and parents / caregivers will need to be aware of and encouraged to use these high-yield supports and services 

Each year, an action plan will be developed with a primary goal of incrementally moving towards this vision

2023-2024 action plan

The action plan for the 2023-2024 school year includes a primary focus on response and recovery related to the COVID-19 pandemic and related social and emotional impacts. There has been an understandable and significant toll on the well-being of young people through this global experience, and this influence has been felt most deeply by those who have been disproportionately impacted because of poverty, racialization, marginalization, prior health and mental health concerns, etc.  

The supports and services offered are meant to build a sense of belonging and hope for young people as we emerge from the pandemic.

The six key areas of focus in the 2023- 2024 action plan are: 

  1. Centre the needs of students who have been disproportionately impacted by the social determinants of health, racism, and/or marginalization, through an explicit focus on equity, reconciliation, and identity-affirming school mental health.
  2. Focus on wellness promotion and mental health literacy within the context of mentally healthy learning environments and strong home and community connections.
  3. Elevate student participation and leadership in identity-affirming mental health promotion and stigma reduction, following recommendations from #HearNowON 2021.
  4. Equip a range of school staff to identify and support students experiencing mental health problems and to help them through service pathways when needed.
  5. Support school mental health professionals to use brief, evidence-informed prevention and early
    intervention protocols from an identity-affirming approach.
  6. Continue to collaborate with community partners to contribute to an improved system of care for child and youth mental health, following Right Time, Right Care principles.

Questions and answers about the strategy

It is an overarching, comprehensive and coordinated blueprint that helps school boards enhance student mental health. In the complex field of school mental health, the range of options for learning, programming and services can be overwhelming. A strategy helps with identifying a “north star” to work towards, and a way to organize supports so that they can be introduced, implemented, evaluated, scaled, and sustained over time. The provincial School Mental Health and Addictions Strategy provides an evidence-informed framework to guide each board-level strategy and action plan (which in turn informs school-level mental health and addictions strategy and action planning). This strategy cascade helps with consistency, quality, scalability and sustainability across the province of Ontario.

A provincial strategy that is rooted in evidence and responsive to the Ontario practice landscape helps with consistency and focus in mental health learning, training, and resources. There are many available programs, speakers, resources, tools, and services designed to support student mental health. While the interest and enthusiasm for mental health promotion and prevention in schools is welcome, in the absence of a clear strategy, such initiatives come and go and sometimes compete for limited time, funding, and staff support. When board Mental Health Leadership Teams make decisions based on alignment with their evidence-informed and locally focused School Mental Health and Addictions Strategy, they ensure better coordination of supports and efficient use of resources.

The provincial School Mental Health and Addictions Strategy is grounded in research evidence and has been informed by formal and informal input from many stakeholders, including: students, school mental health professionals, educators, school leaders (principals and vice-principals), superintendents with responsibility for mental health, and Directors of Education (through the CODE Advisory Team for SMH-ON). Inputs and critical perspectives from several provincial working tables with interest in post-pandemic school mental health were also woven into decision-making related to strategy priorities (e.g., Right Time, Right Care system collaboration working table, Indigenous School Mental Health Project Advisory Team, Identity-Affirming Social Emotional Learning Advisory Team). Key insights from national and international network dialogue also contributed to the School Mental Health and Addictions Strategy (e.g., Canadian School Mental Health Leadership Network, School Mental Health International Leadership Exchange, International Initiative on Mental Health Leadership).

No. School Mental Health Ontario has been creating and sharing a School Mental Health and Addictions Strategy and related supports for boards across the province since 2011. Each Strategy is 3-years in duration and builds iteratively on the one before. In addition, School Mental Health Ontario outlines a one-year action plan each year to assist with prioritizing specific initiatives, resources, learning and training for the coming year. School boards have also been creating three-year School Mental Health and Addictions Strategy and one-year action plan since joining the provincial initiative between 2011 and 2014.

References

  1. Short, K. H., Bullock, H. L., Crooks, C. V., & Georgiades, K. (2022). Using Implementation Science to Optimize School Mental Health During the Covid-19 Pandemic. CANADIAN JOURNAL OF COMMUNITY MENTAL HEALTH, 41(3), 17.
  2. Stephan, S. H., Sugai, G., Lever, N., Connors, E. (2015). Strategies for integrating mental health into schools via a multitiered system of support. Child and Adolescent Psychiatric Clinics of North America, 24(2), 211-231. 
  3. Stoiber, K., Gettinger, M. (2016). Multi-Tiered Systems of Support and Evidence-Based Practices. In: Jimerson, S., Burns, M., VanDerHeyden, A. (eds) Handbook of Response to Intervention. Springer, Boston, MA.
  4. Short, K.H. (2016). Intentional, explicit, systematic: Implementation and scale-up of effective practices for supporting student mental well-being in Ontario schools, International Journal of Mental Health  Promotion, 18:1,33-48, DOI: 10.1080/14623730.2015.1088681