PolicyLab

Public schools are a key setting for the delivery of evidence-based prevention (Tier I) and early intervention (Tier II) programming to support student mental health. However, there are substantial implementation challenges in this setting. Using the Exploration Preparation Implementation Sustainment (EPIS) framework, the goal of this study was to identify perceived implementation determinants (i.e., barriers and facilitators) to the adoption, implementation, and sustainment of Tier I and Tier II programming. Thirty-nine educators (i.e., 12 district administrators, 9 principals, 9 teachers, and 9 student services staff) completed semi-structured interviews about the barriers and facilitators they perceive to Tier I and Tier II mental health programming in schools. We took an integrated and pragmatic approach to codebook development and qualitative analysis. Seventeen key determinants for implementing Tier I and Tier II mental health programming were identified (e.g., school staff supports and teaming, sociopolitical climate, partnership with outside agencies) and organized across EPIS contextual levels (i.e., “inner context,” “outer context,” “bridging factors,” and “innovation factors”). The same general categories of determinants were described by participants across roles, although some determinants were more salient or described differently by participants in a certain role. These findings underscore the complex and multifaceted factors that influence successful mental health prevention and early intervention programming in schools. The identified determinants can guide school-based researchers and practitioners seeking to strengthen Tier I and Tier II mental health programming holistically.