Supported by a four-year grant, the Children’s Hospital of Philadelphia (CHOP) Tri-County School Mental Health Consortium (SMHC) is a collaboration between CHOP researchers from PolicyLab and the Department of Child and Adolescent Psychiatry and Behavioral Sciences and the Chester, Delaware and Montgomery County Intermediate Units (IUs). In Pennsylvania, IUs serve as regional education agencies that provide operational and instructional services to school districts and non-public/private schools. 

The goal of this project is to build upon existing initiatives to strengthen school- and district-level capacity to implement, evaluate, and sustain Tier 1 and 2 school mental health services. Within a framework of multitiered systems of support, Tier 1 services are universal interventions for all students in the school or classroom, and Tier 2 services provide targeted early intervention for students who would benefit from support beyond Tier 1. 

In the first phase of this work, the SMHC team conducted an exploratory assessment to characterize key needs and priorities for Tier 1 and 2 programs among the three IUs and the schools and districts they serve, understand current resources and programming, and identify implementation barriers and facilitators. This phase included a brief survey of Directors of Student/Pupil Services of school districts within the three counties, as well as semi-structured qualitative interviews to gather more in-depth perspectives from school-level and district-level staff.

Across survey and interview results, school and district staff members identified anxiety, disruptive behavior, dysregulation, peer relationships, and trauma as among their top concerns regarding student mental health need. They also described key barriers and facilitators to Tier 1 and Tier 2 program implementation, such as the availability of training and ongoing technical assistance, collaboration between leadership teams and implementers, and the match between programming and student need. Results from this phase pointed to a particular need for additional evidence-based Tier 2 programming.

These data informed the creation of two learning collaboratives for school staff during the 2024-2025 school year—one focused on leveraging data to improve Tier 1 and Tier 2 mental health programming, and the other focused on training and supporting school staff to implement Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), an evidence-based Tier 2 prevention program for middle and high school students that aims to enhance interpersonal problem solving and communication to improve mood. 

Given feedback from project partners about the importance of continuity, the team will continue offering both learning collaboratives during the 2025/2026 school year. The team has also expanded programming to offer an additional learning collaborative focused on training and supporting school staff to implement Friend to Friend, a Tier 2 small-group aggression prevention program for 3^rd-5^th grade students.