University of Southern California Dissertations and Theses

Student mental health and wellness in K-12 high-performing school districts in Northern California: best practices for educational leaders

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Student mental health and wellness in K-12 high-performing school districts in Northern California: best practices for educational leaders

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Content Running Head: STUDENT MENTAL HEALTH AND WELLNESS
Copyright 2018 Trista Ramirez

STUDENT MENTAL HEALTH AND WELLNESS

IN K-12 HIGH-PERFORMING SCHOOL DISTRICTS

IN NORTHERN CALIFORNIA:

BEST PRACTICES FOR EDUCATIONAL LEADERS

By

Trista Ramirez

____________________________________________________________________________

A Dissertation Presented to the
FACULTY OF THE USC ROSSIER SCHOOL OF EDUCATION
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF EDUCATION

May 2018

STUDENT MENTAL HEALTH AND WELLNESS ii
PROQUEST PAGE /Publishing Info

STUDENT MENTAL HEALTH AND WELLNESS iii
Dedication
I dedicate this work to my girls, Taylor and Morgan Ramirez, who have shown
tremendous patience and love during this process. I hope you understand that education can
allow you to be anything that you want in life. My earning this doctorate degree is an example to
you both that nothing is out of your reach. And remember, I will always be most proud of my
title as your mom.

STUDENT MENTAL HEALTH AND WELLNESS iv
Acknowledgments
I would like to convey sincere appreciation to everyone that encouraged, supported, and
guided me throughout these past years at the University of Southern California, Rossier School
of Education. I first want to recognize the tremendous contribution of my dissertation chair, Dr.
Rudy Castruita, who allowed me to grow and flourish through this process. I would also like to
thank my committee members, Dr. Pedro Garcia and Dr. Charles Park, who guided me through a
successful dissertation process. The feedback given from all three members was invaluable. I
appreciate their knowledge, mentorship and guidance both professionally and personally.
I also want to thank all of the superintendents and school professionals who participated
in this study. Their generous participation and willingness to share their knowledge is greatly
appreciated.
A special thank you to my writing partner and best friend, Jeremy Meadows. He gave me
the courage to attend this program, pushed me to keep going when I wanted to quit, and believed
in my passion to make an impact in the lives of kids. I am forever grateful and could not have
imagined this process without him.
As the saying goes, it takes a village and this has been a time in my life when I needed a
village. Going back to school and balancing my life could not have happened without the
support and participation from my family and friends. Thank you, Matt, for giving me the time,
encouragement and opportunity to pursue my dream. Thank you to my girls for being
understanding and amazing during these years. Thank you to Geraldine Machi for keeping me
on track, listening patiently when I needed it, and hustling me to class every week. And finally,
to my parents, you taught me to believe in myself and that nothing was out of reach with hard
work and dedication. Thank you for dropping everything at any time to be there for my family.
STUDENT MENTAL HEALTH AND WELLNESS v
TABLE OF CONTENTS
Dedication iii
Acknowledgments iv
List of Tables vii
List of Figures viii
Abstract ix
Preface x
Chapter 1: Overview of the Study 1
Background of the Problem 3
Statement of the Problem 5
Purpose of the Study 6
Research Questions 7
Theory 8
Importance of the Study 9
Limitations and Delimitations 10
Key Terms and Definitions 11
Organization of the Study 14
Chapter 2: Literature Review 15
History and Background 17
Current Status: California Assembly Bill 2246 19
Family Dynamics 21
Pressure to Perform 23
Perfectionism 25
Substance Use 27
Depression/Anxiety/Stress 30
Suicidal Ideation and Self-Injurious Behavior 31
Presentation of Theories 32
Conclusion 33
Chapter 3: Methodology 34
Purpose of the Study 34
Research Questions 34
Qualitative Methods 35
Quantitative Methods 36
Data Analysis 40
Ethical Considerations 42
Summary 43
Chapter 4: Results 44
Purpose 45
STUDENT MENTAL HEALTH AND WELLNESS vi
Response Rates 46
Research Findings Pertaining to Research Question One 48
Research Findings Pertaining to Research Question Two 54
Research Findings Pertaining to Research Question Three 62
Research Findings Pertaining to Research Question Four 66
Summary 77
Chapter 5: Conclusions 82
Statement of the Problem 83
Purpose of the Study 84
Research Questions 85
Review of Literature 85
Methodology 87
Findings 88
Implications for Practice 90
Limitations 92
Recommendations for Future Study 93
Conclusion 94
References 95
Appendix A: Survey Letter of Introduction/Explanation 101
Appendix B: Interview Letter of Introduction 102
Appendix C: Survey Questions 103
Appendix D: Superintendent Interview Protocol 107

STUDENT MENTAL HEALTH AND WELLNESS vii
List of Tables
Table 1. Key Indicators of Student Well-Being 44
Table 2. Survey Respondents 45
Table 3. Respondents’ Years of Experience in Current Positions 46
Table 4. Qualitative and Quantitative Demographic Data: Northern and Southern California
School Districts Surveyed 47
Table 5. Student Mental Health 49
Table 6. Student Mental Health Issues on Campus 49
Table 7. Substance Use 51
Table 8. Suicidal Ideation 52
Table 9. Depression/Anxiety 52
Table 10. Impact of Mental Health on Student Achievement 55
Table 11. Student Mental Health Issues on Campus 56
Table 12. Practices to Support Student Achievement 57
Table 13. Awareness of Suicide Prevention Bill 58
Table 14. Estimated Number of Students Expressing Ideation Annually 59
Table 15. Estimated Number of Students Attempting Suicide Annually at Respondents’
School Sites 59
Table 16. Funding Sources (LCAPs, Foundations, Grants, Site/District Funding) 63
Table 17. Student Mental Health and Wellness Included in District or Site Plan 63
Table 18. High School Counselor Position 64
Table 19. Professional Development 67
Table 20. Professional Development 68
Table 21. Staffing 70
Table 22. Preventative Programs 72
Table 23. Services Lacking to Support Student Mental Health 75
STUDENT MENTAL HEALTH AND WELLNESS viii
List of Figures
Figure 1. SCT conceptual framework 9
Figure 2. Triangulation of findings 41

STUDENT MENTAL HEALTH AND WELLNESS ix
Abstract
The purpose of this study was to identify the influence of mental health on student achievement
in high-performing school districts in California and investigate how a focus on student wellness
can support achievement on the school campus. This study also aimed to determine the best
practices currently being utilized by high-performing school districts in California to effectively
address prevention, intervention, and postvention in the areas of depression, anxiety, substance
use, and suicidal ideation. A mixed-methods study was implemented with 56 high school site
leaders who completed a 24-question survey about student mental health and wellness in their
respective school districts. Ten current superintendents, 5 from Southern California and 5 from
Northern California, were interviewed as well.
Through the process of triangulation, the study’s findings indicated that high
expectations, pressure to succeed, and fierce competition are causing extreme levels of stress and
anxiety for students in high-performing school districts, which can lead to concerns regarding
suicidal ideation. These school districts have protocols and programs in place to address students
struggling with various mental health concerns. A team approach allowed for the development of
student support plans that allowed continued access to curriculum. Many districts have programs
that are grounded in prevention and intervention to reduce student stress and create opportunities
for support. Finally, the creation of policy change, such as adjusted calendars, bell schedules and
homework policies, seemed to solidify the student mental health and wellness programs within a
school district. Overall, this study presents the best practices that are currently being employed
within high-performing school districts to address student mental health and wellness.

STUDENT MENTAL HEALTH AND WELLNESS x
Preface
This dissertation was co-authored and has been identified as such. While jointly authored
dissertations are not the norm of most doctoral programs, a collaborative effort is reflective of
real-world practices. To meet their objective of developing highly skilled practitioners equipped
to take on real-world challenges, the USC Graduate School and the USC Rossier School of
Education have permitted our inquiry team to carry out this shared venture.
This dissertation is part of a collaborative project with one other doctoral candidate,
Jeremy Meadows. Both students were interested in researching the extent of and differences in
student mental health needs in high-performing school districts across California. The process
for dissecting and understanding the problem was too large for a single dissertation. As a result,
the two dissertations produced by our inquiry team collectively address the findings from high-
performing school districts across the state of California. The authors are listed alphabetically,
reflecting the equal amount of work by all those listed (Meadows, 2018; Ramirez, 2018).

STUDENT MENTAL HEALTH AND WELLNESS 1
Chapter 1
Overview of the Study
It is difficult to separate one’s overall physical health from mental health, as the two are
intertwined and reliant upon each other. According to the National Alliance on Mental Illness
(n.d.), one in five adults in the United States experiences mental illness in a given year, with
depression being the leading cause of disability throughout the world. The impact of depression
can be significant in an individual’s life, limiting one’s ability to concentrate, causing a loss of
interest in activities, and challenging daily functioning. Mental health issues can influence an
individual’s productivity, and that lack of productivity costs the United States $193.2 billion in
lost earnings every year. Nearly half of all lifetime mental disorders start by the mid-teen years,
which means that primary prevention efforts should begin early in life (Kessler et al., 2007). The
significance of mental health issues lies not just in the impact on the individual suffering from
the disorder, but also in the family or school having to help, support, and manage the often-
challenging crisis that comes with this.
There is also great stigma surrounding mental health issues, including depression,
anxiety, and substance abuse. Therefore, it is important for public health, as a field, to work
toward removing the stigma and encouraging people who are suffering to seek treatment. One
example of changes in the attention given to mental health is by the World Health Organization
and its new annual World Mental Health Day, observed on October 10, as well as the recently
developed Comprehensive Mental Health Action Plan 2013–2020. Pending legislation at the
national level in the U.S. also promises better and more accessible, comprehensive, and
integrated mental health treatment services. At the same time, the media has begun a noticeable
shift in its coverage of mental health issues, from focusing exclusively on instances in which a
STUDENT MENTAL HEALTH AND WELLNESS 2
person with mental illness perpetrates an act of violence to covering instances in which people
lead productive lives and contribute to the community (Aneshensel, 2015).
It is important that educators consider the role of public services in addressing mental
health, including education, prevention, and intervention. The National Institute on Mental
Health (2005) has described mental disorders as chronic diseases of the young, yet there is a long
delay between the onset of the disorder and treatment, with a median delay of a decade. Thus, it
is critical to implement programs in schools that help students develop self-efficacy, coping
strategies, and mental health and wellness literacy. K-12 school enrollment is the one constant in
the life of youth and would be the logical place to implement a program to address student
mental health and wellness. This type of comprehensive program would be a preventative,
education-based effort regarding the signs and symptoms of mental illness so that students know
when to get help or when to help others get help before a crisis erupts (Kutcher & Yifeng, 2012).
From 2013-15 in the state of California, the Healthy Kids Survey collected data from
13,859 11th grade students in over 43 school districts. The results of this survey indicated that
the 11th grade state average for students that have seriously considered suicide in the prior 12
months is 17.8% (2013-2015; Austin, Polik, Hanson, & Zheng, 2016). Another important
statistic from the California Healthy Kids Survey is that 33.8% of 11th grade students in
California reported experiencing chronic feelings of hopelessness and sadness. Lastly, 35.2% of
California 11th grade students reported using alcohol and drugs frequently. Given these statistics,
it is clear the youth in California are being affected by various social emotional concerns, which
in turn can influence their academic achievement in school. In a survey conducted by the Jason
Foundation, students stated that a teacher or counselor was the number one person to whom they
STUDENT MENTAL HEALTH AND WELLNESS 3
would turn for helping a suicidal friend (O’Donnell, n.d.). Thus, it is imperative that schools are
prepared to address the mental health and wellness of their students.
Background of the Problem
The data from the 2013-2015 California Healthy Kids Survey clearly outline concerns
statewide regarding the mental health of high school students (Austin et al., 2016). Although the
researchers recognize that all students can suffer from mental health concerns, an often
overlooked group of students in the research are those from high-performing school districts,
where mental health issues are often rooted in academic achievement, demands for excellence,
and pressure to perform. Although students within high-performing school districts experience a
significant amount of success, along with this comes tremendous pressure and stress for students
to excel and thrive in all areas of academics, athletics, and extracurricular activities. According
to Lyman and Luthar (2014), “In schools that are predominated by high achievers, educators and
parents alike must remain cognizant that strivings for perfectionism can become unhealthy,
indeed inimical, to the overall well being of today’s youth” (p. 927).
More and more frequently, students with mental health issues are requesting help from
support services in their educational setting. Luthar, Barkin, and Crossman (2013) reported that
high school and college counseling centers are seeing unprecedented numbers of students with
serious problems including substance abuse, bipolar disorder, depression, anxiety, eating
disorders, and non-suicidal self-injury. These problems have reached the point that student
mental health is considered one of the top five critical issues on campuses nationwide. The JED
Foundation (2015) reported that, based on reports from first year college freshman, emotional
preparedness is critical for college success, and thus must be integrated into the work of the high
school communities in preparing their students for post-secondary education.
STUDENT MENTAL HEALTH AND WELLNESS 4
These mental health concerns are highlighted in the data from the California Healthy
Kids Survey, showing high rates of alcohol and drug use, feelings of sadness and hopelessness,
and suicidal ideation in California students. Research shows these mental health issues are
impacting student learning as displayed in attendance patterns, focus issues, withdrawal from
extracurricular activities, and limited classroom engagement, thereby resulting in reduced
academic achievement. Research has long linked academic engagement to positive social,
psychological, and physical developmental outcomes; however, qualitative studies in high-
performing schools find that some students who work hard in school may be compromising their
mental and physical health in the pursuit of top grades (Conner & Pope, 2013).
This research study shows how mental health issues (depression, anxiety, suicidal
ideation and alcohol and drug use) in high school students are presenting within high-performing
schools districts in Northern and Southern California. The research also brings to light the impact
of mental health on student achievement, including academic performance, attendance,
discipline, and postsecondary options. California’s Local Control and Accountability Plan
(LCAP) includes a goal focused on the engagement of pupils and the school climate, making it
incumbent on school leaders to address the issue of student mental health. This study researched
the funding and budget allotment for supporting student mental health and wellness through
high-performing districts’ LCAP plans and budget proposals. Finally, the study sought to
uncover the best practices in the field of education that address mental health on school
campuses and how leaders can most effectively influence this important part of their students’
lives.
STUDENT MENTAL HEALTH AND WELLNESS 5
Statement of the Problem
Throughout the large body of literature focused on teen mental health, little academic
research has focused on the needs of high-performing adolescents. Researchers commonly
assume that these students are not affected by mental health issues due to their available wealth
and resources. Mental health issues such as substance use, depression, anxiety, and suicidal
ideation have been researched in relation to low-income or disadvantaged students, but little
research has been conducted on these issues within high-performing school communities. Yet,
adolescents in these communities experience a tremendous amount of stress and pressure
surrounding achievement in academics, athletics, and extracurricular activities, all in an attempt
to ensure that they have every opportunity for success regardless of the cost.
The review of the relevant literature highlights various overarching themes that are
affecting the high-achieving youth community and their mental health. Teens within these
communities are affected by engagement in substance use, perfectionism, an intense pressure to
perform, and family dynamics that influence their day-to-day functioning. Within each of these
areas, research has revealed certain key dynamics that appear to be connected specifically to the
youth within these affluent communities, demonstrating how these dynamics manifest through
emotional adjustment and mental health issues. As educators, it is critical to remember that
achievement within school is both an area of competence and a developmental task that impacts
students’ well-being (Ansary, McMahon, & Luthar, 2012).
As a first step in addressing this often overlooked crisis, research is needed to shine a
light on the mental health issues facing today’s youth within affluent communities. School
leaders and educators can no longer ignore this critical issue, as it is significantly affecting the
students on their campuses. It is necessary to evaluate how these mental health issues are
STUDENT MENTAL HEALTH AND WELLNESS 6
influencing student achievement and engagement within the school community. Best practices
addressing student mental health and wellness should be analyzed to gather understanding for
replication in similar high-performing districts. Teachers’ and administrators’ understanding of
these concerns is crucial to supporting the mental health and academic success of high achieving
youth across the nation.
Purpose of the Study
In a typical high school in the United States, it is estimated that three students attempt
suicide each year (The Trevor Project, 2016). Protecting the health and well-being of young
people is an ethical imperative for all professionals working with students. At the beginning of
the 2017-2018 school year, Assembly Bill 2246 took full effect, requiring schools to address
mental health, specifically suicide prevention, in grades 7-12 in California schools. The policy in
each school district must be developed in consultation with school and community stakeholders,
school-employed mental health professionals, and suicide prevention experts to address
procedures relating to suicide prevention, intervention, and postvention (O’Donnell, n.d.). This
dissertation adds to the body of literature available for educators when they are developing and
refining programs to address student mental health and wellness.
Although all students are important, the vast majority of literature is focused on teen
mental health issues for students in low socioeconomic status (SES) backgrounds, and little
academic research has focused on the needs of high-performing adolescents, many of whom
reside in affluent communities. Researchers commonly assume that these students are not
affected by mental health issues due to their available wealth and resources. Mental health issues
such as substance use, depression, and suicidal ideation for low-income disadvantaged students
are manifested due to the various risk factors faced by this population. According to the National
STUDENT MENTAL HEALTH AND WELLNESS 7
Center for Children in Poverty (2010), the risk factors for these students include receiving public
assistance, having unemployed or teenage parents, or being in the foster care system, which
increase their prospects for developing mental health issues.
Although these same mental health concerns of substance use, anxiety, depression, and
suicidal ideation are present among students in low performing schools, the risk factors are
significantly different within high-performing schools, including high levels of perfectionism,
intense pressure to perform, and lack of parental connectedness. This study shows how mental
health issues (i.e., suicidal ideation, hopelessness/sadness, and alcohol and drug use) in high
school students are presenting within high-performing schools districts in California. The study
brings to light the influence of mental health on student achievement to help school leaders
understand the importance of focusing on student wellness to support school wide achievement.
Finally, and most importantly, this study highlights best practices in the field of education,
focusing on mental health and wellness programs in high-performing school districts that are
effectively addressing prevention, intervention, and postvention within their school district.
Research Questions
1. How is the mental health of students in high-performing school districts in California
currently manifesting on school campuses?
2. How do mental health issues affect student achievement?
3. How are school districts in California utilizing their financial resources, including
LCAPs, parent organizations, and education foundations to support student mental
health and wellness?
4. How are high-performing school districts in California addressing student mental
health and wellness issues?
STUDENT MENTAL HEALTH AND WELLNESS 8
Theory
The conceptual framework utilized to guide the research process for this study was social
cognitive theory (SCT). SCT, initially known as social learning theory (SLT), was developed by
Albert Bandura in the 1960s. In 1986, it became known as SCT (LaMorte, 2016). One of the
main aspects of SCT is described as follows:
Learning occurs in a social context with a dynamic and reciprocal interaction of the
person, environment, and behavior. The unique feature of SCT is the emphasis on social
influence and its emphasis on external and internal social reinforcement. SCT considers
the unique way in which individuals acquire and maintain behavior, while also
considering the social environment in which individuals perform the behavior. (LaMorte,
2016, p. 1)

SCT is composed of three major aspects: self-efficacy, choice, persistence and goal setting, all of
which ultimately affect the outcomes of learning (LaMorte, 2016). The major tenet of SCT that
can affect students’ mental health is self-efficacy, which can be defined as a reflection of an
individual’s beliefs about what he/she can achieve at a certain level of success given a particular
task. Higher levels of perceived self-efficacy have been associated with greater choice,
persistence, and more effective strategy use (Denler et al., 2014). These higher levels of self-
efficacy affect the mental health concerns outlined in this study.
It is essential that effort is made toward the development of programs in schools that
help students develop goal setting, self-efficacy, persistence and coping strategies: all major
components of SCT (Clark & Estes, 2008). Although SCT has been applied to a variety of areas
within personal functioning, it has been applied successfully to the areas of mental and physical
health (Denler, Wolters, & Benzon, 2014). This theory also can be applied to learning within the
classroom context, as students’ thoughts and self-beliefs strongly affect learning.
The conceptual framework (See Figure 1) outlines how SCT is connected with student
mental health issues, which in turn influence achievement, attendance, and attention in the
STUDENT MENTAL HEALTH AND WELLNESS 9
classroom. Given that school leaders are attempting to influence achievement, attendance, and
attention through the mitigation of mental health issues, this study was structured to investigate
how schools are implementing programs to affect mental health and the overall academic success
of their students.

Figure 1. SCT conceptual framework.
Importance of the Study
Findings from this study contribute to current available literature by bringing attention to
the alarming statistics related to the poor mental health of students in high-performing districts.
This study identifies and defines best practices for addressing mental health in high schools,
which can guide the development of action plans at the national, state, and local levels. The
findings outline best practices that educators can start to employ immediately. In a larger sense,
the goal of the study was to provide a roadmap that will help school districts navigate the
challenges and barriers associated with poor mental health and putting systems in place to
STUDENT MENTAL HEALTH AND WELLNESS 10
support them. This study allows schools to create K-12 roadmaps or plans to accurately and
effectively address mental health issues in ways that will best prepare students for full and
meaningful participation in society.
Limitations and Delimitations
Limitations. Limitations of this study included a strong dependence on self-report
measures through the California Healthy Kids Survey, interviews, and observations. Quantitative
results of this study were limited by the characteristics of the participants. This study was set in
high-performing school districts within Northern and Southern California. There is a strong
emphasis on college readiness in these students’ homes, as well as at school and in the
community.
The sample size was small, which was inevitable given the uniqueness of high-
performing schools and the hesitancy of some schools to allow their staff members to participate
in studies of this type. Although the factors selected for this study were chosen based on a review
of relevant literature, the existence of other factors must be considered. It is probable that other
influential factors exist, both at the individual and familial levels, that could exert significant
influence on student maladjustment.
The current study only evaluated what strategies leaders had implemented to address
student mental health in terms of both best practices and newly established LCAP goals. This
was done with a small sample of high-performing school districts. Although the researchers
proposed that the factors included in the models were culturally salient based on prior literature,
the research does not compare the results to low-or middle-class adolescents or examine the
model with an ethnically diverse sample. Therefore, future research is needed to clarify whether
the theories proposed in the current study are unique to a high-performing population or whether
STUDENT MENTAL HEALTH AND WELLNESS 11
there is a consistent pattern among youth and families from a wide range of socioeconomic and
ethnic backgrounds.
Finally, the qualitative aspects of this study acquired through interviews and surveys
were limited and open to interpretation of the researchers and participants. Thus, they may be
subject to some levels of bias. Although measures were taken to collect data from multiple
viewpoints, a small level of bias is still a concern of the researcher. However, bias is to be
expected in any qualitative study.
Delimitations. Taking into account the aforementioned limitations, this study is an
analytical case study of the best practices for educational leaders in addressing mental health and
wellness in high-performing school districts. A delimitation of this study is the assumption that
these mental health concerns are specific to students within high-performing high schools. There
may be other factors outside of extreme pressure, perfectionism, and high expectations that are
impacting students’ mental health state.
Additionally, the researchers recognized that mental health concerns such as depression,
anxiety, substance use, and suicidal ideation are present in other student groups from various
types of schools, but for the purposes of this study, the focus was intentionally on high-
performing students and the impetus for their mental health concerns. Variables such as race,
ethnicity, and gender were not taken into account in this study. A longitudinal study that
incorporates multiple data sets from different student groups would help add more validity to the
study.
Key Terms and Definitions
The following is a list of key terms and definitions for the study:
STUDENT MENTAL HEALTH AND WELLNESS 12
• 504 Plan: A legal plan developed for a child with a disability that provides
accommodations to ensure academic success and equal access.
• 5150: When an individual is considered a danger to himself/herself or others, he/she
can be taken into custody via the application of Welfare and Institutions Code 5150
for up to 72 hours for evaluation at a mental health facility.
• Achievement pressure: The perception of achieving at a level beyond what is
comfortable to perform; may be associated with feelings of stress.
• Affluence: Communities with upper-middle class to upper class SES environments
and have very high expectations for their children.
• Affluenza: A sharp focus on material wealth spreading through upper-middle class
communities.
• California Healthy Kids Survey: The main survey given statewide to students in
public schools that measures resilience, protective factors, risk behaviors, and school
climate in California.
• Basic Aid School District: A school district that receives funding strictly from local
property taxes because it exceeds what they would receive under the Local Control
Funding Formula model from the state of California.
• California Assessment of Student Performance and Progress (CAASPP): The
CAASPP exam measures student performance of state standards in Math and English.
This test is given annually to students in grades three through eight and 11 (CDE,
2017).
• California Department of Education (CDE): The governing body for public education
in the state of California.
STUDENT MENTAL HEALTH AND WELLNESS 13
• Challenge Success Program: Based out of Stanford, California and founded in 2007,
this organization partners with schools and families to support kids with the
academic, social, and emotional skills needed to lead a well-balanced life.
• Depression: A common and serious medical illness that negatively affects a person’s
feelings, thoughts and behaviors. (Parekh, 2017)
• High-performing school district/school: A school district or school with above
average graduation rates, SAT/ACT test scores and CAASPP English and Math
scores.
• IEP: Individualized education plan for students in special education.
• Helicopter Parenting: Overly involved parenting style that can have a negative
impact on their child’s development.
• Local Control Accountability Plan (LCAP): The LCAP is a critical part of the Local
Control Funding Formula (LCFF). Each school district must engage parents,
educators, employees, and the community to establish these plans (CDE, 2017b).
• LGBTQ: A term for a group of people that identify themselves as either lesbian, gay,
bisexual, transgender, and/or questioning/queer.
• Local Control Funding Formula (LCFF): Accountability. As part of the LCFF,
school districts and charter schools are required to develop, adopt, and annually
update a 3-year LCAP using a template adopted by the California State Board of
Education (CDE, 2017b).
• Mental health: A level of psychological well-being that may include an individual’s
ability to enjoy life, and create a balance between life activities and efforts to achieve
psychological resilience (CDE, 2017c).
STUDENT MENTAL HEALTH AND WELLNESS 14
• Perfectionism: A characteristic of individuals who expect nothing less than perfection
from themselves, becoming overly concerned about mistakes, destructively self
critical, and rigidly driven to meet their own and/or others’ expectations (Assor &
Tal, 2012; Gilman & Ashby, 2003; Levine, 2006)
• Substance use: Also known as drug abuse, a patterned use of a drug or alcohol in
which the user consumes the substance in quantities or methods that are unsafe.
• Suicidal ideation: Thoughts about or preoccupation with suicide.
• Stress: A normal part of everyone’s life, a reaction to a difficult event that can be a
physical, emotional or mental response (Mayo Clinic, 2016).
• Wellness: The quality or state of being healthy, both physically and mentally.
Organization of the Study
This research study is organized into five chapters as follows: Chapter 1 – Overview of
the Study, Chapter 2 – Literature Review, Chapter 3 – Methodology, Chapter 4 – Results, and
Chapter 5 – Discussion and Findings. Chapter 1 provides background on the problem, the
statement of the problem, and the purpose and importance of the study. Chapter 2 reviews the
existing literature relevant to the problem. Chapter 3 explains the qualitative methods used for
the study, how the sample population was selected, the instruments designed for data collection,
and how data were collected and analyzed. Chapter 4 details the results and major themes of the
research study. Chapter 5 discusses the major themes in relation to the research. Finally,
recommendations were made for application of the major themes to the field of education and for
future areas of study.
STUDENT MENTAL HEALTH AND WELLNESS 15
Chapter 2
Literature Review
Within the field of educational research, much attention has been given to understanding
the needs and risk factors of underachieving students. Given the high stakes of education, it is
understandable that research has focused primarily on a group of students that has been targeted
as most in need of support. Contrastingly, very little attention has been paid to or research
conducted addressing the risk factors for high-achieving students, even though they suffer from
issues ranging from intense pressure to perform, anxiety, depression, and substance use. Both
educational researchers and practitioners point to these high-achieving students as being a
relatively new at-risk group in need of further examination and research (Luthar & Sexton,
2004).
According to Luthar and Barkin (2012), affluent youth are an up and coming group to be
categorized as at-risk, but they have not been represented consistently in the past as a research
group or one that is in need of intervention. Yet, affluenza, a hyper focus on material wealth, is
spreading through upper-middle class communities, and children within these communities are
experiencing elevated levels of mental health issues including substance use, depression, and
anxiety. Novotney (2009) stated that “adolescents reared in suburban homes with an average
family income of $120,000 report higher rates of depression, anxiety and substance abuse than
any other socioeconomic group of young Americans today” (p. 50).
The teen years have been characterized as a time of significant growth, change, and
transition. During a time that can be tumultuous for many people, adolescents can also
experience an escalation in anxiety and depression (Lund & Dearing, 2013). Previous studies
show that suburban teenagers in affluent communities experience different adjustment
STUDENT MENTAL HEALTH AND WELLNESS 16
difficulties comparable to those felt by teenagers living with economic deprivation, sparse
resources, and exposure to violence (Luthar & D’Avanzo, 1999). Specifically, the adjustment
difficulties include internalizing problems (i.e., anxiety and depressive symptoms) to which
affluent, high-achieving teenagers are especially vulnerable (Luthar & Barkin, 2012; Luthar &
D’Avanzo, 1999)
A review of the relevant literature highlighted various overarching themes that are
affecting high-achieving youth communities and their mental health. Teens within these
communities engage in substance use, experience perfectionism, feel intense pressure to perform,
and have family dynamics that may affect their day-to-day functioning. Within each of these
areas, research is revealing key dynamics that are connected specifically to the high-achieving
youth within affluent communities that manifest through emotional maladjustment and mental
health issues.
This literature review examines the history and background of mental health issues,
influence on adolescence, and how research has evolved over time to address the emerging
concerns related to the emotional well-being of high-achieving youth. Current changes within the
education system have emerged out of this research, requiring schools to address the influence of
mental health issues on youth. The reviewed literature outlined emerging themes described
previously that are affecting high-achieving youth, as well as the ensuing outcomes, namely
substance use, depression, anxiety, and suicidal ideation. These emerging themes and outcomes
were examined through the lens of SCT, as it has been applied to a variety of areas within
personal functioning, including successful application to the areas of mental and physical health
(Denler et al., 2014).
STUDENT MENTAL HEALTH AND WELLNESS 17
History and Background
As early as the 1970s, researchers began to investigate underserved youth living in
poverty and their progress within the education system. With reforms in education, changes in
student groups and school systems, and government mandates, it became clear that research
needed to expand to include an often-overlooked student population: high achievers. Given that
this population has a unique set of issues and concerns, researchers began to investigate the
forces that were influencing high-achieving students, including how the pressure to perform
influenced their emotional and mental well-being (Landsheer, Maassen, Bisschop, & Adema,
1998).
Very few early studies brought attention to the problems of high-achieving and affluent
youth. The first was a study conducted in 1994 investigating the connection between depression
and substance use through the comparison of inner-city and suburban teens (Way, Stauber,
Nakkula, & London, 1994). The study intended to explore the link between substance use and
depression while taking into consideration the SES of teens. This quantitative study found a
connection between increased depressive symptoms and use of substances such as cigarettes,
marijuana, and harder drugs for the suburban teens, but no such connection for urban students.
Additionally, it was found that the suburban teens were more significantly engaged in substance
use than urban teens, with the exception of marijuana use.
Another study by Luthar and D’Avanzo (1999) highlighted the same connection between
drug use and internalizing problems (i.e., depression and anxiety) for 10th grade students in both
urban and suburban areas. Again, it was discovered that suburban students scored higher on
measurements related to anxiety, depression, and substance use than did students in urban areas.
This study also highlighted two important factors for suburban youth: the suggestion that the
STUDENT MENTAL HEALTH AND WELLNESS 18
substance use was related to self-medicating in an attempt to address their depression and
anxiety, and among the male peer group in this suburban study high substance use was endorsed
and encouraged. These early investigations served as a catalyst for researchers to endorse the
need for further research within the area of high-achieving students, pressure to perform, and
connections to their social-emotional health.
In addition to the emergence of peer-reviewed journal publications on adolescent mental
health concerns, the United States government, specifically the Centers for Disease Control and
Prevention (CDC) began gathering data via longitudinal studies to track mental health statistics
starting in 1994 (Perou et al., 2013). The CDC recognized that mental health disorders are an
important public health issue in the United States to monitor and address because of the
“prevalence, early onset, and impact on the child, family, and community, with an estimated total
annual cost of $247 billion” (p. 1). Further, the CDC noted that 13-20% of children living in the
United States experience a mental disorder in a given year, and monitoring from 1994-2011 has
shown that the prevalence of these conditions is only increasing (Perou et al., 2013).
The CDC maintains that mental health surveillance efforts continue to be necessary for
documenting the impact of mental disorders. This type of public monitoring allows for the
analysis and circulation of data to encourage public health action (Perou et al., 2013). Ultimately,
the CDC’s longitudinal studies can illuminate limitations and gaps in information while
presenting ideas and options to bridge those gaps. Monitoring mental health on a national level is
critical for: policy and program development, documenting the impact of mental disorders
among children, tracking changes over time, understanding mental disorders across the lifespan,
monitoring health service use and availability, increasing prevention and promotion activities,
and supporting the allocation of funding for services.
STUDENT MENTAL HEALTH AND WELLNESS 19
Given the emergence of the current alarming mental health statistics, large scale
movements in the education system have begun to address the mental health needs of students.
Specifically, changes have been seen in curriculum requirements, school safety plans, emerging
programs, and state-led initiatives like in California.
Current Status: California Assembly Bill 2246
The current state of supporting student mental health is gaining momentum in California,
as many students in the state have recently attempted or completed suicide. California
Assemblyman Patrick O’Donnell recently authored Assembly Bill (AB) 2246. The bill was
signed by Governor Jerry Brown in September 2016 and is the first assembly bill to address
student mental health concerns. According to the Trevor Project (2016), this bill requires the
adoption of suicide prevention, intervention, and follow-up plans by all California school
districts with students in grades 7-12 by the summer of 2017. AB 2246 mandates that all school
districts in California implement suicide prevention policies that specifically address the needs of
student mental health. Specifically, the bill makes significant progress to support the LGBTQ
(lesbian, gay, bisexual, transgender, and questioning/queer) student population. School districts
must create policies in conjunction with suicide prevention experts, school and community
stakeholders, and school mental health professionals.
Existing law in California’s Education Code encourages schools to adopt suicide
prevention policies, but does not require that schools have them. The important fact to note is
that suicide is preventable, and educators and schools play key roles in suicide prevention. AB
2246 represents the first step in addressing the rising mental health concerns of students. The
Family Acceptance Project has found that among LGBTQ youth, having at least one supportive
adult can reduce their risk of suicide. Having a suicide prevention policy in place in all schools
STUDENT MENTAL HEALTH AND WELLNESS 20
with students in grades seven and above is one of the first essential steps in preventing youth
suicide, and is part of a holistic approach that promotes healthy lifestyles, families, and
communities, the importance of which was emphasized in the National Strategy on Suicide
Prevention (The Trevor Project, 2016).
With teachers identified as the number one person a student would turn to for help with a
suicidal friend, it is critical to provide teachers with tools for intervention. This bill requires
schools to adopt policies to give teachers the tools necessary for suicide awareness and
prevention (The Trevor Project, 2016). One of the most alarming statistics found in current
literature notes that adolescent suicide rates have tripled over the past 60 years, making suicide
the second leading cause of death among young people aged 10-24 (Kruisselbrink, 2013).
Additional studies have also shown that LGBTQ youth are up to four times more likely to
attempt suicide than their non-LGBTQ peers (The Trevor Project, 2016).
To help school districts develop policies for student suicide prevention, the CDE would
also be required to develop and maintain a model to serve as a guide for school districts. This
model policy could be based on an existing model policy developed by the Trevor Project,
American Foundation for Suicide Prevention, American School Counselor Association, and the
National Association of School Psychologists. AB 2246 points out the high-risk youth identified
previously to ensure they are not overlooked and to guide schools to address their needs
specifically (The Trevor Project, 2016).
Through the review of historical and current research on mental health issues for high-
achieving youth, themes emerged regarding the various factors affecting their lack of mental
well-being. These factors included family dynamics, pressure to perform, perfectionism,
excessive risk-taking behaviors, and intense academic expectations.
STUDENT MENTAL HEALTH AND WELLNESS 21
Family Dynamics
Upon a deeper analysis of the literature, a common theme of poor family dynamics and
parenting skills is adding to problems in affluent communities with high-achieving students.
First, research has shown that supervision and parental closeness play a role in reducing
depression and drug use in teens. Most notably, low parental support actually exacerbates
maladjustment (Bogard, 2005). The lack of physical presence of parents has a predictive impact
on a teen’s mental health, including an increase in both internal and external problems, less
family time, and a decrease in academic performance (Luthar & Latendresse, 2005). Additional
research from Crouter, Head, McHale, and Tucker (2004) shows that an increase in family time
can support stronger psychosocial adjustment among adolescents. Thus, parental presence and
involvement are incredibly important and influential on adjustment for affluent adolescents.
When looking at the parent-teen relationship, the closeness of this relationship has been
shown to be the best predictor of adjustment for a teen. However, within many affluent
communities, lack of parental supervision is common. Teens are seen as self-sufficient, and
professional parents are often absent from the home due to extensive work-based commitments.
The level of disconnection between these children and their parents is at the level equivalent to
that experienced by youth in severe poverty (Luthar & Latendresse, 2005). This low emotional
connectedness within the family due to absent, disengaged parents is creating isolation among
teens and is connected to both drug use and emotional instability for both teenage boys and girls
(Bogard, 2005).
Luthar and Latendresse (2005) concurred that “upper-middle-class families, secondary
school students are often left home alone for several hours each week, with many parents
believing that this promotes self-sufficiency” (p. 2). Suburban children’s needs for emotional
STUDENT MENTAL HEALTH AND WELLNESS 22
closeness may often suffer as the demands of professional parents’ careers erode relaxed family
time and youngsters are shuttled between various after-school activities.
Although significant research has supported the importance of parental involvement to
the positive adjustment in the lives of children and teens, the concept of over-involvement,
commonly referred to as helicopter parenting, can have strong negative implications for a teen’s
development. Early research by Ginsburg and Bronstein (1993) found parental over-involvement
and control regarding homework and grades were associated with reduced academic
achievement and maladjustment.
More recent research further reinforces the negative impact of overparenting on
adolescent development. There is tremendous pressure on parents to cultivate their children
through engagement in activities, thereby striving to optimize their developmental outcomes
(Schiffrin, Godfrey, Liss, & Erchull, 2015). Research has found that parental involvement needs
to coincide with appropriate child developmental levels, gradually allowing for more autonomy
through adolescence. When the family dynamic involves overparenting, teens experience an
increase in depression, anxiety, and stress, as well as reported lower life happiness and self-
efficacy (Segrin, Givertz, Swaitkowski, & Montgomery, 2015).
An additional theme uncovered in the literature was that parents have difficulty seeking
help for their children and find it embarrassing. Luthar and Latendresse (2005) noted that
“upper-class parents can be particularly reluctant to seek help for the less visible problems
because of privacy concerns, unless symptoms include those that inconvenience adults, such as
disobedience or asthma” (p. 4). The rich are more often dismissed as not needing help even when
they report distress that others typically judge to merit assistance. Lyman and Luthar (2014)
reported similar findings that affluent adults can be very concerned about keeping family
STUDENT MENTAL HEALTH AND WELLNESS 23
troubles private and are embarrassed to discuss them with their peers or friends. “Parents in
general tend to be aware when their children are depressed, but tend not to seek professional
help. Students reported significantly more use of all substances alcohol, cigarettes, marijuana,
and hard drugs than did their low-SES counterparts” (p. 913).
When it comes to seeking assistance for their teens that are suffering from substance use,
depression, or anxiety, affluent families seek to keep their personal concerns private. They do not
actively seek assistance for their teens, even when they are aware of the depression (Lyman &
Luthar, 2014). According to Luthar and Latendresse (2005), concerns for the family’s reputation
or the perception of the community override the importance of addressing the teen’s manifested
symptoms. Thus, upper-class families will not seek help for problems that may not be as visible
to the outside, unless at some point the symptoms become an inconvenience.
Pressure to Perform
The literature defines parental pressure in terms of how teens view the standard of
behavior set forth for them to perform and, when the teen fails to reach that standard, the parental
response to and criticism of their performance (Luthar & Becker, 2002; Sagar & Stoeber, 2009;
Stumpf & Parker, 2000). Clinicians have asserted that parental overemphasis on achievement
creates the perception of pressure to perform and ultimately contributes to the adjustment issues
experienced by some adolescents. Weissbourd (2011) referred to this phenomenon as teens who
have become “strung-out achievement junkies and the parents who drive them relentlessly”
(p. 23).
Upper-class parents have become overly focused on their children’s academic
achievement and performance, giving the impression that this is of greatest value to ensure their
success and post-secondary options. Researchers argue that teens are participating in extra-
STUDENT MENTAL HEALTH AND WELLNESS 24
curricular activities and community service programs to respond to pressure from their parents
and build a resume to enhance their possibility of gaining admission to a top college (Fredricks,
2012). Teens come to undervalue personal qualities, and the pressure to perform becomes so
intense that they are willing to sacrifice character to achieve success. Pope, Connor, and
Galloway (2009) reported that 95% of the 3,645 students in their survey admitted to cheating at
least once during high school, including copying homework and cheating on tests due to intense
pressure.
In a survey conducted by Weissbourd (2011) of 40 juniors at independent high school,
over one-third of those surveyed responded that getting into a good college was more important
than being a good person. Additionally, almost half of these same students stated that it was
more important to their parents that they get into a good college than be classified as a good
person. These students described in great detail how they have struggled with being caring and
honest when the competition and pressure to achieve has become so intense.
Luthar and Becker (2002) found that when teens believe their parents overemphasize
their achievements, they experience higher levels of internalizing symptoms, which prevents
them from coping effectively when they do not experience success. This combination of parental
pressure, extreme expectations, and perceived criticism for lack of success contributes to the
development of various psychological problems, including low self-efficacy, high levels of
anxiety, and strained child-parent relationships (Biran & Reese, 2007; Luthar & Barkin, 2012;
Renshaw, 2008). Ultimately, teens experience an increase in depression, anxiety, and drug use
when they believe their parents overemphasize their accomplishments (Novotney, 2009).
The pressure to perform is causing upper-class children to manifest elevated disturbance
in several areas like substance use, anxiety, and depression (Luthar & Latendresse, 2005). Two
STUDENT MENTAL HEALTH AND WELLNESS 25
factors seem to create excessive pressure to perform: isolation from parents (both literal and
emotional) and overemphasis on achievement by parents. Bogard’s (2005) research also yielded
similar findings, indicating that affluent teens are using drugs as a way to cope with
perfectionism and depression. Depression and the pressure to be perfect are found often among
affluent adolescent females, and substance use levels are highest among upper-class males when
compared to females. More than ever before, these teens seek to be popular with peers, and the
affluent peer group actively endorses counter-conventional behaviors (Luthar et al., 2013). The
pressure to perform can also lead to another major factor in the causes of these at-risk behaviors:
perfectionism.
Perfectionism
A useful definition of perfectionism found across relevant literature is “unrealistic and
exceedingly high personal standards, hypersensitivity to criticism and mistakes, feeling of being
overwhelmed by failure and rigid all-or-nothing thinking” (Fletcher, Speirs Neumeister, & Flett,
2014, p. 897). Another definition of perfectionism is a “personality disposition characterized by
excessively high standards for performance, accompanied by tendencies for overly critical self-
evaluations of one’s behavior” (Sagar & Stoeber, 2009, p 1). Although some view perfectionism
as a positive characteristic that can help a person achieve elite status, prestige, or enhanced
performance, mental health professionals view perfectionism as a characteristic that undermines
performance and represents an impediment to normal development (Sagar & Stoeber, 2009).
Researchers who study perfectionism have identified three different types: other-oriented
perfectionism, self-oriented perfectionism, and socially prescribed perfectionism. Other-oriented
perfectionists expect people to meet their unrealistic, rigid demands. Self-oriented perfectionists
demand that they reach their own personal high standards of achievement. Lastly, socially
STUDENT MENTAL HEALTH AND WELLNESS 26
prescribed perfectionists believe that others maintain unrealistic and exaggerated expectations
that are difficult or impossible to meet, but must be met in order to win approval and acceptance.
Socially prescribed perfectionism adds to an individual’s anguish in his/her own inability to
achieve what others seem to expect and thereby earn the approval that they need. Dysfunctional
and socially prescribed types of perfectionism affect affluent adolescents and may be subject to
their achievement-oriented environments. These types of maladaptive perfectionists commonly
experience depression and suicidal ideation (Flett, Coulter, Hewitt, & Nepon, 2011).
The majority of research on perfectionism has been conducted among adult-age college
students, but newer measures of perfectionism developed in the past 20 years have increased
what we know about perfectionism in adolescents. Findings on perfectionism in today’s high-
performing youth mimic findings of research conducted with adults. These findings include fear
of failure, concern over mistakes, and high standards for oneself or imposed on by others. All of
these examples can result in low self-esteem, anxiety, depression, eating disorders, and suicidal
ideation (Fletcher et al., 2014). According to research from Luthar and Latendresse (2005),
Children with very high-perfectionistic strivings, those who saw achievement failures as
personal failures had relatively high depression, anxiety, and substance use, as did those
who indicated that their parents overemphasized their accomplishments, valuing them
disproportionately more than their personal character. (p. 2)

It is critical that within schools, educators and parents remain aware of these perfectionistic
tendencies among high-achieving students, as they can lead to depression, anxiety, and substance
use (Lyman & Luthar, 2014).
Similar to the research by Luthar and Sexton (2004), Novotney (2009) found that
adolescents raised in suburban homes where parents earned an average income of $120,000
reported “higher rates of depression, anxiety and substance abuse than any other socioeconomic
group of young Americans today” (p. 1). Further research by Madeline Levine (2006) asserts that
STUDENT MENTAL HEALTH AND WELLNESS 27
the fear of failure and perfectionism are creating upper-middle-class teens’ mental health
problems. Some of these parents are concerned that if their children do not attend Ivy League
colleges, they are not going to be successful in life. Further research shows that parents fear their
children will not thrive in this competitive world; this has led parents to obsess over test scores
and access to the best colleges in the world for their children (Ansary & Luthar, 2009).
It is not necessarily always bad for adolescents to pursue high standards and excellence.
Schools, communities, and parents often work hard to help students cultivate high standards and
expectations. When standards and expectations are manageable for the adolescent, it can create a
pathway to goal attainment and a healthy sense of accomplishment. Yet when the pursuit of
excellence goes too far, it can create an obsession for the teen to be perfect. This crusade for
perfection often leads adolescents to have negative self worth when it is not achieved. Negative
or maladaptive types of perfectionism are associated with depression, anxiety, and stress, and
often lead to mental health treatment like medication and therapy, whereas positive types of
perfectionism involve pushing or striving for achievement (Sagar & Stoeber, 2009).
Substance Use
Adolescence is a time of maturation and rapid mental and physical growth. Youth who do
not adjust appropriately to the challenges they face in their young lives can develop patterns of
unhealthy behaviors like alcohol and substance use that can last a lifetime (Bogard, 2005).
Teenage substance use is not something to take lightly, regardless of demographics or cultural
background. However, studies show that among high school and middle school students,
adolescents with upper SES are more likely to become depressed and use illegal substances than
their lower income counterparts (Luthar & D’Avanzo, 1999). In a study by Bogard (2005), more
affluent adolescents reported using illegal drugs and alcohol as a way to relax and escape
STUDENT MENTAL HEALTH AND WELLNESS 28
problems, whereas lower SES adolescents reported using illegal drugs and alcohol to cope with
peer pressure or have fun. Additional studies have shown that alcohol and marijuana use is more
prevalent among adolescents in affluent communities. Specifically, alcohol use among girls and
illicit drug use among boys were more common (Luthar & D’Avanzo, 1999).
Teenagers in affluent communities often have the financial means and ways to acquire
illegal drugs and alcohol more easily than lower SES adolescents. Logistically, affluent youth are
able to use substances more frequently and heavily because of ample money and easier access to
substances. Also, affluent teens have very efficient systems involving instant messaging, social
media, fake IDs, knowledge of local providers (often peers), and cars that allow rapid acquisition
(Luthar et al., 2013).
A lack of supervision and isolation from parents added to an intense pressure to perform
academically creates the perfect recipe for adolescent substance use (Luthar & Becker, 2002).
Again, research results have shown that both literal and emotional isolation were linked to
distress as well as substance use. This increased engagement in drug use can be tied to various
factors, with a perceived lack of parental closeness being an overarching theme in the literature.
According to Bogard (2005), “Youth who perceive low parental attachment experienced an
exacerbation of depression and drug use” (p. 282). The literature asserts that affluent, high-
achieving youth are vulnerable to difficulties in life adjustments due to the lack of supportive
adult figures in their lives to buffer the isolation they feel from their parents.
Essentially, adolescents attempt to mitigate the pressures of a complicated young life and
seek out peer-accepted ways to cope, including drinking and illicit drug use. Coincidentally,
parents in affluent communities experience a large parental gap in discipline and recognizing that
their child has a problem. Often, parents in affluent communities discover their child is
STUDENT MENTAL HEALTH AND WELLNESS 29
experimenting with drugs and alcohol, but look the other way because it is more socially
acceptable in the community (Luthar & Barkin, 2012). The lack of attention and concern given
to such dangerous behavior, combined with limited consequences, reduce adolescents’ adverse
perceptions regarding these behaviors. Another alarming theme discovered in the literature on
substance use is that parents’ regular alcohol and/or drug use encourages their own children’s
substance use. In fact, many families earn a reputation for allowing teenage alcohol consumption
in their homes and hold parties with alcohol being served (McMahon & Luthar, 2006).
In addition, a study by Luthar and McMahon (2006) indicated that in some peer settings,
alcohol use is a status symbol of which teens often actively approve (Luthar & Becker, 2002;
Luthar & D’Avanzo, 1999). The level of acceptance of substance use and pressure for affluent
teens to succeed in all areas can lead to a common saying among this group, “Work hard, play
hard” (Luthar et al., 2013, p.1531). Due to peer norms, teens are commonly expected to get
wasted at social gatherings. Relevant research notes the “Commonplace rituals organized around
substance use, including ‘beerpong’ (Ping-Pong, but with a lost point implying a swigged drink),
‘beer bongs”’ (large containers with pipes for efficient consumption) and ‘pregaming’ (drinking
before a party, to feel relaxed on arrival)” (p. 1,153).
Although some in society may view substance use as a rite of passage for teenagers, the
prevalence of vaping, drug use, and alcohol use in affluent adolescents should be cause for
alarm. However, the increased frequency of alcohol consumption at the middle and high school
levels can indicate that students are using substances to mask their real problems. Unfortunately,
substance use is becoming a reality at an earlier age. If not addressed appropriately, excessive
substance use by affluent teens has the ability to exacerbate other mental health concerns like
depression, anxiety, and stress.
STUDENT MENTAL HEALTH AND WELLNESS 30
Depression/Anxiety/Stress
It is a common assumption that teenagers experience heightened levels of anxiety and
stress from time to time. Naturally, some levels of anxiety and stress may be helpful rather than
damaging, and it is unrealistic to believe that all anxiety or stress can be removed from a
teenager’s life. Clear cut and definitive stressors affecting student depression, anxiety, and stress
should be examined in greater detail. In order to do so, one must find the causes that induce
stress and anxiety in students of high-performing schools.
The CDC conducted a recent longitudinal monitoring study on adolescent mental health.
Mental Health Surveillance Among Children, United States 2005-2011 identified an increase in
psychological ailments including negative mental health issues, such as stress, depression,
anxiety, and self-harm. Mental health problems are on the rise, with 8% of adolescents aged 12–
17 years reported experiencing more than 14 mentally unhealthy days in the past month. The
study also found an 80% increase in hospital stays from 1997-2010 among children for mood
disorders (Perou et al., 2013).
Research comparing levels of stress and anxiety for high-achieving students is mixed
when comparing them to their peers. Some studies point to high-achieving students as
experiencing high levels of stress, and yet other research shows that these high-achieving
students can also mask their stress levels with various coping mechanisms and high levels of self
esteem (Peterson, 2009; Suldo, Shaunessy, & Hardesty, 2008; Wilburn & Smith, 2005). Still
other research concludes there are minimal concerns surrounding depression and anxiety related
specifically to students who are high-achieving (Cross, Cassady, Dixon, & Adams, 2008;
Shaunessy & Suldo, 2010). Finally, Mueller (2009) even concluded that gifted students
experienced less depression than their peers.
STUDENT MENTAL HEALTH AND WELLNESS 31
In 2009, Peterson, Duncan, and Canady published the results of a longitudinal 11-year
analysis that followed students from elementary school through high school graduation. The
review of their data showed that of the 59 students, all but one expressed stress related to their
academic performance and achievement. These students cited stress related to academic
competition, challenging course requirements, focus on college admissions, and demanding
Advanced Placement courses. Much of the students’ stress was focused on their over-
commitment to activities and the pressure to maintain involvement, often to support the emphasis
on achievement for college admissions.
Throughout the 2009 study, the student participants were asked to rate their stress level
on a scale of 1 to 10, with 10 being extreme stress. As the students moved through school, their
levels of stress increased with startling results in high school. Only eight of the 48 students rated
their stress level at that time at a 5 or below. The study showed that these students felt intense
academic pressure, found the transitions in school distressing, struggled often with peer
relationships, and experienced stress from being over-committed (Peterson et al., 2009).
Suicidal Ideation and Self-Injurious Behavior
Suicidal ideation is an intrusive thought process related to ending one’s life, and suicide
is the act of actually ending one’s life (Yates, Tracy, & Luthar, 2008). Suicide is the second
leading cause of death among adolescents (Taliaferro & Muehlenkamp, 2014). According to the
CDC (2015), in a nationwide study conducted with teens in grades 9-12, “17% of students
reported seriously considering suicide, 13.6% reported creating a plan, and 8% reporting trying
to take their own life in the last 12 months” (p.1).
It is essential to recognize behaviors that can precede suicidal behavior, including
thoughts, threats, and unsuccessful attempts (Wilburn & Smith, 2005). Several risk factors point
STUDENT MENTAL HEALTH AND WELLNESS 32
to an increase in suicidal ideation and suicide attempts, and many of these can be overlapping.
The risk factors include mental health issues including depression, substance use, stress,
isolation, family history, significant loss, illness, lack of educational achievement, and not
seeking help (Sharp, 2013).
According to Taliaferro and Muehlenkamp (2014), another critical risk factor
differentiating attempted suicide from only thoughts of suicide among adolescents is self-injury.
Through the repetitive act of self-injury, adolescents reduce their fear of harming themselves,
which may ultimately increase their risk of suicide. Research from Sharp (2013) indicated that
after engaging in self-injurious behavior, suicidal behavior increases at a rate of 50-100 times.
According to Sharp (2013), little research has been conducted on the connection between
school, academic performance, and stress as it relates to suicidal ideation and self-injury.
However, stress related to school achievement has also been recognized as a contributing risk
factor. This is a critical area for further research in order to understand the connection among
adolescent suicide rates, internalizing and externalizing factors, and academic performance.
Presentation of Theories
The conceptual framework utilized for this study was SCT. Although SCT has been
applied to a variety of areas related to personal functioning, it has been applied successfully to
the areas of mental and physical health (Denler et al., 2014). This theory also can be applied to
learning within the classroom context, as a student’s thoughts and self-belief affect his/her
learning.
Another major tenet of SCT that can affect students’ mental health is self-efficacy. Self-
efficacy is defined as a reflection of an individual’s beliefs about what he/she can achieve at a
certain level of success given a particular task. Higher levels of perceived self-efficacy have been
STUDENT MENTAL HEALTH AND WELLNESS 33
associated with greater choice, persistence, and more effective strategy use (Denler et al., 2014).
These higher levels of self-efficacy will likely affect the mental health concerns outlined in this
research study.
Conclusion
As stated previously, significant attention has been given to understanding the needs and
risk factors of underachieving students. However, very little attention has been paid to
addressing the risk factors for high-achieving students, even though they suffer from issues
ranging from intense pressure to perform, anxiety, depression, and substance use. The review of
the relevant literature highlights various overarching themes that are affecting the high-achieving
youth community and their mental health. Teens within these communities engage in substance
use, experience perfectionism, feel intense pressure to perform, and have family dynamics that
may affect their day-to-day functioning.

STUDENT MENTAL HEALTH AND WELLNESS 34
Chapter 3
Methodology
The preceding chapters provided an overview of the study and a review of the literature
that is germane to the topic under examination. This chapter outlines the purpose and design of
the research study, identifies the participants, clarifies how data will be collected and analyzed,
and explains the instruments used to conduct the research.
Purpose of the Study
This study shows how mental health issues (suicidal ideation, anxiety/depression,
hopelessness/sadness and alcohol/drug use) in high school students are emerging within several
high-performing school districts in California. The study brings to light the impact mental health
has on student achievement to help school leaders understand the importance of focusing on
student wellness to support school wide achievement. Although these same mental health
concerns of substance use, depression, and suicidal ideation are present for students in low-
performing schools, high-performing students’ risk factors are significantly different, including
high levels of perfectionism, intense pressure to perform, and lack of parental connectedness.
Finally, and most importantly, this study highlights best practices in the field of education,
focusing on mental health and wellness programs in high-performing school districts that are
effectively addressing prevention, intervention, and postvention on the school campuses across
the State of California.
Research Questions
1. How is the mental health of students in high-performing school districts in California
currently manifesting on school campuses?
2. How do mental health issues affect student achievement?
STUDENT MENTAL HEALTH AND WELLNESS 35
3. How are school districts in California utilizing their financial resources, including
LCAPs, parent organizations, and education foundations to support student mental
health and wellness?
4. How are high-performing school districts in California addressing student mental
health and wellness issues?
This study was designed as a mixed-methods study, utilizing both qualitative and
quantitative methods to collect and analyze the data. The study was conducted with California
public school leaders at high-performing high schools. The study involved the collection of
qualitative data from open-ended interview questions conducted with 10 superintendents and
quantitative surveys with 56 site administrators, school psychologists, and school counselors.
Gathering data via both interviews and surveys enables triangulation between the results, which
was critical to substantiating the findings of this research (Merriam & Tisdell, 2016).
Qualitative Methods
Qualitative research is intended to enhance the understanding of a given research problem
from the perspective of the population involved. With this research study addressing mental
health of students in high-performing high schools, there was strength in utilizing qualitative
research as it is grounded in process theory, which explores the connections among people,
situations, and events leading to an analysis of the influence these connections can have on the
others (Maxwell, 2013). Qualitative methods offered a means for the researchers to provide
complex contextual descriptions of school leaders views of student mental health concerns. This
method had the ability to uncover how leaders are addressing the mental health issues within
their student body, an often unexamined, difficult topic for all stakeholders involved in the
process. The researchers utilized 10 interviews in conducting this qualitative research study.
STUDENT MENTAL HEALTH AND WELLNESS 36
Through interviews, the researchers were able to gather data that reflected the respondents’
opinions, feelings, and knowledge, which is critical with a complex topic such as student mental
health issues. According to Merriam and Tisdell (2016), the crucial factor in this type of
interview is in the potential for each respondent to contribute to the development of insight and
understanding of the phenomenon.
With the qualitative data being gathered through the use of interviews, the interview
questions were written to ensure that they targeted the research questions and reflected the
conceptual framework. The interview protocol developed by the researchers consisted of 10
questions; with a semi-structured interview, the researchers were able to ask follow-up questions.
The interview protocol, including the follow-up questions, can be found in Appendix D. Follow-
up questions are a critical part of the interview process, as probes can allow for clarification and
deeper understanding of the responses. These interviews were conducted by the researchers for
approximately 30 minutes, both in-person and via phone conference. The interview protocol was
followed consistently throughout each interview, but additional questions were asked when
necessary. While a pre-determined protocol is critical to ensuring consistency, the researcher
needs to ask follow-up questions to gain further clarity or deeper understanding from the
respondent (Merriam & Tisdell, 2016).
Quantitative Methods
For this study, quantitative data were gathered using a 24-question survey given on
surveymonkey.com (see Appendix C). The survey questions focused on all four research
questions and were created based on the review of literature. The survey was designed to elicit
attitudes, beliefs, and values from school administrators and counselors, providing the
researchers with numerical descriptions regarding current mental health concerns for high-
STUDENT MENTAL HEALTH AND WELLNESS 37
performing schools. Creswell (2014) has proposed several tips for creating exceptional surveys,
including posing meaningful questions using standard language and wording and avoiding using
biased words and phrases.
Question types within the survey included structured responses and selected open-ended
prompts regarding the perceptions and behaviors of mental health of high school students within
high-performing high schools. Part 1 of the survey addressed participants’ demographic
information including background information and current job status. Part 2 of the survey
consisted of 5-point Likert-scale questions using the following descriptors for responses: 1
indicated Not at All Concerned, 2 indicated Slightly Concerned, 3 indicated Somewhat
Concerned, 4 indicated Moderately Concerned, and 5 indicated Extremely Concerned. Part 3 of
the survey utilized open-ended questions and allowed respondents to answer questions more
fully.
The survey instrument was emailed to a total of 110 California public school
professionals: 30 to site administrators, 65 to counselors, and 15 to school psychologists.
Participants completed the survey using surveymonkey.com, which tabulated the number of
responses returned. The survey also included a cover letter (see Appendix A), survey questions,
and final instructions, all of which can be found in the appendices. To increase participation in
the survey, respondents were promised an executive summary of the findings upon completion of
the research study.
Sample and population. For this study, the identified population was school leaders
from high-achieving high schools within the State of California. Purposeful sampling was
utilized for both the qualitative and quantitative data collection. Maxwell (2013) identified five
possible goals for purposeful selection: typicality, heterogeneity, critical cases, comparison, and
STUDENT MENTAL HEALTH AND WELLNESS 38
productivity of relationships. This research study utilized purposeful selection to ensure that all
pre-selected respondents fit within the description of working at a high-performing school or
district. A minimum sample size for the survey responses was set at 50 participants, and the
minimum sample size for the interviews was set at 10 participants.
An explanation of the research study was given in both the survey and interview,
including an explanation of the topic and the purpose of the study. The respondents were
informed that the study was a voluntary opportunity to provide information, and all responses
and interviews would be confidential. The actual names of the schools or districts were not
utilized in the research study, and any information that could possibly identify the school campus
was changed. Given the personal nature of the research topic of mental health, it was critical that
respondents felt confident about the high level of confidentiality, allowing for their open and
honest responses.
Instrumentation. Survey and interview questions were designed specifically for this
study after analyzing the current literature and identifying gaps in research. The survey inventory
was field-tested beforehand in one high-performing school district in Los Angeles County. The
field test was designed to test for biases and ensure that protocols and interview questions were
succinct and self-explanatory. The field test also ensured that the survey could be finished within
the given time and that the results generated by the survey addressed the research study and
proposed questions. The survey instruments were administered to principals, district
administrators, counselors, and school psychologists. Some minor changes to the survey and
interview questions were made based upon the input of those individuals and responses elicited.
Appendix C contains the survey questions that were sent to each respondent.
STUDENT MENTAL HEALTH AND WELLNESS 39
The researchers designed a semi-structured interview protocol to uncover how the
superintendents are addressing mental health issues within their districts. The largest part of the
interviews was guided by a list of questions with unstructured follow-up questions for
clarification (Merriam & Tisdell, 2016). The interview protocol was also designed to be open
and unbiased in its approach, with the hope of gathering honest viewpoints about current
practices surrounding mental health practices for the students within the district. The interview
questions were structured to understand how leaders perceive mental health impacting the overall
academic success of their students. Appendix D contains the superintendent interview protocol.
The conceptual framework utilized for this research study was based on SCT. Although
SCT has been applied to a variety of areas within personal functioning, it has been applied
successfully to the area of education as well as mental and physical health. This theory can be
applied to learning within the classroom context, as learning is impacted by a student’s thoughts
and self-belief. Self-efficacy, a major tenet of SCT, is a reflection of an individual’s belief about
what he/she can achieve at a certain level of success given a particular task that is clearly tied to
a student’s level of success in the classroom. Higher levels of perceived self-efficacy have been
associated with greater choice, persistence, and more effective strategy use (Denler et al., 2014).
Students’ self efficacy, choice, persistence and goal setting all affect their current state of mental
health, as outlined in the study. The conceptual framework outlined how SCT is connected with
student mental health issues, which are in turn impacting achievement, attendance, and attention
within the classroom.
Data collection. Survey participants were contacted initially via email, providing them a
summary of the research study and a link to take the survey. Participants spent an average of 20
minutes completing the online survey. Given that a high response rate is critical in achieving
STUDENT MENTAL HEALTH AND WELLNESS 40
reliable results (Creswell, 2014), a protocol was developed to remind participants to complete the
survey as needed. A second email was sent approximately 2 weeks later to prospective
participants who had not yet completed the survey. After each participant completed the survey,
a follow-up thank you email was sent.
For the interviews, participants were selected based on specific criteria, including
employment as a superintendent within a high-achieving school district. Initial phone calls were
made to superintendents with the goal of recruiting a total of 10 interviewees. During this call,
the researchers identified the purpose of the call and research study, and scheduled an
appointment for the interview. An email was sent to each participant, restating the purpose of the
interview and providing the questions in advance of the meeting (see Appendix B). The
interviews took place via a combination of phone conference and in person. To ensure the
researchers’ engagement and ensure data could be gathered fully (Creswell, 2014), the interviews
were recorded with permission from the participants. Recordings were then transcribed by the
researchers for data analysis and qualitative coding was used to identify emerging themes.
Data Analysis
This mixed-methods study used quantitative and qualitative data from the surveys and the
qualitative data from the interviews. Every aspect of the survey and interview protocols was
linked directly to the four research questions. Several expert researchers (Maxwell, 2013;
Merriam & Tisdale, 2016) have noted that researchers must make every effort to start data
analysis immediately following data collection.
Once the data were collected from the online questionnaire and interviews, separate
reports were created to document findings from each data source. Through the process of
triangulation (See Figure 2), the findings were compared to each other, the current literature, and
STUDENT MENTAL HEALTH AND WELLNESS 41
SCT as a method of connecting the findings within these larger perspectives. This process
allowed the researchers to uncover convergent and divergent findings (Creswell, 2014). Lastly,
the researchers strategically analyzed quantitative and qualitative data to identify the key
strategies that school districts and/or administrators, counselors, and school psychologists are
employing to combat mental illness in high-performing high schools.

Figure 2. Triangulation of findings.
Quantitative data analysis. Through the online survey, data were collected and analyzed
based on the four outlined research questions. Responses were tabulated from 56 participants, a
response rate of 46.6%. The researchers quantified the mean for each question with a
spreadsheet. In addition to generating the mean response for each item, additional descriptive
statistics were also generated. These additional descriptive statistics find variance within the
data, and provide perspective to reduce the impact of extreme scores.
Qualitative data analysis. Creswell’s (2014) six-step framework that was used to code
and interpret the qualitative data received from interviews and open-ended survey questions.
STUDENT MENTAL HEALTH AND WELLNESS 42
Transcriptions of the interviews, along with the accompanying notes, were analyzed to identify
overall key findings. The first step was to identify the research problem and review the literature.
The second step was to collect and transcribe the interview data. The third step was to sort
through all the transcribed data to identify initial first impressions. The fourth step was to
organize the data into larger themes using the four research questions as a guide. The fifth step
was to code the data with labels that represent each individual research question. The sixth step
was identifying final themes for each research question and organizing them with descriptive
visual aids, tables, and detailed narrative passages (Creswell, 2014).
To ensure that the data were coded accurately, the transcripts of the survey results and
interviews were read through several times. The researchers tagged, labeled, and sorted
information into categories. This inductive process of analysis immersed the researchers into the
data to identify key findings and themes about how educators are addressing mental health
concerns (Creswell, 2014). After conducting a systematic method of coding the data, a visual
model of the themes and emerging theory were developed.
Ethical Considerations
Throughout the design and implementation of this research study, the researchers
followed ethical considerations. All guidelines and procedures for the University of Southern
California Institutional Review Board (IRB) were reviewed and implemented carefully during
the study. All participants were informed of the purpose and nature of the research study, and
their consent to participant was received. Participants were informed that confidentiality and
anonymity throughout the study would be adhered to, thus ensuring ethical standards of practice.
STUDENT MENTAL HEALTH AND WELLNESS 43
Summary
Through the use of a mixed-methods research, this study integrated quantitative data
from a survey and qualitative data from interviews and open responses to the survey. Through
these findings and an in-depth review of the literature, the researchers triangulated the data to
provide a more complex analysis of the best practices for administrators to address the mental
health issues of students within high-performing high schools. Chapter 4 presents the findings of
this research study, along with conclusions and implications for practice.

STUDENT MENTAL HEALTH AND WELLNESS 44
Chapter 4
Results
Within the field of educational research, much attention has been paid to understanding
the needs and risk factors of underachieving students. Given the high stakes of education, it is
understandable that research has focused primarily on a group of students that has been targeted
as most in need of support. Contrastingly, very little attention has been paid or research
conducted addressing the risk factors for high-achieving students, even though they suffer from
issues ranging from intense pressure to perform, anxiety, depression, and substance use. Both
educational researchers and practitioners point to these high-achieving students as being a
relatively new at-risk group in need of further examination and research (Luthar & Sexton,
2004).
Data from the 2013-2015 California Healthy Kids Survey clearly note elevated concerns
statewide regarding the mental health of students (Austin et al., 2016). This statewide survey
data shows students across the state are struggling with high rates of substance use and
depression, as well suicidal ideation (Table 1).
Table 1
Key Indicators of Student Well-Being
Grade 7 Grade 9 Grade 11
2011-13
(%)
2013-15
(%)
2011-13
(%)
2013-15
(%)
2011-13
(%)
2013-15
(%)
Current Drug/Alcohol Use* nc 11.2 nc 24.3 nc 35.2
Chronic Hopelessness/Sadness** 25.6 30.7 31.7 33.0 33.8
Considered Suicide** na na 19.3 19.3 17.5 18.7
Note. *Past 30 Days; **Past 12 Months; na- Not asked; nc – Not comparable. Adapted from School Climate,
Substance Use, and Student Well-Being in California, 2013-2015: Results of the Fifteenth Biennial Statewide
Student Survey, Grades 7, 9, and 11, by G. Austin, J. Polik, T. Hanson, and C. Zheng, 2016, San Francisco, CA:
WestEd Health & Human Development Program. Copyright 2016 by the authors.

This statewide survey data outlined in Table 1 prompted both researchers to investigate
how these same mental health issues were manifesting specifically in high-performing school
STUDENT MENTAL HEALTH AND WELLNESS 45
districts. Although the researchers recognize that all students can suffer from mental health
concerns and these data encompass students performing at all academic levels, an often
overlooked group of students in the research is those from high-performing school districts. In
these types of districts, mental health issues are often entrenched in high academic achievement,
demands for excellence, and pressure to perform from parents and the community. With this in
mind, the researchers specifically targeted high-performing school districts in California to
investigate with surveys and interviews about how their respective school districts are handling
concerns of student mental health.
Purpose
Chapter 4 presents and analyzes data collected from a mixed-methods study of best
practices to support student mental health and wellness. The purpose of this study was to identify
how top performing school districts in the state of California are addressing increased and
complex student mental health and wellness concerns. Quantitative and qualitative data were
obtained through an online survey that consisted of 24 questions with opened and closed ended
questions and Likert-scale questions. Table 2 presents the total sample size of 56, consisting of
12 high school principals, 23 high school assistant principals and 21 high school counselors. All
56 people participated in the survey and answered a range of questions about student mental
health and wellness in their respective school districts.
Table 2
Survey Respondents
f %
Assistant Principal 23 41.07
Counselor 21 37.50
Principal 12 21.42
Note. n = 56.

STUDENT MENTAL HEALTH AND WELLNESS 46
Table 3 specifies the level of experience for each respondent with the highest number of
respondents, 26.79%, being in their current position for 1-3 years, and 25% being in their
position for 3-5 years. This information was important to gauge the level of knowledge the
respondents would have regarding their current school site. The three respondents with less than
one year experience in their current position often had limited knowledge and information when
answering the survey questions.
Table 3
Respondents’ Years of Experience in Current Positions
f %
Less than 1 Year 3 5.36
At Least 1 Year but >3 15 26.79
At Least 3 Years but >5 14 25.00
At Least 5 Years but >10 13 23.21
10 Years or More 11 19.64
Note. n = 56.

Additional qualitative data were collected from interviews with five current
superintendents from school districts that participated in the survey. The researchers determined
that interviews from superintendents would give a larger, more global perspective on how school
districts were addressing student mental health, thus encompassing all stakeholders within the
district. Chapter 4 also outlines survey and interview response rates as well as demographic
information of the respondents and school districts.
Response Rates
Selective criteria were used to qualify a school district for participation and were based
upon several components that categorize a high-performing school district. The criteria used to
select school districts were above average scores in the following areas: high school graduation
rates, average ACT scores, average SAT scores and school district CAASPP score for English
and math. After analyzing the selection criteria for this study, 25 school districts in California
STUDENT MENTAL HEALTH AND WELLNESS 47
met requirements for participation and were asked to participate in the survey. Of the 25
potential school districts, 11 school districts opted to participate in the survey (see Table 4).
Table 4
Qualitative and Quantitative Demographic Data: Northern and Southern California School
Districts Surveyed and Interviewed

Expense
Per ADA
Basic
Aid
Free or
reduced
lunch
Proficiency
in ELA
Proficiency
in Math
Average
SAT
Score
Average
ACT
Score
Grad
Rate
School
District 1
$10,142 No 2.8% 78% 74% 1300 29 99%

School
District 2
$9,952 No 6.2% 78% 69% 1290 29 97%
School
District 3
$10,576 No 1.3% 85% 82% 1320 30 98%
School
District 4
$9,280 No 5.9% 79% 71% 1280 29 97%
School
District 5
$17,941 Yes 7.1% 76% 66% 1250 29 98%
School
District 6
$13,063

No 3.6% 84% 85% 1340 31 96%
School
District 7
$17,839

Yes 20.2% 78% 69% 1320 30 95%
School
District 8
$12,770

No 4.6% 85% 71% 1300 30 98%
School
District 9
$16,420

Yes 20.5% 76% 55% 1250 29 95%
School
District 10
$10,616

No 21.7% 68% 65% 1300 29 95%
School
District 11
$15,171

Yes 2% 82% 71% 1340 31 97%
Note. Adapted from “Current Costs of Education: 2015-2016 Annual Expense Report,” by the California
Department of Education, 2017 (https://www.cde.ca.gov/ds/fd/ec/currentexpense.asp). Copyright 20187by the
author. Adapted from “Best School Districts in California,” by Niche, 2018 (https://www.niche.com/k12/search
/best-school-districts/s/california/). Copyright 2018 by the author.

Twelve superintendents from qualifying school districts were also asked to participate in
an interview. The researchers received 10 responses and each conducted five interviews with
superintendents from their respective regions in California. This equated to a response rate of
44% from participating school districts for surveys and a response rate of 83% for superintendent
interviews. These percentages met the overall goal of the researchers, which was a response rate
of 40% or more, which can reveal more reliable results (Creswell, 2014). Each school district
STUDENT MENTAL HEALTH AND WELLNESS 48
that participated in either the interview or survey was offered an executive summary of the
findings once the study was completed.
The participants in this study were selected from two target regions of comparison:
Northern California and Southern California. The two researchers split the study for comparison
by each selecting Northern California and Southern California school districts. Actual names of
school districts and superintendents were not used for confidentiality purposes, but descriptions
of district demographics were used to provide context.
The study was guided by the following research questions:
1. How is the mental health of students in high-performing school districts in California
currently manifesting on school campuses?
2. How do mental health issues affect student achievement?
3. How are school districts in California utilizing their financial resources, including
LCAPs, parent organizations, and education foundations to support student mental
health and wellness?
4. How are high-performing school districts in California addressing student mental
health and wellness issues?
Research Findings Pertaining to Research Question One
RQ1 asked: How is the mental health of students in high-performing school districts in
California currently manifesting on school campuses? This first research question focused on
gathering data regarding how mental health concerns are manifesting across high-performing
school districts in Northern and Southern California. The researchers sought data points to
ascertain the concern surrounding mental health and the frequency with which these issues are
impacting the campuses. The current literature clearly indicates that issues of anxiety,
STUDENT MENTAL HEALTH AND WELLNESS 49
depression, suicidal ideation and substance use affect students in affluent, high-performing
school districts. The following data support the mental health concerns outlined in the literature
review and show a high prevalence across high-performing school districts in the state.
Table 5 indicates school site professionals’ responses to the question about mental health
being a concern for their school. Table 6 shows the perception of increasing frequency of mental
health issues on the respondents’ campuses. These questions were designed by the researchers to
validate that mental health concerns were prevalent for high-performing school districts and the
frequency levels were increasing on campuses across the state.
Table 5
Student Mental Health
Concern for the School f %
Yes 55 98.21
No 1 1.79
Note. n = 56.

Table 6
Student Mental Health Issues on Campus
Increasing frequency f %
Yes 49 87.50
No 4 7.14
I don’t know 3 5.36
Note. n = 56.

This study’s survey data found that an overwhelming 98% of respondents felt student
mental health issues were a concern for their school site. A high school principal summarized
this concern as follows:
We are seeing more than ever before, high amounts of student depression, debilitating
anxiety, and suicidal ideation. Because these issues are triggered or exacerbated by
academic stress and high parent expectations, school personnel are often the first ones to
address the situation and parents are often unaware.

STUDENT MENTAL HEALTH AND WELLNESS 50
Another survey question asked respondents if they personally felt that student mental health
concerns were increasing in their school. Survey results indicated that 87.50% of respondents
agreed that student mental health concerns (of depression/anxiety, substance abuse and suicidal
ideation) were increasing. Specifically, one Northern California superintendent stated, “Mental
health is the biggest change I have seen over time in my 30+ year career.”
Student stress was indicated as a major concern by all the superintendents interviewed,
who stated that stress is affecting students in these districts at high rates and can manifest in their
attendance, focus, and achievement within the classroom. Research shows these mental health
issues are impacting student learning as displayed in attendance patterns, focus issues,
withdrawal from extracurricular activities, and limited classroom engagement, thus resulting in
reduced academic achievement (Conner & Pope, 2013). One Northern California superintendent
stated,
School refusal is an emerging concern with our high-performing kids. They are not
coming to school and want work electronically. Hospitalization continues to increase.
Truancy looks different not, now truancy is normal for high-performing kids because
these other issues are impacting their attendance. It’s a truancy trap.

These statements affirm that superintendents are seeing student mental health as a priority
in their districts. A decline in student mental health affects levels of achievement which
ultimately can impact a student’s options for post-secondary education. However, there are
continual competing interests in these high-performing school districts where the community
claims to want balance for their students while also expecting academic success. One Northern
California superintendent said, “We need our families to come to grips with the level of anxiety
that this type of culture can drive.” Another Northern California Superintendent said, “We need
to have our kids sleep more and use their phones less.” This sentiment was echoed by yet another
superintendent who explained,
STUDENT MENTAL HEALTH AND WELLNESS 51
We want to recognize the fact that our society is running at a pace that is not healthy for
anybody and how do we slow that down. Disconnect from our device, and be present
with other human beings. That seemed to resonate with our community and our teachers
as well.

To further understand the impact of student mental health on school campuses, three
main areas of focus were utilized based on the California Healthy Kids Survey, specifically
depression and anxiety, substance use, and suicidal ideation. By responding to a series of survey
questions, school site educators rated their levels of concern for their students in these three areas
through a Likert rating scale ranging from not at all concerned through extremely concerned. The
results for these survey questions are outlined in the following sections.
Substance use, suicidal ideation and depression/anxiety. Tables 7, 8, and 9 depict the
level of concern school site professional have for their students in the three main focus areas,
substance use, suicidal ideation and depression/anxiety. Respondents were asked to rate their
levels of concern regarding these three areas utilizing a Likert scale where 1 indicated Not at All
Concerned, 2 indicated Slightly Concerned, 3 indicated Somewhat Concerned, 4 indicated
Moderately Concerned, and 5 indicated Extremely Concerned.
Table 7
Substance Use
Level of Concern for Students f %
Not at All Concerned 6 10.71
Slightly Concerned 11 19.64
Somewhat Concerned 9 16.07
Moderately Concerned 21 37.50
Extremely Concerned 9 16.07
Note. n = 56.
STUDENT MENTAL HEALTH AND WELLNESS 52
Table 8
Suicidal Ideation
Level of Concern for Students f %
Not at All Concerned 11 19.64
Slightly Concerned 13 23.21
Somewhat Concerned 16 28.57
Moderately Concerned 11 19.64
Extremely Concerned 5 8.92
Note. n = 56.
Table 9
Depression/Anxiety
Level of Concern for Students f %
Not at All Concerned 3 5.36
Slightly Concerned 10 17.86
Somewhat Concerned 13 23.21
Moderately Concerned 17 30.36
Extremely Concerned 13 23.21
Note. n = 56.
The survey results in each focus area show different levels of concern from the school
site professionals. Level of concern related to substance use showed 37.5% of respondents were
Moderately Concerned, with Slightly Concerned having the next highest response rate at
19.64%. Suicidal ideation had a 28.57% response rate for Somewhat Concerned, the majority
with 16 responses, followed by Slightly Concerned with 13 responses or 23.21%. Response rates
for depression/anxiety showed the highest response with Moderately Concerned at 30.36% or 17
site professionals.
When looking at the data for response rates for Extremely Concerned, depression/anxiety
received the highest response rating with 13 respondents, 23.21%. Yet when combining the
responses for both Moderately Concerned and Extremely Concerned, both substance use and
depression/anxiety had a response rate of 53.57%, a majority of the respondents.
STUDENT MENTAL HEALTH AND WELLNESS 53
The concerns represented in the survey responses were consistent with the themes in the
interviews with superintendents. Stress, depression, and anxiety were discussed repeatedly by all
the superintendents, including the significant impact they are having on their school campuses.
One Northern California superintendent stated, “Anxiety is definitely on the rise. Depression also
gets a lot of attention. But as a high-performing school district, there a lot of bi-products from
anxiety that have been self-reinforcing or praised within our community.” In fact, another
Northern California superintendent stated,
Student mental health faces bigger and bigger challenges each year. At least once a year a
graduate commits suicide, our 5150 rates have been climbing. Last year we had 50,
5150s. Our ED qualifications are climbing each year and placements for residential
treatment centers is climbing each year also. Home hospital instruction is 50-60 students
each year.

Other factors affecting depression and anxiety were raised by superintendents during the
interview process. These included the impact of social media, sleep deprivation, and cell phone
use, with students not disconnecting appropriately and thereby affecting their mental health. This
situation was summarized by one Northern California superintendent,
The cell phone is a major influence in a bad way. Our students have sleep deprivation
because they can’t disconnect the phone. In my opinion, uncontrolled cell phone use is
crippling this generation of students and is creating depressed and anxiety ridden students
in these high-performing communities.

Discussion. High-performing school districts are evolving to meet the social and
emotional needs of their students. Schools, families, and students are striving to create a fine
balance between achieving success and maintaining a healthy approach to the pressure and
stress. A 2015 study done by the Yale Center for Emotional Intelligence highlighted several
current concerns nationally regarding student mental health and wellness. The online survey was
given to 22,000 high school students and asked students to provide three words to describe how
STUDENT MENTAL HEALTH AND WELLNESS 54
they feel at school. The top two answers were “tired” and “stressed.” Overall, this study showed
that nationally students reported feeling stressed 80% of the time (Brackett, 2015).
The research from this study supports the growing concern about student mental health in
high-performing school districts as expressed during the interviews and through survey
responses. One assistant principal described students as “less resilient and lacking problem
solving skills.” And another site professional went on to describe their concerns, noting that there
is “more pressure on students than there was even 5 years ago and issues around mental health
are increasing every single year.”
Superintendents went on to describe how there are polarizing ideologies in high-
performing school districts between wanting top GPAs and admission to Ivy League schools and
also asking about reducing stress and lowering anxiety. As shared by one Northern California
superintendent,
One of the common problems are competing interests in the community because parents
still wants their child to attend top level schools. They want more homework and more
AP classes, while some kids and parents want balance. It is my role as superintendent to
balance these competing interests by educating the community with a top level parent
speaker series, along with robust parent resources on the district website.

School districts are facing precisely this tightrope balance when it comes to meeting the mental
health needs of their students. The superintendents described the contradictions between
excelling academically at the level their communities have come to expect while supporting a
positive approach to mental health. The examination of the influence of mental health issues on
student achievement is the focus of research question two.
Research Findings Pertaining to Research Question Two
RQ2 asked, What is the impact of mental health issues on student achievement? The
origin of mental health issues in high-performing school districts is often rooted in academic
STUDENT MENTAL HEALTH AND WELLNESS 55
achievement, demands for excellence, and pressure to perform. Although students in these
districts experience is significant amount of success, along with this comes tremendous pressure
and stress for students to excel and thrive in all areas of academics, athletics, and extracurricular
activities. “The headlines are alarming, many students who feel the pressure to succeed have
been cheating, pulling all-nighters to study, becoming depressed, and seeking relief in drug use
and self-mutilation” (Pope et al., 2009, p.121). The impact of student mental health struggles on
achievement is significant in how it manifests in the classrooms and on campuses in high-
performing schools.
Table 10 depicts the levels of concern from survey respondents as related to the impact of
mental health on student achievement. Respondents were asked to rate their levels of concern
regarding these three areas utilizing a Likert scale where 1 indicated Not at All Concerned, 2
indicated Slightly Concerned, 3 indicated Somewhat Concerned, 4 indicated Moderately
Concerned, and 5 indicated Extremely Concerned.
Table 10
Impact of Mental Health on Student Achievement
Level of Concern for Students f %
Not at All Concerned 3 5.45
Slightly Concerned 4 7.27
Somewhat Concerned 9 16.36
Moderately Concerned 18 32.72
Extremely Concerned 21 38.18
Note. n = 56.
Survey respondents reported that 38.18% were Extremely Concerned with the impact of
mental health challenges on student achievement on their campuses. Moderately Concerned was
indicated by 18 of the respondents at 32.72%. These results show that school site professionals
clearly connect student mental health and achievement in the classroom. In an open-ended
STUDENT MENTAL HEALTH AND WELLNESS 56
survey response, one principal made the following statement regarding the impact of mental
health on student achievement; “We are redefining what success looks like for all students.”
Another high school counselor stated, “Our district needs review on what values define student
success.”
The superintendents echoed the concerns expressed by the principals, assistant principals,
and counselors regarding the relationship between mental health and student achievement. All
five superintendents commented on the increased pressure and competition felt by students,
adding to the increased mental health needs of their students. A Northern California
superintendent stated,
Students are facing increased social and academic pressures adding to increased mental
health needs. Competitiveness to get into college has increased and thus the demands on
counselors to assist students in meeting their college goals.

This increase in stress and pressure can lead students to experience anxiety and
depression, which the survey respondents indicated were affecting their students’ achievement in
the classroom. As these student needs become evident on a school campus, the site personnel,
often in conjunction with the district, develop procedures and protocols to address these concerns
with all stakeholders. The next two tables examine programs and procedures that have been
setup to support achievement when students are facing mental health issues. Table 11 shows
whether there are programs set up at the respondents’ school sites and table 12 outlines the types
of interventions available to help students struggling with mental health concerns.
Table 11
Student Mental Health Issues on Campus
Programs and Procedures to Support Achievement f %
Yes 51 91.10
No 5 8.90
Note. n = 56.
STUDENT MENTAL HEALTH AND WELLNESS 57
Table 12
Practices to Support Student Achievement
Type of Practice for Students Needing Intervention f %
Intervention/Safety Plans 23 41.07
Re-Entry Meeting/Student Study Team 23 41.07
504 plan/Individualized Education Program 20 35.71
Counseling 13 23.21
Outside Referrals 7 12.50
Home Hospital Instruction 7 12.50
Note. n = 56.
Of the 56 respondents to the survey, 51 indicated that their school district had programs
and procedures currently in place to support student achievement when mental health issues were
affecting their access to classroom curriculum. However, while there are programs and
procedures in place, it was clear from the respondents’ open-ended responses that there are
struggles with providing these supports. One principal stated, “We are in the initial stages of
developing these types of programs, but we need time and money allocated to this type of
support.” A counselor commented on the difficulty of finding “wrap around services” that will
support the student in all areas of need.
When reviewing the responses regarding types of interventions available for students
with mental health concerns, the top two responses were intervention/safety plans and re-
entry/Student Study Team (SST) meetings, both with 41.07% of the respondents indicating this
as a current practice. For students with more pervasive needs, 35.71% of the respondents
indicated that a 504 plan or Individualized Education Program may be put into place to provide
the student with greater support and intervention. From the open-ended responses, it was again
clear that each school site and district may have a different approach to how to support a student
struggling with issues such as stress, depression and anxiety. As expressed by one counselor,
“This is a gray area. Our students are living with mental health concerns and having to work
STUDENT MENTAL HEALTH AND WELLNESS 58
through life with daily support. There is not a defined method for academic support and student
achievement.” Another assistant principal described the SST meeting as,
The first step in the intervention process to discuss as a team the students need. We then
provide an intervention plan with accommodations and can even consider the student for
an IEP in which the student can qualify for Special Education with the qualification of
emotional disturbance. There is a tiered level of support based on the student’s need.

During the interviews, the superintendents acknowledged the effect that mental health
can have on student achievement. There was agreement by all superintendents that there need to
be programs and procedures in place to address this, but the superintendents have a viewpoint of
achievement from a districtwide perspective. They are developing and implementing programs
districtwide that are focused on both prevention and intervention. As described by one Northern
California superintendent,
We are looking at policy, procedure and documentation to make sure that we have more
of a fluid system to address our students’ mental health. One of the things we have
worked on in our initiative is de-stigmatizing and normalizing mental health care as just a
standard part of healthcare.

The next three survey questions focused on suicidal ideation and the current impact on
the school campus. Table 13 presents the number of respondents that were aware of the new
California AB 2246, which focuses on suicide prevention. Respondents were also asked how
their districts were addressing the bill with their teachers and staff. The next two survey
questions (Table 14 and Table 15) asked survey respondents about their knowledge of suicidal
ideations and attempts on their campus in the last year.
Table 13
Awareness of Suicide Prevention Bill
f %
Yes 40 71.50
No 16 28.50
Note. n = 56.
STUDENT MENTAL HEALTH AND WELLNESS 59
Table 14
Estimated Number of Students Expressing Ideation Annually
f %
0 0 0
1-10 Students 13 23.21
11-20 Students 11 19.64
21-30 Students 13 23.21
More than 30 Students 13 23.21
I don’t know 6 10.71
Note. n = 56.
Table 15
Estimated Number of Students Attempting Suicide Annually at Respondents’ School Sites
f %
0 Students 5 9.09
1-2 Students 14 25.45
3-4 Students 13 23.64
5 or more Students 12 21.83
Other 11 20.00
Note. n = 56.
Table 13 depicts the respondents’ knowledge of the new AB 2246, which, according to
the Trevor Project (2016), requires the adoption of suicide prevention, intervention, and follow-
up plans by all California school districts with students in grades 7-12 by the summer of 2017.
AB 2246 mandates that all school districts in California implement suicide prevention policies
that specifically address the needs of student mental health.
Of the 56 respondents, 71.50% were aware of the new assembly bill regarding suicide
prevention. Thirteen of the respondents indicated that their prevention policy was focused on
training staff about warning signs suicidality. Some respondents also indicated that they were
educating their students on suicide awareness and prevention. One counselor reported “our
school site is promoting a ‘See something, Say something’ Program, educating our students
about the resources available on campus for social emotional support.” All superintendents
STUDENT MENTAL HEALTH AND WELLNESS 60
interviewed were aware of the new assembly bill and had district staff that had begun to work
with site staff to implement the mandated requirements. One Northern California superintendent
stated,
Our social workers and wellness counselors have trained all staff members at the high
schools across the district on suicide prevention training, meeting the requirement for
newly implemented Assembly Bill 2246. We are also rolling out systematic protocols for
students after they return from hospitalization or out of state, ensuring that the student
comes back with a detailed plan and protocol for support.

As shown in Tables 14 and 15, respondents were asked to estimate the number of
students expressing suicidal ideation and attempting suicide annually. A total of 46.42% of
respondents indicated that there were over 21 students per year expressing suicidal ideation, with
23.21% reporting more than 30 students per year. In table 15, the two largest respondent groups
were in the 1-2 and 3-4 range of attempts annually. This aligns with the report from the Trevor
Project (2016), which states there is an average of three suicide attempts on a typical high school
campus each year. Twenty percent of respondents selected “other” as their response. The “other”
responses stated it was hard to estimate the number of annual suicide attempts at their school
because they were a new employee at that school site. A few respondents also indicated that it
was difficult to respond accurately because they only work with a portion of the student body.
Each superintendent expressed concerns regarding potential student suicide and how such
an event would affect their school sites. Each district had increased their focus on student mental
health with some type of plan and program particularly focused on suicide prevention and
education. As stated by one Northern California superintendent,
We had two deaths by suicide this last year. Our 5150 rate is off the chart. Our school
staff take an online class for suicide prevention and signs to look for yearly. Student
social emotional health is a big concern.

STUDENT MENTAL HEALTH AND WELLNESS 61
During the interviews, all five superintendents stressed the importance of training for teachers
and staff as they are on the front lines with these students in crisis. Early prevention and
identification were common themes amongst the superintendents.
Discussion. Research shows these mental health issues consisting of stress, depression,
anxiety, and suicidal ideation are affecting student learning as displayed in attendance patterns,
focus issues, withdrawal from extracurricular activities, and limited classroom engagement thus
resulting in reduced academic achievement. Research has long linked academic engagement to
positive social, psychological, and physical developmental outcomes; however, qualitative
studies in high-performing schools find that some students who work hard in school may be
compromising their mental and physical health in the pursuit of top grades (Conner & Pope,
2013). As described by one high school counselor,
Students are faced with far more choices these days, many of which may lead to either
anti-social or self-harming behavior. At our school, students are also under far more
stress these days than they were in the past. Academic competition is intense and real.

The impact of student mental health on achievement is clearly a concern across school
districts. Superintendents often discussed the counterpoints that can exist within their districts
between high levels of academic achievement and maintaining positive mental health programs.
In high-performing school districts, there is a demand from the community for multiple honors
and AP courses, coupled with an array of extracurricular activities and community service
commitments. Yet, at the same time, the district is promoting balance and programs to reduce
stress and anxiety. One Northern California superintendent stated,
High parental expectations along with hopes of ivy league schools is causing high stress
for students. Releasing the pressure valve for kids is hard in this community because of
how high the bar is set and personal balance can be dismissed.

STUDENT MENTAL HEALTH AND WELLNESS 62
Each superintendent expressed the importance of focusing on mental health issues and
combating the stress, anxiety, and depression that affect their students. As stated by one high
school principal, “Everyone knows that the high school is a pressure cooker by nature.” Districts
are establishing programs and protocols to support student mental health and wellness, and in
doing this, districts are having to examine how they are allocating their financial resources. The
next research question presents findings of how school districts are utilizing their financial
resources to address mental health and wellness.
Research Findings Pertaining to Research Question Three
RQ3 asked, How are school districts in California utilizing their financial resources,
including LCAPs, parent organizations, and education foundations to support student mental
health and wellness? Developing new programs, policies, and staffing requires the financial
means and capability to do so for school districts. In order for school districts to allocate funding
for mental health and wellness it needs to be included in their LCAP plan with specific goals. In
fact, after examining the California Healthy Kids Survey data on school connectedness,
perceived school safety, and pupil engagement, as they are indicators that each school district is
required to address in its annual LCAP (WestEd, 2014). Not every school district is funded the
same, and with the LCAP, larger, urban school districts receive significant more amounts of
funding than neighboring districts, whereas other school districts are just getting by on lower
level funding. School districts that receive basic aid funding bring in significantly more money
than typical districts. Districts receiving less money are often left looking for grants and raising
money through school foundations and leveraging the community for resources. Table 16 shows
how many respondents stated that mental health and wellness was included in their district
LCAPs.
STUDENT MENTAL HEALTH AND WELLNESS 63
Table 16
Funding Sources (LCAPs, Foundations, Grants, Site/District Funding)
f %
Yes 44 78.57
No 12 21.43
Note. n = 56.
Of the respondents, 78.57% noted that their school district has included mental health and
wellness in their LCAPs. Further, in regard to staffing, this Northern California superintendent
also stated, “A large portion of the budget is now spent on student mental health staffing. It’s an
evolution in high-performing districts.” A Northern California superintendent stated,
Our school district recently received a multi year grant from a healthcare organization in
the community. This grant contributes $500,000 to our LCAP and is used specifically to
hire more social workers and wellness counselors for the high schools.

One Northern California superintendent noted that their parent education foundation has made
student mental health a priority with their funding. He explained,
Our Education Foundation donates a lot of money just to mental health for things like
parent and student guest speakers, social worker positions and the new position of
Director of Mental Health. It is now a line item for them and we hope to be able to fund it
annually.

Table 17 depicts the inclusion of student mental health and wellness in the respondents’
school districts’ board goals and school/site plans for achievement. Respondents were asked to
identify how and/or if mental health and student wellness was addressed.
Table 17
Student Mental Health and Wellness Included in District or Site Plan
f %
Yes 45 80.36
No 11 19.64
Note. n = 56.
STUDENT MENTAL HEALTH AND WELLNESS 64
Of the 56 respondents, 80.36 % noted that their school district has included mental health
and wellness in either their district or site plans for achievement. The researchers estimate that
this number could actually be higher, due to respondents being uncertain of their district, board
and site goals.
One main way that high-performing school districts are addressing mental health and
wellness is through staffing. Specifically, new positions are being created or existing ones
altered. One Northern California superintendent stated, “We now have three special therapists,
and a student services coordinator at each high school and a clinical services director at the
district level. Wellness Centers will be included in the upcoming facilities master plan.”
Similarity, one counselor stated,
Our wellness program is exceptional and is specifically included in our LCAP. We have
licensed therapists (LCSWs or LMFTs) on each campus who offer group and individual
therapy, class and full grade presentations, school events bringing awareness to mental
health, teacher consultation, drop in sessions, crisis management, staff presentations, and
family work. I am really pleased with my school district’s vision of support student
mental health

One interesting theme in both the survey data and the interviews is the perception of how
role of the high school counselor has changed in the last 5-10 years. This was highlighted by the
survey question, “Do you consider the job of the high school counselor much different than 5-10
years ago?” Responses to this question are outlined in Table 18, as well as the responses to the
open-ended question regarding how the position has changed.
Table 18
High School Counselor Position
Change in Role Last 5-10 Years f %
Yes 49 87.50
No 7 12.50
Note. n = 56.
STUDENT MENTAL HEALTH AND WELLNESS 65
The increased mental health demands being seen by high school counselors in top
performing school districts are actively reshaping the job description and scope of what is
required. As described by one high school assistant principal,
Our counselors are often dealing heavily with social and emotional student needs, leaving
them less time for academic counseling and college and career readiness. There seems to
be a higher student population at risk, so counselors have become very well versed in
supporting students’ mental and emotional health needs.

Counselors struggle to balance the academic counseling needs of students with running a
triage of mental health needs; if a school is not staffed sufficiently, students’ mental health needs
can be overlooked. However, when counselor ratios are staffed at lower levels, schools can better
support all students’ needs. One Northern California superintendent stated, “Our school
community is dedicated to the notion of a low counselor to student ratio at 300-1. We are using
our parcel tax money to fund it. That’s one major way we are addressing student mental health.”
An example of how the high school counselor position has morphed over the years is seen in a
statement by a high school principal, who stated,
The job of the high school counselor is vastly different. It is not an academic counseling
position anymore. It is a crisis counselor/therapist/referral specialist. In fact, I wanted,
and did, hire a social worker to fill my last counseling position.

A high school counselor went on to explain,

As educators, we are limited in what we can do. In my opinion, the need of the student
often exceeds the scope of what a school can reasonably do. We can’t diagnosis and we
can’t offer therapy. Sometimes, when it comes to mental health issues, it feels like there
is an expectation placed on the counseling office to “fix the problem” that the student is
facing. That’s like expecting the athletic trainer for our football team to fix a broken leg.

The demands of mental health needs have changed the role of the school counselor and increased
the need for additional support personnel on the school site, which will be discussed in the
findings for research question four.
STUDENT MENTAL HEALTH AND WELLNESS 66
Discussion. High-performing school districts are seeking ways to combat mental health
and wellness in their communities to the best of their financial ability. One of the common
problems districts face is little room in the budget due to employee compensation. On average,
employee compensation makes up 85% of districts’ budgets in California (Fensterwald, 2017).
With little left to allocate, the best way to ensure that school districts adamantly addressing
mental health and wellness is by including it in their districts’ LCAPs as a need from the
community.
One Northern California superintendent stated, “We have used our one-time money to
address these issues. But as this goes away, it will become more challenging for us to keep
funding these types of programs and services.” In contrast, another Northern California
superintendent describes their commitment to funding wellness programming,
We are very fortunate to be well funded as a basic aid district. And with being very well
funded comes the moral imperative to focus on the wellness and safety of our students.
We have been able to allocate our funds to support our student wellness.

Regardless of funding level, all superintendents stressed in importance of transparent
spending and utilizing funding to implement mental health programs with fidelity. The final
research question addresses the best practices school districts are specifically using to address
student mental health and wellness, which aligned with four themes from both the survey and
interview data.
Research Findings Pertaining to Research Question Four
RQ4 asked, How are high-performing school districts in California addressing student
mental health and wellness issues? The final question of this study delved into how high-
performing school districts are addressing the mental health issues that have become increasingly
prevalent among their students. The survey data and interview findings yielded clear themes of
STUDENT MENTAL HEALTH AND WELLNESS 67
how high-performing school districts are addressing increased student mental health and
wellness concerns. These themes include professional development, staffing, and programs, each
with extensive subsets of data related to how these are being presented within the school
districts. Finally, the researchers sought to understand what was still lacking with programs and
services in these high-performing school districts. Best practices for educational leaders emerged
when reviewing the survey and interview data regarding programs and services currently being
offered but also in the practices and programs that are lacking in these school districts.
Professional development. With increases in student mental health demands, high-
performing school districts reported to have changed several things to meet their students’ needs.
One is that a major shift in teacher and staff education and awareness. Early identification of
mental health problems by a teacher or staff member can make a big difference and get a student
the help he/she needs. The first survey question (Table 19) asked if staff training regarding
mental health has been conducted in the school district. Respondents that affirmed training was
conducted were asked to provide open-ended responses regarding the types of professional
development at their school sites, with results tabulated in Table 20.
Table 19
Professional Development
Teacher/Staff Training Regarding Mental Health f %
Yes 50 89.30
No 6 10.70
Note. n = 56.
Of the 56 survey respondents, 89.30% reported attending or participating in a recent
professional development or training for student mental health. The importance of training
teachers and staff could not be overstated by both site professionals and superintendents.
Teachers are on the front lines working with students on a daily basis, and can see changes in a
STUDENT MENTAL HEALTH AND WELLNESS 68
student’s attendance, work completion, and achievement in the classroom. As stated by an
assistant principal,
Our district wide staff training on student mental health and wellness significantly helped
our teachers identify students who are struggling emotionally/mentally. We definitely
have an increase in student referrals to the counseling office this year after our teachers
have more knowledge of what to look for.

Table 20
Professional Development
Type of Training f %
Mental Health 37 66.07
Suicide Prevention 18 32.14
Trauma Informed Practices 7 12.50
Mindfulness 4 7.14
Note. n = 56.
During the interviews with superintendents, there was strong agreement that professional
development for teachers and staff was a critical component of their overall approach to
addressing student mental wellness. As stated by one Northern California superintendent,
“Professional development in our district is important because a lot of our teaching staff are also
high-performing and maybe a bit of perfectionists by nature so it is naturally reinforced with our
teachers.” Superintendents also expressed concerns about the differences in the progress in some
districts based on various grade levels. As explained by one Northern California superintendent,
In our elementary schools, they get it. Our middle schools mostly get it, but once you
start to individualize content there are a lot of people that went into teaching to teach
math, not teach how to be a young adult. We are seeing the more teachers that we train,
on SEL or mindfulness, we are seeing it coming into the classroom.

Respondents outlined the types of professional development being offered to their
teachers to support student wellness. Of the respondents, 66.07% indicated that their professional
development was focused on mental health topics and identification of at-risk signs. The second
leading topic was professional development addressing suicidal ideation (32.14%). The
STUDENT MENTAL HEALTH AND WELLNESS 69
researchers were surprised by this low percentage rate for this type of professional development,
given the requirements for teacher training from AB 2246. However, interviews from
superintendents gave insight into an area of difficulty surrounding coordinated efforts regarding
the various large-scale initiatives that can happen in a high-performing school district. As
described by one Northern California superintendent, “What seems to be a common problem in
high-performing districts is there is a lot going on but it is not well coordinated. And people feel
stretched by this. We had to coordinate our efforts.” One area that seemed to be a common
coordinated effort in high-performing districts was the addition of staffing resources to address
student mental health. This was a recurring theme in both the surveys and interviews conducted
by the researchers.
Staffing. Beyond professional development, the number one way that school districts are
addressing mental health is with increases or changes to their staffing. Site based professionals
responded to the survey with a myriad of concerns related to staffing and the increase in the
demands being placed on their current counseling staff. As described by one counselor, “You
have to be ready to see more students who are in crisis and emotionally stressed. The level of
expectations and demands have grown considerably.” As put simply by one high school
principal, “My counselors need more help.”
Table 21 outlines the new positions hired or created within high-performing school
districts to address student mental health and the percentages for which a respondent included
that type of position in their response.
STUDENT MENTAL HEALTH AND WELLNESS 70
Table 21
Staffing
Type of Position f %
Mental Health 37 66.07
Additional School Psychologist 18 32.14
Social Worker 16 28.50
Wellness/Mental Health Counselor 11 19.64
Increase in School Counselor 5 8.92
District Coordinator/Director of Mental
Health/Wellness
3 5.35
Note. n = 56.
Of the 56 respondents, 32.14% indicated additional school psychologists have been
added to the school site staff to support student mental health and wellness. Sixteen, or 28.50%,
of respondents indicated that they had hired a social worker to join their site staff. One principal
remarked, “The counselor position has changed. It is a crisis counselor, therapist, referral
specialist. In fact, I wanted, and did, hire a social worker to fill my counseling position.” The
need for more specialized services on the school site was a common theme among survey
respondents. As described by one high school assistant principal,
Our counselors are often dealing heavily with social and emotional student needs, leaving
them less time for academic counseling and college and career readiness. There seems to
be a higher student population at risk, so we need staff that is very well versed in
supporting students’ mental and emotional health needs.

Interviews with superintendents validated the survey responses as they indicated changes
in types of staffing and new positions being created for student mental health. Of the five
superintendents interviewed, all stated that they increased staffing to the maximum ability
allowable for new or unique positions for student mental health and wellness. One Northern
California superintendent stated,
High school assistant principals are too busy dealing with student discipline, getting the
broken toilet fixed and conducting teacher evaluations and observations, so student
mental health concerns need to be addressed by on-site professionals.
STUDENT MENTAL HEALTH AND WELLNESS 71

Both site professionals and superintendents recognized that bringing in on-site therapists is an
enormous change in philosophy for many school districts. In high-performing school districts,
the school site was not always recognized as the appropriate place for students to access mental
health support services. As student needs have increased over time, anxiety, stress, and
depression have begun to affect student access to curriculum, causing issues with attendance,
focus and achievement. One Northern California superintendent described the shift within their
district in addressing social emotional concerns,
We are making sure that people understand that these social emotional skills matter, and
maybe even matter more than an AP test score. Last year, weighted GPA was a hot topic
in our district, with every parent wanting to give their student an advantage. They don’t
want them to lose out. But we are now starting to see a tipping point in our conversations
towards what skills really makes people happy and successful.

The addition of mental health support staff has also allowed high-performing school districts to
coordinate efforts surrounding preventative programs districtwide. The next set of research
questions examines the types of programs that are being utilized across high-performing school
districts.
Programs. With the increase in mental health staff, high-performing school districts have
begun to implement both preventative programs and intervention programs to address student
mental health on campus. These coordinated efforts allow schools to bring a comprehensive
approach to addressing the clear needs they are seeing from their students. In an open-ended
survey response, one high school principal stated, “We are creating stronger, more focused
mental health procedures and process. We want to provide information to students and staff,
strengthen our protocol, identify early and support academically as well as emotionally.” Table
22 outlines the various types of preventative programs that are currently in place within high-
performing school districts.
STUDENT MENTAL HEALTH AND WELLNESS 72
Table 22
Preventative Programs
Type of Program f %
Wellness Program 21 37.50
Group Counseling 19 33.92
Drug and Alcohol Counseling 15 26.78
Challenge Success School 14 25.00
On-Site Therapy 11 19.64
Peer Mentoring 11 19.64
Parent Education 10 17.85
Student Assemblies 10 17.85
Wellness Centers 9 16.07
Student Advocacy Meeting 9 16.07
Yoga 7 12.50
Mindfulness for Students 6 10.71
GE Support Class 3 5.35
Social Emotional Learning 3 5.35
Enhanced Health Class 2 3.57
Restorative Practices 2 3.57
Note. n = 56.
Numerous preventative programs were identified through survey data with school site
professionals. Of the respondents, 37.5% indicated that wellness programs were in place at their
school site to address student mental health. Some form of counseling on the school campus
(group counseling, drug/alcohol, and on-site therapist) was indicated by 45 responses, clearly
showing the strong need for school-based counseling services. One counselor described their
wellness program and counseling services as follows,
The Wellness Program is a new program which began last school year. Marriage and
Family Therapists and Social Workers were hired to implement mental health
intervention into the school the district. We provide individual counseling services, group
services, parent education and support, training, and case-management services to youth.

Peer to peer support was another area recognized by survey respondents as a critical
preventative program, earning 19.64% of responses. Through peer to peer programs, students are
providing support to one another. These programs can look different throughout the schools
STUDENT MENTAL HEALTH AND WELLNESS 73
surveyed, but the key factor with these types of programs is identification, reducing academic
competition, and creating connective relationships. As described by one Northern California
superintendent,
We are hearing students trying to help each other normalize the access to wellness
services, understanding the human condition that we need support, and that they are
under a lot of pressure. It is a shared focus on providing safety and support mechanisms
for our students.

Although it is important for students to support one another to promote increased
connectivity amongst peers, high-performing school districts are also implementing a robust
parent education component in order to combat mental health concerns in their school district
and community. Although only 17.85% of survey respondents mentioned parent education, the
superintendents interviewed supported educating their parent population as a critical component
of combatting increases in student mental health. The recurring theme of competing interests in
terms of parent education emerged again. Although parents want to understand strategies to
address anxiety and stress, they are also inquiring with the school about the appropriate numbers
of AP classes and college admission statistics for Ivy League schools. One Northern California
superintendent stated,
We would bring in leading professionals in this area, and what we would find is that we
were bringing in the same 60 parents at every event and it wasn’t really broadening our
message. We have tried recording the sessions and creating a video series.

Wellness centers are a newly created concept within high-performing school districts,
with 16.07% of survey respondents indicating this being implemented as a preventative program
on campus. One Northern California superintendent explained the concept of their wellness
centers.
We have opened up wellness centers with the idea being not adding services but pulling
the services together in one space. The wellness centers serve as a place where students
can take a 15-minute break. The space is tech-free, the atmosphere is calm, there is tea
STUDENT MENTAL HEALTH AND WELLNESS 74
and wellness programming that is coming through the TV. The purpose is to allow kids a
brain break, if you want to talk with someone you can, or you can be in that space to
recoup and go.

Another new initiative across some high-performing districts is the concept of
mindfulness, with 10.71% of respondents indicating that they had integrated some form of this
program on their campus. Mindfulness has been added to the curriculum of existing classes as a
means to help students manage stress and have a positive approach to their mental health. One
Northern California superintendent stated, “We have brought mindfulness into PE in ninth and
10
th
grade. We have couched the conversation in how mindfulness can help your performance
and has helped both teachers and students.”
One common theme came from the superintendent interviews regarding preventative
programs that was not included in our survey results was making policy changes to impact
student mental health. Given that policy changes must be implemented based on a district
initiative in conjunction with the board of education, policy change is a part of a preventative
program that would be driven by the superintendent. The importance of policy change was a
recurring theme during the interviews. All of the superintendents described current initiatives
that were under current discussion, those that were already put into place, and some that they
hoped to create in the future. Another Northern California superintendent discussed the
important changes in the school calendar and homework policies,
We have changed our school calendar to beginning earlier and then end the semester at
winter break so our high school students have no work during winter break. This is
actually part of our board policy that no one is allowed to have homework or do anything
during winter break. Our calendar is progressive and was difficult to pull off.

One Northern California superintendent worked with his board of education to adjust the
start time at their high school, giving students more time to sleep. Another went on to describe
how the board of education set goals to “focus on the social and emotional support of students,”
STUDENT MENTAL HEALTH AND WELLNESS 75
which led to a change in their schedule to a modified block schedule with intervention periods
added. The concept of built in support time with a change of bell schedules was also described
by another superintendent,
We have done a lot of work around changing bell schedules to create more built in time
so students can get support. They can exercise, get academic support or participate in a
mindfulness activity. They can do any activity that they want to choose.

Perceptions of lacking services and programs. With the increases in professional
development, staffing, and preventative programs outlined previously, both site professionals
and superintendents recognize that there are still lacking services and programs within their
districts. These programs and services were identified as a best practice that would benefit or
support the school campus or overall district. Table 23 reflects the survey responses to services
(program, practice, or position) that is lacking on the school site.
Table 23
Services Lacking to Support Student Mental Health
Type of Program, Practice, or Position f %
Onsite Therapist/Social Worker 17 30.35
Wellness Center/Program 10 17.85
Policy Changes (Course Load, Bell Schedule, Homework, and Calendar) 9 16.07
Parent Education 9 16.07
Lower Counselor to Student Ratio 8 14.02
Blended Learning Option 7 12.50
Student Assemblies 4 7.14
Increased PD 3 5.35
K-12 SEL Program 3 5.35
District Coordinator/Director of Mental Health/Wellness 2 3.57
At Risk Identification System 2 3.57
Improved Health Course 2 3.57
Note. n = 56.
With the increase in students’ mental health needs on school campuses, it is not
surprising that 30.35% of survey respondents indicated the need for more onsite therapists and
social workers. With the day to day demands on school sites to address student wellness,
STUDENT MENTAL HEALTH AND WELLNESS 76
additional support providers seem to be needed from the perspective of the site professionals. As
described by one counselor, “You have to be ready to see more students who are in crisis and
emotionally stressed. The level of expectations and demands have grown considerably.”
Of the respondents, 17.85% indicated that some sort of wellness program or center would
be a helpful addition to their school campus. The third most indicated were policy changes and
parent education (16.07%). As described by one counselor,
An ideal district wide program would include on campus mental health programs and a
referral process that is dialed out. Social and Emotional Learning (SEL) programs would
be in place at all levels. Flexibility for student schedules and options for learning would
also be ideal

It is still the changes to policy that superintendents indicated as the number one component
lacking in their current program to support a wellness program. One Northern California
superintendent shared, “Resources are a major issue for our district. If I had a magic wand, I
would work with the board and teachers to create a homework policy, eliminating summer and
holiday homework.”
Discussion. As demonstrated by survey and interview data, it is clear that mental health
and wellness programs and practices are being implemented across all the high-performing
school districts. The themes of professional development, staffing, and programs were common
among survey responses and interviews. All superintendents interviewed described programs
being implemented in their districts that are intended to directly reduce student stress and
anxiety. There was a clear indication from survey respondents and superintendents that increased
staffing is a priority in most of the districts as students’ needs have continued to increase. During
the superintendent interviews, participants drew connections between the districts that have
moved beyond program development to changes in policy.
STUDENT MENTAL HEALTH AND WELLNESS 77
Superintendents that were working with their school boards to make policy changes
surrounding homework, school calendars, and start times seemed to have well established mental
health and wellness programs. Although all districts are engaged in addressing student mental
health concerns in some way, some districts are farther along in their progress of establishing
programs and practices that are entrenched in the daily operations of their school campuses.
Student mental health programs need to be seen as a critical component of the school curriculum,
not an additional or supplemental program. As described by one Northern California
superintendent,
In education, there is always an initiative of the week. A flash in the pan and then it burns
out. And we start to focus on something else. We are talking about how social emotional
learning and wellness isn’t another thing on your plate or your students’ plate, this is
actually the plate.

Although best practices of addressing mental health emerged from the survey data and
interviews, what became most clear is that high-performing school districts must be committed
to a comprehensive well-defined approach to student mental health and wellness with support
from all stakeholders allowing the program to become a sustainable and integral part of the
school, district, and community.
Summary
Chapter 4 presented the analysis of data gathered from surveys with school site personnel
and interviews with superintendents. The survey was divided into open and closed-ended
qualitative and quantitative questions, yielding numerical data and free response answers to
open-ended questions. In addition to the numerical and written data gathered by the survey, this
chapter also presented information gathered from interviews with five Northern California
superintendents. School site staff survey and superintendents’ interviews provided a number of
strategies their school/district utilize to support student mental health and wellness. More
STUDENT MENTAL HEALTH AND WELLNESS 78
specifically, the findings highlighted best practices regarding student mental health and wellness
in relationship to the themes of professional development, staffing, and budget, and
programs/services. The qualitative and quantitative data suggests the following findings related
to the four research questions.
Research question one asked, How is the mental health of students in high-performing
school districts in California currently manifesting on school campuses? Both survey data and
interview responses showed high levels of concern regarding student mental health in high-
performing districts with increasing levels of frequency regarding the impact on students. The
main areas of focus that this study uncovered were that students in high-performing school
districts are being impacted greatly by stress, depression, and anxiety, which can lead to
concerns regarding suicidal ideation.
When comparing survey data, participants showed equal concern about
depression/anxiety and substance use among students. However, this concern from the survey
data was not echoed in the interviews with superintendents, as they did not express concerns
regarded substance use but instead focused heavily on stress leading to anxiety and depression.
Both school site personnel and superintendents reported that high expectations, pressure to
succeed, and fierce competition were impacting the students in high-performing school systems,
causing extreme levels of stress and anxiety. A final common theme of competing interests was
expressed in all interviews with high-performing school districts being expected to continue to
have their students excel academically while also having a positive approach to student wellness.
Research question two asked, How do mental health issues affect student achievement?
Through survey data and interviews, participants expressed a high level of concern surrounding
the effect stress, depression, and anxiety can have on student achievement. Students are facing
STUDENT MENTAL HEALTH AND WELLNESS 79
increased pressure and competition regarding academic achievement, which leads to high levels
of stress. The study showed that schools have protocols and programs in place to address
students struggling with various mental health concerns and continue to support their academic
achievement. Schools are utilizing a team approach with school site personnel to develop support
plans for students to allow continued access to curriculum.
With the development of AB 2246, suicide prevention and interventions are the new
mandate for all California school districts as of the 2017-18 school year. The data from this study
regarding suicidal ideation were aligned with the current literature, and superintendents
interviewed expressed their concern regarding the effect a student suicide can have on a school
and district. From the superintendents’ perspective, early identification and prevention programs
were the key to limiting the influence of mental health concerns on student achievement.
Research question three asked, How are school districts in California utilizing their
financial resources, including LCAPs, parent organizations, and education foundations to support
student mental health and wellness? This study uncovered a variety of ways that high-performing
school districts are fundraising and using school district money for mental health and wellness.
Commonly, school districts use a three pronged approach funding formula for addressing mental
health and wellness. The formula consists of parent foundations/groups, community
grants/partnerships, and an allocation of general fund dollars through the LCAP. Mental health
and wellness have become not only a part of district LCAP plans, but in many districts, they
have become part of their school board and district goals.
The data suggested that given the increased demands on schools regarding student mental
health, there have been changes to the role of the school counselor. Thus, school districts are
using their money creatively for new staff positions that may not have been present previously.
STUDENT MENTAL HEALTH AND WELLNESS 80
Superintendents indicated allocation of additional counseling resources to school sites as a
critical part of addressing stress, anxiety, and depression among students. Survey data and
interviews showed that additional counseling personnel was a focus of funding for these districts.
Mental health and wellness appear to account for a major portion of the spending allocation for
high-performing school districts.
Research question four asked, How are high-performing school districts in California
addressing student mental health and wellness issues? This study found four main themes in
high-performing school districts’ approach to addressing student wellness: professional
development, staffing, programs, and policy changes. Prevention and intervention were the
foundation of these four areas of addressing student mental health and wellness. The intended
outcome by school districts is to reduce stress and create opportunities for support, which would
decrease the anxiety and depression seen in their students and ultimately reduce numbers of
students expressing suicidal ideation.
A robust professional development program is one of the main ways school districts are
increasing awareness and highlighting warning signs for teachers and staff. With the demands on
school sites due to the increased frequency of mental health issues, staffing was an integral
outcome of the survey and interview data. Although not all school districts interviewed had been
able to increase their counseling staff, it was the most common need expressed by both school
site personnel and superintendents. It was clearly recognized that there is an increased need for
on-site therapy and counseling to support student wellness, and this need can only be met
through an increase in support providers to students.
All respondents in both survey and interview data reported some type of program to
address student mental health and wellness on campus. Although the types of programs varied,
STUDENT MENTAL HEALTH AND WELLNESS 81
common themes included parent education programs, peer to peer support programs, and
comprehensive wellness programs. Yet, it was the creation of policy change that seemed to
solidify the student mental health and wellness programs within a school district. By creating
broad policy change, superintendents have worked to adjust calendars, bell schedules, and
homework policies in an effort to reduce student stress and maintain a healthy approach to
academic achievement. Ultimately, it is a combination of measures including policy change
being implemented by the school district that will truly combat mental health and wellness
concerns in a lasting, meaningful way.
Chapter 5 provides further analysis of data and a summary of the research study, along
with implications for practice, limitations, and conclusions.

STUDENT MENTAL HEALTH AND WELLNESS 82
Chapter 5
Conclusions
Mental illness can significantly alter one’s life, causing a loss of interest in activities and
challenging to day to day functioning. It is important for preventative efforts to begin early in the
life of a teenager, as approximately half of all lifetime mental disorders start by the mid-teen
years (Kessler et al., 2007). One of the challenges to addressing mental health is the stigma
surrounding these issues, including depression, anxiety, and substance abuse. Therefore, it is
important for public health, as a field, to work toward removing this stigma and encouraging
people who are suffering to seek treatment and for public agencies to put systems in place for
early intervention and prevention.
In the education sector, leaders also need to consider the role of schools in addressing
mental health, including education, prevention, and intervention. The National Institute on
Mental Health (2005) has described mental disorders within youth as a pervasive recurring
concern that must be examined. With enrollment in the school setting spanning approximately 13
years, schools have the opportunity to support student mental health through the implementation
of programs focused on self-efficacy, coping strategies, and wellness literacy. According to
Kutcher and Yifeng (2012),
Mental health literacy encompasses knowledge and skills that address the biological,
psychological, and social aspects of mental health to increase the understanding of mental
health and mental disorders, reduce stigma, help recognize and prevent mental disorders,
and facilitate help-seeking behaviors in youth along the pathway to mental health care.
(p. 2)

This chapter provides a summary of the study, including a statement of the problem,
purpose of the study, research questions, and a review of the literature and methodology used,
STUDENT MENTAL HEALTH AND WELLNESS 83
followed by findings related to the four research questions. In closing, implications, limitations
and recommendations for future study will be detailed.
Statement of the Problem
Although a significant amount of research has focused on teen mental health, an area that
is lacking research is mental health issues affecting high-performing students and communities.
Prior to the recent focus on teen suicide in schools, a common belief among researchers is that
adolescents with the available wealth and resources are not impacted by mental health issues in
the same way as their peers living in low-income communities. Adolescents in high-performing
school communities are affected by issues of anxiety, depression, suicidal ideation, and drug use,
but little research has been conducted in these communities. These teens are affected by the
stress and pressure to perform and achieve at high levels in academics, athletics, and
extracurricular activities at any cost.
Throughout the literature review, overarching themes were found regarding the effect of
mental health on the high achieving youth community. These themes included substance use,
perfectionism, an intense pressure to perform, and family dynamics, with a clear influence on the
daily lives of students within high-achieving schools. Within each of these areas, research has
revealed certain key dynamics that appear to be connected specifically to the youth within these
affluent communities, demonstrating how dynamics manifest through emotional adjustment and
mental health issues. Ansary et al. (2012) emphasized that achievement in school affects the
well-being of students, as it is considered both a competency and a developmental task.
It is imperative for school leaders and educators to address the mental health issues facing
the youth within high-performing school districts. Research needs to be conducted regarding the
influence mental health issues are having within these school districts and evaluate the impact on
STUDENT MENTAL HEALTH AND WELLNESS 84
student achievement and engagement both within the school and greater community. In
conducting this research, there must be an analysis of current practices to address student mental
health and wellness, which will provide an opportunity for replication in similar high-performing
districts. With teachers and administrators on the front lines to provide intervention and support,
this research will provide crucial data on how to address mental health and achievement for high-
achieving youth across the nation.
Purpose of the Study
It is estimated that three students attempt suicide annually in the typical high school
across the United States (The Trevor Project, 2016). At the beginning of the 2017-2018 school
year, California AB 2246 took full effect, requiring schools to address mental health, specifically
suicide prevention, in grades 7-12 in schools. Protecting the health and well-being of young
people is an ethical imperative for all professionals working with students. The policy in each
school district must be developed in consultation with school and community stakeholders,
school-employed mental health professionals, and suicide prevention experts to address
procedures relating to suicide prevention, intervention, and postvention (O’Donnell, n.d.). This
dissertation will add to the body of literature available for educators when they are developing
and refining their programs to address student mental health and wellness.
Although the mental health concerns of substance use, depression, anxiety, and suicidal
ideation are present among students in low performing schools, the risk factors are significantly
different within high-performing schools, including high levels of perfectionism, intense pressure
to perform, and lack of parental connectedness. This study investigated how mental health issues
of suicidal ideation, depression, anxiety, and substance use in high school students are presenting
within high-performing schools districts in California. The study focused on the influence of
STUDENT MENTAL HEALTH AND WELLNESS 85
mental health on student achievement and understanding how a focus on student wellness can
support achievement of all students on a school campus. Lastly, this study highlighted best
practices in the field of education, focusing on mental health and wellness programs in high-
performing school districts and how they are effectively addressing prevention, intervention, and
postvention in the areas of depression/anxiety, substance use, and suicidal ideation.
Research Questions
This study was guided by the following research questions.
1. How is the mental health of students in high-performing school districts in California
currently manifesting on school campuses?
2. How do mental health issues affect student achievement?
3. How are school districts in California utilizing their financial resources, including
LCAPs, parent organizations, and education foundations to support student mental
health and wellness?
4. How are high-performing school districts in California addressing student mental
health and wellness issues?
Review of Literature
Given the magnitude of the influence education can have on individuals’ lives, research
has placed a significant focus on the needs and risk factors of underachieving students. They are
a group with high needs within the school setting and targeted interventions have been
implemented based on extensive research. In contrast, little research has been conducted
regarding the impact of needs of and risk factors for high-achieving students who can suffer from
a range of issues including anxiety, depression, substance use, and suicidal ideation. Luthar and
Sexton (2004) have argued that researchers and practitioners in the area of education need to see
STUDENT MENTAL HEALTH AND WELLNESS 86
high-achieving students as an at-risk group, needing both prevention and intervention in the area
of mental health.
Although high-achieving youth are being categorized as a new at-risk group, they are not
represented in the research as a focus group or one that needs to be addressed through prevention
programs and direct intervention. Although children who attend high achieving districts often
come from upper-middle class communities and beyond, they are experiencing an uprising in
mental health issues including depression, anxiety, suicidal ideation, and substance use. Research
indicates that adolescents face higher rates of depression, anxiety, and substance abuse when
raised in a suburban home with an income over $120,000 than any other young American
socioeconomic group (Novotney, 2009).
Teens are experiencing a tremendous amount of change and transition in all areas of their
lives, biologically, emotionally, socially, and mentally. These young people experience an
increase in anxiety and depression that can lead to tumultuous teen years (Lund & Dearing,
2013). In a study by Luthar and D’Avanzo (1999), suburban teens in high SES areas were found
to be experiencing adjustment issues that were different from those experienced by teens living
in poverty with violence and few resources for support. Yet, high-achieving teens were
particularly susceptible to internalizing their problems, leading to anxiety and depression (Luthar
& Barkin, 2012; Luthar & D’Avanzo, 1999).
The school and parent communities must partner to address these mental health concerns
within the high-achieving teen group. School-based interventions are needed to support these
students and address substance use, anxiety, depression, and suicidal ideation are critical (Ansary
& Luthar, 2012). An open dialogue among all stakeholders is needed to clearly address the
multitude of issues that are impacting the social-emotional health of this teen community.
STUDENT MENTAL HEALTH AND WELLNESS 87
Parents, teachers, and school leaders must actively seek to support students who are exhibiting
signs of at-risk behavior, which will directly affect their academic and personal growth. Current
changes within the education system have emerged out of this research, requiring schools to
address the impact of mental health issues on the youth.
Through the review of the literature, there overarching themes emerged surrounding the
influence of mental health issues on the youth who are achieving at high levels in the areas of
academics, athletics, and extracurricular activities. These themes include the teens engaging in
substance use, pressure to perform, perfectionism, and family dynamics that are impacting their
daily functioning. Within each of these areas, research revealed key dynamics that are
specifically connected to the high-achieving youth within affluent communities that manifest
through emotional maladjustment and mental health issues.
Methodology
Researchers utilized a mixed-methods study, interviewing 10 current California
superintendents and surveying 56 high school principals, assistant principals, and counselors.
School districts were selected for participation based on the criteria of above average college
entrance exam scores, state test scores, and graduation rates. Quantitative and qualitative data
were obtained through an online survey that consisted of 24 questions. Participants completed
the survey using surveymonkey.com and answered a variety of questions about student mental
health and wellness in their current school district.
The survey questions were guided by four research questions and a review of current
literature, state and federal laws, and education codes. Question types within the survey included
structured responses and selected open-ended prompts regarding the perceptions and behaviors
high school students’ mental health within high-performing high school communities and the
STUDENT MENTAL HEALTH AND WELLNESS 88
type of support school districts are providing. Part 1 of the survey addressed participants’
demographic information including background information and current job status. Part 2 of the
survey consisted of 5-point Likert-scale questions. Part 3 of the survey utilized open-ended
questions and allowed respondents to answer questions more fully.
The interview protocol developed by the researchers consisted of 10 questions and
followed a semi-structured interview format. These interviews were conducted by the researchers
and lasted approximately 30-minutes in person or via phone conference. The researchers’
interview protocol was created to uncover how superintendents are addressing mental health
issues within their districts and the extent of the mental health crisis. The interview protocol was
also designed to be open and unbiased, with the hope of garnering subjective viewpoints of
current best practices supporting students surrounding mental health practices within their
district. Lastly, all data gathered through surveys and interviews were coded to uncover common
themes, analyzed, and interpreted to support the significant research findings as they related to
each of the four research questions.
Findings
The qualitative and quantitative data suggest the following findings related to the four
research questions. Research question one asked, How is the mental health of students in high-
performing school districts in California currently manifesting on school campuses? Both survey
data and interview responses showed high levels of concern regarding student mental health in
high-performing districts with schools reporting increasing levels of frequency from previous
years regarding the influence on students. The main areas of focus that this study uncovered was
that students in high-performing school districts are being affected greatly by stress, depression,
and anxiety, which can lead to concerns regarding suicidal ideation. Yet this concern from the
STUDENT MENTAL HEALTH AND WELLNESS 89
survey data was not echoed in the interviews with superintendents, as they did not express
concerns about substance use, but instead focused heavily on stress leading to anxiety and
depression. Both school site personnel and superintendents reported that high expectations,
pressure to succeed, and fierce competition were affecting the students in high-performing
school systems, causing extreme levels of stress and anxiety.
Research question two asked, How do mental health issues affect student achievement?
Survey data and interviews revealed a high level of concern surrounding the influence stress,
depression, and anxiety can have on student achievement. Students are facing increased pressure
and competition regarding academic achievement, which leads to high levels of stress. The study
showed that schools have protocols and programs in place to address students struggling with
various mental health concerns and continue to support their academic achievement. Schools are
utilizing a team approach with school site personnel to develop support plans for students to
allow continued access to curriculum.
Research question three asked, How are school districts in California utilizing their
financial resources, including LCAPs, parent organizations, and education foundations to support
student mental health and wellness? This study uncovered a variety of ways that high-performing
school districts are fundraising and using school district money for mental health and wellness.
Commonly, school districts use a three pronged approach funding formula for addressing mental
health and wellness, consisting of parent foundations/groups, community grants/partnerships,
and an allocation of general fund dollars through the LCAP. The data suggested that given the
increased demands on schools regarding student mental health, the role of the school counselor
has changed. Thus, school districts are using their money creatively for new staff positions that
may not have been present previously.
STUDENT MENTAL HEALTH AND WELLNESS 90
Research question four asked, How are high-performing school districts in California
addressing student mental health and wellness issues? This study found four main themes in the
approach from high-performing school districts in addressing student wellness: professional
development, staffing, programs, and policy changes. Prevention and intervention were the
foundation of these four areas in addressing student mental health and wellness. The intended
outcome of school districts is to reduce stress and create opportunities for support, which would
decrease the anxiety and depression seen in their students and ultimately reduce the numbers of
students expressing suicidal ideation.
All schools in both the survey and interview data reported having some type of program
to address student mental health and wellness on campus. Although the types of programs varied,
common themes included parent education programs, peer to peer support programs, and
comprehensive wellness programs. However, it was the creation of policy change that seemed to
solidify the student mental health and wellness programs within a school district. By creating
broad policy change, superintendents have worked to adjust calendars, bell schedules, and
homework policies in an effort to reduce student stress and maintain a healthy approach to
academic achievement. Ultimately, it is a combination of measures, including policy change
being implemented by the school district, that will truly combat mental health and wellness
concerns in a lasting, meaningful way.
Implications for Practice
The results and findings of this study emphasize the importance of the specific role that
high-performing school districts play in addressing students’ mental health and wellness in high
schools. Overwhelmingly, all school districts in the study noted elevated student mental health
concerns and a sharp rise of pressure and stress in schools, especially given the current extreme
STUDENT MENTAL HEALTH AND WELLNESS 91
competition in college admissions. This study adds to the current body of literature for
practitioners by identifying the strategies and forward thinking used by school districts and
educational leaders to combat student stress, anxiety, depression, substance use, and suicidal
ideation. This study also confirms that statewide, high-performing school districts are observing
similar concerns with students socially and emotionally. In a broader sense, the goal of the study
was to provide a roadmap to guide educational leaders in navigating the challenges and barriers
associated with supporting student mental health and wellness in schools.
It is noted in this study that Northern California school districts have been tackling
mental health in schools aggressively, whereas this is an emerging topic in most Southern
California districts. In Northern California, there is a deep rooted belief that student mental
health and wellness must be an integral part of the district’s mission. They have made this an
extensive focus with goals and objectives to address student wellness in their board goals, district
road maps, and site planning. Northern California superintendents have been addressing this
issue with the same dedication as new academic standards or a textbook adoption. These districts
are treating student wellness as an integral part of learning programs on each school campus; it is
not considered an add-on program or a week-long spirit ribbon week. Instead, it is a team effort
from the superintendent and board to site administration to school staff, not a charge being led by
a single individual or a parent group hiring a guest speaker. Rather, it is a comprehensive
approach with sustainable, financial backing that is a vital part of the district’s decision making
and core values.
In Southern California, while it is clear from the survey data and interviews that mental
health issues are a focus, these programs tend to be in a newer phase of implementation. These
school districts are shifting their focus to student wellness, opening dialogue with all
STUDENT MENTAL HEALTH AND WELLNESS 92
stakeholders, and beginning the implementation of wellness programs. These school district are
making strides in addressing student wellness, but each district only has pieces of the programs
that are being implemented in Northern California. Some have worked to make important policy
changes, whereas others have increased their mental health support staff, and still others have
opened wellness centers and implemented school wide programming. All of the Southern
California superintendents discussed ways that they were furthering their mission to support
student mental health and wellness.
Although there is no one way to solve this growing epidemic in high achieving
communities, school districts must move aggressively to create policy change that is student
centered and aimed at reducing stress. School districts must make student mental health and
wellness a main priority and focus for the district, adopting a multifaceted approach to
professional development, parent education, and student awareness. Prevention, intervention, and
postvention programming must also be included in the approach, as well as having staffing in
place to increase the needed mental health support on school campuses.
Educators want all students to come to school each day ready to engage in the learning
process. Yet, it is important to remember that students must be emotionally available in order to
engage successfully in the classroom curriculum. If the culture of school and community is
unhealthy, learning will become secondary. If high-performing school districts are not deliberate,
tactful, and consistent in this effort, they will continue to lose students to suicide each year due to
systemic flaws in their educational system.
Limitations
In addition to those mentioned in chapter 1, there are further limitations to the current
study. By exploring a research topic that had not been extensively studied previously, there is a
STUDENT MENTAL HEALTH AND WELLNESS 93
lack of data to compare findings from this study. Additionally, in utilizing survey questions that
were open-ended, the researchers recognized that data regarding programs and services offered
at high schools may have been underreported. Survey respondents did not have a menu of
options from which to select, so there may have been services or programs that they neglected to
identify, thus leading to underreporting in the data provided.
Recommendations for Future Study
Given the critical importance of addressing the support of student mental health, the
researchers recommend the following be considered for future study:
• Expand the current study to include studying high school students and parents,
encompassing all stakeholders.
• Further explore the impact of student mental health and support service by comparing
low achieving school districts with high achieving school districts.
• Explore the impact of mindfulness practices in schools on student achievement.
• Further explore the differences in programs based on funding formulas for various
schools including differences between schools with basic aid funding versus a
traditional Average Daily Attendance (ADD) funding.
• Expand the current study to include best practices being done in private schools.
• Expand research outside of the state of California to discover best practices across the
nation.
• Explore possible changes in the college admissions process to reduce academic
competition in high schools to address the themes of academic stress, pressure to
perform, and perfectionism.
STUDENT MENTAL HEALTH AND WELLNESS 94
• Explore the differences between the structure of mental health services and programs
offered on high school campuses compared with college campuses.
Conclusion
Students in high-performing school districts are under extraordinary, unprecedented
amount of stress and pressure to succeed and this crisis is erupting throughout the state of
California. Students are battling mental health issues of anxiety, depression, substance use, and
suicidal ideation in record numbers, and these issues are manifesting in classrooms and on school
campuses. It is part of educators’ moral imperative to develop programs to address students’
mental health needs in these high-performing school districts. Programs must address students’
needs from all angles, including preventative education, intervention during crises, and
postvention support to ensure smooth and continual access to curriculum.
Educational leaders must start an honest dialogue in schools with all stakeholders to
ratchet down the intense pressure that students feel to achieve. All stakeholders must stop
focusing on college acceptance rates, GPAs, and excessive expectations in student achievement,
athletics, and extracurricular activities. Without these changes, students will continually fail to
meet unrealistic expectations leading to alarming mental health issues that will alter their lives.
Educational leaders can change the tenor of the conversation surrounding student wellness and
mental health and explore how everyone can begin to make meaningful changes that puts
students and their mental wellness first.

STUDENT MENTAL HEALTH AND WELLNESS 95
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STUDENT MENTAL HEALTH AND WELLNESS 101
Appendix A
Survey Letter of Introduction/Explanation
June 1, 2017
RE: Permission to Conduct Dissertation Survey
Dear Superintendent _________,
We are writing to request permission to conduct a dissertation survey and possible interview in
your school district with your high school administrators. We are currently completing our
doctoral dissertation in the Rossier School of Education at the University of Southern California.
The study is entitled: STUDENT MENTAL HEALTH AND WELLNESS IN K-12 HIGH-
PERFORMING SCHOOL DISTRICTS IN CALIFORNIA: BEST PRACTICES FOR
EDUCATIONAL LEADERS
We are looking to anonymously survey principals, assistant principals, and counselors. The
survey will take approximately 15-20 minutes to complete. If you would like to preview the
survey, please click the link below. https://www.surveymonkey.com/r/uscdissertation
The purpose of the study is to focus on how educators within high-performing school districts
are addressing mental health within their student body. The intended outcome of this study is to
shine a light on the mental health issues facing today’s youth within high-performing
communities. The results will be analyzed solely for this dissertation and individual results of
this study will remain absolutely confidential and anonymous, then destroyed when the study has
come to its end. No school district names will be mentioned and no costs will be incurred. Once
completed, you will receive an executive summary of the findings.
Your approval to conduct this study will be greatly appreciated as it will allow us to finish our
dissertation. If you agree, kindly reply to this email and we will email the survey directly to your
school site staff. If you have any questions or concerns, please feel free to let us know.
Sincerely,
Trista Ramirez Jeremy Meadows
USC Rossier Ed.D Student USC Rossier Ed.D Student
Principal, Palos Verdes Intermediate Assistant Principal, La Costa Canyon HS

STUDENT MENTAL HEALTH AND WELLNESS 102
Appendix B
Interview Letter of Introduction
July 1, 2017
RE: Permission to Conduct Dissertation Interview
Dear Superintendent _________,
We are currently working towards an Ed.D. at the University of Southern California with a
dissertation focused on how high-performing school districts are addressing student mental
health and wellness. We are conducting interviews with superintendents and hoping you would
be available for a 15-20 minute phone interview.

The intended outcome of our study is to shine a light on the mental health issues facing today’s
youth within high-performing communities. The results will be analyzed solely for this
dissertation and individual results of this study will remain absolutely confidential and
anonymous. No school district names will be mentioned and no costs will be incurred. Once
completed, your district will receive an executive summary of the findings.

The interview protocol, which includes an overview of this study, is attached for your reference.
In order to ensure accuracy, the interview will be audio recorded with your permission. We
would sincerely appreciate your participation and we can conduct the interview at your
convenience. Please let us know a time and date that will work in your schedule and one of us
will be in contact to confirm the interview.

Sincerely,
Trista Ramirez Jeremy Meadows
USC Rossier Ed.D Student USC Rossier Ed.D Student
Principal, Palos Verdes Intermediate Assistant Principal, La Costa Canyon HS

STUDENT MENTAL HEALTH AND WELLNESS 103
Appendix C
Survey Questions
Survey Topic: STUDENT MENTAL HEALTH AND WELLNESS IN K-12 HIGH-
PERFORMING SCHOOL DISTRICTS IN CALIFORNIA: BEST PRACTICES FOR
EDUCATIONAL LEADERS

Confidentiality: Your responses to the survey questions will be confidential. While your
answers will be shared for the purpose of the study, your identity will remain anonymous. No
names of people or places will be used in this study.

Purpose of the Study: The purpose of this study is to focus on how educators within a high-
performing school district are addressing mental health within their student body. These mental
health issues include substance use, depression, and suicidal ideation. The intended outcome of
this study is to shine a light on the mental health issues facing today’s youth within high-
performing communities. The basis for this study is founded on the increase of observed at-risk
students and consistently elevated scores on the California Healthy Kids Survey within a high-
performing school district in Northern California. For the purposes of this study, a high-
performing school district is being defined as one with a particular range of median income,
college admission test scores, and percentage of students matriculating to a 4-year college.

1. What school and school district do you work at? This will not be used to identify any specifics
in the study, but solely for tracking survey completion rates.

2. What is your job title?

Principal
Counselor
School Psychologist
Assistant Principal
Other (please specify)

3. About how many years have you been in your current position?

Less than 1 year
At least 1 year but less than 3 years
At least 3 years but less than 5 years
At least 5 years but less than 10 years
10 years or more

4. Does your school administer the CA Healthy Kids Survey?

No
Yes
If yes, how does your school use the data for mental health purposes?
STUDENT MENTAL HEALTH AND WELLNESS 104

5. Do you consider student mental health a concern in your school? (Depression, substance
abuse, suicidal ideation)

Yes
No
I don’t know

6. Are you aware of CA Assembly Bill 2246 regarding suicide prevention policies in schools?
No
Yes
If Yes, please explain how your school is addressing the new policy:

7. In your opinion, are student mental health concerns increasing in your school? (Depression,
substance abuse, suicidal ideation)

Yes
No
I don’t know

8. Please estimate the number of students at your school expressing suicidal ideation annually

0
1-10
11-20
21-30
More than 30
Other (please specify)

9. To your knowledge, what is the approximate number of suicide attempts in your school
annually?

0
1-2
3-4
5 or more
Other (please specify)

10. What is your level of concern with student mental health in your school?
0 1 2 3 4 5

11. At what level is depression impacting the students attending your school?
0 1 2 3 4 5

12. At what level is suicidal ideation impacting the students attending your school?
0 1 2 3 4 5
STUDENT MENTAL HEALTH AND WELLNESS 105

13. At what level is substance use impacting the students attending your school?
0 1 2 3 4 5

14. What is your level of concern regarding mental health issues impacting your students’
achievement?
0 1 2 3 4 5

15. Have procedures and/or training been put into place to support teachers and staff to help
identify students with mental health concerns in your school?

No
Yes, please explain:

16. Have programs, procedures and/or interventions been put in place to support student
achievement when s/he is impacted by a mental health concern in your school?

No
Yes, please explain:

17. Is student mental health and well-being specifically addressed in your district’s Local Control
Accountability Plan (LCAP) or school/district plan like the SPSA, board goals etc.

Yes
No
If yes, how is it being addressed?

18. Has your district allocated funding through any of the following means to address student
mental health and well-being? (LCAP, Ed Foundations, Site/District Funding)

Yes
No
If yes, how is the funding being utilized?

19. What mental health and wellness programs have been established to support students within
your school?

20. What current services or interventions are lacking at your school to support student mental
health and wellness?

21. What impact if any, has the district leadership had on your school’s mental health programs?

22. Do you consider the job of the school counselor different today than 5 -10 years ago?

No
Yes
STUDENT MENTAL HEALTH AND WELLNESS 106
If yes, how/why?

23. Thinking statewide, what are the best practices being utilized by high school administrators,
counselors and school psychologists to address mental health and wellness in high schools?

24. Thank you for completing our survey. If you are willing to be interviewed about this same
topic, please provide your contact information. The interview would be apx. 30 minutes long in-
person or through video conference depending on proximity.

STUDENT MENTAL HEALTH AND WELLNESS 107
Appendix D
Superintendent Interview Protocol
Respondent’s Name: ______________________________________________
Respondent’s Position: ____________________________________________
Interviewer: _____________________________________________________
Date: __________________________________________________________
Method of Interview: _____________________________________________

Interview Guidelines

Participation: As a participant in this study, you are responsible for what you decide to share
and always have the right to pass on any question if you do not feel comfortable for any reason.

Respect and Responsibility: Throughout this interview, it is my intention to actively listen to
what you are sharing and treat you with respect throughout the process. You are encouraged to
openly share your own experiences when answering the interview questions.

Confidentiality: Your responses to the interview questions will be confidential. While your
answers will be shared for the purpose of the study, your identity will remain anonymous. No
names of people or places will be used in this study, and a pseudonym for participating school
districts will be used.

Purpose of the Study: This study will show how mental health issues (suicidal ideation,
anxiety/depression, hopelessness/sadness and alcohol/drug use) in high school students are
presenting within several high-performing schools districts in California. The study will bring to
light the impact mental health has on student achievement to assist school leaders in
understanding the importance of focusing on student wellness to support school-wide
achievement. While these same mental health concerns of substance use, depression, and suicidal
ideation are present for students in low performing schools, the risk factors are significantly
different including high levels of perfectionism, intense pressure to perform, and lack of parental
connectedness. Finally, and most importantly, this study will highlight best practices in the field
of education, focusing on mental health and wellness programs in high-performing school
districts that are effectively addressing prevention, intervention and postvention on the school
campuses across the state.

STUDENT MENTAL HEALTH AND WELLNESS 108
Interview Questions

Research Question 1: How are high performing school districts in California addressing mental
health issues (depression, anxiety, suicidal ideation, drug and alcohol use)?

1. What are some of the most common mental health issues facing the students in your
district high schools?

2. Have you seen a change in the mental health needs of the students in your district?
a. If no, please explain.
b. If yes, how have they changed?

3. Has there been a change or addition in any of the following in your district to support
student mental health?
a. Programs:
b. Parent Education:
c. Staffing:

Research Question 2: What is the impact of mental health issues on student achievement?

1. How do you see mental health issues impacting student achievement in the classroom?

2. What type of professional development has been provided to the teaching staffs regarding
student mental health issues? To the site administration?

3. In what ways does the district office support the site administration in addressing student
mental health to limit the impact on student achievement?

Research Question 3: How are school districts’ in California utilizing their financial resources
including LCAP, Parent Organizations, and Education Foundations to support student mental
health and wellness?

1. What financial resources have been allocated for to school sites to provide programs to
support student mental health? Where have these resources come from?
a. If additional resources have been allocated, how has this made an impact in your
district? In the community?

Research Question 4: What are the best practices utilized by school districts, high school
administrators, and counselors to address mental health and wellness in California high schools?

1. Of the mental health programs that are currently established in your district, what do you
feel is most effective in supporting your students?

2. What gaps do you see in your current student wellness program that need to be
addressed?

Abstract (if available)

Abstract The purpose of this study was to identify the influence of mental health on student achievement in high-performing school districts in California and investigate how a focus on student wellness can support achievement on the school campus. This study also aimed to determine the best practices currently being utilized by high-performing school districts in California to effectively address prevention, intervention, and postvention in the areas of depression, anxiety, substance use, and suicidal ideation. A mixed-methods study was implemented with 56 high school site leaders who completed a 24-question survey about student mental health and wellness in their respective school districts. Ten current superintendents, 5 from Southern California and 5 from Northern California, were interviewed as well. ❧ Through the process of triangulation, the study’s findings indicated that high expectations, pressure to succeed, and fierce competition are causing extreme levels of stress and anxiety for students in high-performing school districts, which can lead to concerns regarding suicidal ideation. These school districts have protocols and programs in place to address students struggling with various mental health concerns. A team approach allowed for the development of student support plans that allowed continued access to curriculum. Many districts have programs that are grounded in prevention and intervention to reduce student stress and create opportunities for support. Finally, the creation of policy change, such as adjusted calendars, bell schedules and homework policies, seemed to solidify the student mental health and wellness programs within a school district. Overall, this study presents the best practices that are currently being employed within high-performing school districts to address student mental health and wellness.

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Asset Metadata

Creator Ramirez, Trista Robin (author)

Core Title Student mental health and wellness in K-12 high-performing school districts in Northern California: best practices for educational leaders

School Rossier School of Education

Degree Doctor of Education

Degree Program Education (Leadership)

Publication Date 04/12/2018

Defense Date 03/05/2018

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag AB2246,affluent,anxiety,Assembly Bill 2246,basic aid,Depression,high-performing schools,intervention,LCAP,Mental Health,mindfulness,MTSS,OAI-PMH Harvest,perfectionism,pressure,social and emotional,Stress,student supports,substance use,suicidal ideation,Suicide,wellness

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Castruita, Rudy (committee chair), Garcia, Pedro E. (committee member), Park, Charles (committee member)

Creator Email tristara@usc.edu,tristaramirez310@gmail.com

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c89-3478

Unique identifier UC11671312

Identifier etd-RamirezTri-6233.pdf (filename),usctheses-c89-3478 (legacy record id)

Legacy Identifier etd-RamirezTri-6233.pdf

Dmrecord 3478

Document Type Dissertation

Rights Ramirez, Trista Robin

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the a...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA