Identifying Challenges and Developing Strategies and Solutions

Challenge/Gap

Strategy/Solution

Inadequate access to mental health care in schools and communities 

• Implement programs to grow and diversify the school mental health workforce
  • Examples: Scholarships, loan forgiveness, community health workers, diversity initiatives
• Improve insurance payment for school-based mental health, particularly through Medicaid 
• Expand telemental health in schools, prioritizing schools with mental health workforce shortages 

Loneliness and lack of connectedness among youth due to isolation during the COVID-19 pandemic and the over-use of social media to fill the gap

• Engage youth in advisory councils on student mental health 
• Provide students with media literacy education to counteract the negative effects of social media

Influence of racism and bias on educators’ response to behaviors associated with student mental health challenges

• Establish training, accountability measures, and incentives for educators to identify and respond effectively and equitably to behaviors linked to mental health challenges 
• Utilize school climate and discipline data to drive continuous improvements in policies and practices

Ongoing stigma surrounding mental health concerns

• Implement mental health literacy training for students
• Conduct social media campaigns and encourage school staff to check in regularly with students about mental health to de-stigmatize mental health challenges and promote help-seeking behaviors

Challenge/Gap

Strategy/Solution

Inconsistent messaging due to silos in public health and education 

• Create a standing committee to meet regularly with a pre-determined plan and defined responsibilities that can scale up during PHEs
• Through the committee, develop a PHE communications strategy to support timely and organized dissemination of consistent information in accessible, plain language

Loss of staff with experience from the COVID-19 pandemic 

• Foster public trust by promoting credibility and expertise of new public health and education workforce 
• Engage staff with COVID-19 pandemic experience in documenting lessons learned, developing trainings for future staff, and developing PHE plans

Insufficient evidence and information to inform timely decision-making 

• Agree on source(s) of information to inform shared guidance from all partners
• Provide training, resources, and exercises for staff to support and practice rapid and effective approval processes during a PHE

Diverse language and culture needs are not well represented during planning and response

• Hire diverse and representative leaders in public health and education
• Partner with diverse and marginalized communities to develop PHE guidance to ensure their needs, preferences, and voice are reflected

Challenge/Gap

Strategy/Solution

Lack of equitable access to information across languages, cultures, geographic area, and demographics

• Identify, foster, and sustain relationships with trusted community partners to champion communications during PHEs
• Establish sustainable funding for internet and cell phone access in rural and tribal localities

Poor communication reduces public trust

• Conduct robust evaluation to determine effective communication strategies

Ensuring the dissemination of accurate, tailored information and countering disinformation

• Examples: Issuing unified, consistent messages from all agencies and organizations; tailoring information to meet the needs of the audience; communicating scientific information in a way that is appropriate for the general public; educating the public to identify misinformation; reducing politicization

• Disseminate clear guidance tailored to various audiences and media channels with consistent message and terminology
• Hold town halls to allow direct, bi-directional communication 

Managing the flow of rapidly changing information  

• Examples: Notification to partners of changes to guidance; maintaining “version control” of guidance documents; effectively communicating knowns and unknowns; managing public expectations around changes; issuing updates in a timely manner

• Establish procedures to enhance information-sharing among federal, state, tribal, and local agencies 
  • Example: Advance notification of changes from federal partners

Challenge/Gap

Strategy/Solution

Lack of effective, coordinated state/tribal agency support structure for schools  

• Develop clear, defined job descriptions for state/tribal staff to ensure the right people are involved with developing and practicing PHE plans 
• Establish state/tribal infrastructure for collaboration and proactive planning for PHE response in schools
• Provide regular PHE trainings and practice exercises for state/tribal agency and district staff 
  • Examples: Training new state school board members, state superintendents, and state school nurse consultants through their professional associations

Ensuring guidance issued to schools is feasible and balances public health with the Whole School, Whole Community, Whole Child model 

• Require a school nurse in every school and a state school nurse consultant in every state to increase capacity to interpret guidance and implement mitigation measures
• Establish an advisory committee with state/tribal, local, and family partners to inform guidance and assess feasibility

Lack of coordination on messages and guidance, leading to conflicting information 

• Identify trusted community members as communications champions
• Implement a communication plan that facilitates timely, coordinated information that is jointly disseminated by all state/tribal-level partners

Insufficient district and family input into decision-making

• Establish an advisory committee with state/tribal, local, and family/youth partners
• Implement a process for collecting timely feedback on proposed policies and recommendations 

Challenge/Gap

Strategy/Solution

Lack of adherence to and evaluation of emergency plans 

• Establish a proactive PHE planning and evaluation process with clear roles and authority
• Disseminate clear and concise PHE plans that allow for local flexibility in implementation

Inconsistent funding for public health and public education

• Implement a process for distributing emergency funding and services equitably
• Streamline requirements and allow for local flexibility in using funds

Insufficient diversity in existing partnerships

• Establish a mechanism to improve communication between state/tribal and local entities
• Create a partner organizational chart to identify diverse groups to engage

Erosion of public trust

• Increase transparency in decision-making and demonstrate use of evidence and data
• Collaborate with partners to disseminate clear and concise communications, with opportunities for public input

Challenge/Gap

Strategy/Solution

Lack of recovery planning, including lack of data collection and analysis to identify needed recovery supports

• Convene state/tribal-level committee to develop an emergency operations plan with school and community feedback that includes short- and long-term recovery components
• Establish a data dashboard to assess changes in student, teacher, school nurse, and staff health and well-being by comparing pre- and post-PHE measures 

Insufficient understanding of how schools operate, their important role during PHEs, and the resources they need

• Clarify and communicate to schools who within state/tribal governance structure has authority to make decisions for education and health during PHEs (including if that decision authority is given to the local community)
• Establish a repository of key contacts at the state/tribal level for PHE support

Inadequate community and partner inclusion in the PHE planning process 

• Regularly conduct focus groups and/or engage students and community advocacy groups to gather input on emergency operations plans and participate in after action reviews
• Ensure that interventions and mitigations are universally accessible across language, literacy, culture, and disability

School workforce and resource constraints

• Identify strategies to consistently resource schools  and avoid a funding influx followed by sharp drop-offs after PHEs
  • Examples: Federal funds, Medicaid, other third-party billing
• Work with higher education to develop training programs for school health and mental health professionals to expand the workforce