School-Based Mental Health Education: Program Effectiveness and Trends in Help-Seeking

One of the strategies to address the persistent youth mental health crisis is school-based educational programming. This paper reports on two distinct studies regarding Coming Up for AIR, a school-based mental health education program: (1) program effectiveness, measured as gains in student mental health literacy; and (2) trends in help-seeking behavior before, during, and after the pandemic. A survey on program content was administered to assess program effectiveness. Data collected between 2020 and 2023 from four schools yielded 473 responses. A comparison of pre- and post-scores demonstrated statistically significant gains in program content. Mental health literacy improved across gender and grade level (8th, 9th, and 10th), as well as for students with prior exposure to a mental health curriculum. In the second study, help-seeking behavior was evaluated before, during, and after the pandemic. While other programs measure intention, Coming Up for AIR measures actual behavior as students can ask for help for themselves or a friend. Data did not reflect individual student responses, but rather were aggregated and provided the number of students per presentation who requested help. Archived declaration card data from January 2019 through February 2024 was accessed, representing 28 different schools and 16,289 middle and high school student responses. School-level data were analyzed by grade level (middle school or high school) and date (pre-, intra-, or post-COVID-19). Significant differences in self-referral were found for both grade level and presentation date. Self-referrals were significantly higher post-COVID-19 compared to pre-COVID-19 with middle schoolers increasing 90% and high school students increasing 36%. Analysis of friend referrals showed a significant difference for grade level, but not presentation date. Again, middle school students were more likely to make a referral than high schoolers. The data suggest that the mental health crisis in middle school students persists at an alarming rate. Schools are at the forefront of addressing mental health issues for youth. External educational programming can bring awareness to mental health concerns and promote help-seeking in youth.