The Carolina Network for School Behavioral Health (CNSBH), established in 2010, is a multidisciplinary school mental health network among professionals in North Carolina and South Carolina, including K-12 educators, academics, and mental health professionals. From its inception, the network has aimed to facilitate productive collaborations within and between states, including clinical activities, empirical endeavors, grant writing, policy development, and dissemination of evidence-based practice. The goal of each of these activities has been to promote a full continuum of effective mental health promotion, prevention, and early intervention for youth in both states to promote behavioral and physical health, wellness, academic achievement, and postsecondary vocational success. 

Through partnerships with schools, community agencies, families, and youth-serving systems and organizations, the CNSBH hopes to improve all children's educational outcomes, especially those with unmet mental health needs. The CNSBH seeks to accomplish this mission by 1. Understanding and facilitating communications between local and state initiatives to promote supportive policies to expand and improve SMH in North Carolina and South Carolina, 2. Building a full continuum of effective strategies focused on mental health promotion, prevention of social, emotional, and behavioral problems, early intervention and intervention for students in general and special education, 3. Evaluating the quality of SMH in North Carolina and South Carolina to ensure that students remain in school, positively engaged in their home life, and out of trouble, 4. Building and sustaining action to promote a shared agenda for mental health-education-family collaborations with essential stakeholder representation through family-driven and youth-guided programs and services, and 5. Promoting awareness and reducing stigma surrounding mental health needs and the critical links between positive mental health and school success for North Carolina and South Carolina youth. 

The School Behavioral Health Team received funding from BlueCross® BlueShield® of South Carolina Foundation (June 2021-June 2024) to create an infrastructure to recruit, train, and retain school mental health supports and professionals by working with both undergraduate and graduate students across the Carolinas. The Enhancing Capacity in School Mental Health (ECSMH) program, now funded by The Duke Endowment (January 2025-December 2027), recruits undergraduate students to participate in an internship designed to support the tiered mental health needs of North and South Carolina public school students and families by helping to close any gaps in service provided by school mental health professionals (e.g., mental health clinicians, social workers, counselors, psychologists).  ECSMH targets undergraduate students interested in pursuing a future career in school mental health. Additionally, this program recruits graduate students enrolled in mental health related programs (i.e., counseling, school psychology) to increase their training in school mental health and connect them to “school-based” positions.

Through ECSMH, the School Behavioral Health Team provides the hands-on and timely experience of assisting NC and SC in building and training a well-qualified school mental health workforce. This program also builds our connection to schools and districts across the Carolinas that need to better support the mental health challenges facing their students and families. 

Along with researchers at East Carolina University, the SBHT was funded by the Institute for Education Sciences (IES) on a research grant titled Improving Social, Emotional, Behavioral, and Academic Functioning of Elementary School Students through the Interconnected Systems Framework. This project is more commonly referred to as Early Supports for Student Success, and was funded from 2020-2025. This project aims to improve the Social, Emotional, Behavioral, and Academic functioning of elementary school students. It will evaluate the best way to support students using the Interconnected Systems Framework , an evidence-based approach to supporting students' mental health. This project will take place in 16 North Carolina and South Carolina schools, following one cohort of students during their third to sixth-grade years. This project will inform many aspects of SBH programming through its enhanced universal screening of students for SEBA functioning, improved education-community mental health connections, expanded District-Community Leadership Team support, more intentional involvement of students in both general and special education, and better use of disaggregated data to address disciplinary inequities for students of color. Additionally, SBH programming will be further informed through the project's aims to understand the contribution of the ISF on overall team functioning and student needs, as well as the cost-effectiveness of implementing the ISF in comparison to current SBH programming efforts. 

In 2011, in recognition of significant emotional and behavioral needs of children in SC, particularly students contending with ED, the South Carolina (SC) School Behavioral Health (SCSBH) Community was formed to foster a unified agenda for effective prevention, early intervention and treatment of student emotional and behavioral problems, capitalizing on the universal natural environment of schools and focused on achieving outcomes valued by families, and health and educational systems.  A major goal of the SCBHC was to help the SBH agenda in SC to be more coherent, and to involve all disciplines and systems (e.g., education, mental health, child welfare, juvenile justice, disabilities, primary health care) in working together to improve the depth, quality, and impact of SBH services in the state.  

The Southeastern School Behavioral Health Community (SSBHC) builds on the work of the SCBHC and now enables multiscale learning and collaboration with 12 other states in the southeast region, enabling showcasing SC’s leadership in this area, and bringing in lessons learned, insights and resources from these other states. The SSBHC includes diverse stakeholders from southeastern states, representing families and youth, leaders and staff from youth serving systems (e.g., education, mental health, juvenile justice, child welfare, primary care), government officials, researchers, advocates and others, and has close relationships with national centers for school mental health and PBIS, a range of other regional organizations, and widespread and deep relationships with leaders and staff from diverse student-focused systems in SC. SSBHC began hosting annual conferences in 2014, bringing together professionals from across the US to promote best practices in school behavioral health policy, practice, and research. 

Through the support of the PCORI award, leaders for the SSBHC conducted forums throughout SC on critical issues to advance SBH.  The outcomes of the annual forums (2015-2017) were the identification of key conference themes and special populations: 1) building school-wide approaches, 2) promoting family-school-mental health and other youth serving system partnerships, 3) assuring that programs and services are of high quality and are evidence-based, 4) enhancing implementation support for effective practices, 5) promoting cultural competence/humility in all efforts and 5) child welfare, juvenile justice, and military connected youth. Findings from these forums have lead to additional funding for multiple projects as well as the book, School Behavioral Health: Interconnecting Comprehensive School Mental Health and Positive Behavior Support. 

This five-year longitudinal study, funded by the Patient-Centered Outcomes Research Institute (PCORI), included partners at the Medical University of South Carolina, University of Maryland – Baltimore, National Center for School Mental Health, Baltimore City Public Schools, Greenville (SC) County Schools, and the Greater Greenville Mental Health Center (SC DMH). Through this project, the SBHT sought to understand the incremental impacts of evidence-based enhancements to a framework for evidence-based practice in school behavioral health. Partnering with 22 middle schools in the target districts, the project evaluated the impact of an intervention on increasing the number of students and families who received services and expressed satisfaction with them; the impact on students’ social, emotional/behavioral, and academic outcomes; and the follow-up effects in high school. The project also examined the impact of a mental health literacy curriculum, cultural responsiveness and equity training with school mental health clinicians, and use of a modular, evidence-based practice system. It aimed to increase family engagement in school mental health systems and utilized the Extension for Community Healthcare Outcomes (ECHO) model to disseminate knowledge across sites statewide.

Learn more at partneringforstudentwellness.com.

This project, funded by Blue Cross Blue Shield (BCBS) of South Carolina, involved a program evaluation of the Ending the Silence (ETS) suicide awareness program for students, staff, and families by the National Alliance on Mental Illness (NAMI) SC. The evaluation team used surveys to assess changes in knowledge and perceptions of mental health conditions, stigma, suicide awareness and prevention, and the benefits of early intervention. They also measured whether the presentation led to youth seeking treatment. Team members conducted qualitative interviews with participants to gather in-depth insights on their knowledge of suicide and mental health, their preparedness to respond to suicidal ideations, and their satisfaction with the ETS training.

This project focused on building resilience among children contending with poverty in Florence, Darlington, and Marion counties in South Carolina. Funding supported the creation of sustainable Safety & Support Teams (SSTs) in schools, including SBMH clinicians working closely with school nurses and counselors. The goal was to move beyond fragmented approaches for students with emotional/behavioral (EB) issues toward an integrated system of effective practices to prevent and reduce problems while promoting resilience and healthy functioning. BCBS Foundation grant funding supported the placement of SBMH clinicians in elementary schools in these counties. These clinicians provided daily mental health intervention and participated in SSTs that included school-employed staff and family members. The teams coordinated prevention, early intervention, and treatment strategies across a multi-tiered system of support (MTSS) and used data to guide continuous improvement.

Funding from PCORI supported two high-quality conferences in 2016 and 2017 on effective school behavioral health (SBH) for patients, families, youth-serving professionals, and other stakeholders in Myrtle Beach, SC. The conferences addressed a three-pronged agenda: engaging patients and stakeholders in training, research, and dissemination. The project increased engagement and collaboration between the research community and stakeholders. Specifically, the grant:

1) Provided state-of-the-art training on evidence-based prevention, early intervention, and treatment in SBH.

2) Supported a research pre-conference with patients, clinicians, researchers, and stakeholders, focusing on PCORI principles, Comparative Effectiveness Research, and collaborative strategies for SBH improvement in SC.

3) Disseminated information through a listserv, website, newsletters, and other media to share evidence-based practices and research progress in SBH across the state.

This National Institute of Justice-funded study evaluated the efficacy of the Interconnected Systems Framework (ISF) in improving school safety, climate, behavioral and emotional health, and academic outcomes. It was the first experimental study to assess the impact of ISF beyond that of Positive Behavioral Interventions and Supports (PBIS) alone or PBIS combined with separately functioning school mental health (SMH) clinicians. The study included 24 elementary schools in South Carolina and Florida that had implemented PBIS with high fidelity but minimal existing SMH services. Schools were randomly assigned to one of three groups: PBIS only, PBIS+SMH, or ISF. Students and teachers completed climate and exposure surveys. The study hypothesized and later confirmed that students in ISF schools experienced fewer disciplinary referrals and fewer emotional/behavioral concerns. The findings expanded knowledge in the field and have potential implications for national judicial and educational policy.