NYP-Columbia Program Empower Schools to Support Students' Mental Health

The start of the school year can be exciting as students reconnect with friends, meet their teachers, and pursue new interests and activities. But for some, the pressures of academic performance, social dynamics, and personal expectations can take a toll on mental health, often in ways that are not immediately visible.

This is particularly true for children and adolescents facing mental health challenges. According to CDC data, nearly 1 in 5 children ages 3-17 have a mental, emotional, or behavioral disorder, such as anxiety, depression, ADHD, autism spectrum disorder, disruptive behavior disorder, or Tourette syndrome.

“As we begin this school year, parents, caregivers, and educators must stay vigilant for signs of stress or concerning behaviors,” said Sebastian Cisneros-Trujillo, MD, medical director of the School-Based Mental Health Program at New York-Presbyterian Morgan Stanley Children's Hospital.

Dr. Cisneros-Trujillo, a psychiatrist and instructor in psychiatry at Columbia University Irving Medical Center, emphasized that early diagnosis and treatment are vital for children with psychiatric and behavioral disorders. Unfortunately, many children and families lack access to high-quality, localized behavioral health care, making essential interventions out of reach.

Bridging the psychiatry gap

School-based programs can play a transformative role in bridging the mental health gap. Since the early 1980s, the NYP-Columbia School-Based Mental Health Program has worked to ensure that students receive timely, effective treatment without the added barriers of travel or cost. The program provides behavioral health services, including assessment, treatment, and referrals, through on-site clinics embedded in public schools in Upper Manhattan. These clinics are staffed by a multidisciplinary team affiliated with Columbia’s Department of Psychiatry.

Columbia Psychiatry News spoke with Dr. Cisneros-Trujillo, about the impact of school-based care, why incorporating social-emotional learning into curriculums is critical for success, and how the NYP-Columbia program partners with communities and families, among other topics.

What are the most significant mental health challenges facing students in grades K-8?

We continue to see a rise in children needing additional educational and mental health support, even years after the COVID-19 pandemic. These students are dealing with anxiety, depression, self-harm, grief, trauma, and attention-deficit/hyperactivity disorder. The pandemic amplified these concerns, particularly in underresourced communities where additional layers of trauma and loss are prevalent.

Can you describe the types of interventions provided by site-based mental health professionals?

The School-Based Mental Health Program collaborates with 14 public schools (K-8) in Upper Manhattan to provide targeted treatment based on each child’s needs, offering individual and group psychotherapy, psychopharmacology, and case management services. The clinical team also delivers prevention initiatives, including teacher training and caregiver workshops. Schools are ideal settings for students to access prevention and intervention services in a non-stigmatizing environment.

What key observations during your time with the program inform your role as medical director?

Having served in our school-based program as an attending psychiatrist for three years, I cannot overemphasize the importance of collaboration among mental health professionals, school staff, and families in creating a supportive environment for children and adolescents. Schools are often the frontline in identifying youth and families with mental health needs. Early identification and intervention can significantly alter a young person’s life trajectory.

Do you have data demonstrating the program's impact on student well-being?

In recent years, we’ve seen significant improvements in school attendance and academic performance, particularly in math and ELA proficiency. Our preventative efforts, including trauma-informed interventions for teachers, have led to better classroom coping mechanisms, enhanced student engagement, and improved classroom management. Teachers report higher satisfaction as a result of these interventions.

What strategies enhance students’ social, emotional, and behavioral adjustment?

Our team works closely with schools to support students, caregivers, and teachers. Caregiver support and family services, including case management, are essential, especially in historically marginalized communities. Our program primarily serves students in predominantly Latinx communities surrounding the medical center and hospital. We also assist teachers in implementing trauma-informed behavior management strategies and teaching coping techniques that foster an engaging learning environment. These strategies directly benefit students, and teachers feel supported as partners in managing challenging situations.

How does the program engage and support parents and caregivers?

The New York-Presbyterian Hospital Community Health Needs Assessment 2022-2024 identified mental health as the community's primary health concern. Support for patients, caregivers, and teachers is crucial, and the need continues to grow. Clinicians provide skill-building workshops—in both English and Spanish—for families and the community on topics like emotional wellness, social-emotional learning, and the early identification of children in need of mental health services. Social-emotional learning helps students understand their emotions and develop social awareness, leading to increased academic achievement, heightened self-awareness, and improved behavior.

What are the future directions for addressing the school community's social-emotional learning and psychiatry needs?

Future directions include refining our programming to better meet the community's needs, particularly in light of the pandemic's emphasis on educational disparities. Continued collaboration with schools to address social-emotional learning and psychiatric needs, along with expanding access to children’s mental health services, will be crucial in creating a supportive and healthy environment for our youth.