The increasing mental health challenges faced by students, particularly in under-resourced communities, force us to examine how we have historically viewed mental health services as something we “provide,” indicating a more hierarchical and expert, top-down approach rather than something we “co-create” with the input of the experts or those who are experiencing it. The MOMENTUM Residency was founded during the COVID-19 pandemic to build upon the lessons learned from this time. It emphasizes the importance of co- creating solutions, challenging the status quo to foster progress, and to equip professionals with the necessary skills for our constantly evolving workforce.
The pandemic revealed that traditional “business as usual” approaches were inadequate and ineffective in addressing the youth mental health pandemic that was illuminated by the pandemic. By pivoting to community-centered care that provides an opportunity for families and students to define their own priorities, we can apply a trauma-informed approach at a systems level.
Bessel Van der Kolk’s (2014) work on narrative reconstruction for healing is typically applied at the individual level, but there are lessons to be learned by applying it to a macro/systems level. Just as trauma survivors need to reclaim their personal narratives for healing, communities, and systems experiencing collective trauma benefit when those most affected can shape the narrative of response and recovery. Schools are uniquely suited to address collective trauma in communities that have experienced historical marginalization and the social factors that contribute to poor health and mental health outcomes.
This shift from top-down to collaborative care models mirrors the core principles of trauma recovery:
- Safety and Empowerment – When students and families define their priorities, they regain the agency lost during trauma.
- Transparency and Trust- Co-creation builds trust that may have been damaged by systemic responses to trauma.
- Voice and Choice – Centering student and caregiver voice counteracts the helplessness that characterizes traumatic experiences.
- Cultural Responsiveness – Children and family- defined priorities naturally incorporate culture and nuance that top-down approaches can miss.
By moving from expert-driven to co-created models, school mental health systems can avoid inadvertently replicating a traumatic system’s experience.
PARTNERSHIP AND IMPACT: THE MOMENTUM RESIDENCY
The MOMENTUM Residency (“MOMENTUM”) was founded to address the critical mental health crisis among DC public school students and the need to develop a pipeline of school mental health clinicians who are prepared to better support students, particularly those impacted by trauma, poverty, and oppression. The MOMENTUM Residency’s mission is to equip early-career clinicians with knowledge, support, and strategies to ensure DC public school students have equitable access to high-quality, culturally-nuanced, and integrated mental health and wellness services. MOMENTUM’s professional development centers its learning on community voice, with students, caregivers, and teachers serving as part of our faculty.
Residents work full-time in schools while learning with a multi-sectoral faculty to co-create practices and interventions, both macro and micro, drawing on research and integrating social context into practice. MOMENTUM’s relationship-based model relies on sharing and collaboration among trainees. The MOMENTUM model addresses resiliency in individuals, communities, and systems, with an emphasis on personal reflection and relationships, grounded in children and family perspectives.
As MOMENTUM developed its model and approach, much attention was given to feedback from existing clinicians regarding their ability to sustain in school- based work. The majority of the feedback focused on developing confidence, having an excellent supervisor, practicing well-being and self-awareness, and mitigating implicit bias and savior complex. Less emphasis was placed on other factors such as flexibility, a hybrid work schedule, or training. When clinicians (residents) can co-create a shared experience, they increase their emotional investment, leading to a strong commitment to the work.
The MOMENTUM model was developed as a parallel process to the co-creation of mental health services, giving clinicians a voice and choice in determining what was needed and how to build their skills, confidence, and sustainability. Through alignment of training, supervision, mentorship and a unique capstone project, MOMENTUM ensures a focus on the voice and perspective of caregivers and parents, teachers and staff, and students as they co-create interventions and approaches that lean into community expertise.
WHY IS IT INNOVATIVE? PARTNERSHIPS THAT BUILD COMMUNITY
A review of postgraduate training programs in school mental health showed a number of options for adults, but very few focused specifically on children. Of the few that do exist for children, they are not centered in school settings and are not comprehensive, addressing what clinicians noted they needed to sustain the work.
Given the well-documented crisis facing youth mental health and access to care, this approach is critical and timely. Based on research available up to October 2024, approximately 50-60% of children who receive their first mental health services in schools are there because school personnel (teachers, counselors, school psychologists) identified the mental health concern (Burns 2024). Furthermore, some studies highlight that schools not only provide services but also play a crucial role in identifying mental health needs that might otherwise go undetected (Braverman, 2009). In a school setting for youth who are furthest from opportunity and access, it is often the school that can provide the most consistent support for a child’s mental health needs. When schools embrace family and youth engagement in the co-creation of policies and programs, there is a deeper connection and buy-in regarding how to address challenges of all kinds, including mental health. This co-creation reduces stigma and allows for more impactful programs and effective approaches.
External community partnerships can address uncovered gaps when families are involved in the process. MOMENTUM introduces residents to community partners and creates networking and relationship opportunities that encourage collaboration between partner organizations, schools, and families. As these relationships build, we remove barriers for families to address the social determinants of health and create a healthier ecosystem for families and school communities. Unmet needs are often uncovered through intake and engagement with mental health professionals and include immigration support, food insecurity, support for domestic violence or health problems. Provider relationships gain a child and family’s trust enough to reveal unmet needs, which we can then address. Partnerships play a critical role in prevention as they meet the social and economic needs of families, allowing children to release stress, engage in learning, and be children. MOMENTUM’s approach alleviates much of this work that school systems are too overwhelmed to address, acting as a preventive for exacerbation of mental health challenges.
Below, a MOMENTUM resident shares a powerful narrative of families whose lives have been positively impacted by the efforts of mental health teams and the training provided by MOMENTUM.
STATESMAN ACADEMY PUBLIC CHARTER SCHOOL, WASHINGTON, DC
The following case study is told from our MOMENTUM resident’s experience and identifying information has been changed to protect confidentiality:
When Kylian, Jude, and Vinicius, (not real names) a group of siblings, began the school year, teachers noticed they were often tired and withdrawn, with frequent absences. Their grades slipped, they stopped participating in class and would often run away from school. Concerned, their teachers reached out to the school social worker, who reached out to the students and their mother. This was followed by a home visit.
The family had a layered set of challenges: The mother had recently lost her job and was managing her own mental health concerns the best way she knew how. The boys had no beds and there was barely food in the refrigerator. Without a stable place to sleep and inadequate meals the siblings struggled to get enough rest, maintain a routine, and focus on school. The boys were carrying the emotional weight of their family’s instability which manifested in withdrawing from engagement in school activities.
With permission from the mom, the MOMENTUM resident activated a support network of partners that was able to deliver beds and mattresses. They got connected to school-based therapy to alleviate their anxiety in a safe, supportive space without missing additional school time.
The school operates an in-house food pantry that supported the family, and mom was connected to mental health services of her own as well as family therapy. In addition to the school-based therapy, the scholars identified trusted adults on the staff as people they could confide in, laugh with, and learn from.
Within a few months, the impact was clear. The scholars’ attendance improved. They are engaged in class, are smiling again, and started advocating for themselves in small but powerful ways. With their family needs met, the students are engaged in school with less worry and concern for their mother, who is receiving support.
Kylian, Jude, and Vinicius’ story is just one example of how strong school-family-community partnerships—led by compassionate, responsive social work—can intervene before a child falls through the cracks. By coordinating care, offering holistic support, and building trust, the school community helped them not just survive their circumstances, but thrive.
HOW PARTNERSHIPS STRENGTHEN SCHOOL-BASED MENTAL HEALTH EFFORTS
Partnerships provide a link to creative and well- developed resources, alleviating the burden on an already overburdened school system. Restorative justice programs, social service providers, and immigrant- serving organizations offer specialized expertise. These organizations fill gaps that families identify as critical for mental health and wellness. Hunger, fear of parental deportation, or experiencing or witnessing violent student conflict exacerbates anxiety. Anxious children cannot learn nor develop healthy social and emotional habits. Alleviation of these burdens for families creates a sense of agency and stability for families, allowing children to avoid bringing this burden into the classroom. Hunger, fear of parental deportation, or experiencing or witnessing violent student conflict exacerbates anxiety. Anxious children cannot learn nor develop healthy social and emotional habits. Alleviation of these burdens for families creates a sense of agency and stability for families, allowing children to avoid bringing this burden into the classroom.
Mental health practitioners are often trained through a deficit lens – how do we identify and treat mental health disorders? Less time is allocated to prevention and early intervention, or even examining treatment services as preventive, particularly at early stages, such as elementary school. MOMENTUM delivers, as a central part of our residency, a full training curriculum on the Public Health approach to school mental health. In partnership with staff from the Center for Health and Health Care in Schools (CHHCS), interactive training modules on public health principles and strategies were developed for MOMENTUM residents that integrated topics such as identifying and addressing the social influencers of health and education, utilizing surveillance data to recognize school community needs and assets, and tailoring preventative approaches to unique school environments. Practitioners broaden their scope of practice, learning to apply a full range of support for children on a continuum of care, from prevention and early intervention to treatment, aftercare, and community referrals to ancillary services.
MOMENTUM’s model recognizes that collaboration and community expertise have a deeper impact than a medical/deficit model.
WHAT SCHOOL PSYCHOLOGISTS NEED TO KNOW
School Psychologists’ primary role in a school setting is to evaluate students through testing. In the 3 brothers case study above, one could imagine that the brothers would have been referred for testing to identify a disability related to their behavior, particularly because it persisted.
However, consider how these factors might influence test results and evaluations when we do not take the time to understand their meaning:
- A child who appears inattentive but is actually preoccupied with his parents’ crippling depression.
- A student labeled “oppositional” who comes from a culture where questioning adults is encouraged as a sign of critical thinking.
- A child showing “poor impulse control” who hasn’t eaten a proper meal in two days.
- A student who seems academically delayed but is actually navigating the challenges of learning English while adapting to an entirely new educational system.
School systems often lack sufficient staffing to create meaningful, consistent, and ongoing trust with families. However, building meaningful connections doesn’t have to be a heavy lift, nor should it rely solely on the psychologist. MOMENTUM’s focus on collaboration can allow for small shifts in how teams address equity in how children’s needs are addressed. Consider these small shifts that the charter school example above has addressed in practice:
- Scheduling home visits before formal testing begins or as a tier 1 approach – all students receive one home visit from someone at school once per year.
- Asking parents about their child’s strengths and interests and highlighting them before discussing concerns.
- Learning about the family’s culture, values, and previous experiences with schools through family events – ensuring representation from the mental health team at these events.
- Observing the child in multiple settings—classroom, playground, lunchroom.
- Connecting with community members who know the family (with permission).
- Asking about recent changes or stressors in the child’s life once trust has been established.
- Approaching all the above as a team – sharing information among team members and letting families know this collaborative approach is intended to reduce the burden and fragmentation of services families often face.
When mental health teams work in collaboration, small steps, and effective communication can create a powerful team that offers equitable and thorough evaluations and responsive care.
Early outcomes indicate that MOMENTUM residents effectively apply core concepts of youth and adult partnerships in schools and find supervisory alignment with these concepts to be useful in their skill development and overall satisfaction with the program. Our training and clinical supervision emphasizes a model of care that is collaborative, holistic, and multisectoral, which enhances confidence in resident clinicians. Moreover, human-centered practice that addresses implicit bias, self-awareness, well-being of the self and the collective has created an openness to learning and growth that we anticipate will show up in school feedback forthcoming in June 2025.
A CALL TO ACTION: MAKING PROGRESS IN SCHOOL MENTAL HEALTH
- Place more focus on culture, race, and place, neighborhoods that allow for sharing of the collective culture and experience of the school community.
- A fundamental shift in our approach to “helping”: integrate our knowledge and research with what our community tells us.
- A recalibration of professional development for our school mental health workforce that integrates lessons learned from youth, adult, community partnerships.
Through the alignment of training and supervision, which includes personal connections to stakeholders, MOMENTUM ensures a focus on the voice and perspective of caregivers, parents, teachers, staff, and students as they co-create interventions and approaches that leverage community expertise.
