Abstract

In a 2023 United States survey by the Centers for Disease Control and Prevention, 40% of high school students reported symptoms of depression, and 10% reported an attempted suicide.1 For students experiencing mental health symptoms, school nurses are ideally positioned to identify and respond to them.2 However, few school nurses employ a comprehensive intervention strategy that includes all three components of SBIRT: 1) screening for mental health concerns, 2) in-the-moment brief intervention, and 3) referral to mental health treatment if warranted.2-4 The purpose of this study was to describe how school nurses perceive their role in addressing student mental health and to determine if their practices align with SBIRT components.

An open-ended question about the role school nurses play in student mental health was embedded in a survey given to 38 school nurses in a mind-body intervention study. Their responses (n=36) were analyzed using content analysis and magnitude coding.5 The responses were assigned to one or more of the three SBIRT components with which the responses aligned or to an “other” component. Responses assigned to each component were then coded and categorized to identify common school nurse activities related to student mental health believed to be within their scope of practice.

The findings indicate that almost half (17/36) of participants mentioned an activity aligned with at least one component of SBIRT, whereas only one participant mentioned activities aligned with all three components. Seven participants mentioned screening or identifying student mental health concerns; 7 mentioned brief intervention activities; and 7 mentioned providing referrals. In addition, 30 mentioned other activities such as being a first contact for mental health concerns, providing resources, listening, offering support, and building a trusting relationship.

These results suggest school nurses engage in activities aligned with some components of SBIRT but do not often engage in activities aligned with all three. School nurses also address student mental health by listening, forming trust, and providing support. Results indicate that school nurses consider SBIRT activities within their realm of practice, but they do not provide a comprehensive three-pronged approach. The development of an SBIRT intervention for school nurses is thus indicated. Our team will collaborate with school, SBIRT, and implementation experts to develop and test such an intervention.

Notes

References:

1. Centers for Disease Control and Prevention. (2024). Youth Risk Behavior Survey Data Summary & Trends Report: 2013–2023. U.S. Department of Health and Human Services. https://www.cdc.gov/yrbs/dstr/pdf/YRBS-2023-Data-Summary-Trend-Report.pdf

2. Taylor-Beirne, J., & Taylor-Beirne, S. (2022). The role of the school nurse in supporting school-age children with mental health difficulties: An integrative review. British Journal of Child Health, 3(3), 135–147. https://doi.org/10.12968/chhe.2022.3.3.135

3. Bourgault, A., & Etcher, L. A. (2022). Integration of the screening, brief intervention, and referral to treatment screening instrument into school nurse practice. Journal of School Nursing, 38(3), 311–317. https://doi.org/10.1177/10598405211009501

4. Williams, K. A., Selwyn, C. N., Wilmoth, M., & Bydalek, K. (2021). SBIRT and MI training among school nurses and psychiatric mental health nurse practitioner students: A pilot study of competency and acceptability. Madridge Journal of Nursing, 6(1), 173-179. https://doi.org/10.18689/mjn-1000131

5. Saldaña, J. (2021). Coding techniques for quantitative and mixed data. In A. J. Onwuegbuzie & R. B. Johnson (Eds.), The Routledge Reviewer’s guide to mixed methods analysis, (1st ed, pp. 151-160). Taylor & Francis.

Description

School nurses are well-positioned to support student mental health. Based on responses to an open-ended online survey question, this study describes the alignment of school nurses’ activities in addressing student mental health with the components of an SBIRT (screening, brief intervention, referral to treatment) intervention.

Author Details

Andrea Lynn Tanner, PhD, RN, NCSN; Claire Burke Draucker, PhD, RN, FAAN

Sigma Membership

Alpha

Type

Poster

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Other

Keywords:

Implementation Science, Public and Community Health, Stress and Coping, School Nurses, Mental Health, Students, High School Students

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Click on the above link to access the poster.

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School Nurses’ Role in Screening, Brief Intervention, and Referral to Treatment for Mental Health

Seattle, Washington, USA

In a 2023 United States survey by the Centers for Disease Control and Prevention, 40% of high school students reported symptoms of depression, and 10% reported an attempted suicide.1 For students experiencing mental health symptoms, school nurses are ideally positioned to identify and respond to them.2 However, few school nurses employ a comprehensive intervention strategy that includes all three components of SBIRT: 1) screening for mental health concerns, 2) in-the-moment brief intervention, and 3) referral to mental health treatment if warranted.2-4 The purpose of this study was to describe how school nurses perceive their role in addressing student mental health and to determine if their practices align with SBIRT components.

An open-ended question about the role school nurses play in student mental health was embedded in a survey given to 38 school nurses in a mind-body intervention study. Their responses (n=36) were analyzed using content analysis and magnitude coding.5 The responses were assigned to one or more of the three SBIRT components with which the responses aligned or to an “other” component. Responses assigned to each component were then coded and categorized to identify common school nurse activities related to student mental health believed to be within their scope of practice.

The findings indicate that almost half (17/36) of participants mentioned an activity aligned with at least one component of SBIRT, whereas only one participant mentioned activities aligned with all three components. Seven participants mentioned screening or identifying student mental health concerns; 7 mentioned brief intervention activities; and 7 mentioned providing referrals. In addition, 30 mentioned other activities such as being a first contact for mental health concerns, providing resources, listening, offering support, and building a trusting relationship.

These results suggest school nurses engage in activities aligned with some components of SBIRT but do not often engage in activities aligned with all three. School nurses also address student mental health by listening, forming trust, and providing support. Results indicate that school nurses consider SBIRT activities within their realm of practice, but they do not provide a comprehensive three-pronged approach. The development of an SBIRT intervention for school nurses is thus indicated. Our team will collaborate with school, SBIRT, and implementation experts to develop and test such an intervention.