Mental Health Triage
In providing care for students in the aftermath of a school crisis, the organizational model and school crisis response plan recommend that the school crisis response team follow the principles of mental health triage.4 Staff in support rooms should provide mental health triage and make appropriate referrals to other support and counseling services in the school and community.
Schools operate with a zero reject policy. That is, schools were established to serve all students and are mandated to provide all necessary services required by students to facilitate their education. The principles of triage recognize that in certain settings and under certain conditions it is not possible to provide all needed mental health services to everyone. Instead, decisions must be based on the most efficient use of limited resources to prevent the most harm. In this context, mental health triage during a school crisis means that children in need of immediate evaluation and services by a mental health professional should be referred directly to appropriate community resources and should not receive extensive evaluations or counseling services by school personnel. This requires preexisting access to appropriate urgent mental health services for traumatized children and adolescents. Children who are not in need of urgent mental health services may be offered limited interventions, such as counselor-led discussions in group settings like classrooms and support groups. Evaluations made during the immediate aftermath of a crisis must have specific goals—to identify those in need of urgent services and to expedite their referrals. Until additional resources become available, longer and more indepth evaluations should be postponed.