Behavioral Health Student Assistance Programs: Leveraging Non-Traditional Mental Health Providers to Address Workforce Shortages and Mitigate the Youth Mental Health Crisis.

Workforce shortages and other barriers have undermined efforts to address recent spikes in youth behavioral health problems. This study evaluates Washington State's Behavioral Health Student Assistance Program (BH-SAP), a novel approach to addressing the youth behavioral health crisis by using paraprofessional-delivered services in schools to expand the continuum of services available to youth. During the 2022-23 school year, 60 Student Assistance Specialists (SASs) delivered 3,218 prevention activities, provided group interventions to 1,158 students, and served 2,532 students with individual interventions, though there was substantial variation in the relative rates of BH-SAP activities across Washington's nine regional Educational Service Districts. Students receiving group and individual interventions reported significant improvements in hope, social connection, mental health agency, and reductions in internalizing symptoms and behavioral incidents, with small to moderate effect sizes (d = 0.23-0.39). Over 96% of N = 1,061 students who completed surveys reported the program was helpful. Students served by SASs who demonstrated greater adherence to the state's BH-SAP fidelity rubric showed greater improvements than those from lower-adherence providers. Results show that paraprofessionals, when properly trained and supervised, can effectively expand the workforce and extend the reach of evidence-based interventions in schools, and that a consistently implemented student assistance program can provide a promising strategy to address the youth mental health crisis.