Welcome to the

School Nurse’s
Mental Health Toolkit

Continuing Education Curriculum and Nurse-Led Discussion Guides for Student Support Teams

America’s children spend nearly 1,000 hours a year in school.

Where do kids in school go when experiencing mental health distress?

A school nurse!

This toolkit is here to help you start meaningful conversations with your student support team about mental health topics, such as school avoidance, anxiety, and suicide prevention. It’s designed to guide your team in figuring out what challenges you’re facing, what strategies might help, how to make the most of the resources you already have — and where to look for more support if you need it.  

This continuing education series is a part of the School Nurse’s Mental Health Toolkit. Online/Mobile |PDF|Order print version

Use this toolkit to earn continuing education (CE) credits

To watch the videos and get credit, you’ll need to create a quick login. Before you dive in, we’ll ask a few questions to learn more about your background, help us better understand your experiences, and improve future content.

Your privacy is important to us — your responses will remain confidential and won’t be linked to your name or identity. All data will be reported anonymously and your information won’t be shared with anyone outside the research team.

If you’re viewing this toolkit on a computer browser and would like to view it on a mobile device, please scan the QR code.

How to use this website

Step 1

Pick a topic you’d like to focus on and invite your student support team to join. Ask everyone to send in questions or thoughts ahead of time so you can hit the ground running.

Step 2

Decide if you’d like your team to view the videos together in a group or ahead of time. The videos are short (10-20 minutes), so watching together can keep the concepts fresh in everyone’s mind. Watch the Mental Health Action Signs intro video first.

To access the videos in the modules, you’ll need to create an account.

Step 3

Take a look at the Discussion Facilitator Guide for a quick checklist. It covers how to kick things off, keep everyone engaged, handle any tough moments, and wrap things up smoothly.

Step 4

Choose 3-5 questions to guide the conversation. Read through the Discussion Guide for the topic you’ve chosen — it’ll give you helpful info and ideas to keep the conversation focused and useful.

Step 5

Complete the post-assessment and print your CE certificate(s)! The toolkit has an electronic version that can be bookmarked on your work computer for easy future reference.

Returning Users Login

School Mental Health Toolkit Registration

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Please Read the Following

You’re invited to participate in a research study about improving school nurses' knowledge and confidence when addressing student mental health. This form explains what the study involves. Take your time and ask questions before deciding whether to participate.

What’s the purpose of this study?

To evaluate whether educational materials—like discussion guides and videos—help school nurses better recognize, respond to, and support students experiencing mental health challenges.

What will I be asked to do?

If you agree to participate, you’ll: 1. Complete a very short online survey about your current knowledge and confidence regarding student mental health. 2. Review educational videos developed for school nurses. 3. Complete a follow-up survey to assess your experience.

Are there any risks to participating?

No. Some survey questions may ask about sensitive issues related to student well-being, which could be mildly uncomfortable.

Are there any benefits?

You may gain new strategies or insights for supporting student mental health and access to useful educational tools for your practice. Your feedback will also help improve mental health resources for other school nurses.

Is participation voluntary?

Yes. You can choose not to participate or to stop at any time without penalty or loss of continuing education credit.

Will my information be kept confidential and securely stored?

Yes. Any identifying information will be removed before analysis. Only the research team will have access to the data. No individual names will be used in reports or publications.

Who can I contact with questions about the study?

Dr. Leslie Caughell | lcaughell@vwu.edu/(757) 233-8853

If you have questions about your rights as a participant: Dr. Ariel (rariel@vwu.edu)/Dr. Martorell (gmartorell@vwu.edu)

Consent statement

By checking the box below, you indicate that you:
  • Are 18 years of age or older.
  • Have read and understood the information above.
  • Voluntarily agree to participate in this study.
Please select:(Required)
Upon submission you will be asked to log-in.
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Mental Health Crisis Protocols

Does your Virginia school need to develop mental health crisis protocols? Click here.

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Help with CEs

If you’re experiencing trouble with your certificate of completion, click here.

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Virginia Association of School Nurses (VASN) Regional Directors

To access facilitator support, click here. Allow seven business days for a response.

Discussion Facilitator Guides

As the facilitator, your job is to guide a friendly, open, respectful conversation where everyone feels comfortable learning and sharing about student mental health topics. PDF for Printing

Quick Checklist for Facilitators

✔️ Review and pick 3-5 starter questions.

✔️ Start with simple ground rules.

✔️ Be flexible to let the conversation flow.

✔️ Encourage everyone to share their thoughts.

✔️ Handle tough moments with care.

✔️ Wrap up with key takeaways and appreciation.

 

Before the Discussion

  • Look at the questions submitted by your coworkers.
  • Pick the ones that feel most relevant to your group’s experiences or what they might be dealing with right now.
  • Aim for 3-5 starter questions to get the conversation going.
  • Be sensitive to topics that might bring up strong emotion. Let everyone know it’s okay to take a break.
  • Stay flexible! Be ready to go with the flow when the discussion gets going.

Starting the Discussion

  • Set some simple ground rules — like being respectful, keeping things confidential, and listening without judgment. Work hard to draw out those more reluctant to speak by asking them open-ended questions. 
  • Ask the group if they’d like to cover other topics or if they have questions.
  • A simple check-in or icebreaker can go a long way in creating a welcoming environment that encourages discussion.

During the Discussion

  • Use the questions as a starting point, but be open to following the group’s lead.
  • Open-ended follow-up questions can get everyone involved.
  • Silence and time for reflection are okay — quiet moments can give people time to think.
  • It’s natural for group energy to shift. Acknowledge any concerns, reflect back what’s been shared (“What I hear you saying is…”), and gently steer the group back to a more productive space by asking a question that focuses on what can be improved or changed.
  • If emotions run high, offer support and remind everyone about available resources.

Navigating Difficult Moments

  • Let people know it’s normal to feel vulnerable (“It’s okay not to have all the answers.”).
  • Keep bringing the discussion back to what’s useful and practical. 
  • If things get tense, stay calm, be respectful, and try to refocus on shared goals.

Closing the Discussion

  • Wrap things up by going over the main takeaways and key themes.
  • Invite everyone to share one final thought (e.g., “One takeaway from today?”).
  • Thank the group for being part of the conversation.
  • Share any helpful follow-up next steps or resources.

Discussion Guides

School Avoidance
Anxiety
Panic Attacks
Depression
Suicide Prevention
Self-Harm
Anger
Coping and Relaxation
Resources

Order Printed Version

Introduction to School Nurse Mental Health Curriculum and Action Signs

Please watch this short video before taking the modules.

Module 1 • School Avoidance

Before completing the module, take a pre-assessment.

Pre-Assessment | School Avoidance

Module 2 • Anxiety

Before completing the module, take a pre-assessment.

Pre-Assessment | Anxiety

Module 3 • Panic Attacks

Before completing the module, take a pre-assessment.

Pre-Assessment | Panic Attacks

Module 4 • Depression

Before completing the module, take a pre-assessment.

Pre-Assessment | Depression

Module 5 • Suicide Prevention

Before completing the module, take a pre-assessment.

Pre-Assessment | Suicide Prevention

Module 6 • Self-Harm

Before completing the module, take a pre-assessment.

Pre-Assessment | Self-Harm

Module 7 • Anger

Before completing the module, take a pre-assessment.

Pre-Assessment | Anger

Module 8 • Coping & Relaxation

Before completing the module, take a pre-assessment.

Pre-Assessment | Coping & Relaxation

Module 9 • Resources

Before completing the module, take a pre-assessment.

Pre-Assessment | Resources

School Health Committee Mission

The Virginia AAP recognizes that our work as pediatricians is connected with educators and school nurses who are our partners in caring for children and families. Please see our chapter’s School Health Committee webpage for more information. 

This toolkit was born from a collaboration in Virginia between school nurses and pediatricians to learn and partner together to support children and families with evidence-based tools.

Acknowledgments and Gratitude

Virginia Chapter, American Academy of Pediatrics

  • Jacqueline Cotton, MD, FAAP, Project Lead for School Nurse Mental Health Curriculum, VMAP REACH PPP and Project ECHO Faculty, REACH National Program Faculty Member, Virginia Beach, VA
  • Leah Rowland, MD, FAAP, Project Lead for School Nurse Mental Health Curriculum, Pediatrician, Children’s Hospital of The King’s Daughters, Assistant Professor, Macon & Joan Brock Virginia Health Sciences at Old Dominion University, School Health Committee Co-Chair, Virginia Chapter, American Academy of Pediatrics (AAP), Norfolk, VA
  • Amy Dryer, MD, FAAP, TPG Pediatrics, Woodbridge, VA, Delegate, Virginia Chapter AAP, Course Leader and Faculty, National and VMAP REACH PPP
  • Amy Harden, MD, FAAP, VMAP PPP Faculty, Southwest Virginia VA-AAP Delegate, Marion, VA
  • John Farrell, MD, FAAP, School Health Committee Co-Chair, South Riding, VA
  • Amy C. Kryder, MD, FAAP, Associate Professor, Virginia Tech Carilion School of Medicine, Pediatrician, Carilion Pediatric Medicine, VMAP REACH Education Lead, Daleville, VA
  • Paige Perriello, MD, FAAP, VA-AAP Delegate for Independent Practices, Charlottesville, VA

School Nurse Leadership Contributors

  • Joanna Pitts, BSN, RN, NCSN, CNOR, Virginia Department of Health School Health Nurse Consultant, Nurse Planner
  • Na-Keisha A. White, MSN-PH, RN, NCSN, School Health Coordinator, Virginia Department of Education, Virginia Association of School Nurses (VASN) President-Elect, VASN Continuing Education Committee, Nurse Planner
  • Angela Knupp, BSN, RN, NCSN, Student Health Services: School Nurse Specialist, Harrisonburg City Public Schools, Harrisonburg, VA
  • Heather “Shea” Pugh, BSN, RN, NCSN, Windsor High School, Windsor, VA

Virginia Association of School Nurses Collaborators and Nurse Advisors

  • Colette Hokana, BSN, RN, NCSN, VASN Continuing Education Committee, Primary Nurse Planner
  • Betsy Looney, BS, BSN, RN, NCSN, VASN President, School Nurse Coordinator, Nurse Advisor, VASN Continuing Education Committee
  • Tammy Moody, BSN, RN, NCSN, School Nurse, Lunenburg County Public Schools, VA, Nurse Advisor, VASN Continuing Education Committee
  • Suzanne Queheillalt, MSN, APRN, ACNS-BC, VASN Continuing Education Committee, Nurse Planner
  • Sara Vigneault, BSN, RN, School Health Nurse, Greenville Elementary School, Fauquier County Public Schools, VA

Supporting Contributors and Consultants

  • Leslie Caughell, PhD, Virginia Wesleyan University
  • Bethany Geldmaker, PhD, PNP, PMHC, an HRSA Grant Administrator, Virginia Department of Health
  • Amy Horvath, Creative Consultant
  • Mark Hinson, Graphics of Distinction, Web Design
  • Aaron Cole and Ian Levenstein, V2 LLC
  • Keith Montgomery, Executive Director, Virginia Chapter, American Academy of Pediatrics
  • Caroline Moore, MPH, School Health Program Coordinator, Virginia Department of Health
  • Megan Wojcik, copyeditor

Supporting Partners

  • Children’s Hospital of The King’s Daughters
  • The REACH Institute and Lisa Hunter Romanelli, PhD
  • The Virginia Department of Health
  • Virginia Mental Health Access Program

This resource is supported in part by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $1,167,341, with 20% financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, HRSA, HHS, or the U.S. government. For more information, please visit HRSA.gov.

“A nurse’s caring smile can brighten the darkest days.”

“Nurses may not always wear capes, but they are always superheroes.”

“School nurses are essential to the mental health of students—they see the whole child.” 

National Association of School Nurses (NASN)

“There’s no health without mental health.”

World Health Organization (WHO)

“Mental health is just as important as physical health in children and adolescents.”

American Academy of Pediatrics (AAP)

“When we invest in children’s mental health we invest in their future.” 

U.S. Department of Health and Human Services (HHS)

This resource is being made available by the VA-AAP to the general public and is for informational purposes only. The views expressed in this resource should not necessarily be construed to be the views or policy of the VA-AAP, or any partners in this work.

The information in this resource is believed to be accurate. However, the VA-AAP does not make any warranty regarding the accuracy or completeness of any information provided. The information is provided as-is and VA-AAP and its partners expressly disclaim any liability resulting from use of this information. The information in this resource is not, and should not be relied on as medical, legal, or other professional advice, and readers are encouraged to consult a professional advisor for any such advice.

In addition, this resource is not a substitute for the exercise of one’s independent professional judgment, which shall be exercised in the sole discretion of the individual. No part of this resource may be reproduced or distributed in any form or by any means without the prior written permission of the VA-AAP.