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Position Statement 45: Discipline and Positive Behavior Support in Schools
As a leading advocate for the mental health and wellness of children and adolescents, Mental Health America (MHA) opposes corporal punishment and zero tolerance policies and supports individuated school disciplinary processes that take account of mental health conditions and emotional disturbances and promote the healthy mental and emotional development of our country's youth. More proactively, MHA supports school-wide positive behavior support and “no reject, no eject” policies aimed at providing a child who misbehaves with the necessary supports and resources that support behavior change in positive, non-punitive ways.
Corporal punishment involves the deliberate infliction of pain upon a child, by an adult, in an attempt to correct and/or punish the child's perceived misbehavior. Scientific research has concluded that corporal punishment is ineffective and detrimental to the emotional and educational needs of children. There are many more effective means of discipline which promote self-control and the development of appropriate socially adaptive behaviors in constructive, non-harmful ways.
Other school disciplinary measures, while less physically violent, are often equally harsh, and lead to students’ with mental health needs being disenfranchised, or worse, dropping out of school. Thus, the widespread use of suspension and expulsion for often minor infractions that is the hallmark of zero tolerance policies has compromised the appropriate role of schools in shaping appropriate student behavior. These wrong-headed disciplinary procedures should be rethought and reformed. But more broadly, MHA strongly urges that new programs that address the mental wellness of all students are essential to lessen the need for school discipline and promoting alternative strategies that strengthen the mental health of school-aged children and young adults.
Mental Health America has a long-standing position advocating Prevention of Mental Health and Substance Use Disorders in Young People. In fulfillment of that policy, school-based promotion of mental wellness and positive socialization in the art and science of social interaction is the necessary foundational building block, as is early tiered intervention as problems are encountered and surmounted, avoiding segregation of young people with disabilities whenever that can be made to work.
In 2004, the American Academy of Pediatrics published a policy calling for universal school-based programs to encourage mental health and prevent mental illness:
Activities …need to be ubiquitous so that they target all children in all school settings. Preventive programs are those that focus on decreasing risk factors and building resilience, including providing a positive, friendly, and open social environment at school and ensuring that each student has access to community and family supports that are associated with healthy emotional development. A sense of student “connectedness” to schools has been found to have positive effects on academic achievement and to decrease risky behaviors. For example, schools should provide students with multiple and varied curricular and extracurricular activities, thereby increasing the chances that each student will feel successful in some aspect of school life. Schools also should provide numerous opportunities for positive individual interactions with adults at school so that each student has positive adult role models and opportunities to develop a healthy adult relationship outside his or her family. Schools can provide families with support services and should implement “prevention” curricula (e.g., curricula that decrease risk-taking behaviors). Behavioral expectations, rules, and discipline plans should be well publicized and enforced school-wide.
During 2004-2006, the Task Force on Community Preventive Services (Task Force) of the United States Center for Disease Control conducted a systematic review of published scientific evidence concerning the effectiveness of these programs. The results of this review provide strong evidence that universal school-based programs decrease rates of violence and aggressive behavior among school-aged children. Program effects were demonstrated at all grade levels. An independent meta-analysis of school-based programs confirmed and supplemented these findings. On the basis of strong evidence of effectiveness, the Task Force recommended the use of universal school-based programs to prevent or reduce violent behavior.
Based on these findings, educators are turning to a comprehensive and proactive approach to discipline commonly referred to as school-wide positive behavior interventions and support [SWPBIS]. SWPBIS is based on the assumption that when faculty and staff in a school actively teach and acknowledge expected behavior, the proportion of students with serious behavior problems will be reduced and the school’s overall climate will improve. Strategies such as behavioral coaching, behavioral rehearsal and role play, daily goal setting, and self-monitoring can be helpful in teaching students to manage their own behavior and emotions more effectively. Skill building may be an important intervention for students who are displaying aggressive and disruptive behaviors. As part of an assessment process, an effort should be made to gain an understanding of the underlying causes for disruptive behavior, and to teach alternative behavioral strategies as needed.
A Technical Assistance Center on Positive Behavioral Interventions and Supports has been established by the Office of Special Education Programs, U.S. Department of Education. http://www.pbis.org/default.aspx. The website defines SWPBS:
One of the foremost advances in school-wide discipline is the emphasis on school-wide systems of support that include proactive strategies for defining, teaching, and supporting appropriate student behaviors to create positive school environments. Instead of using a piecemeal approach of individual behavioral management plans, a continuum of positive behavior support for all students within a school is implemented in areas including the classroom and non-classroom settings (such as hallways, buses, and restrooms). Positive behavior support is an application of a behaviorally-based systems approach to enhance the capacity of schools, families, and communities to design effective environments that improve the link between research-validated practices and the environments in which teaching and learning occurs. Attention is focused on creating and sustaining primary (school-wide), secondary (classroom), and tertiary (individual) systems of support that improve lifestyle results (personal, health, social, family, work, recreation) for all children and youth by making targeted behaviors less effective, efficient, and relevant, and desired behavior more functional.
The Judge David L. Bazelon Center for Mental Health Law has published a fact sheet describing SWPBIS, entitled “Way to Go: School Success for Children with Mental Health Needs.” According to Bazelon, the literature summarizing studies of school-wide PBIS suggests that, on average, PBIS schools see improvements in social climate and academic performance and experience 20- to 60-percent reductions in disciplinary incidents. The fact sheet stresses the need for adherence to the best-practice standards, particularly family involvement and social-emotional learning. Bazelon emphasizes that SWPBIS, “requires family buy-in, participation and support.” 
Unfortunately, this kind of universal school-based prevention is still typically “grant-based, and often unpredictable or unsustainable.” But developments in California show positive options on the horizon. A recent concept paper directed at implementing California’s innovative mental health prevention set-aside legislation focused on a proposed state-wide “Response to Intervention” (“RTI”) approach: “decoupling the “emotionally disturbed” eligibility and/or psychiatric diagnosis from the provision of services through endorsing and implementing a tiered approach to prevention and intervention targeted toward salient risk factors students may possess regarding life adjustments, transitions, adverse childhood experiences, and emotional/behavioral concerns. Prevention is understood to be the foundation of the approach, with addressing risks to students’ emotional/behavioral health being the initial focus of intervention, versus waiting for actual functional deficits and psychiatric pathologies to develop. RTI ‘provides the opportunity to help struggling children immediately rather than waiting until well-ingrained patterns of emotional and behavioral difficulties are established.’”
Tier one RTI services would target the whole school community and would be comprised of universal prevention efforts that include:
- Social-emotional health, emotional regulation and mental health skill development for students, staff, and families;
- mental health consultation for school staff;
- curricula and/or preventative programs designed to address specific community needs (e.g. violence prevention, drug use, bullying, etc.); and
- screening and evaluation of all students for risk factors or specific needs that may benefit from higher intensity intervention.
The National Center for Learning Disabilities sponsors the Response to Intervention Action Network, which has compiled a helpful compendium of field studies of RTI programs around the country. While the studies are small and focused on elementary education, and secondary education remains to be studied, the authors concluded that: “All of the studies examining the impact of an RTI program on academic achievement or performance resulted in some level of improvement, and the authors attributed the changes to the RTI approach they used. Thus, there is emerging evidence that a tiered early intervention approach can improve the academic performance of at-risk students.” Another source of information on RTI is the Center on Response to Intervention at the American Institutes for Research.
Since 2003, Mental Health America has supported efforts in Congress and the states to put more funding and emphasis on SWPBIS and on more specific interventions like RTI, school-based mediation and mental health programs, anti-bullying programs that integrate school-wide positive behavior support and redefine the bullying construct, confidential peer support and counseling and intervention programs for children in crisis, related teacher training and evaluation, and broadening mental health support beyond special education programs to deal with a wider range of mental health conditions and emotional disturbances.
The key word is support, not therapy, and the goal of SWPBIS and similar programs is avoidance of stigma by making mental wellness a central concern of all schools and for all students, while constantly screening and referring students for tiered interventions to respond to problems as they develop.
Mental Health America is on record in support of “no reject, no eject” policies that deal with the underlying issues related to misbehavior rather than getting rid of challenging students through suspension or expulsion. There are times when isolation of the offender is the only responsible choice, but MHA believes that the better choice is not to deprive the student of services and to integrate all children into the classroom whenever possible, using more subtle tools that shape better behavior rather than giving up when a child acts out.
Call to Action
Mental Health America supports the adoption of proactive approaches like school-wide positive behavioral intervention and support and “no eject, no reject” policies. MHA will support SWPBIS legislation in the Congress. MHA will provide information to the affiliate field and others to promote State and local legislation which transforms school discipline into a system of supports that furthers mental wellness.
The Mental Health America Board of Directors approved this policy on June 8, 2014. It will be reviewed as required by the Public Policy Committee.
Expiration: December 31, 2019
 The abolishment of corporal punishment in our nation's schools is also called for by, inter alia, the National PTA, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, the National Congress of Parents and Teachers, the National Education Association, the American Bar Association, and EPOCH-USA.
 See MHA Position Statement No. 46.
 Flaherty, L. & Osher, D., “History of Mental Health in Schools in the United States,” in M.D. Weist, S. Evans, & N. Tashman (Eds.), School Mental Health Handbook (pp.11-22). New York: Kluwer Academic Publishing Company (2002).
 See, e.g., American Psychological Association press release, dated June 26, 2002: “In a large-scale meta-analysis of 88 studies, psychologist Elizabeth Thompson Gershoff, PhD, of the National Center for Children in Poverty at Columbia University, looked at both positive and negative behaviors in children that were associated with corporal punishment. Her research and commentaries on her work are published in the July 2002 issue of Psychological Bulletin, published by the American Psychological Association.”
While conducting the meta-analysis, which included 62 years of collected data, Gershoff looked for associations between parental use of corporal punishment and 11 child behaviors and experiences, including several in childhood (immediate compliance, moral internalization, quality of relationship with parent, and physical abuse from that parent), three in both childhood and adulthood (mental health, aggression, and criminal or antisocial behavior) and one in adulthood alone (abuse of own children or spouse). Gershoff found "strong associations" between corporal punishment and all eleven child behaviors and experiences. Ten of the associations were negative such as with increased child aggression and antisocial behavior. The single desirable association was between corporal punishment and increased immediate compliance on the part of the child.” http://www.apa.org/releases/spanking.html
 Writing in the Harvard Education Review, Pedro Noguera argues that the primary function of harsh punishment is to assert authority rather than to change behavior. Pedro A. Noguera, “Preventing and Producing Violence: A Critical Analysis of Responses to School Violence,” Harvard Education Review (1995), p. 189-212.
 American Academy of Pediatrics, “School-based Mental Health Services,” Pediatrics124(2):845 (2004), http://pediatrics.aappublications.org/content/113/6/1839.full.html .
 Hahn, R., Fuqua-Whitley, D., Wethington, H., Lowy, J., Liberman, A., Crosby, A., Fullilove, M., Johnson, R., Moscicki, E., Price, L., Snyder, S.R., Tuma, F., Cory, S., Stone, G.,,Mukhopadhaya, K., Chattopadhyay, S., & Dahlberg, L., “The Effectiveness of Universal School-based Programs for the Prevention of Violent and Aggressive Behavior: a Report on Recommendations of the Task Force on Community Preventive Services,” MMWR Recomm Rep. 10;56(RR-7):1-12 (2007).
 Osher, D., Dwyer, K., & Jackson, S. (2004). Safe,Ssupportive, and Successful Schools: Step by Step. Longmont, CO: Sopris West (2004); Doll, B., Zucker, S., & Brehm, K., Resilient Classrooms: Creating Healthy Environments for Learning. New York: Guilford Press (2004).
 Colvin, Kame’enui, & Sugai, 1993; Sugai & Horner, 1994; Sugai, Sprague, Horner, & Walker, 2000.
 SCHOOL MENTAL HEALTH COMPREHENSIVE STRATEGY BASED ON RTI [citation needed – Rusty Selix], at 4.
 California Mental Health Services Act Prevention and Early Intervention Program, California Welfare and Institutions Code, Division 5, Part 3.6, Section 5840.
 Op. cit. endnote 10, at 4-5 (citing Gresham, 2007 at 216).
 Hughes, C., and Dexter, D.D., “Field Studies of RTI Programs, Revised,” published on line, http://www.rtinetwork.org/learn/research/field-studies-rti-programs