2 - (SYM 30) Transforming Research into Action: Preliminary Outcomes of TRAILS Implementation in a Large Urban School District

Abstract Body

Background: There is a need for effective training and implementation support for school-based providers to ensure all students, especially those from marginalized communities, have access to effective mental health services. TRAILS (Transforming Research into Action to Improve the Lives of Students) is an implementation program supporting evidence-based, culturally responsible, mental health practice delivery in schools. The current talk will explore the preliminary outcomes of implementing TRAILS in a large urban school district. We will examine: school mental health provider (SMHP) training completion rates, implementation support outcomes, reported barriers to implementation, and strategies taken to overcome barriers.

Method: TRAILS, the Youth Policy Lab at the University of Michigan, and the Detroit Public Schools Community District (DPSCD) collaborated to conduct a delayed treatment randomized controlled trial of TRAILS implementation in DPSCD schools. SMHPs participating in TRAILS attend a 6-hour didactic training in CBT, attend implementation support, and deliver the CBT skills to students. DPSCD serves 48,536 students, has a rich and complex administrative structure, and serves a minority-majority student body. We completed a pilot semester during the 2022 academic year. Full-scale implementation support for half the target schools (year one) launched during fall 2023. Year two (implementation support for the delayed treatment of schools) will launch in Fall 2024.  We recruited 18 SMHPs for the pilot and 59 additional trainees in year one.

Results: During the pilot, 94% of recruited SMHPs attended the didactic training, and 72% attended at least one coaching session. 44% were non-responsive or started but then dropped TRAILS coaching. Primary barriers to implementation were: student recruitment and absences; juggling school responsibilities; and protecting time for program delivery. In response to these barriers, the team adapted the implementation approach to improve implementation outcomes. In year 1, 100% attended the training and 80% attended at least one implementation support session. However, barriers to implementation remain.

Conclusions: This presentation provides an opportunity to share the implementation outcomes, the barriers, and the adaptations we have made to our program to support current and future implementation. We will explore the main lessons and ongoing hurdles that may be useful for other organizations to consider when implementing mental health support in a large school district.