Year

2026

Season

Summer

Paper Type

Doctoral Dissertation

College

Silverfield College of Education and Human Services

Degree Name

Doctor of Education in Curriculum and Instruction (EdD)

Department

Education

Committee Chairperson

Dr. Christopher Janson

Second Advisor

Dr. Rakesh Maurya

Third Advisor

Dr. Sophie Filibert

Fourth Advisor

Dr. Amy Hall

Department Chair

Dr. Christian Winterbottom

College Dean

Dr. Steve Dittmore

Abstract

 

This qualitative explanatory case study examined how school-based mental health services (SBMHS) are implemented within an elementary school’s Multi-Tiered System of Supports (MTSS). Guided by the Consolidated Framework for Implementation Research (CFIR) and sensemaking theory, the study examined how educators and school-based professionals interpret and enact their roles in supporting student mental health within educational contexts. Data were collected through interviews with five MTSS team members and analyzed using a combination of deductive and inductive coding. Results showed that mental health implementation is not a fully integrated system of supports but rather a process shaped by roles and relationships influenced by academic priorities, structural limitations, and collaborative practices. Five themes emerged: (a) the prioritization of academics over mental health within MTSS, (b) gaps in screening and reliance on behavior-driven referrals, (c) the role of relationships in compensating for structural limitations, (d) capacity constraints limiting the depth and continuity of services, and (e) high professional commitment alongside gaps in preparation. Participants demonstrated strong motivation to support student well-being; however, their capacity to do so was affected by differences in preparation, role clarity, and resource availability. These findings suggest that implementation challenges stem from a broader mismatch between expectations and system capacity rather than a lack of educator commitment. This study contributes to the literature by framing implementation as an interpretive process, shaped through roles and embedded within organizational and societal conditions, highlighting the need to better align training, roles, and system structures to support sustainable school-based mental health services.

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