Mental Health: Multi-Tiered Trauma-Informed School Programs to Improve Mental Health Among Youth, Updated 2026

Details

• Alternative Title:
  Mental Health: Multi-Tiered Trauma-Informed School Programs to Improve Mental Health Among Youth: Community Preventive Services Task Force Finding and Rationale Statement Ratified November 2023; Updated 2026
• Corporate Authors:
  Community Preventive Services Task Force (CPSTF)
• Description:
  Context: Trauma is a response to an event, series of events, or set of circumstances experienced by an individual as physically or emotionally harmful or life-threatening and can have lasting adverse effects on the individual's mental, physical, and emotional well-being (SAMHSA Concept of Trauma 2014 [https://ncsacw.acf.hhs.gov/userfiles/files/SAMHSA_Trauma.pdf]). Traumatic events in childhood, referred to as adverse childhood experiences, or ACEs, are experienced by more than two-thirds of children by the age of 16 (SAMHSA 2023). Childhood experiences of trauma may lead to learning or behavioral problems or both, such as inability to focus on schoolwork, or intense outbursts of anger (Burke et al 2011). In adolescence and adulthood, ACEs are linked to chronic health problems, poor mental health (e.g., post-traumatic stress disorder [PTSD], feeling sad or hopeless), and risk behaviors (e.g. substance use), as well as socioeconomic challenges in adulthood (CDC 2022). Preventing and reducing underlying trauma in childhood could reduce negative outcomes in adulthood and promote safer communities for children (CDC 2022).
  
  Multi-tiered trauma-informed school programs aim to prevent and reduce the impact of trauma among all students while offering additional help to students who need intensive support (National Child Traumatic Stress Network, Schools Committee 2017). Multitiered programs aim to implement interventions at universal (tier 1), targeted (tier 2), or individualized (tier 3) levels (Fondren et al 2020). These programs may connect students, especially those with a higher likelihood of traumatic exposures (e.g., students from households with low socioeconomic status [SES] or racial or sexual minority groups, students living with disability; NCTSN 2023), to mental health services and academic supports (Chafouleas et al 2016), which may promote health equity.
  
  The Community Preventive Services Task Force (CPSTF) findings and recommendations for "Mental Health: Multi-Tiered Trauma-Informed School Programs to Improve Mental Health Among Youth" are based on systematic reviews of evidence of effectiveness and economic impact. All CPSTF findings and recommendations were originally published in The Community Guide.
  
  The 2023 Findings and Rationale Statement was updated in July 2026. This update includes the addition of these supporting document appendices: Appendix A: Analytic Framework (Effectiveness Review); Appendix B: Search Strategy (Effectiveness Review); Appendix C: Included Studies (Effectiveness Review); Appendix D: Summary Evidence Table (Effectiveness Review).
  
  
• Subjects:
  Adolescent Adverse Childhood Experiences Health Education Mental Health School Health Services Schools Stress Disorders, Post-Traumatic Students
• Keywords:
  Mental Health And Mental Illness School Health Trauma Trauma-Informed Care Trauma-Informed Programs Youth
• Series:
  CPSTF Finding and Rationale Statement
• Subseries:
  Adolescent Health ; Mental Health
• DOI:
  https://doi.org/10.15620/cdc/168660
• Publisher:
  Community Preventive Services Task Force (CPSTF) ; Centers for Disease Control and Prevention (CDC) (U.S.)
• Document Type:
  Text
• Genre:
  Report
• Place as Subject:
  United States
• Rights:
  Public Domain
• CIO:
  Office of Science (OS)
• Topic:
  Diseases and Conditions
• Location:
  North America
• Pages in Document:
  41 pdf pages
• Citation:
  The Community Preventive Service Task Force (CPSTF). Mental Health: Multi-Tiered Trauma-Informed School Programs to Improve Mental Health Among Youth, Updated 2026. The Community Guide [www.thecommunityguide.org]. The Community Preventive Service Task Force, Atlanta, Georgia, 2026. https://doi.org/10.15620/cdc/168660
• Collection(s):
  The Community Guide
• Main Document Checksum:
  urn:sha-512:eaa99e6a1f934467649f1eb38aac2ee6665299ebca48398cd60223053986bcbb73c5f76a5a6c592a708f171874f268c1258156d9c90e3ba58ec657652068f21d
• Download URL:
  https://stacks.cdc.gov/view/cdc/168660/cdc_168660_DS1.pdf
• File Type:
  [PDF - 1.36 MB ]