Analysis of student health incident data highlights behavioral health issues as experienced in schools. Student aggression is a substantial cause underlying significant injuries at the secondary level. It is important to note that these numbers do not reflect the total number of aggressive incidents on campus, but rather the most severe incidents that involved SHS staff. Nor do they reflect disciplinary events related to aggression, which are tracked and addressed separately by AISD.


Injury incidents resulting from student aggression accounted for 60% of student injuries overall (74% of middle school, 62% of high school and 38% of elementary student injuries) in SY 2014-15. The proportion of elementary student injury incidents due to aggression nearly tripled over the prior year and is significantly different from the multiyear trend at the elementary level. It more than doubled at the high school level. Aggression incidents resulting in student injury at the middle school level generally reflect a multiyear increasing trend. Although the total number of student injuries increased only slightly over the prior year (from 963 to 981), the percentage of injuries due to aggression increased by 50% (from 310 to 465). SHS staff note that there have not been changes in the definitions or tracking of aggression incidents, indicating that the data reflect a true increase in significant aggressive behavior.

Social Emotional Learning and Aggression Prevention Efforts in AISD

Social and Emotional Learning (SEL) is a process for helping children and adults develop fundamental skills for life effectiveness. SEL teaches the skills we all need to handle ourselves, our relationships, and our work effectively and ethically. These skills include recognizing and managing our emotions, developing caring and concern for others, establishing positive relationships, making responsible decisions, and handling challenging situations constructively and ethically.

AISD is a recognized leader in urban education and one of the first districts in the nation to commit to the development of the whole child by incorporating social and emotional learning. During SY 2014-15, SEL is being implemented in 101 schools serving 80 percent of the students in AISD. In SY 2015-16 the district expanded SEL in 129 schools serving all of the district’s 84,000 students.

SEL reaches beyond the classroom to all aspects of life. Skills and concepts are integrated in academic lessons and practiced to enhance the climate of the school. Out of school time providers and parents reinforce SEL skills as well.

There are several other evidenced-based anti-bullying, violence prevention, and mediation programs being implemented in AISD. One example is the Safe Start program, a collaboration between SHS and SafePlace to encourage healthy dating behavior, reducing vulnerability to partner and domestic abuse.

Aggression-induced injuries are not the only behavioral health incidents that are tracked and trended by SHS. Substance abuse, suspected abuse/neglect of students and student suicidal intent episodes involving health staff are also monitored.


Based on incidents involving health staff, aggression is an ongoing concern. Substance abuse incidents are a greater concern at the high school level. However in SY 2014-15, substance abuse incidents among middle school students nearly doubled over the prior year, and there appears to be a multiyear trend of increasing incidents at the middle school level.

Substance abuse incidents were further analyzed by grade level and by campus. Comparing middle and high school rates for SY 2014-15, the incident rate per 1000 students at the middle school level (2.77) actually exceeded the rate at the high school level (2.55). Considering incidents by grade level also provided insight, as did campus level analysis. The single year data identify the southeast area of the district as a geographic area of concern. Campuses with the highest incidents were part of the same feeder pattern, indicating the potential to target a possible intervention strategy.



SHS and AISD staff participate in community adolescent suicidality prevention and postvention efforts. School RNs have been trained in the ASK protocol. An additional area of student behavioral health concern and consequent professional development is student depression and non-suicidal self-injury. SHS has worked with Seton Shoal Creek Hospital to insure post-discharge continuity of care for students hospitalized for significant mental health needs.

In SY 2012-13 AISD implemented a new policy to decrease ALC placements through enhanced campus-based services with behavioral health as a significant consideration affecting staffing at the campus level. The annual AISD School Safety and Substance Use and Survey (SSSUS), completed by a random sample of secondary students, provides information on the general behavioral health of AISD students. Behavioral health maps addressing school and community safety, substance use, discipline, clinical care and community supports are available Analysis of more recent SSSUS data includes neighborhood level (Zip code) results.

Understanding and responding effectively to student behavioral and mental health needs is an area of on-going collaborative development for SHS, AISD and community partners. Professional development in identifying and addressing behavioral health issues has increased, and individualized health care plan development processes have been refined.

Campus Based Counseling Referral Centers

Austin ISD Campus Based Counseling Referral Centers (CBCRCs) are made possible by strong collaboration between Austin ISD and Seton Healthcare Family. This innovative collaboration supports district-wide initiatives focusing on student comprehensive health needs, which support the whole child. Beginning with the pilot program at Crockett HS in Spring 2012,CBCRCs expanded to 4 additional campuses in 2014 and to four additional campuses in 2014-15. By the end of 2016, the district will have 18 operational CBCRC’s geographically across Middle and High Schools in AISD.

The treatment model in Austin ISD CBCRCs is based in the following evidence-based orientations: Cognitive Behavioral Therapy, Trauma Informed Care, and Motivational Interviewing. All services are carried out in the form of individual, group, and family therapy sessions. Students are referred for CBCRC services by the campus Child Study Team, or parent/guardian. Parent/ Guardian consent is required in order for a student to receive services. CBCRC services do not interfere with any other services the student may be receiving. CBCRCs offer a variety of payment options for both insured and uninsured, which help meet the range of needs of AISD families.