Psychiatric Clearances in Schools

March 20, 2023

With increasing frequency, children are being removed from educational placements due to safety concerns, and their parents are told that, before their children can return to the classroom, they must undergo a psychiatric evaluation. This trend has been reflected both in increased calls to our 800.4.AUTISM Helpline and in the rise of news stories in both local and national news about informal removals from school.

This article offers multiple perspectives and considerations to promote clear communication between parents and professionals to maximize everyone’s safety.

The New Jersey Department of Education Memo

The New Jersey Department of Education (DOE) responded to this significant upswing in psychiatric clearances for students with disabilities in their February 8, 2023 memo. The memo clarified that, if a student has an IEP, removing that student pending psychiatric clearance is an informal removal that can trigger the need for a Manifestation Determination Review. It also underscored that parents should not pay for psychiatric clearance evaluations and that even students without IEPs may have additional protections if they are suspected of having a disability.

Complex Decisions

While the DOE’s memo offers general guiding principles and requirements, keeping everyone safe requires a great deal of student- and situation-specific knowledge and real-time decision making. Teachers and administrators face the difficult balancing act of supporting students with complex mental and behavioral health challenges in the context of the national labor shortage while maintaining an environment that is safe and promotes learning for all students.

Questions and Considerations for Parents and Professionals

When can a psychiatric removal be appropriate?

A psychiatric removal can be appropriate in instances where a child poses a danger to themselves or others in the school.

For parents, what should I do if the school tells me to pick up my child due to a safety concern?

This can be a highly emotional situation for all involved, so you might want to consider bringing a trusted friend or family member with you to help you stay calm and remember all the relevant information.

For school professionals, how can we support parents during a safety concern?

This can be a highly emotional situation for all involved, so it’s important to support each other and the family. Try to have as much of the below information available to the family to promote clarity and collaboration during this difficult time.

What information should be available in writing?

Request – The school’s request for an evaluation including the reason, an incident report detailing the events leading to the clearance, and other courses of action that were considered.

If self-harm is a concern: any screening protocols used, who conducted the screening, and the results.
If aggression toward someone else is a concern: information about who might be hurt.

NOTE TO PARENTS: The school likely cannot provide specific names but likely can share if it is a classmate, teacher, staff, or administrator.

Personnel – School personnel involved in the decision-making process.

Individualized Education Plan (IEP) services – If and how any IEP-mandated services will be provided during the child’s time out of the school building.

Suspension – Clarification if the district is suspending the child until the screening is conducted.

Payment – Who is financially responsible for the screening.

Screener – Qualifications of the screener (see below). This can include any relevant professional credentials and state licenses for clarity and agreement prior to conducting the screening.

Documentation – All necessary paperwork for the screening and the required content of the screener’s evaluation to clear the student to return to school.

Who can conduct the screening, and where should it happen?

There are a few options regarding who and where so families can often choose the one that’s best for them and meets the school’s qualifications.

NOTE TO PARENTS: Be sure to share the school’s written request with any potential screeners to ensure that they meet the school’s qualification standards and can provide all the required information.

Hospitals – Some hospitals offer Psychiatric Emergency Screening Services that send someone to the school or home to conduct the screening. Local emergency departments might also be able to provide a screening.

NOTE TO PARENTS: Emergency department waits can be very long. Be prepared to stay at the hospital for a few hours. You might wish to bring snacks, water, a sweatshirt or other warm clothing, your cell phone charger, and a notebook to write down any important information.

District referral – Some districts have contracts with agencies or individual providers that provide screening services. Working with a contracted agency/provider can be a more streamlined process.

Private mental health clinician – The student’s current mental health clinician or another private clinician may be able to conduct the screening.

What should happen after the child returns to school?

If the student has an IEP or 504 plan, the following suggestions could be considered during formal meetings.

Review past supports – Review any supports that were in place and to what degree they were implemented and effective.

Plan current supports – Consider if some of the previous supports should remain in place or be strengthened and if more proactive strategies are warranted.

If the child is able to seek help on their own, identify trusted adults in the school setting and determine how they can access these adults if further concerns arise.
If the child works with clinicians or professionals outside of school hours, consider their recommendations.

Explore any patterns – If safety concerns are frequent, consider the least restrictive and most educationally beneficial supports and settings.

Expert consultation – When a pattern of safety concerns arises, consider working with a consultant (e.g., school or clinical psychologist, Board Certified Behavior Analyst) with the knowledge and skills to conduct a more thorough assessment and make more comprehensive recommendations.

Experience Our Power of Connection

For more information about school services and special education, parents can read our special education articles, visit our special education page, and review the helpful DOE publication titled Parental Rights in Special Education (PRISE). Families can also contact our helpline staff by calling 800.4.AUTISM or emailing us at information@autismnj.org.

Autism New Jersey appreciates Dr. Matthew Strobel’s contributions to this article. Dr. Strobel is a Licensed Psychologist, Certified School Psychologist, and Founder of Navesink Psychological Services.