Mental Health Related Absences

Mental Health Absences Guidance

Watch the Mental Health Absences Guidance webinar to hear an overview about mental health excused absences, as well as a discussion on what implementation may look like.

ESSER Attendance and Reengagement

OSPI supports attendance & reengagement through the ESSER Attendance & Reengagement Project. Find out more by reading the Attendance and Reengagement Project Explainer.

Contact Information

Mental Health Absences

Krissy Johnson

Jenna Millett

The Washington State Legislative Youth Advisory Council (LYAC) and other youth advocates worked with state representatives to introduce and pass House Bill (HB) 1834: Mental Health Related Absences, during the 2022 Legislative Session.

HB 1834 directs OSPI to categorize a student's absence from school due to a mental health reason as an excused absence due to illness, health condition, or medical appointment; and to develop the rule and guidance to implement the rule in consultation with a student advisory group and the Graduation A Team Effort (GATE) Advisory Committee.

The rule went into effect on August 1, in time for the 2022-23 school year!

Policy & Guidance


There are various guides, toolkits, and resources to support school and district systems to address mental health issues and the absences that may occur because of them. We have selected a few key areas of focus to guide school districts in their work.

1834 Media Toolkit

In the Spring of 2023, OSPI worked with the Student Voice Network at the Association of Washington Student Leaders (AWSL) to create a media toolkit for school districts. This toolkit is available for all Washington State schools and districts to share on the mental health-related absence rule. The toolkit includes videos, social media posts, and printable handouts. For more information, please read the Media Toolkit Introduction.

Handouts and Social Media Content 

The handouts and social media content can be used to share on school districts social media pages or printed for student handbooks.

What is House Bill 1834?

Mental Health Brain

Student Resources for Mental Health

House Bill 1834 Mental Health Stigma

7 Ways to Cope with Stigma

Mental Health Day

AAPI Resources

Excused Mental Health Absences (PDF)

Body & Mind Self-Care (PDF)

Mental Health Excused Absence FAQ (PDF)

Mental Health Excused Absence Purpose (PDF)

Mental Health Day Schedule (PDF)

Healthy Habits (PDF)

Take a Mental Health Day (PDF)

Mental Health Days Are For…(PDF)

Your Well-Being Matters! (PDF)

Forms of Self-Care (PDF)

A Mental Health Day for Students (PDF)

Mental Health Absence FAQ (PDF)

Mental Health Q&A for Families (PDF)

Supporting Your Child (PDF)

Video Content

The video content can be used to share on school districts social media pages, at orientation or health class.

Tabitha George, High School Teacher 

Jordan Hummel, High School Teacher 

Challenges with implementing Mental Health Related Absences 

Key Components for a Comprehensive Mental Health Program 

Claudia Goodhew, High School Counselor 

Supporting Parents 

Supporting Students 

Kayla Gable, High School Teacher 

Joe McPherson, Elementary School Counselor 

Graham O’Brien, High School Counselor 

Kameron Franklin, High School Teacher 

Maria Mathisen, School Counselor 

Tyler Needy, High School Counselor 

OSPI would like to thank the Student Voice Network at AWSL for their hard work and dedication to this project. All materials posted were created by: Aleeza U., Audrey V.K., Mahi M., Elias A., Kara M., Jinhan L., Megan B., Khushi C., and Pradyu K.

Tools for Addressing Anxiety and School Refusal

Seattle Children's Hospital developed the Fast Approach Skills Training (FAST) resources for brief, evidence-based behavioral approaches for youth and families with common mental health concerns. These tools are specifically created for use in schools and other non-long-term-treatment settings.

Along with the FAST program handouts and workbooks, you'll also find FAST Program training modules for support.

You'll find: FAST-A for Anxiety, FAST-B for Behavior, FAST-D for Depression, FAST-P for Parenting Teens, FAST-T for Trauma, FAST-S for Safety.

Family Handout on Anxiety: Attendance Works created a handout for educators to share with families that offers brief information on the signs of anxiety and what families can do to support their child.

Addressing Mental Health Stigma

Youth Mental Health Communication Toolkit No Shame in Your Brain

This toolkit provides social media assets and posters to share positive messaging and supportive resources.

Youth Mental Health First Aid

Youth Mental Health First Aid is designed to teach how to help an adolescent who is experiencing a mental health or addiction challenge or is in crisis. Youth Mental Health First Aid is primarily designed for adults who regularly interact with young people. Topics covered include anxiety, depression, substance use, disorders in which psychosis may occur, disruptive behavior disorders (including AD/HD), and eating disorders. Some ESDs offer YMHFA training. Reach out to your region’s prevention center director for more information.

The Student/Youth Mental Health Literacy Library

The Student/Youth Mental Health Literacy Library gives any teacher, school counselor or other staff member a comprehensive resource of professionally vetted curricula and school presentations to easily and quickly compare available programs at their fingertips

Establish a System for Proactively and Supportively Responding to Absences

The following are two toolkits that guide schools and districts to include and address attendance in their multi-tiered system of support.

For Principals: Leading Attendance

This toolkit walks building leaders through cultivating a school-wide culture of attendance, using chronic absence data to determine need for additional support, developing staff capacity to adopt effective attendance practice and advocate for resources and policies to improve attendance.

Pathways to Engagement: Covid-19 Recovery through School Attendance

This toolkit walks schools through establishing or enhancing a teaming approach to attendance, reviewing data to understand strengths and challenges, developing tiered engagement strategies, and assessing what works.

Find more attendance-related resources on OSPI’s Attendance page and at Attendance Works.

Build or Strengthen School Mental Health Systems within a MTSS

This resource helps states, districts, and schools understand the core components of comprehensive school mental health and engage in a planning process around implementation of services.

Supporting Child and Student Social Emotional Behavioral Health (US Department of Education)

This resource highlights seven key challenges to providing school- or program-based mental health support across early childhood, K–12 schools, and higher education settings, and presents seven corresponding recommendations. The appendix provides additional useful information, including (a) numerous examples corresponding to the recommendations highlighting implementation efforts throughout the country; (b) a list of federal resource centers; (c) a list of resources to assist educators (teachers, providers, and administrators) in implementing the recommendations; and (d) guidance on existing programs that can support social, emotional and mental health services for students.

The SHAPE Assessment

The SHAPE Assessment helps schools and districts improve their school mental health systems

  • SHAPE users map their school mental health services and supports
  • Assess system quality using national performance standards
  • Receive custom reports and strategic planning guidance and resources
  • Utilize additional SHAPE features including the Screening and Assessment Library and Trauma-Responsive Schools Assessment and Resources

Northwest Mental Health Technology Transfer Center

Co-developed by the Mental Health Technology Transfer Center (MHTTC) Network Coordinating Office and the National Center for School Mental Health (NCSMH) to help states, districts, and schools across the United States understand the core components of comprehensive school mental health and engage in a planning process around implementation of services, these implementation guidance modules focus on the following core features of effective school mental health initiatives.


988 Suicide and Crisis Lifeline

Call, text, or chat 988 to be connected to the National Suicide Prevention Lifeline (NSPL). It will be confidential, free, and available 24/7/365

Crisis lines for specific groups

(transgender, military, disabled)

Educator Wellness Resources

Reducing Secondary Traumatic Stress in the K-12 Workforce

In 2021, the Washington State Legislature passed SHB1363: Addressing Secondary Traumatic Stress in the K-12 Workforce. SHB1363 directs districts to adopt a policy and procedures to take meaningful steps in supporting staff’s health and well-being.

To help districts implement WSSDA policy and procedure 5515, OSPI and the Alliance for a Healthier Generation partnered to provide these free resources and an online assessment.

Washington State Health Care Authority’s Smart Health

SmartHealth is Washington State's voluntary wellness program that supports you on your journey toward living well. It is included in your SEBB benefits at no cost to you.

Washington OSPI’s Workforce Secondary Traumatic Stress

Ensuring the well-being of educators is a critical component to sustaining an effective workforce and promoting student outcomes. By implementing policy through strategic use of professional learning and a continuous improvement process, districts and schools can reduce staff turnover, increase student outcomes, and model healthy behaviors for the entire school community.

Kaiser Permanente Thriving Schools

Thriving Schools takes a comprehensive approach to school health, curating the best thinking and guidance on how to keep students, staff, teachers, and families healthy across these dimensions of health.

Related OSPI Programs

Attendance, Chronic Absenteeism, and Truancy

Find resources, guidance, and attendance awareness materials to support embedding attendance into a multi-tiered system of support.

Youth Suicide Prevention, Intervention, & Postvention

Find resources and support to help in the development of Suicide Prevention Plans.

Multi-tiered System of Support

Multi-Tiered System of Supports (MTSS) is a framework for enhancing the adoption and implementation of a continuum of evidence-based practices to achieve important outcomes for every student.

Social Emotional Learning (SEL)

Broadly understood as a process through which individuals build awareness and skills in managing emotions, setting goals, establishing relationships, and making responsible decisions that support success in school and in life. When we think of educating the whole child, their social and emotional development must be considered as a part of overall instruction.

Substance Use Prevention & Intervention

The Student Assistance Prevention-Intervention Services Program (SAPISP) is a comprehensive, integrated model of services that fosters safe school environments, promotes healthy childhood development and prevents alcohol, tobacco, and other drug abuse.

Behavioral Health Resources

Behavioral Health is the promotion of mental health, resilience, and wellbeing; the treatment of mental and substance use disorders; and the support of those who experience and/or are in recovery from these conditions, along with their families and communities (US Substance Abuse Mental Health Services Administration).

Project AWARE

Project AWARE is a grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) spread over five years to both build and grow mental health services and behavioral health education within the awarded districts. OSPI’s Project AWARE is now in its second cycle. It is the vision of OSPI that all young learners can be successful. Mental health services and educators, staff, mental health professionals, and community members who have behavioral health training are integral to this success.

Youth-led Resources

Guide to connect teens to multicultural mental health care

There can be added layers of challenge for youth who identify as people of color, from cultural taboos around discussing mental health to a lack of therapists and physicians of color who specialize in treating young people. This guide is designed to outline the steps teens and young adults can take to find a provider that suits their needs.