One of the important aspects of a tier 1 program according to Multi-Tiered Systems of Supports (MTSS) is that it connects students to support and offers a referral process. At Erika’s Lighthouse, we know that it is important to make help available to students who may need it after participating in our classroom education programs, so all three classroom programs use self-referral cards. These cards are developmentally appropriate and provide students the opportunity to ask for help if needed. 


The Level I program, We All Have Mental Health calls the self-referral cards “exit tickets.” The exit tickets ensure that a student is able to identify a trusted adult and identify how the information they learned about in the lesson made them feel. The exit ticket for lesson 1, asks the students to fill in the emoji that they feel after the lesson and to identify if this is an everyday feeling or an overwhelming feeling. The exit ticket for the second lesson, asks the students to identify a trusted adult and write what they would say to that person. The exit ticket for the third lesson, asks the student to select a box that is most appropriate for them. The choices are “I need to speak to a trusted adult very soon,” “I need to speak to a trusted adult sometime this week,” and “I do not need to speak with a trusted adult”. Each of these exit tickets is developmentally appropriate for students in grades 4 to 6 and allows the school mental health staff to identify which kids need more support.


The self-referral cards for Level II: Depression Awareness and Level III: Depression Education and Suicide Awareness are intended to be distributed to students after lesson 1. Each of the cards states, “I need to speak to a trusted adult in 24 hours”, “I need to speak to a trusted adult in the next week”, “I do not need to speak to a trusted adult”. The self-referral cards should be given to every student and every student should be required to complete the card and return it at the end of the lesson. This is an important aspect of using self-referral cards, as we do not want a student who needs to speak to a trusted adult to feel embarrassed, nervous, or ashamed because their classmates are not turning one in. 


It is not mandatory for an educator to use the self-referral cards. However, if the self-referral cards will be used, it is important that there is a process in place to support the students who have identified as needing support. We recommend having a conversation with the mental health staff and developing a plan to support the students. We want the students, educators and mental health professionals to feel confident, capable and prepared when using self-referral cards.