Republic of the Philippines

Department of Education
Region III – Central Luzon
SCHOOLS DIVISION OF AURORA
Bacong, San Luis, Aurora

NAME OF SCHOOL: ___________________________________________________________________

DISTRICT: ____________________________________________________________________________
NAME OF SCHOOL HEAD: _____________________________________ Contact No._______________
NAME OF COORDINATOR: _____________________________________Contact No. _______________
NAME OF ALTERNATE COORDINATOR: _________________________Contact No._______________
TYPE OF SCHOOL: Elementary, Grade 1- 6 ( )
Integrated School ( )
Secondary, Junior HS ( )
Secondary, Junior HS+SHS ( )
Senior HS (Stand Alone) ( )
DATE MONITORED: ______________________________

SCHOOL MENTAL HEALTH MONITORING TOOL

EXTENT OF IMPLEMENTATION
INDICATORS EVIDENT PARTIALLY NOT REMARKS
EVIDENT EVIDENT

School has mental health care structure

such as a wellness room.

School conducts daily, dance exercise or

the likes

School organize sportsfest

School initiate personnel’s annual

medical check-up

School conducts learning action cells on

healthy mental habits at work such as
daily prayer, mindfulness, 10 minutes of
silence
School spearheads fitness program of
personnel

School has PROVIDED MHPSS

modules during the 1st week of classes

School conducts LAC sessions that

integrate brain exercises

Personnel attended webinars on MHPSS

participated

School imposes policy that teachers

should have moderate workload

School imposing rules not to pressure

personnel on their work but not
compromising the quality of tasks

The school is free from noise

School is implementing normal class

sizes

School has no any conflict between

school personnel and school authorities

School has conceptualized a MH plan for

the coming School Year

School is implementing teachers’

manageable students’ behavioral
problems

School is implementing stress

management

School is organizing sessions on how to

handle problem behavior on the part or
parents

School is initiating bonding moments of

school personnel

School is further developing relationship

 with colleagues, superiors, parents and
students

School provided psychosocial support

among its personnel

School is conducting psychosocial

support services among pupils/students

CASE FINDING # OF CASES REPORTED NOT REPORTED

1. Bullying

2. Bullying(personnel)

3. Depression

4. Severe Anxiety

5. Other mental health issues

Conforme:
_____________________________________________________________________________
NAME AND SIGNATURE OF SCHOOL MENTAL HEALTH COORDINATOR/RESPONDENT

____________________________________________
NAME AND SIGNATURE OF SCHOOL HEAD

Monitored by:
______________________________________________________
NAME AND SIGNATURE OF MONITORING REPRESENTATIVE