Leading the Charge: A Qualitative Descriptive Study Exploring How Public Middle School Principals Perceive and Enact Their Role as Advocates for School-Based Mental Health

Abstract

Adolescent mental health concerns have increased significantly during the middle school years, requiring school leaders to expand their role in supporting students’ social, emotional, and psychological well-being. Although schools are uniquely positioned to deliver comprehensive mental health services, how public middle school principals perceive and enact their role as advocates for school-based mental health services remains underexplored. The purpose of this qualitative descriptive study was to explore how public middle school principals perceive and enact their role as advocates for school-based mental health services. Guided by social cognitive theory (SCT), this study examined how personal beliefs, behavioral practices, and environmental influences shaped principals’ leadership actions. Participants included middle school principals and assistant principals from five public middle schools in a suburban district in the southeastern United States. Data were collected through an eligibility questionnaire and semistructured interviews. Data analysis followed a reflexive thematic approach using iterative coding, clustering, and theme development procedures. Seven themes emerged: leaders as frontline mental health advocates, systemic constraints that undermine implementation, multitiered systems of support as an operational framework, relational leadership and trust building, balancing structure and care in leadership identity, staff capacity and training needs, and evolving expectations of middle school leadership. Findings indicated that principals viewed themselves as central decision-makers in shaping school culture and normalizing mental health support, while encountering structural barriers such as funding limitations, staffing shortages, and competing accountability demands. Conclusions suggest that leadership preparation, district policy alignment, and organizational support structures are critical for strengthening principal- vii led mental health advocacy and fostering equitable, developmentally responsive school environments. Keywords: middle school leadership, adolescent mental health, school-based mental health advocacy, qualitative descriptive research, social cognitive theory, educational leadershi