RAP Club: A New Approach to Mental Health Promotion in Schools

In 2023, 40% of high school students in the United States reported experiencing persistent sadness over the course of the year. Tamar Mendelson, Bloomberg Professor of American Health and Director of the Center for Adolescent Health at the Johns Hopkins Bloomberg School of Public Health, is working to change this alarming trend in schools nationwide.

Adolescents face numerous barriers to accessing mental health care, including financial, cultural, and geographical challenges. Recognizing the urgency, Mendelson and her team launched an innovative approach in 2014 to bring care directly to students—at school.

RAP Club—short for "Relax, be Aware, and do a Personal rating"—teaches students in Baltimore City schools mindfulness techniques to help them manage adversity. Students attend RAP Club during periods when elective courses are offered and are encouraged to participate in engaging activities that illustrate the importance of mindfulness. Programming includes a check-in that asks students to identify their stress levels using a thermometer and activities where they can see the effects of stress in action through an exploding soda bottle and practice tolerating difficult emotions using their five senses.

An efficacy trial testing the program in 29 public schools showed that the program significantly reduced student depressive symptoms, anxiety, post-traumatic stress disorder symptoms, and behavioral issues during the critical transition to high school.

However, in this and previous studies, the program was delivered by trained members of Mendelson’s research team, which is not a sustainable or scalable model. To address this issue, Mendelson secured funding from the Bloomberg American Health Initiative to explore an alternative approach—training existing school staff to implement RAP Club.

Between 2022 and 2023, staff members in three Baltimore City schools were trained to deliver the program to 8th graders. The results were promising: staff achieved over 60% adherence to the curriculum, providing strong preliminary evidence that RAP Club could be effectively implemented without specialized mental health training.

Feedback from school staff participating in the program was overwhelmingly positive. One administrator shared, “I have worked in Baltimore City Schools for 17 years and run more programs than I can count, but this is by far the best one I have ever implemented."

Encouraged by these successes, Mendelson and her team have submitted two federal funding applications to test school personnel delivery of the RAP Club program. This work advances Mendelson’s goal of scaling the program broadly to give young people across the country greater access to vital mental health support.