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A Framework and Resources to Advance School-Based Services for - - PowerPoint PPT Presentation

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Bringing School Mental Health to a New Level: A Framework and Resources to Advance School-Based Services for Students and Families Elizabeth Connors, Ph.D., Assistant Professor Sharon Hoover, PhD. Associate Professor Child and Adolescent

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Bringing School Mental Health to a New Level: A Framework and Resources to Advance School-Based Services for Students and Families

Elizabeth Connors, Ph.D., Assistant Professor Sharon Hoover, PhD. Associate Professor Child and Adolescent Psychiatry University of Maryland School of Medicine Center for School Mental Health

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Center for School Mental Health Team

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National Center for School Mental Health

MISSION To strengthen the policies and programs in school mental health to improve learning and promote success for Americas youth

  • Established in 1995. Federally funded by the Health Resources and Services Administration.
  • Focus on advancing school mental health policy, research, practice, and training.
  • Shared family-schools-community agenda.

Co-Directors: Sharon Hoover, Ph.D. & Nancy Lever, Ph.D. Director of Quality Improvement: Elizabeth Connors, Ph.D. www.schoolmentalhealth.org (410) 706-0980 TWITTER - @CtrSchoolMH

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2018 Annual Conference

  • n Advancing School Mental Health
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AGENDA

  • What is comprehensive school mental health?
  • National School Mental Health Census and Performance Measures
  • The SHAPE System
  • Best practices and innovation in school-community-family partnerships

in school mental health

  • Application to your local team processes and systems
  • Questions/Discussion
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Comprehensive School Mental Health Systems

Trauma-informed Social Emotional Learning

Mental Health Treatment

Restorative Justice

Safe and Supportive

Positive Behavioral Interventions Mental Health Promotion and Supports (PBIS)

Positive School Climate

Educating the Whole Child

Mental Health Literacy

Substance Use Prevention and Intervention

Resilience-Promoting ACES Aware

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WHAT IS A COMPREHENSIVE SCHOOL MENTAL HEALTH SYSTEM?

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What School Mental Health is NOT

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Comprehensive school mental health systems (CSMHSs) represent a strategic collaboration between school systems and community programs…

CSMHS Definition - US Department of Health and Human Services, 2018

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The partnerships between school staff and community mental health program staff are purposeful, and augment the abilities of schools to integrate student mental health into education.

CSMHS Definition - US Department of Health and Human Services, 2018

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Family-youth-school-community partnerships represent a key feature of CSMHSs.

CSMHS Definition - US Department of Health and Human Services, 2018

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Multi-tiered system of supports provided, based

  • n principles of prevention and address the

range of academic, behavioral, and social needs

  • f a school’s student body.

CSMHS Definition - US Department of Health and Human Services, 2018

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Services and supports use evidence-based methodologies

CSMHS Definition - US Department of Health and Human Services, 2018

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CSMHS Target Outcomes

 Purposefully integrate student mental health into education  Expand children’s access to a full continuum of effective,

evidence-based mental health services

 Achieve positive social, emotional, behavioral and educational

  • utcomes

 Promote mental health and wellness  Reduce the prevalence and severity of mental illness  “Enhance sense of school as a community” (improve school climate,

student engagement, attendance, and educational outcomes)

CSMH, 2013; US Department of Health and Human Services, 2018

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MTSS School-Community Partnerships

Kathy Short, 2016, Intl J. of Mental Health Promotion

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WHY GROW SCHOOL MENTAL HEALTH?

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Median Age of Onset: Mental Illness

Age 40 Age 80 Age 20 Birth Age 60

Psychosis

Phobias & Separation Anxiety

ADHD

Conduct Disorder Opposition Defiant Disorder Intermittent Explosive Disorder

Major Depression Substance Abuse

Mid- teens Mid- 20s

Autism Spectrum Disorders

WHO World Mental Health Surveys as reported in Kessler et al., 2007

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Advantages of Mental Health in the School Setting

  • Greater access to all youth  mental health promotion/prevention
  • Less time lost from school and work
  • Greater generalizability of interventions to child’s context
  • Less threatening environment
  • Students are in their own social context
  • Clinical efficiency and productivity
  • Outreach to youth with internalizing problems
  • Cost effective
  • Greater potential to impact the learning environment and educational
  • utcomes
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Successes

  • Increasing emphasis on:

– Multi-tiered Systems of Support (RtI, PBIS-SMH/ISF, etc) – Evidence-based (research-supported) Practice (EBP) – Consideration of cultural context in development, selection, implementation, and evaluation of EBPs – Meaningful partnership with youth and families – School-community partnerships – Workforce training for mental health providers and educators – Outcomes

  • Pockets of funding to support school mental health

– Increased federal investments – Creative funding streams at local/state levels

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Challenges

  • Limited, variable funding
  • Difficulties with system integration (Mental Health-Education)
  • Poor practice selection
  • Gaps in training, particularly related to working schools, engaging

families, evidence-based practice “C.O.W. Therapy” – Crisis of the Week

  • Poor implementation support
  • Limited accountability of providers and services provided
  • Lack of good data metrics and infrastructure
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We need STANDARDS, PROCESSES, and STRATEGIES for integrating mental health into education

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What is the NQI?

The National Quality Initiative (NQI) is an effort to advance accountability, excellence, and sustainability for school health services nationwide by establishing and implementing an online census and national performance measures for school-based health centers and comprehensive school mental health systems.

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National School Mental Health Census and Performance Measure Development

Phase 1: Review of history of related efforts (e.g., state surveys, Foster et al., 2005)

Phase 2: Expert Advisor and Project Advisory Group Input

Phase 3: Pilot testing with school districts in national SMH learning collaborative

Phase 4: Revision via user feedback

Phase 1: Expert Advisor Consensus

Phase 2: Project Advisory Group nominal group decision-making

Phase 3: School mental health stakeholder modified Delphi process

Phase 4: Revision via user feedback from school districts in national SMH learning collaborative

(Connors, Stephan, Lever, Ereshefsky, Mosby & Bohnenkamp, 2016)

National School Mental Health Census

Quality and Sustainability Performance Measures

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National School Mental Health Census Sections*

I. SHAPE Leader Information II. School/District Information (grades served, students enrolled) III. Students Served and Data Systems (data points used and for what purpose to support students) IV. District Staffing (types of team members, school or community employed and FTEs) V. Services Provided (by type of mental health need and tier)

*Schools and districts can complete this by registering their school or district and filling out the School Mental Health Profile on www.theshapesystem.com

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Schools and School Districts Can Use SHAPE To:

  • Document your service array and multi-tiered

services and supports www.theshapesystem.com

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Advance a data-driven mental health team process for the school or district

 Strategic Team Planning  Free Custom Reports

Schools and School Districts Can Use SHAPE To:

www.theshapesystem.com

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Access targeted resources to help advance your school mental health quality and sustainability

www.theshapesystem.com

Schools and School Districts Can Use SHAPE To:

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Schools and School Districts Can Use SHAPE To:

Achieve SHAPE Recognition to increase opportunities for federal, state and local grant funding

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View, print, share, and review the SMH Profile and Quality and Sustainability Assessments anytime by visiting SHAPE home page

Full and Abbreviated Versions

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Why would a district use SHAPE?

Districts that:

  • want to document what mental health services they have

across tiers of support in the district

  • need a uniform quality improvement process to

understand school mental health strengths and needs throughout the district

  • would like to standardize the process of school-community

mental health partnerships in their district, while still allowing schools to individualize services to their needs

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Why would a school use SHAPE?

Schools that:

  • want to document their school- and community-employed mental

health staffing

  • need to identify what services they have for specific problem areas

across a multi-tiered system of support (MTSS)

  • are interested in improving their universal screening practices, but

don’t know where to start

  • would like to better partner with community mental health

providers, but want to be sure that added services meet needs, and are complementary with and augment existing staff supports

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Be Counted and Get your Blue Star on the Map!

www.theshapesystem.com

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Registration Initiated

You have selected to register JEFFERSON UNITED School District. Please enter your e-mail address to proceed with your registration.

E-mail Address

doe@jane.com

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email@example.com

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School Mental Health Playbook Series

Playbooks can be found in the resource library at www.theshapesystem.com or at http://csmh.umaryland.edu/Resources/BriefsReportsWhite-Papers/

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New to SHAPE

 Trauma-Responsive Schools Implementation Assessment

https://theshapesystem.com/trauma/

 Screening and Assessment Library

https://theshapesystem.com/assessmentlibrary/

 State SHAPE Accounts

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Trauma-Responsive Schools (TRS) Implementation Assessment www.theSHAPEsystem.com/trauma

Developed by the NCTSN, Treatment and Services Adaptation Center for Resiliency, Hope and Wellness in Schools (www.traumaawareschools.org) and the CSMH (www.schoolmentalhealth.org) Domains:

 School-wide Safety (e.g., predictable routines, physical safety)  School-wide Programming (e.g., restorative justice, culturally responsive teaching)  Staff Trauma Knowledge (e.g., school/classroom impact of trauma, neurological impact)  Staff Trauma Skills (e.g., trauma-informed communication, de-escalation)  Early Intervention Activities (e.g., trauma screening, early intervention evidence-based trauma practices)  Targeted Intervention Activities (e.g., School-based Trauma Treatments, Referrals)  Staff Wellness/Burnout/Secondary Traumatic Stress (e.g., Staff Assessment, Staff Supports)

All items are on a 6-point Likert scale reflecting degree of implementation

Sharon Hoover, 2018

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States can use SHAPE to:

Systematically view the landscape of school mental health at schools and districts in their state Document and advance quality improvement and sustainability in school mental health

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National SHAPE Adoption

State Teams: Arkansas Connecticut Delaware Indiana Massachusetts New Hampshire New York City North Carolina Oklahoma Rhode Island Texas (Houston) Washington Wisconsin Wyoming

24 CoIIN Districts: Schools and districts in 48 states + Washington DC have started using SHAPE and completed the School Mental Health Census

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The SHAPE System: Voices from Early Adopters

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“It has brought key folks to the table that had not previously worked together for a common purpose/shared goals. It sparked ideas and

  • enthusiasm. It helped the school and community providers better
  • align. It provided lots of learning for our team that we can spread to
  • thers in the district. It gave us a framework, resources, and ideas to

use in our efforts. It gave us a reason to get started on

good work.”

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“It forces us to look at our progress, and how we are coding, collecting and reporting data.” [I love that] “… we are a collective group of unique individuals working towards the same goal.” User friendly and accessible Assessment and feedback

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“We are finally beginning to talk about mental health and develop a system to track our students who are in need of and/or receiving services. It has been a very slow process, but at least it is now on the radar with the district.”

Enhanced recognition of school mental health

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“It has made us accountable in setting goals/outcomes, tracking data and conducting ongoing assessments on how we are integrating mental health supports in our schools.”

Provided teams with structure

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Effectively supported quality of services

“Our system has improved across the board regarding implementation of the National Performance Measures, which has, in turn, translated into better services for students, stronger and more sustainable partnerships with community mental health agencies and universities, improved practices regarding identification of students and progress monitoring, and the adoption of policies and strategies that place school mental health as a central focus for district improvement. Funding has improved as well, and the district has teamed to move the mental health initiative in [our district] moving forward.”

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Examples from the Field

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Coordination with community mental health providers

  • Many of our schools have individual partnerships with community mental health providers, but these

relationships vary greatly across the district.  Map existing community partner relationships  Identify strengths and gaps of existing partnerships  Clarify goals at the district level  Create uniform MOU that includes roles and responsibilities of each party, fiscal and non-fiscal resource sharing and data sharing considerations

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Mapping and refining teams

A school district had an existing system of student support services teams in each school building but they operated very differently and some were more effective than others.

 Innovation

 Started with a case study of several teams across the district  Mapped purpose, frequency, meeting process, membership, targeted outcomes  Identified strengths within individual teams  Created a matrix to more uniformly define structure and processes for SST teams across the district

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Developed by Baltimore City Public Schools, 2017 as a part of the School Mental Health Collaborative for Improvement and Innovation Network

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Creating a district CSMHS team

A school district wanted to create a district CSMHS team to oversee and

  • rganize their SMH quality improvement work.

 Innovation

 Identified school and district staff that would be critical members  Addressed time and logistical barriers by holding virtual meetings 1x per month  Clearly defined the goals and targeted outcomes

Engage in CSMHS quality improvement process starting with performance domain of teaming Measure improvement by SMH National Performance Measure Quality Assessment

 Utilized meeting best practices to ensure efficiency and accountability

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Youth and Family Engagement

A school district had informal youth and family participation in their CSMHS decision making but wanted to create a structure for more meaningful engagement.

Innovation

Students and families were invited to join a first meeting about the CSMHS at one school. During the meeting, attendees provided feedback about the CSMHS, their SMH priorities and how to foster continued engagement. A youth and family advisory council was created with the goals of providing education about MH, helping plan initiatives and connecting with other families about SMH.

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SHAPE your school mental health system

  • How could SHAPE be useful in your

school/district/state?

– What domains of school mental health quality or sustainability are the least well implemented?

  • What are next steps to engage your

stakeholders in SHAPE?

  • What questions remain?
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Discussion/Questions

Center for School Mental Health www.schoolmentalhealth.org Email: csmh@psych.umaryland.edu Phone: (410) 706-0980 @CtrSchoolMH

Sharon Hoover, Ph.D. shoover@som.umaryland.edu @drsharonhoover Elizabeth Connors, Ph.D. econnors@som.umaryland.edu