ALIGNING COMMUNITY SCIENCE AND SCHOOL

BASED MENTAL HEALTH: POLICY TO PRACTICE

Paul D. FlaspohlerCarl E. Paternite

Noelle DuvallMelissa Maras

Abe Wandersman

June 11, 2005 - Champaign, ILJune 11, 2005 - Champaign, ILA Symposium at the10th Biennial Conference A Symposium at the10th Biennial Conference of the Society for Community Research & Actionof the Society for Community Research & Action

A Strategy: Expanded School Based Mental Health

Student Well Being

And School Success

Enhanced Systems (Family, School, Community)

Policies

InfrastructuresResources

Practices

Primary and

Secondary Prevention

Assessment and

Early Intervention

Intensive

Treatment

Mental H

ealth

Promotion

Awareness of Need

Strategic Planning

Training (Pre- and In-

Service)

Collaboration

Effective Practice

Evaluation

Quality Assessment And Improvement

Common Language

Coordination

Best Practice Principles of ESBMH (Weist et. al., 2005)

• All youth and families are able to access appropriate care regardless of their ability to pay.

• Programs are implemented to address needs and strengthen assets for students, families, schools, and communities.

• Programs and services focus on reducing barriers to development and learning, are student and family friendly, and are based on evidence of positive impact.

• Students, families, teachers and other important groups are actively involved in the program's development, oversight, evaluation, and continuous improvement.

• Quality assessment and improvement activities continually guide and provide feedback to the program.

Principles of ESBMH (cont’d)

• A continuum of care is provided, including school-wide mental health promotion, early intervention, and treatment.

• Staff hold to high ethical standards, are committed to children, adolescents, and families, and display an energetic, flexible, responsive, and proactive style in delivering services.

• Staff are respectful of and competently address developmental, cultural, and personal differences among students, families, and staff.

• Staff build and maintain strong relationships with other mental health and health providers and educators in the school, and a theme of interdisciplinary collaboration characterizes all efforts.

• Mental health programs in the school are coordinated with related programs in other community settings.

Ohio’s Efforts

• Strengthening Policy: the Shared Agenda• Bridging Policy and Practice: The Ohio

Mental Health Network for School Success• Providing Prevention Support – The Ohio

Community Collaboration Model for School Success

• Providing Prevention Support - University-Community Partnerships

• Pre- and In-Service Training: The Mental-Health Education Integration Consortium

Strengthening Policy: Development and

Implementation of Ohio’s Shared Agenda

Carl E. PaterniteCenter for School-Based

Mental Health Programs (Miami University)and

Ohio Mental Health Network for School Success

Legislative Forum On Mental Health and School SuccessCreating A Shared Agenda In Ohio

Kristin’s TestimonyOctober 9, 2003

Guiding Principles for a Mental Health,Schools,

Families Shared Agenda

• Mental health is crucial to school success

• There are shared opportunities for mental health, schools, students and families to work together more effectively address the well-being and school success of youth

Infrastructure for Ohio’s SharedAgenda Initiative

Hearing on Mental Health and School Success (February 8, 2001)

Presided over by Ohio’s First Lady Hope Taft and convened by:Ohio Department of Mental Health (ODMH)

Center for Learning ExcellenceOhio Department of Education (ODE)

Governor’s Office

Publication of Mental Health and SchoolSuccess: Hearing Summary and Resource

Guide (Spring, 2001)

Infrastructure for Ohio’s SharedAgenda Initiative

Formation in 2001 of the Ohio Mental Health Network for School Success

(OMHNSS)

Action Networks spearheaded by affiliate

organizations in six regions of the State

Ohio’s Positive Behavior Support Initiative

Collaborative efforts of: Special Education Regional Resource Centers The Ohio Association of Elementary School Administrators The Ohio Association of Secondary School Administrators

There currently are over 700 building teams and 10,000 educational staff trained in Positive

Behavior Supports

Policymaker Partnership (now the IDEA Partnership) at the National Association of State Directors of Special Education (NASDSE) and the National

Association of State Mental Health Program Directors (NASMHPD)

Concept Paper:Mental Health, Schools and Families Working

Together for All Children and Youth:Toward A Shared Agenda (2002)

Purpose of the Concept Paper

“Encourage state and local family and youth organizations, mental health organizations, education entities and schools across the nation to enter new relationships to achieve positive social, emotional and educational outcomes for every child.”

Missouri, Ohio, Oregon,South Carolina, Texas, and Vermont

With Ongoing Across-State NetworkingFacilitated by IDEA Partnership/NASDSE

Shared Agenda Seed Grant Awards to:

Additional Funding for Ohio’s Shared Agenda Initiative

Ohio Department of Mental HealthOhio Department of Education

Ohio Department of Healthand

Numerous Additional State-level and Regional Organizations

Ohio’s Mental Health, Schools, and Families Shared Agenda Initiative

http://www.units.muohio.edu/csbmhp/sharedagenda.html

Phase 1—Statewide forum for leaders of mental health, education, and family policymaking organizations and child-serving systems(March 3, 2003)

Phase 2—Six regional forums for policy implementers and consumer stakeholders (April-May, 2003)

Phase 3—Legislative forum involving key leadership of relevant house and senate committees (October 9, 2003)

Phase 4—Ongoing policy/funding advocacy and technical assistance to promote attention to the crucial links between mental health and school success

Approximately 725 participants

Keynote presentations by national and state experts

Promising work in Ohio showcased

Youth and parent testimony

Cross-stakeholder panel discussions

Facilitated discussion structured to create a collective vision, build a sense of mutual responsibility for reaching the vision, instill hope that systemic change is possible, and problem-solve regarding implementation issues

Strategies and Features of Phase 1 and 2 Shared Agenda Forums

Materials compiled and developed to inform the Fall, 2003 Shared Agenda Legislative Forum

Through Legislative Forum raise public awareness and build advocacy for policy and fiscal support for better alignment for education and mental health in the next biennial budget process

Website created to track and publicize Ohio’s Shared Agenda initiative (http://www.units.muohio.edu/csbmhp/sharedagenda.html)

Following Phases 1 and 2

Development of format for forum, and selection of date

Commitment of participation from ODMH and ODE leadership

Identification and preparation of legislative co-chairs

Invitation to additional legislative panelists

Invitation to stakeholders throughout the state

Legislative Forum PreparationOctober 9, 2003

Promotional work

Selection of students for written and oral testimony and identification of facilitator

Selection of adults (parents, educators, and mental health providers) for written and oral testimony and identification of facilitator

Development of written materials for the legislators

Plan for pre-forum events with student and adult participants

More Legislative Forum PreparationOctober 9, 2003

Legislative Forum On Mental Health and School SuccessCreating A Shared Agenda In Ohio

October 9, 2003

Legislative Forum On Mental Health and School SuccessCreating A Shared Agenda In Ohio

October 9, 2003

Comments from Legislators Following the Adult Testimony

From Representative Joyce Beatty (Member House Education Committee)In a question/challenge to fellow legislative panelists:

“Is there legislation that we should be looking at?”

From Representative Arlene Setzer (Chair, House Education Committee)In response to Representative Beatty:

“During this whole process I was also taking notes and marking because, as you indicated there have been some specifics provided to us which we truly need many

times when looking at legislation. And, as most of you know currently the house and the senate are working on Senate Bill 2 House Bill 2 which is for the teacher success and

identifying highly qualified teachers. And within that realm…..I am going to guide that discussion around some of things that I have heard today about the idea that teachers

need to understand regardless of what their teaching assignment might be…”

Phase 4 Steps for Ohio’s Shared Agenda Initiative

ODMH and ODE jointly formed an ad hoc workgroup to address action steps related to the Shared Agenda Recommendations

Public Awareness and Advocacy Professional Development/Training and Service Delivery Policy and Funding

Final report with recommended goals and objectives released, Summer 2004 (see handout)

Phase 4: An Immediate Legislative Outcome

(signed into law, June 2004)

Senate Bill 2Standards for Educator Professional Development

Section 3319.61, specifying what the new educator standards board is charged to do: Item E (lines 2912-2915) —

“The standards for educator professional development developed under division (A) (3) of this section shall

include standards that address the crucial link between academic achievement and mental health issues.”

Building A Bridge Between Policy and Practice: The

Ohio Mental Health Network for School Success

Noelle Duvall

Children’s Resource Center

Bowling Green, OH

Funding:

Ohio Department of Mental HealthOhio Department of Education

Co-Leadership:

Center for School-Based Mental Health Programs (Miami University)

Center for Learning Excellence(Ohio State University)

To help Ohio’s school districts, community-based agencies, and families work together to achieve improved educational and developmental outcomes for all children — especially those at emotional or behavioral risk and those with mental health problems.

Mission

The Ohio Mental Health Network forSchool Success

Action Agenda

Create awareness about the gap between children’s mental health needs and “treatment” resources, and encourage improved and expanded services (including new anti-stigma campaign).

Partner with regional action networks to enhance within-region implementation of the action agenda, actively soliciting student and family input. Also, contribute to statewide efforts (e.g., training institutes, workshops, research, etc.).

Conduct surveys of mental health agencies, families, and school districts to better define the mental health needs of children and to gather information about promising practices.

Phase 4 Steps for Ohio’s Shared Agenda Initiative

Ohio’s SAMHSA-sponsored 3-year Elimination of Barriers Initiative (EBI), focusing on the school age population. Contact strategies include:

Youth speaker panel/bureau

School resource materials

The Ohio Mental Health Network forSchool Success

Action Agenda (continued)

Provide training and technical assistance to mental health agencies and school districts, to support adoption of evidence-based and promising practices, including improvement and expansion of school-based mental health services.

Develop a guide for education and mental health professionals and families, for the development of productive partnerships.

The Ohio Mental Health Network forSchool Success

Action Agenda (continued)

Assist in identification of sources of financial support for school-based mental health initiatives.

Assist university-based professional preparation programs in psychology, social work, public health, and education, in developing inter-professional strategies and practices for addressing the mental health needs of school-age children.

Examples of OMHNSS Special Projects (2003-2005)

• Southwest: University-Community Partnership in Effective Implementation of the Olweus Bullying Prevention Program

• Northwest: Wood County Cross Training Initiative; Olweus Program Implementation

• Northeast: Intensive Positive Behavior and Support Training and TA

• Central: Development and Use of an Intensive School District Survey

• Southeast: Expansion of Youth Experiencing Success in Schools (Y.E.S.S.) Program

• North Central: See Me Hear My Feelings and related youth experience initiative; SBMH needs surveys in schools

Partnership Characteristics and Capacities

Local and State Level Actions and

Activities

Immediate

Mental Health Delivery OutcomesOutputs

Process and Activity Immediate

Training, Technical Assistance, and

Consultation Outcomes

Long-Term

Outcomes and Impacts

Contextual Conditions at

Local, County, and State Levels

Promoting School Success and Student Well-being Through

Effective Community Collaboration

Paul FlaspohlerAngie LedgerwoodMiami University

Dawn Anderson-Butcher Ohio State University

For Some of Our Kids Getting the Conditions Right is Difficult

Smart & Bored

Abused

Poor Health

Hungry

Depressed

Parents Did Not Do Well

in School Alcoholic Mother

Isolated

ODE Logic Model

Students receive high quality instruction

aligned with academic content standards

HIGHER ACHIEVEMENT

FOR ALL STUDENTSStudents have the right

conditions and motivation for learning

ODE’s Logic Model (Fall, 2004)

Student Achievement

Conditions & Resource Assessment

Youth Development

Parent/Family Engagement

& Support

Health & Social

Services

Community Partnerships

Evaluation &

Feedback

Collaborative Leadership & Sustainability

ODE’s new and expanded version for school improvement...

Getting the Conditions Right!!!!

AcademicOutcomes

Why an expanded model

• Builds upon traditional walled-in school reform strategies

• Addresses conditions underlying learning (i.e., non-academic barriers)

• Mobilizes community and school resources in support of school improvement

Bridging Research and Practice

• Implementation guide• Tools and resources • OCCM liaisons providing on-site technical

assistance• Professional development and training

opportunities• Cross-site networking and sharing

OCCMSI Pilots

Initial Lessons Learned @ Implementation

• School-driven from continuous improvement planning process

• Strategic, sustainable partnership • Attention to process and relationships• Connection of needs/outcomes to

effort/activities• Priority for systems change• Need for new roles and responsibilities • Local context matters

• Sustainable, capacity-building• Development of experts who share

their knowledge and experiences• Mutual learning about connections of

research and practice • Role of change agent and tendencies

to become part of system• Questions about who is prepared to do

this work• Implications for pre- and in-service

training

Initial Lessons Learned @ Technical Assistance and Training

Next Directions

• Future pilot project in 6+ districts across Ohio

• Embedded training within Regional School Improvement Teams

• EPIC• Connections of local level to content

expertise • Implications for policy

Keeping Our Eye on the Prize - Making School Improvement

Happen One Student at a Time Student Strengths and

Needs •Academic•Developmental•Social and Emotional•Physical and Behavioral Health

The Student

School and Community Services and Supports

Attributes•Individualized•Accessible•Timely•Best Practice Based•Competent

Types (Examples)•Academic Enrichment•Health Services•Social Services•Recreation Opportunities•Counseling Services•After-school Programs•Mental Health Services

The System

The Goal - To have a school-parent-community system in place that supports teachers by responding quickly and competently to student needs

Teachers in the Classroom

A Home Environment that Encourages and

Supports Learning Parents and Family

Prevention Support through University-Community Partnerships

Melissa Maras, Chris Reiger, Rochelle Rokusek, Kathy Conoway, Jim Mosher, Marc McLaughlin, & Angie

Ledgerwood

A Developing Philosophy

• School is the most appropriate setting for the provision of mental health intervention, prevention and promotion services (expanded school-based mental health)

• The effectiveness of these services hinges on successful collaboration between stakeholders

• Pre-service training is essential for stakeholders to build the skills necessary for doing expanded school-based mental health

Community Psychology in a Clinical Program?

Traditional Clinical Program

Individual/ FamilyPsychotherapy in School

Setting

Individual/ FamilyPsychotherapy in Clinic

Setting

Individual/ FamilyPsychotherapy in School

Setting

Prevention and Health Promotion in School Setting

Center for School-Based Mental Health Programs

ClassroomsCommunities

Schools/ Programs

Children and Families

Schools, Communities, Families & Children

• Opportunities– Access to diverse services– Support– Great resources at an excellent value

• Obstacles– State-mandated proficiency requirements– Resistance to expanded school-based mental health– Amount of services v. Collaboration between service-providers

Graduate Students

• Opportunities– Training

• Collaboration with MH stakeholders

– Research/ Practice Integration– Flexibility

• Obstacles– Constraints of Role Expectations

• The “expert” and “fix-it” syndrome• Frequent turnover

– Training Students for Multiple Roles• The tension between community and clinical psychology

– Accountability

Lessons Learned

• Better preparation• Join the community• Transparency• Modeling

• Accountability• Engaging families• Building bridges

Promoting Mental Health and School Success: Workforce Issues

The Mental Health—Education IntegrationConsortium (MHEDIC)

Bringing to together national experts in education and mental health fields to address:

pre-service workforce preparation issues

development of effective in-service training curricula and strategies

Administered through CSBMHP (Miami U.) and working in conjunction with the Center for School Mental Health Assistance (U. of Maryland), IDEA Partnership, and School Mental Health Alliance

In Addition to Parents, Teachers are On the Mental Health “Front Line”

• Yet, teachers/educators are very poorly trained in problem recognition and mental health promotion

• Significant need to enhance teacher/educator training based on analysis of issues confronted in the classroom/school

What Teachers/Educators Need

Basic Current Knowledge About:

Role of stress in students’ lives and impacts on learning

Signs and symptoms of mental illness diagnoses (e.g., depression, ADHD, anxiety disorders, conduct disorders…)

Risk factors and warning signs for suicide

Protective factors that promote resilience in students

Effective, culturally-informed treatments and supports for students with mental health problems

Medications and effects (intended and side effects) on learning and behavior

How to access community support and referral

Impacts of stigma

What Teachers/Educators Need

Effective Strategies and Skills for:

Promoting mental health (well-being) and academic achievement through instructional techniques and curriculum

Creating a positive classroom climate that offers a healthy learning environment and promotes academic, social, and emotional development for all students

Creating a positive, inclusive and safe school culture and climate

Working with students displaying typical emotional and behavior problems

Interacting with parents in empowering and affirming ways

Listening to students

EPE Content Review and

Revision

EPE Process Review and

Revision

Effective Practice

Integration Council

Content EPE /

U-C Partner

Process EPE /

U-C Partner

Stakeholder

Credibility Check

OCCMSI Shared AgendaABCFCF Councils

Effective Practice Network: Development and Implementation of Enhanced Content, Tools and Processes for SBMHDRAFT

Building and County /

District Engagement

Building and County /

District Engagement

OMHNSS

Enhanced SBMH Content

SBMH Sample Tools

Enhanced SMBH

Process

Products of the EPIC –

Synthesized and Translated Tools , Processes , and

Content to promote

successful implementation of effective practices in

Expanded School -Based Mental Health .

Piloting with PfS Academy

OCCMSI District Pilots

IDEA

PartnershipCASEL CSMHA MHEDIC

Partner

States

Department

of Education

Department

of Mental Health

Department

of Youth Services

National Partnerships State Partnerships

EPIC

Effective and Culturally Competent

Practice Synthesis and Translation

OMHNSS

Statewide

Effective Practice

Dissemination

RSITS

Statewide School

Improvement mechanisms

OCCM Liaisons

School Building School

Improvement Mechanism

PriorityNeeds

Lessons

Learned

Content ,

Tools , and processes for

Effective Practice

Models and

Mechanisms for Training

and Technical Assistance

OCCM Management

School Building

Planning , Implementation &

Evaluation

Collaborative

Structures

Linkage

Protocols

Ohio Schools

PreventionResearch System

Synthesis and

Translation

CDC Prevention Support

National Prevention Support Organizations

Org.Capacity

InnovationSpecificCapacityBuilding

GeneralCapacityBuilding

State Prevention Support System

Org.Capacity

InnovationSpecificCapacityBuilding

GeneralCapacityBuilding

Intermediary Prevention Support System

Org.Capacity

InnovationSpecificCapacityBuilding

GeneralCapacityBuilding

Local Prevention Delivery System

General and Innovation Specific

Capacity

Innovations (Principles ,

Processes , &

Programs )

Mental Health and School Success Websites

National:National Association of State Directors of Special Education

(www.nasdse.org)

Center for School Mental Health Assistance (CSMHA, http://csmha.umaryland.edu)

Center for Mental Health in Schools(http://smhp.psych.ucla.edu)

Ohio:Center for School-Based Mental Health Programs

(http://www.units.muohio.edu/csbmhp)

Center for Learning Excellence, Alternative Education and Mental Health Projects(http://altedmh.osu.edu/omhn/omhn.htm)

Ohio’s Shared Agenda Initiative(http://www.units.muohio.edu/csbmhp/sharedagenda.html)

This PowerPoint Presentation is posted on the Center for School-Based Mental Health Programs website

http://www.units.muohio.edu/csbmhp/