1. I NTEGRATING M ENTAL H EALTH INTO K INDERGARTEN AND E ARLY C HILDHOOD E DUCATION Kelly Perales Community Care Behavioral Health October 30, 2014 PBIS Leadership Forum

2. BIG I DEA … How Multi-tiered Systems of Support (MTSS) can enhance mental health in schools Installing SMH through MTSS in Schools The Interconnected Systems Framework (ISF) SMH +MTSS=ISF

3. Community Care as Part of the State Community of Practice on School Based Behavioral Health Demonstration Project: Scranton Montrose Demonstration Project: Scranton Montrose

4. PA PBS N ETWORK Affiliated partnership with representatives from: Department of Drug and Alcohol Programs Department of Education Department of Public Welfare Department of Health Office of Child Development and Early Learning Devereux Center for Effective Schools Community Care Behavioral Health Value Behavioral Health McDowell Institute Office of Mental Health and Substance Abuse Services

5. Compelling Factors Detention/ RTF t h Intake CW Sys Intake Referral MH Sys D&A Sys JJ Sys Ed. Sys Intake MCO Sys MR Sys Intake Referral Partial Psych Detox AAA Intake Court Probation Residential Eligibility Counseling Special Ed Truancy Mentor APS Partial Residential Mobile T Case Mgmt. TSS/BSC Inpatient Case Mgmt.. Care Mgmt. Primary Care Case Work Foster Care Health Sys ER Intake Hospital. Therapist. Psychiatrist

6. SMH AND PBIS C OMMON P URPOSE Schools supporting/promoting MH of ALL students Prevention, early access, interventions commensurate with level of need (versus labeling with no or poor follow-up) School personnel feel confident and competent in identifying and intervening with accuracy and effectiveness

7. L OGIC Youth with challenging emotional/behavioral problems are generally treated very poorly by schools and other community agencies, and the “usual” approaches do not work Enhanced resources, staff and coordination of ISF helps to build and enhance systems at all tiers

8. L OGIC ( CONT.) Effective academic performance promotes student mental health and effective mental health promotes student academic performance. The same integration is required in our systems

9. Advancing Education Effectiveness: Interconnecting School Mental Health and School-Wide Positive Behavior Support Editors: Susan Barrett, Lucille Eber and Mark Weist

10. Development of an Interconnected Systems Framework for School Mental Health  Access on the Center for School Mental Health or National PBIS websites: http://csmh.umaryland.edu/Resources/ Reports/SMHPBISFramework.pdf http://csmh.umaryland.edu/Resources/ Reports/SMHPBISFramework.pdf http://www.pbis.org/school/school_mental_health/interco nnected_systems.aspx http://www.pbis.org/school/school_mental_health/interco nnected_systems.aspx  Edited by: Susan Barrett and Lucille Eber, National PBIS Center Partners; and Mark Weist, University of South Carolina (and Senior Advisor to the University of Maryland, Center for School Mental Health )

11. ISF D EFINED ISF provides structure and process for education and mental health systems to interact in most effective and efficient way. ISF is guided by key stakeholders in education and mental health system who have the authority to reallocate resources, change role and function of staff, and change policy. ISF applies strong interdisciplinary, cross-system collaboration.

12. ISF D EFINED ISF uses the tiered prevention logic as the overall organizer to develop an action plan. ISF involves cross system problem solving teams that use data to decide which evidence based practices to implement. ISF involves ongoing progress monitoring for both fidelity and impact. ISF emphasizes active involvement by youth, families, and other school and community stakeholders.

13. T RADITIONAL  P REFERRED Each school works out their own plan with Mental Health (MH) agency; District has a plan for integrating MH at all buildings (based on community data as well as school data);

15. R EGIONAL L EVEL E XAMPLE Behavioral Health Alliance of Rural Pennsylvania Early Childhood Mental Health Partners from Early Intervention Technical Assistance Training for mental health providers and early childhood programs, head starts, child care centers

16. L OCAL LEVEL EXAMPLES SS/HS Grant – “strategy two” Three LEAs Three System of Care Counties Goal regarding Early Childhood ISF Demonstration Site Scranton

17. C ONNECTIONS AND P ARTNERSHIPS Scranton School District Scranton Counseling Center Lourdesmont Friendship House Community Care NEIU 19 PaTTAN KOP

18. E XAMPLE S CHOOL O NE

19. E XAMPLE S CHOOL T WO

20. E XAMPLE S CHOOL T HREE

21. D ISTRICT LEVEL DIALOGUE Physical Health/Behavioral Health Collaboration Wellness and access to care Wright Center – Commonwealth Medical College Data point of children entering Kindergarten – not “ready” – social/emotional/behavioral

22. C OMMUNITY P ARTNERS Head Start Early Childhood Mental Health Community Providers Scranton Counseling Center Friendship House NEIU 19 United Way

23. I NTERVENTION STRATEGIES Program Wide PBIS NEIU PaTTAN Prevent Teach Reinforce – Young Children Typically “tier three” Pre-school and kindergarten teachers attend Use for classroom management strategies Parent Child Interactive Therapy – PCIT Evidence based practice Home/school/community connection

24. I NTERVENTION STRATEGIES CONTINUED : “summer camp” for all enrolled kindergarteners who had no prior “school” experience Funded through Title One dollars with support from United Way 4 week program that included food, parent connection, and pro-social skills for children

25. E XAMPLE O NE 2014

26. E XAMPLE T WO 2014

27. N EXT STEPS : Meeting next Thursday Continue to monitor data Continue to refine intervention strategies Learn from other examples

28. Q UESTIONS ? Kelly Perales peraleskl@ccbh.com 717-770-9365