1. Interconnected Systems Framework (ISF) Replication November 21, 2014

2. Agenda ISF overview Readiness steps (2014-15) Implementation steps (2015-16) Questions

3. Pennsylvania State Community of Practice on School Based Behavioral Health “tertiary demonstration sites”: Scranton Montrose “tertiary demonstration sites”: Scranton Montrose

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

5. 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/interconnected _systems.aspx http://www.pbis.org/school/school_mental_health/interconnected _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 )

6. BIG Idea… 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

7. Logic 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. Logic (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. ISF Defined – 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.

10. ISF Defined – 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.

11. Traditional  Preferred 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);

12. Primary Prevention: School-/Classroom- Wide Systems for All Students, Staff, & Settings Secondary Prevention: Specialized Group Systems for Students with At-Risk Behavior Tertiary Prevention: Specialized Individualized Systems for Students with High-Risk Behavior ~80% of Students ~15% ~5% SCHOOL-WIDE POSITIVE BEHAVIOR SUPPORT

13. Implementation Science Exploration and Adoption Installation Phase Initial Implementation Full Implementation Innovation and Sustainability Fixsen, 2010

14. STUDENTS in one school RtI Special Education SEL Fragmented StructuresFragmented Practices Student Assistance Teams Student Assistance Teams Social Work Services Family Coordinators Pre-referral Interventions After School Programs School-based Mental Health Services Student Support Leaders How does a school decide how to support different students?

15. SCHOOL Violence & Crime Prevention Drug Services Juvenile Court Services Social Services Child Protection Services Special Education Pupil Services Health Services Mental Health Services Drug Prevention Community Based Organizations Clinic After- School Programs Adapted from: Health is Academic: A guide to Coordinated School Health Programs (1998). Edited by E. Marx & S.F. Wooley with D. Northrop. New York: Teachers College Press. Fragmented PolicyFragmented Practices

16. 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

17. Supervisor SW/Psych Building Principal Rep. Service Providers Local Area Network Co-Convenor Homeless Coordinator Mental Health/ 708 Board Curriculum/ Prof. Dev RtI Coordinator Family Groups Police Juvenile Justice Special Education Director Supt/ Asst. Supt Core District and Community Leadership Team

18. Building Level Model Community/ Family Mental Health Rep. SW, School Psych Guidance Principal Special Education Teachers Grade Level Teachers Building Leadership Team

19. Tier 3/Tertiary Interventions 1-5% _____________________ 1-5%Tier 3/Tertiary Interventions ___________________________ Tier 2/Secondary Interventions 5-15% ___________________________ 5-15%Tier 2/Secondary Interventions ____________________________ Tier 1/Universal Interventions80-90% ________________________ 80-90%Tier 1/Universal Interventions ____________________________ School-Wide Systems for Student Success: A Response to Intervention (RtI) Model: SUPPORTS Academic Systems Behavioral Systems Illinois PBIS Network, Revised May 15, 2008. Adapted from “What is school-wide PBS?” OSEP Technical Assistance Center on Positive Behavioral Interventions and Supports. Accessed at http://pbis.org/school-wide.htm

20. Building Level Action Plan Problem Solving Team (individual student) Tertiary Systems Team Secondary Systems Team Universal Systems Team PRACTICES Data Decision Rule UNIVERSAL SYSTEMSECONDARY SYSTEMTERTIARY SYSTEM 20

21. Tier 1/Universal School-Wide Assessment School-Wide Prevention Systems SIMEO Tools: HSC-T, RD-T, EI-T Check-in/ Check-out (CICO) Group Intervention with Individualized Feature (e.g., Check and Connect -CnC and Mentoring) Brief Functional Behavior Assessment/ Behavior Intervention Planning (FBA/BIP) Complex or Multiple-domain FBA/BIP Wraparound ODRs, Attendance, Tardies, Grades, DIBELS, etc. Daily Progress Report (DPR) (Behavior and Academic Goals) Competing Behavior Pathway, Functional Assessment Interview, Scatter Plots, etc. Social/Academic Instructional Groups (SAIG) Positive Behavior Interventions & Supports: A Response to Intervention (RtI) Model Illinois PBIS Network, Revised October 2009 Adapted from T. Scott, 2004 Tier 2/ Secondary Tier 3/ Tertiary Intervention Assessment

22. School Data  Community Data Student and System level Academic (Benchmark, GPA, Credit accrual etc) Discipline Attendance Climate/Perception Visits to Nurse, Social Worker, Counselor, etc Screening from one view Community Demographics Food Pantry Visits Protective and Risk Factors Calls to crisis centers, hospital visits Screening at multiple views

23. Other Datasets Positive Assets Parks & Playgrounds Hospitals Community Centers Recreation Centers Vacant housing Community Core service agencies Disadvantage Census (income, family structure, population Potential Risk Factors Alcohol Outlets Crime Libraries Religious Buildings Fast food outlets Lottery outlets

24. Show outcomes leading to Social and financial Benefit Show outcomes for PBIS and SMH – Social competence – Emotional functioning – Improved GPA, test scores, attendance, teacher retention – Organizational Health – Climate Demonstrate financial impact Show link between fidelity and outcomes Greenberg et al., 2005; Greenberg et al., 2003; Welsh et al., 2001; Zins et al., 2004; Bruns et al., 2004; Lehr et al., 2004; Jennings, Pearson, & Harris, 2000; see Hoagwood, Olin, Kerker, Kratochwill, Crowe, & Saka, 2007 and Wilson & Lipsey, 2007)

25. WSHS

28. Tier One Problem Solving Team Student Team Faculty input Administrative support

29. Annual Fidelity Check Action Planning Benchmarks of Advanced Tiers – Do we have more than one strategy available to support students who need more? – Do we use data to make decisions? – Are we selecting Evidence-Based Practices? – Do we have the staff and resources to implement with fidelity? – Are we progress monitoring?

30. Revisit Resource Map Do we have a continuum of interventions and supports? Does our systems team include representatives from our community partners? Are their gaps that we need filled? Can we present needs to our district and community leadership team?

31. Innovation and Sustainability Community level dialogue – Data – Practices – Systems Collaboration and Communication

32. District 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

33. Example School One

34. Example School Two

35. Example School Three

36. Community Partners Head Start Early Childhood Mental Health Community Providers – Scranton Counseling Center – Friendship House – NEIU 19 United Way

37. Intervention 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

38. Intervention 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

39. Example One 2014

40. Example Two 2014

41. Next steps: Facilitators – identify potential replications sites – Complete readiness activities Spring 2015

42. Questions?