New Levels of Work Together for School-Wide PBIS and School Mental Health, Part 2 New Levels of Work Together for School-Wide PBIS and School Mental Health, Part 2 Mark D. Weist, Ph.D. Center for School Mental Health University of Maryland

Center for School Mental Health* University of Maryland School of Medicine *Supported by the Maternal and Child Health Bureau of HRSA and numerous Maryland agencies

“Expanded” School Mental Health Full continuum of effective mental health promotion and intervention for students in general and special education Reflecting a “shared agenda” involving school-family-community system partnerships Collaborating community professionals (not outsiders) augment the work of school- employed staff

Fundamental Three-Part Rationale Schools are under-resourced for mental health promotion and intervention Connections between people and traditional community mental health centers are difficult By coming together in the most universal natural setting for youth, there are advantages for both systems, and synergies enhance opportunities to achieve valued outcomes

Roles 10-20% Broad Environmental Improvement and Mental Health Promotion (CHANGE AGENT ROLE) 50-60% Prevention and Early Intervention (PREVENTION SPECIALIST ROLE) 20-30% Intensive Assessment and Treatment (CLINICIAN ROLE)

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Expanded School Mental Health Services in Baltimore City 1989: 4 schools 2009: 105 schools –42 Elementary schools –41 Middle/K-8 schools –22 High schools

Baltimore ESMH Funding % 25% 12% 3% 6% 7%

Themes Helping ESMH in Baltimore to Move to the Next Level A strategic plan One network with common expectations A prominent and diverse advisory board Strong cross-agency connections Strong state, national and federal connections Embracing “mental health”

Informal ‘Mental Health’ Definition “Healthy thoughts, feelings and actions that help you be successful” A positive concept like ‘physical health’

Prince George’s School Mental Health Initiative (PGSMHI) Funding from the State Department of Education Intensive, evidence-based mental health intervention for students in special education in 2 and then 6 schools Training and support to 11 schools with specialized programs for youth presenting emotional problems Broader training and support county wide (e.g., for all school psychologists)

Family Needs Addressed Food, health insurance, medical needs, clothing, transportation, utilities, substance abuse services, mental health services, tutoring, mentoring, recreational programs

Absences by Quarter

Data on Non-Public Placements Between September, 2006 and January, 2009, 78 students were seen for more intensive services in the four schools All met multiple criteria for placement in non- public programs 3/78 students were placed in a non-public program

Economic Implications Non public cost per student/year above special education cost = $39,038 Cost of program per student/year = $7,212 Difference = $31,826 saved per student/year 102 nonpublic placement years diverted FOR A NET SAVINGS OF AROUND $3.2 MILLION –Slade et al, 2009, Advances in School Mental Health Promotion

Anne Arundel School Mental Health Initiative Began in school year Operating in two regions of the county, north and west Services in north focused on youth in the red zone at risk of more restrictive placements (6 schools) Services in west focused on early intervention (3 schools near Army base)

Referrals and Enrollment 61 Referrals 44 Enrolled 34 with 4+ sessions 44 Enrolled 34 with 4+ sessions

Student Outcomes: Total (n=34) Prior to 1 st session From the 4 th session on* Change Attendance 24 students 0% Informal Referrals 18 students 15 students 16% Suspensions (# times) 9 students 5 students 44% * The average length of time to complete four sessions is approximately one month.

Student Outcomes Primary and intermediate elementary students demonstrated decreases in absences and tardies, with the exception of increased tardies among intermediate students.

A National Community of Practice CSMH and IDEA Partnership ( providing support 30 professional organizations and 12 states 12 practice groups Providing mutual support, opportunities for dialogue and collaboration Advancing multiscale learning systems Sign up at

Next CSMH Conference 14 th Annual Conference on Advancing School Mental Health. Minneapolis, November 1-4 Sunday evening – Community Share Fare Monday – Community Meetings/Intensive Training Tuesday, Wednesday – Conference Program See or call

Website developed and maintained by the CSMH with funding from the Baltimore City Health Department and Maryland Departments of Education and Mental Health User-friendly school mental health information and resources for caregivers, teachers, clinicians, and youth

Two New Journals Advances in School Mental Health Promotion –The Clifford Beers Foundation and the University of Maryland – School Mental Health –

Advances in School Mental Health Promotion

Contact Information Center for School Mental Health Department of Psychiatry University of Maryland 737 W. Lombard Street, 4 th Floor Baltimore, MD PH: FX: