1. Elizabeth & Melissa – Introduce
Creating and Sustaining Effective Mental Health Services and Supports in the Educational Setting

2. Newport-Mesa Unified School District Team
Melissa Hurd: Psychological Services Coordinator
Joy Cleary: LCSW, PPS
Tucker Cannon: LCSW, PPS
Michelle Lepak: Ed.S., NCSP, School Psychologist, Program Specialist, Behavior Specialist
Eby Kent: MS, School Psychologist, Licensed Educational Psychologist, Behavior Specialist, BCBA
Melissa introduces her team

3. Yuba City Unified School District Team
Elizabeth Engelken: Director of Student Support; Credentialed School Psychologist, PPS; Advanced Nurtured Heart Trainer
Veronica Coates: Psychological Services Specialist; Credentialed School Psychologist, PPS; Advanced Nurtured Heart Trainer
Ivona Mikesell: Credentialed School Psychologist, PPS; ERMHS Behaviorist; Advanced Nurtured Heart Trainer
Elizabeth introduces her team

4. Presentation Outline
History: How did we get “from there to here”? (Newport-Mesa/Yuba City)
Program Development and Rationale (Yuba City)
RtI: A Three Tiered Approach (Newport-Mesa)
Foundation and Methodology (Yuba City)
Assessment Process (Newport-Mesa)
ERMH Services (Yuba City)
Next Steps (Newport-Mesa/Yuba City)
Melissa and Elizabeth will discuss outline

5. History of Mental Health Supports in California Schools
In 1984, Assembly Bill 3632 outlined and required a partnership between school districts and county mental health agencies to deliver mental health services to students with individualized education programs (IEPs). A subsequent Assembly Bill, 26.5, updated the mandate for students with disabilities.
Elizabeth

6. History of Mental Health Supports as a Related Service
In 2011, the California Legislature passed Assembly Bill 114, which repealed the state mandate on special education and county mental health agencies. This action gave school districts the sole ability to decide how mental health services were delivered. Many districts continue to contract with county mental health or other mental health agencies. The term Educationally Related Mental Health Services (ERMHS) refers to those services related to a students educational plan, and developed to address social, emotional and behavioral areas of significant need.
Elizabeth

7. A Journey toward ERMHS Legal Consortiums
Consultation with SELPA leadership and other major stakeholders
Research and observation of model programs
Develop Program Design; Hire Exceptional Staff
Developing a Three Tiered approach to intervention
Elizabeth

8. Foundational Approach
Providing a continuum of services which is effective with special populations
Services which are effective with intense students and families
Acknowledging the common underlying belief that we have tried many methodologies with very limited and poor results
Utilizing a strengths based approach as a foundation for all services delivered
Strengths Based Approach
100% of staff trained in the Nurtured Heart Approach (NHA), utilizing the strategies from classroom to therapy setting
Elizabeth

9. Program Development
ERMH staff is composed of specialists within the field of mental health; psychologists, licensed clinicians, clinical aides and behavior specialists
ERMH clinicians and behaviorists become collaborative and integrated members of IEP teams
Creation of a program which serves students across the special education continuum; from prevention to intense intervention
Elizabeth and Veronica

10. Continuum of Services
ERMH Services are Designated Instructional Services for students with disabilities
ERMH Services fall along the continuum of service – different levels of ERMH intervention are delivered, based on student needs
Veronica

11. Continuum of Services
Veronica (make handout)

12. Response to Intervention: A Three Tiered Approach
Psychological Support Services
Intensive Interventions
and Support
Early Intervention
Newport-Mesa Team
Universal Intervention

13. Tier I: Universal Intervention
Site level School-Wide Positive Behavior Interventions and Support
School Psychologists implement research-based curriculum for identified at-risk students
Push-in whole classroom intervention
Targeted group intervention
Curriculum-Based (Second Step, Steps to Respect)
Expressive Therapy
Progress Monitoring
Data collection, progress reports, teacher input, attendance, work completion, grades, etc.
Student Study Teams
Tier I Counseling Referral
Please refer to form in folder
Parent Education Training
Newport-Mesa Team

14. Tier II: Early Intervention
A need for counseling is suspected for a student receiving special education services.
IEP is held to document a referral for School-Based Counseling
Please refer to Tier I or Tier II Counseling form in folder
Case Carrier completes Counseling Referral and submits to the School Psychologist
School Psychologist reviews referral and determines if additional strategies can be implemented or if Counseling Assessment is warranted.
IEP is held to document School Psych’s recommendations
If Counseling Assessment is recommended, Assessment Plan is presented and consent obtained.
School Psychologist completes ERMHS Counseling Assessment to determine if there is an area of need
IEP is held to document Counseling Assessment results/recommendations
Goals proposed in areas of need
Service recommendation provided
Individual Counseling, Group Counseling (includes Social Skills), Parent Education Training
Minimum of 12 weeks offered (individual and group services)
Newport-Mesa Team

15. Tier II: Early Intervention
Progress Monitoring
Counseling goals are monitored weekly
IEP team reconvenes after 12 weeks and determines continued need/level of Counseling Services based on progress monitoring
Data collection, rating scales (objective and research-based), attendance, work completion, grades, compliance, and team input
IEP team could determine:
Student met Counseling goals and service is discontinued
Student is progressing towards goals and would benefit from continued School-Based Counseling sessions
Student is not making progress and a Clinic-Based Counseling Referral is recommended
Newport-Mesa Team

16. Tier III: Intensive Interventions
and Support
Clinic-Based Services
Individual Counseling
Group Counseling
Targeted Parent Education Counseling and Training
Collateral Family sessions – Push in home support
Non-Public School Placement
Residential Placement
In-State
Out-of-State
Newport-Mesa Team

17. Length of Intense Services
Initial referrals for assessment and those exiting service are a fluid process
Average length of service is months
Veronica

18. Referral Process
After exhausting site based services, IEP team recommends an ERMHS referral
Preventive mental health services are required prior to referral
Veronica

19. Referral Requirements
Parent Approval at IEP to make referral
Site based School Psychologist and Case Manager compile a packet of data to present to Psychological Services Specialist
Psychological Services Specialist analyzes referral with Director of Student Support and ERMH team, assigning a clinician or behaviorist to the student
Once referral is approved, assessment plan is presented to parent
Veronica

20. Assessment Process Yuba City Assessments
ERMH Clinician provides assessments to student, parents, and school staff including, but not limited to:
Standardized Assessments
Observations
Consultation
Collaborates with School Psychologist and site based team
Veronica

21. Assessment Process Newport-Mesa Assessments
Educationally-Related Mental Health Services (ERMHS) Assessments
Conducted by School Psychologists
Residential Assessments
Conducted by a Multi-Disciplinary team of mental health professionals
Newport-Mesa Team

22. Eligibility
A direct link between social-emotional and/or behavioral functioning and a lack of educational progress must be present
Preventive mental health services must have been provided
Veronica

23. Goals Drive Service Example of Annual Goal:
By (date) Student will utilize at least three appropriate coping strategies (i.e. positive self-talk, reframing negative thoughts, taking pride in his inner wealth etc.) to increase positive self-perception in counseling and/or school settings, in 4 out of 5 times as measured by observations and interviews.
Veronica

24. Goals Drive Service Example continued with short term objectives:
By (date), when prompted by a Clinician, Student will identify 5 strengths he sees in himself. 4 out of 5 of these strengths must be statements about his inner wealth, not related to academic or intellectual.
By (date) when prompted by a Clinician, Student will identify at least 3 positive strategies on how he is utilizing his strengths of inner wealth (journaling, verbal positive affirmations, visual positive affirmations, positive self-talk, re-framing negative thoughts, resetting)
By (date) Student will be able to identify 10 positive attributes about himself without prompting, as well as identify how he utilizes these strengths to reset back to inner wealth rather than become trapped in misperceptions of how others feel about him, withdrawal, or negative self talk.
Veronica

25. Services Individual Counseling Group Counseling Parent Counseling
Social Work Services
Psychological Services
Behavior Intervention Services
Ivona (refer back to Newport Mesa’s 3 tier approach)

26. Individual Counseling
Counseling in a 1:1 setting with an ERMH clinician or other qualified individual
No other students are present
Clinician working directly on students individual goals and objectives
Ivona

27. Group Counseling
Student participates in a group led by an ERMH clinician.
A group of students working on similar social skills
A group centered around 1or 2 students with neurotypical peers
Groups are led by clinicians and often co-facilitated by a school counselor, school psychologist or clinical aide
Ivona

28. Social Work Services
Consulting/Training staff and/or parents on specific interventions (i.e. Nurtured Heart Approach)
Training 1:1 aides on specific behavioral and social emotional interventions
Infusing/Modeling strengths based approaches within general and special education classrooms
Assisting teams on Behavior and Social Emotional Care Plans
Psychoeducation groups not related to IEP goals but rather to develop a more positive classroom environment
Ivona

29. Parent Counseling Providing parent support in a 1:1 or group setting
Modeling Strengths Based communication to parents
Providing support before and after IEP meetings
Psychoeducation
Ivona

30. Psychological Services
Services Delivered by the Psychological Services Specialist
Consultation with site based teams
Assessment
Parent support
Counseling
In class Interventions
Liaison to Nonpublic and Residential schools
Ivona

31. Behavioral Intervention Services
Refinement of current Behavioral Support Plan
Data Collection
In Class modeling of interventions in conjunction with Clinical Aide
1:1 Aide and Teacher training
Consultation to site based teams
Ivona

32. Other Services Offered to SELPA and Community
Support provided to sites during crisis or emergency situations (threat assessments, crisis management, grief counseling)
Staff Development Presentations for teachers, administrators and support staff (NHA, Anxiety and Trauma, Selective Mutism, Self-Harming Behaviors, Developing BSP’s, Prevention and Early Intervention)
Veronica and Newport-Mesa to discuss their threat assessment

33. Sustaining Effective Services and Positive Results
Identify new staff to train; keep cycle of training fresh
Develop specialists; classroom support providers, clinical staff for therapy, parenting class and support staff, bilingual staff, training teams
Ongoing Learning Lab
Maintain foundational approach as a district and SELPA wide initiative so that it is embedded in board accepted and approved goals
Elizabeth

34. Future Goals for Newport-Mesa
Develop a needs assessment to determine priorities and future professional development
Leadership Training
Eliminating Barriers to Learning through the Early Identification of Student Mental Health Issues
District-Wide collaboration in addressing barriers to learning
High-Touch Impact on students district-wide
Build upon current Parent Training component
Parent Academy
Refine school reintegration procedures for students placed on psychiatric holds
Therapeutic placement between SDC ED/ NPS & RTC
Explore Day School options
Newport-Mesa Team

35. Next Steps & Future Goals for Yuba City
Continue honing the whole child/strengths based model with a continuum of services
Continue providing trainings SELPA wide (parents, families and staff)
Provide ongoing psychoeducation in classroom settings
Focus on ERMH’s contribution to preventive mental health
Elizabeth

36. Q & A
Burning Questions
ALL team members!