1. ALIGNING COMMUNITY SCIENCE AND SCHOOL BASED MENTAL HEALTH: POLICY TO PRACTICE Paul D. Flaspohler Carl E. Paternite Noelle Duvall Melissa Maras Abe Wandersman June 11, 2005 - Champaign, IL A Symposium at the10th Biennial Conference of the Society for Community Research & Action

3. A Strategy: Expanded School Based Mental Health

4. 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.

5. 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.

6. 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

7. Strengthening Policy: Development and Implementation of Ohio’s Shared Agenda Carl E. Paternite Center for School-Based Mental Health Programs (Miami University) and Ohio Mental Health Network for School Success

8. Legislative Forum On Mental Health and School Success Creating A Shared Agenda In Ohio Kristin’s Testimony October 9, 2003

9. 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

10. Infrastructure for Ohio’s Shared Agenda 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 Excellence Ohio Department of Education (ODE) Governor’s Office Publication of Mental Health and School Success: Hearing Summary and Resource Guide (Spring, 2001)

11. Infrastructure for Ohio’s Shared Agenda 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

12. 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

13. 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)

14. 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.”

15. Missouri, Ohio, Oregon, South Carolina, Texas, and Vermont With Ongoing Across-State Networking Facilitated by IDEA Partnership/NASDSE Shared Agenda Seed Grant Awards to:

16. Additional Funding for Ohio’s Shared Agenda Initiative Ohio Department of Mental Health Ohio Department of Education Ohio Department of Health and Numerous Additional State-level and Regional Organizations

17. 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

18. 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

19. 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

20. 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 Preparation October 9, 2003

21. 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 Preparation October 9, 2003

22. Legislative Forum On Mental Health and School Success Creating A Shared Agenda In Ohio October 9, 2003

24. 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…”

25. 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)

26. Phase 4: An Immediate Legislative Outcome (signed into law, June 2004) Senate Bill 2 Standards 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.”

27. Building A Bridge Between Policy and Practice: The Ohio Mental Health Network for School Success Noelle Duvall Children’s Resource Center Bowling Green, OH

29. Funding: Ohio Department of Mental Health Ohio Department of Education Co-Leadership: Center for School-Based Mental Health Programs (Miami University) Center for Learning Excellence (Ohio State University)

30. 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

31. The Ohio Mental Health Network for School 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.

32. 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

33. The Ohio Mental Health Network for School 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.

34. The Ohio Mental Health Network for School 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.

35. 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

37. Promoting School Success and Student Well-being Through Effective Community Collaboration Paul Flaspohler Angie Ledgerwood Miami University Dawn Anderson-Butcher Ohio State University

38. 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

39. ODE Logic Model Students receive high quality instruction aligned with academic content standards HIGHER ACHIEVEMENT FOR ALL STUDENTS Students have the right conditions and motivation for learning ODE’s Logic Model (Fall, 2004)

40. Student Achievement Conditions & Resource Assessment Youth Development Parent/Family Engagement & Support Health & Social Services Community Partnerships Evaluation & Feedback Collaborative Leadership & Sustainability

41. ODE’s new and expanded version for school improvement... Getting the Conditions Right!!!! Academic Outcomes

42. 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

43. 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

44. OCCMSI Pilots

45. 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

46. 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

47. 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

48. 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

49. Prevention Support through University- Community Partnerships Melissa Maras, Chris Reiger, Rochelle Rokusek, Kathy Conoway, Jim Mosher, Marc McLaughlin, & Angie Ledgerwood

50. 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

51. Community Psychology in a Clinical Program? Traditional Clinical Program Individual/ Family Psychotherapy in School Setting Individual/ Family Psychotherapy in Clinic Setting Individual/ Family Psychotherapy in School Setting Prevention and Health Promotion in School Setting

52. Center for School-Based Mental Health Programs Classrooms Communities Schools/ Programs Children and Families

53. 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

54. 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

55. Lessons Learned Better preparation Join the community Transparency Modeling Accountability Engaging families Building bridges

56. Promoting Mental Health and School Success: Workforce Issues The Mental Health—Education Integration Consortium (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

57. 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

58. 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

59. 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

63. 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)

64. This PowerPoint Presentation is posted on the Center for School-Based Mental Health Programs website http://www.units.muohio.edu/csbmhp/