1. From Awareness to Public Policy to Local Action in Promoting a Mental Health-Schools-Families Shared Agenda: Ohio’s Experience Carl E. Paternite Center for School-Based Mental Health Programs Department of Psychology Miami University (Ohio) paternce@muohio.edu; (513) 529-2416 Facilitated Strategic Planning Session for School-Based Mental Health Services in North Carolina Raleigh, NC August 11, 2005

2. Key Shared Agenda Partners in Ohio Mike Armstrong, Ohio Department of Education (Columbus) Noelle Duvall, Children’s Resource Center (Bowling Green) Stephanie Falor, Ohio Department of Education (Columbus) Paul Flaspohler, Center for School-Based Mental Health Programs (Miami U., Oxford) Terre Garner, Ohio Federation for Children’s Mental Health (Cincinnati) Terri Johnston, Positive Education Program (Cleveland) Diana Leigh, Center for Learning Excellence (Ohio State U., Columbus) Paul Liley, Alcohol, Drug Addiction, and MH Services Board of Hancock Co. (Findlay) Linda Maxwell, Children’s Hospital (Columbus) Sue Mikolic, National Alliance for the Mentally Ill of Ohio (Eastlake) Kathy Oberlin, Heartland Behavioral Health (Cuyahoga Falls) Kay Rietz, Ohio Department of Mental Health (Columbus) Mary Lou Rush, Center for Learning Excellence (Ohio State U., Columbus) Amy Wilms, Center for School-Based Mental Health Programs (Miami U., Oxford) AND MANY OTHERS

3. From Awareness to Public Policy to Local Action in Promoting a Mental Health-Schools-Families Shared Agenda: Ohio’s Experience Learning Objectives: Increase knowledge of strategies for enhancing collaboration Increase knowledge of strategies for jointly mobilizing policy makers, policy implementers, and consumer stakeholders Provide examples of ongoing local, state level, and national action

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

5. Ohio Mental Health Network for School Success 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)

6. Ohio Mental Health Network for School Success 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

7. Ohio Mental Health Network for School Success 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

8. Ohio Mental Health Network for School Success Policymaker Partnership (PMP, now 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)

9. Ohio Mental Health Network for School Success 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.”

10. Ohio Mental Health Network for School Success The Aim The aim is to align systems and ensure the promise of a comprehensive, highly effective systemic collaboration to coordinate and integrate programs and services for children and youth and their families.

11. Ohio Mental Health Network for School Success The Framework The framework encompasses a continuum of interventions, including: 1.Positive development of child, youth, families and communities and prevention of problems; 2.Early identification—interventions for children and youth at risk or shortly after the onset of problems; and 3.Intensive interventions—with a focus on integrated approaches.

12. Integrated Systems to Support the Development of All Children Systems of Prevention and Promotion All Students (universal) Systems of Early Intervention Students At-Risk (selected) Systems of Treatment Students with Problems (indicated) School, Family, and Community Partnerships From: Zins (in progress).

13. Best Practice Principles of Expanded School Mental Health (ESMH) (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.

14. Principles of ESMH (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.

15. Factors Necessary to Achieve Desired Outcomes for Youth Through ESMH Programs and Services (Weist, Paternite & Adelsheim, 2005) Effective mental health promotion, problem prevention and intervention Outstanding staff and program qualities Ongoing training, technical assistance & support School and community buy-in and investment Awareness raising, public policy advocacy and improvement, coalition building, systems-level change, and resource commitment

16. A Strategy to Promote ESMH (Paternite, Weist, Burke & Flaspohler, 2005)

17. Ohio Mental Health Network for School Success Missouri, Ohio, Oregon, South Carolina, Texas, and Vermont With Ongoing Across-State Networking Facilitated by PMP(IDEA Partnership)/NASDSE 2002 Shared Agenda Seed Grant Awards to:

18. Ohio Mental Health Network for School Success 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/Regional Organizations

21. Ohio Mental Health Network for School Success 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

22. Ohio Mental Health Network for School Success 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 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.

23. Ohio Mental Health Network for School Success 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.

24. Ohio Mental Health Network for School Success 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.

25. 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 Development and release of Shared Agenda report Phase 5 Ongoing policy/funding advocacy and technical assistance to promote attention to the crucial links between mental health and school success

26. Ohio Mental Health Network for School Success Approximately 725 participants Keynote presentations by national and state experts Promising work in Ohio showcased (Appreciative Inquiry, D.L. Cooperrider) 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

27. Ohio Mental Health Network for School Success 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, in summer 2003, to track and publicize Ohio’s Shared Agenda initiative (http://www.units.muohio.edu/csbmhp/sharedagenda.html) Following Phase 1 and 2 Forums

28. Ohio Mental Health Network for School Success 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

29. Ohio Mental Health Network for School Success 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

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

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

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

37. 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…because, as you indicated there have been some specifics provided to us which we truly need many times when looking at legislation…as most of you know currently the House and the Senate are working on Senate Bill 2 which is for…teacher success and identifying highly qualified teachers...I am going to guide that discussion around some of the things that I have heard today about the idea that teachers need to understand regardless of what their teaching assignment might be…”

38. Comments from Legislators Following the Student Testimony From Senator Bill Harris (Chair, Senate Finance Committee) “…I listened to the very brave and courageous young people tell us about things of their life. And as you were explaining that to us I am thinking about my sons, I am thinking about my grandchildren, I am thinking about other people that I know and some of the struggles that they have…” From Representative Joyce Beatty (Member, House Education Committee) “…All of the student panel members, I don’t think I have ever heard anything so compelling and moving and informative and educating in my entire life. So let me say to you thank you and let me give it to you with that smile that can be comforting because you have helped us…”

39. Ohio Mental Health Network for School Success Phase 4 of Ohio’s Shared Agenda Initiative ODMH and ODE jointly formed an ad hoc workgroup to develop Shared Agenda recommendations/action steps and to issue a report addressing: Public Awareness and Advocacy Professional Development/Training and Service Delivery Policy and Funding

40. Ohio Mental Health Network for School Success Phase 4 of Ohio’s Shared Agenda Initiative The workgroup met three times between November (2003) and March (2004) A final report with recommended goals and objectives released August 2004

41. 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

42. Phase 5: An Immediate Legislative Outcome Senate Bill 2 Section 3319.61(E) (effective June 9, 2004) “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.”

43. Crucial Links Between Mental Health and School Success Carl E. Paternite Center for School-Based Mental Health Programs (Miami University)and Ohio Mental Health Network for School Success Kay Rietz Ohio Department of Mental Health (Columbus) Presentation to the Educator Standards Board Columbus, Ohio December 6, 2004 PowerPoint Slides Available at: http://www.units.muohio.edu/csbmhp/resources/presentations.html

44. Mental Health Issues and the No Child Left Behind Mandate: Two Important Interrelated Goals— Achievement and Wellbeing  1) Achievement promotes wellbeing  2) Wellbeing promotes achievement School philosophy often acknowledges 1 but fails to sufficiently acknowledge 2

45. Ohio Mental Health Network for School Success Report of President’s New Freedom Commission on Mental Health http://www.mentalhealthcommission.gov Critical Importance of Partnership with Schools: “The mission of public schools is to educate all students. However, children with serious emotional disturbances have the highest rates of school failure. Fifty percent of these student drop out of high school, compared to 30 percent of all students with disabilities. “ “While schools are primarily concerned with education, mental health is essential to learning as well as to social and emotional development. Because of this important interplay between emotional health and school success, schools must be partners in the mental health care of our children.” July, 2003, p. 58

46. Ohio Mental Health Network for School Success Based On a Growing Knowledge Base, Schools That Promote Mental Health Report: Assistance in reaching underserved youth Strong satisfaction by diverse stakeholder groups (e.g., teachers, students, families) Improved student outcomes (e.g., higher academic achievement; higher attendance; fewer behavior problems; increased sense of connectedness to school) Improved school outcomes (e.g., more supportive, inclusive, and safe school climate; fewer special education referrals)

47. Ohio Mental Health Network for School Success 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

48. Ohio Mental Health Network for School Success

49. Non-academic Conditions (barriers) That Exert Powerful Influences On Learning, Achievement, and School Success Environmental –Poor nutrition –Family stress –Family conflict –Peer influences –Exposure to violence –Abuse, Neglect –Poor school environment Personal –Attentional difficulties –Behavioral problems –Depression –Anxiety –Social problems –Trauma reactions

50. Ohio Mental Health Network for School Success 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

51. Ohio Mental Health Network for School Success 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

52. Ohio Mental Health Network for School Success Phase 5 Mental Health and School Success: Ongoing Efforts in Ohio All connected to the Ohio Mental Health Network for School Success, through implementation of the action agenda and special targeted work.

53. Ohio Mental Health Network for School Success Phase 5 Mental Health and School Success: Ongoing Efforts in Ohio NASDSE National Satellite Teleconference School-Based Mental Health Broadcast from Pittsburgh, PA May 5, 2004

54. Ohio Mental Health Network for School Success Phase 5 Mental Health and School Success: Ongoing Efforts in Ohio Network participation in planning and implementation of Ohio’s across-agency Access to Better Care (ABC) Initiative: Designed to increase and improve behavioral healthcare for children and families Focusing on prevention, early intervention and treatment services

55. Ohio Mental Health Network for School Success Phase 5 Mental Health and School Success: Ongoing Efforts in Ohio ODMH and the Network leading Ohio’s Eliminating Barriers Initiative, focusing on the school age population. Pilot testing SAMHSA-developed in-service curriculum for teachers Developing a youth speakers bureau/panel

56. Ohio Mental Health Network for School Success Phase 5 Mental Health and School Success: Ongoing Efforts in Ohio Expansion of evidence-based programs like Ohio’s Positive Behavior Support Initiative are continuing through collaborative efforts of: Special Education Regional Resource Centers The Ohio Association of Elementary School Administrators The Ohio Association of Secondary School Administrators Ohio Mental Health Network for School Success

58. Phase 5 Mental Health and School Success: Ongoing Efforts in Ohio Extended Seed Grant from IDEA Partnership to: Develop guidance document and collaboration guide for families and professionals to contribute to school wide Positive Behavior Support Field test, revise and disseminate the document and collaboration guide

59. Phase 5 Mental Health and School Success: Ongoing Efforts in Ohio Linkage and consultation related to work of: Mental Health—Education Integration Consortium (MHEDIC) Bringing to together national experts and Ohio-based university faculty and practitioners in education and mental health fields to address: pre-service workforce preparation issues development of effective in-service training curricula and strategies

60. Phase 5 Mental Health and School Success: Ongoing Efforts in Ohio Linkage and consultation related to: Ohio’s Community Collaboration Model for School Improvement (which is currently being pilot tested by ODE; see Anderson-Butcher, Lawson, H.A., D., Bean, J., Boone, B., Kwiatkowski, A., Cash, S., et al. (2004). Ohio community collaboration model for school improvement. Columbus, OH: Ohio Department of Education) Ohio School Climate Guidelines (which were recently Adopted by the Board of Education)

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

62. Student Achievement Conditions & Resource Assessment Youth Development Parent/Family Engagement & Support Health & Social Services Community Partnerships Evaluation & Feedback Collaborative Leadership & Sustainability Ohio Community Collaboration Model for School Improvement

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

64. OCCMSI Pilots

65. Bridging Research and Practice Implementation guide Tools and resources OCCMSI liaisons providing on-site technical assistance Professional development and training opportunities Cross-site networking and sharing

66. Ohio Mental Health Network for School Success Examples of Network 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

68. Ohio Mental Health Network for School Success Phase 5 Mental Health and School Success: Ongoing Efforts in Ohio Network’s new SAMSHA-funded: School-Based Mental Health Effective Practice Integration Council (EPIC)

70. Mental Health and School Success Websites National: National Association of State Directors of Special Education (www.nasdse.org) IDEA Partnership (www.ideapartnership.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)

71. Ohio Mental Health Network for School Success This PowerPoint presentation will be posted on the Ohio Mental Health Network for School Success website http://www.units.muohio.edu/csbmhp/network.html