1. Mental Health Planning and Evaluation Template -- ONLINE TJ Cosgrove, LICSW Public Health – Seattle & King County Laura Hurwitz, LCSW Director, School Mental Health Programs

2. Objectives of Webinar Participant will be able to… assess whether the on-line Mental Health Planning and Evaluation Template is an appropriate tool for your setting. learn the steps for using the on-line Mental Health Planning and Evaluation Template. learn how the on-line Mental Health Planning and Evaluation Template can be used in a quality improvement process.

3. MHPET Purpose Enhance the evaluation of mental health services in the SBHC and/or in any school setting Improve mental health practices in the SBHC and/or in any school setting Collect data for school mental health advocacy and technical assistance efforts at NASBHC

4. SBHC Staffing Models (N=1235)

5. Mental Health Services in SBHCs With (n=655) and Without (n=277) Mental Health Providers * P<.01

6. Mental Health Services in SBHCs Fastest growing component of SBHC. In ten years, the percentage of SBHCs with mental health staff went from 30% to over 65%. Survey of SBHC providers in 2004/2005 found that expansion of mental health services was the first priority for program funding.

7. Need for Quality Improvement in Mental Health in SBHCs Increased recognition that objective measures were needed for SBHC quality of care, especially in mental health Such a measure would need to recognize: –Many disciplines –Wide range of interventions –Limited translational research around best practice in schools

8. Continuous Quality Improvement (CQI) at NASBHC Seeks to improve all performance not just areas of unacceptable care. Focuses on the processes of health care delivery and use of research-based approaches to reduce variations in those processes. Need to understand and revise process in order to improve quality 2001 - NASBHC developed CQI tool to assess clinically based sentinel conditions, including MH

9. MHPET Development January 2004 NASBHC convened a workgroup to develop an evaluation tool Based on School Mental Health Quality Assessment Questionnaire (MH-QAQ) developed by Mark Weist et al. at the Center for School Mental Health Broadened questions from clinician to program level Expanded questions to be more inclusive of school staff and non-mental health providers Shortened, fewer dimensions and indicators

10. MH-QAQ School Mental Health Quality Assessment Questionnaire (MH-QAQ) Developed by Mark Weist et al. at the Center for School Mental Health (CSMH) http://csmha.umaryland.edu/research.html/qua lity_assessment.html Part of first ever systematic study “Enhancing quality in expanded school mental health” of school mental health quality assessment and improvement (QAI) This study was supported by the National Institute of Mental Health

11. MHPET Beta-test 41 individuals completed the MHPET tool –20 mental health providers –11 medical providers –6 support staff members –4 administrators 21 unique SBHC sites were represented (Talbot - 9, Illinois - 5, Seattle - 3, Montefiore - 4)

12. MHPET Beta-test Responded to interview questions Revised and finalized tool accordingly: –generalized to school mental health –changed name (“program” to “planning”) –simplified dimensions and language –included substance abuse

13. Beta-test on-line MHPET Beta-test with 29 participants in 6 schools (3 SBHCs) in Baltimore, Pittsburgh, Little Rock, and Worchester Teams completed both sets of MHPET and were given follow-up interview questions Team leads participated in conference calls Based on feedback, adjusted web links and revised instructions (e.g. clarified role of participants and team leads)

14. MHPET web-based tool Now online www.nasbhc.org under “mental health” sectionwww.nasbhc.org Set up to be completed by teams Teams complete tool and go back 3-6 months later to complete a second time Computer generates scores

15. Using the Web-Based MHPET

19. Principles for SBHCs Principles for SBHCs Supports the school Responds to the community Focuses on the student Delivers comprehensive care Advances health promotion activities Implements effective systems Provides leadership in adolescent and child health http://www.nasbhc.org/site/c.jsJPKWPFJrH/b.2743459/k.9519/NAS BHC_Principles_and_Goals_for_SBHCs.htm

22. Laura Hurwitz

48. James A Davis Middle School 1224 Clarendon Ave. Bessamer, AL 2

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55. Set Two Survey will be available after… 3 James A Davis Middle School 1224 Clarendon Ave. Bessamer, AL Set Two Survey will be available after July 25, 2008

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60. Quality Improvement/Planning Indicators with scores of 3 or less are automatically flagged as potential areas for improvement Raters select targeted areas for improvement (dimensions and/or indicators with averages that are low relative to others) Identify resources for improving target areas Develop and implement improvement plan Compare scores 3-6 months later and assess progress

61. Using MHPET to identify improvement targets Examine the lowest rated indicators first. –Which of these can you impact in the next 6 months? Parallel to goal setting with a student/client: –What are the strengths? –What areas are in need of improvement? –Realistic? –Obtainable?

62. Using MHPET to identify improvement targets (cont.) “Halo effect” –By focusing on 2-3 indicators is there potential to positively impact others? If “don’t know” is prevalent in your responses, can you select targets that will result in informing these key people? Place the MHPET results in the context of other data.

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66. Qualifiers and Caveats Quality Improvement for mental health services in schools is new and unfamiliar territory Consider where your program is developmentally This is not about judgment i.e. good or bad, right or wrong Should not be tied to staff performance appraisal or funding

67. MHPET Next Steps Develop compendium of quality improvement resources for each indicator MHPET will have on-line link to resource for each indicator Develop training module on quality improvement (School Mental Health Capacity Building Partnership) Collect and analyze national data from MHPET

68. NASBHC Resources for Quality Improvement: www.nasbhc.org Paper version currently available http://www.nasbhc.org/atf/cf/{CD9949F2-2761- 42FB-BC7A-CEE165C701D9}/MHPET.pdf General mental health resources http://www.nasbhc.org/site/c.jsJPKWPFJrH/b.2642 293/k.85AC/mental_health.htm

69. Resource for Quality Improvement: The School Mental Health Connection www.schoolmentalhealth.org In association with University of Maryland Center for School Mental Health (CSMH) www.csmh.umaryland.eduwww.csmh.umaryland.edu 40 indicators of quality in school mental health services PowerPoints provide background information, a menu of suggested activities, helpful hints, web resources, and references

70. Other Resources for Quality Improvement Center for Health & Health Care in Schools www.healthinschools.org www.healthinschools.org UCLA Center for Mental Health in Schools www.smhp.psych.ucla.edu www.smhp.psych.ucla.edu National Technical Assistance Center for Children's Mental Health at Georgetown University Center for Child and Human Development www.gucchd.georgetown.edu IDEA Partnership www.sharedwork.org

71. Contact Information TJ Cosgrove, LICSW Public Health – Seattle & King County tj.cosgrove@kingcounty.gov 206.263.8352 Laura Hurwitz, LCSW Director, School Mental Health Programs LHurwitz@nasbhc.org www.nasbhc.org 202.638.5872 x205