1. Organizational Conditions for Effective School Mental Health
So, leadership is a critical component in effective school mental health. In the following section, organizational conditions that leaders can work to reinforce are described in detail.
The Top Ten List

2. Self-Reflection
How Concerning?
How Important?
Top 3 Concerns…

3. Research in Organizational Conditions
Implementation Science (e.g., Fixsen et al.)
Getting to Outcomes (e.g., Wandersman et al.)
School-Wide Positive Behavior Support (e.g., Sugai et al.)
Expanded School Mental Health (e.g., Weist et al.)
REACh Framework (e.g., Kratochwill et al.)
Knowledge Translation and Exchange (e.g., Barwick et al.)
There is a growing evidence base on key conditions for supporting school mental health. The School Mental Health ASSIST team reviewed this literature, and consulted with several key leaders in the field, to arrive at a research-based Top 10 List of organizational conditions that support effective school mental health.

5. Navigating system change
Is like behavior change with individuals – it occurs with persistent nudges

6. Top 10 List of Conditions Commitment
School Mental Health Leadership Team
Clear & Focused Vision
Shared Language
Assessment of Initial Capacity
Standard Processes
PD Protocols
School Mental Health Strategy / Action Plan
Broad Collaboration
Ongoing Quality Improvement
Each of these ten conditions will be described in detail next.

7. Self Reflection
Where is your board currently, TODAY, along each of the conditions…
Feel free to discuss, leave blank…
Not handed in…

8. Commitment Condition ONE
Board leaders view child and youth mental health as a priority, and communicate this through action
Board leaders commit to Tiered Support Model
Help board staff to understand the rationale for the model, emphasizing the focus in schools on mental health promotion and prevention and the need to work with community partners for help with students with significant mental health concerns
Board leaders consistently attend community liaison meetings and internal MH team meetings
Board leaders provide visible, strategic and tangible support for needed infrastructure, resources, staffing
Condition #1. Effective school mental health requires commitment. Visible commitment on the part of senior staff – in the form of things like messaging about the Tiered Support Model, regular attendance at meetings, and tangible support towards needed infrastructure and resources.

9. Tiered Support in Systems of Care
Organizational Conditions
Universal Evidence-Based
Mental Health Promotion, Social-Emotional Learning
Targeted Evidence-Based Prevention
E-B Clinical
Intervention
Evidence-Based Clinical Intervention
Universal E-B Mental Health Promotion
Community
Mental Health Capacity
Engagement
Implementation Focus
School Districts
Continuous Quality Improvement

10. School Mental Health Leadership Team
Condition TWO
Board has a multidisciplinary, multi-layered mental health leadership team
All of the right people are at the table (in terms of expertise, influence, relationships, representation)
Parent and youth voice are critical
Team has meaningful liaison with community partners
Team is focused on vision-setting, leadership, collaboration, strategy/program selection, problem- solving
Condition #2. A systematic and coordinated approach to school mental health is aided greatly by the presence of a multidisciplinary mental health leadership team. The composition of this team will vary, but representation is important for shared and distributed leadership. In best cases, this team has responsibility for setting direction, coordinating professional development, implementing the tiered service delivery model, leading mental health programming, and securing accountability.

11. Clear and Focused Vision
Condition THREE
Board has shared, realistic goals
Vision is aligned with AOP, BIPSA, Strategic Directions
Vision is aligned with key principles in school mental health (e.g., preventive, linked with instruction, evidence-based, connected with partners at home and school, strong use of data)
Vision and goals are created collaboratively
Vision is the basis for decision-making
Condition #3. A clear and focused vision, that is created collaboratively and is aligned with board priorities and initiatives, is a key organizational element in school mental health. Most importantly, in districts that have been successful with implementation, this vision is used as a foundation on which to base decisions and actions.

12. Shared Language Condition FOUR
The Board Vision for school mental health is communicated clearly across the organization
Foundational knowledge about student mental health is conveyed
Terms are defined consistently
Where differences in language occur (e.g., across sectors), there is translation
Use of early identification tools can be helpful for finding common ways to speak of problem areas
Condition #4. Effective school mental health requires the involvement of many stakeholders, with varied professional backgrounds, often working across sectors and disciplines. At times, differences in language and understandings can interfere with an integrated system of care. Effective communities work towards shared meanings across partner organizations. There are many examples of communities in Ontario coming together under SSLI or Working Together for Kids’ Mental Health to develop this type of shared understanding.

13. Assessment of Initial Capacity
Condition FIVE
Assessment data informs the development of the board mental health strategy
Before setting priorities, an assessment of organizational strengths, needs, and resources (resource mapping) can be very helpful
This assessment includes a scan of resources, in the form of people, processes, and programs
Staff and student voice data can deepen understanding of needs
Condition #5. Too often, school mental health is managed in a fragmented manner. This occurs, in part, when new initiatives are introduced without appreciation for existing resources. School boards benefit from a period of “taking stock” - of the people, process, and program resources currently available - before embarking on new approaches in this area. Note that part of this taking stock can include gathering the perceptions of staff and students, with respect to priority areas of need.

14. Standard Processes
Condition SIX
Board has standard processes for school mental health:
Who does what (role clarification)
Selection of school and classroom evidence-based programs
Delivery of training and coaching on programs and strategies
Standards and tools for monitoring progress
Partnerships with community
Pathways to service
Condition #6. In order to make school mental health more seamless, certain protocols and procedures can be helpful. Key processes to attend to include: articulating who does what within the board (e.g., What do social workers do? What do psychological consultants do? What do public health nurses do? What do mental health workers in schools do?), identifying how mental health programs are selected, and defining the pathway to service in your board (the route from when a teacher identifies a problem, to the child accessing school / board / community resources). The clarity that such protocols afford can assist with the smooth delivery of services in a tiered support model.

15. Protocols for Professional Development
Condition SEVEN
Board has a systematic approach to capacity building in mental health and well-being that includes:
Mental Health Awareness for all
Mental Health Literacy for those most closely involved with students
Mental Health Expertise for those delivering specialized assessment & intervention services
High quality training protocols, delivered by an engaging expert
Job-embedded, with ongoing coaching
Condition #7. Being systematic about professional development is very important, in order to avoid the trap of one time or fragmented workshops. System leaders need to consider which audiences, need which types of knowledge, delivered in which formats….
Who needs mental health awareness? Who is ready and needing mental health literacy? Are all of our key mental health professionals fluent or do they require training to deepen their expertise in particular areas?
When selecting a speaker, it is important to think about who would be in the best position to deliver sustainable and relevant professional development (an outside expert? a school district leader? a combination?)
Most critically, how can the professional development deepen iteratively over time so that educator knowledge is enhanced at a manageable and useful pace?
School Mental Health ASSIST has worked with a national roundtable to create a Decision Support Tool to help with the selection of professional development strategies in this area. This tool is available to all Ontario school boards.
Tools + Training + Technical Assistance + Quality Assurance

16. Mental Health Strategy / Action Plan
Condition EIGHT
The Board Mental Health Strategy is aligned with system goals
The Strategy is founded on evidence-based practices in school mental health
The Strategy is tailored to local context and data with respect to board needs and strengths
The Strategy is focused on measureable outcomes
An implementation support plan is clearly articulated
Condition #8. A mental health strategy is a very important condition for effective service delivery within a tiered support model. Aligned with system priorities, and manageable in scope, this Strategy can capitalize on board strengths while addressing (a small number of) gap areas over a short period of time. A clear implementation support plan with key measurables is essential for ensuring full execution of the strategy.

17. Broad Collaboration Condition NINE
The Board has several established platforms for dialogue and collaboration:
Across departments and schools in the organization
With community and health agencies
With universities and other research organizations
With parents
With students
With other boards
With government
Condition #9. This work is complex and is best done together! When boards create spaces for co-learning and collaboration, innovation emerges and commitment grows. There are many potential and willing partners. This is an area of passion for many, and tapping into this can lead to rich possibilities.

18. Ongoing Quality Improvement
Condition TEN
The board has a system of ongoing quality improvement, that includes measurement:
Of program / strategy implementation
Of teacher perceptions and knowledge
Of student perceptions and knowledge
Of student outcomes
Condition #10. Continuous quality improvement is a key feature of successful school mental health systems. Measurement of process variables, like program implementation fidelity, of perceptions, and of outcomes, can assist with decisions about future actions. School Mental Health ASSIST is working with a team of leaders in this area to prepare tools to help in the area of future measurement.

19. Support THANK YOU! Your Superintendent / Director
Your Board MH Team, MH Professionals
SMH ASSIST team, and especially your coach, are here to help you to establish these conditions in your board over time
THANK YOU!