PIP, EMHI, and PEI

1
PIP, EMHI, and PEI
(Primary Intervention Program, Early Mental
Health Initiative, and Prevention and Early
Intervention)

• Scott Lindstrom EMHI Consultant, Program
  Coordinator, Chico Unified School
  District
• Mike Newlin EMHI Evaluation Director,
  Duerr Evaluation Resources
• Spence Rundberg EMHI Consultant, Program
  Coordinator, Benicia Unified School
  District and Local Mental Health
  Advisory Board Member

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A Brief History of PIP

• 1957 Primary Mental Health Project Rochester,
  New York
• 1982 Primary Prevention Program in California
• 1991 AB1650 The School-Based Early Mental
  Health Intervention and Prevention Services for
  Children Act, (Early Mental Health Initiative)
• 2007 Current funding under EMHI 15 million

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Program Goals

• To enhance the social and emotional development
  of young children
• To increase the likelihood that students
  experiencing mild to moderate school adjustment
  difficulties will succeed in school
• To increase personal competencies related to
  life success
• To minimize the need for more intensive and
  costly services as students grow older

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Key Elements of EMHI/PIP

• Serve students in kindergarten through third
  grade experiencing mild to moderate school
  adjustment difficulties
• Provide services which are school-based and low
  cost
• Provide services in a culturally competent manner
• Provide services to students in the target
  population from low income families and/or who
  are in out-of-home placement, or are at risk of
  out-of-home placement
• Encourage a close working relationship with
  parents and teaching staff to build alliances to
  promote students mental health and social and
  emotional development
• Provide services in collaboration with
  professional staff of a cooperating mental health
  entity such as County Mental Health or a
  non-profit agency

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Key Elements of EMHI/PIP

• Use a systematic selection process in the
  identification of K-3 students most likely to
  benefit from program participation
• Use alternative personnel, such as child aides,
  to provide direct services to identified students
• Change the traditional roles of mental health
  professionals
• Provide ongoing supervision and training of child
  aides by Pupil Personnel Services (PPS)
  credentialed school psychologists, social
  workers, or school counselors, in collaboration
  with the cooperating MH entity
• Requires ongoing monitoring and evaluation
• Ensure implementation of programs that are based
  on adoption or modification, or both, of existing
  program models that have been shown to be
  effective and which are based on sound research

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Primary Intervention Program PIP

• Early intervention model
• Services provided by child aides
• Services provided one-to-one
• Playroom setting is utilized
• Activities are non-directive
• Service are weekly, 30-45 minutes for 12-15 weeks

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WHY IMPLEMENT PIP SERVICES?

• Addresses barriers to learning
• Provides services for an age and issue for which
  there is a dearth of other funding sources
• Provides early intervention for children at risk
  of later issues
• PIP services are low cost
• Many years of evaluation demonstrate
  effectiveness of PIP services
• 4 5 EMHI programs are cost effective

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WHY WE USE PLAY?(Why not?)

• Developmentally appropriate for children
• Therapeutic tool
• Means to an end the relationship
• No stigmas!
• Also
• A means to enter the childs world on the childs
  terms
• Its FUN!
• AND

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Brain Research

• Emotion drives attention, attention drives
  memory Robert Sylwester
• Relationships shape the developing
  brain Daniel J. Siegel, M.D.
• Two best predictors of risk for
• stress-induced disease
• 1. Poverty
• 2. Social isolation
• Robert Sapolsky

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Relationships

• Effective Schools
• Childs sense of belonging influences the
  acceptance of educational values, motivation and
  commitment to school
• Resiliency
• Three primary factors enhance development of
  resiliency in children
• 1. Presence of supportive, caring relationships
• 2. High expectations with the support to achieve
  them
• 3. Opportunities to make a meaningful
  contribution
• Of these, caring, nurturing relationships are
  consistently found to be the most important
  factor

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Key Players In The Program

Project Coordinator School Base-Mental Health
Professional Mental Health Consultant Child
Aides Principal Teacher School
Resource Personnel
Day-to-day supervision of Child Aides and staff,
and on-site Management of program procedure, PPS
Credentialed School Psychologist, Counselor, or
Social Worker
Overall program management and district
responsibility
Assists with clinical consultation and
training of Child Aides
Offer the student a supportive relationship in a
structured or non-structured environment
Provides administrative support and leadership at
the school site
Identify the students most likely to benefit from
program and Participate as members of program team
Provide a full spectrum of necessary services and
professional support
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What Types of Students Do We Serve?
High
High
Identified High Risk At-Risk EMHI Target
Group Adjusted
Need for Professional Intervention
Severity Of School Adjustment
Low
Low
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SCREENING OPTIONS

• Walker Screening Instrument
• Classroom Observation
• Other Sources/Referrals

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SELECTING STUDENTS

• A Team Decision
• SBMHP
• Mental Health Consultant
• Principal
• Paraprofessional
• Teacher
• SST/CARE Team
• Bargaining
• Final Authority
• Those Who Dont Fit

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BUT

• How do we know it works?

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PROGRAM EVALUATIONDuerr Evaluation Resources

• Walker Screening Instrument (WSI)
• Walker-McConnell Scale (WMS)
• Participant Data Instrument (PDI)
• Local Issues

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Summary of Required Evaluation Instruments
(Available in Scantron)
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Figure 1 2006/07 Instrument Completion
Information

• 99 of forms contained complete information.
• 94 of forms with complete information had
  matching pre-post-pdi forms and were used in the
  statewide data set in 2006/07.

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Figure 2
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Figure 3Longitudinal Participation by Gender
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Figure 4 Longitudinal Participation by Grade
Level
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Figure 5 2006/07 Percentage of Participants
Completing Eight or More Session
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Figure 6 2006/07 Ethnicity of EMHI Participants
and EMHI Schools
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Figure 7 2006/07 Percentage of Participants
with WSI Scores by Percentile Range
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Figure 8 2006/07 PRE-POST SCHOOL ADJUSTMENT
RATINGS
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Figure 9 Longitudinal Changes in Pre-Post
Teacher Preferred BehaviorsPercentile Score
Increases
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Figure 10 Longitudinal Changes in Pre-Post Peer
Preferred Behaviors Percentile Score Increases
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Figure 11 Longitudinal Changes in Pre-Post
Classroom Behaviors Percentile Score Increases
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Figure 12 Longitudinal Changes in Pre-Post
Social Competence and School Adjustment Outcomes
Percentile Score Increases
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Figure 13 2006/07 Social Competence and School
Adjustment Outcomes by Level of Services
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Figure 14 2006/07 PERCENTAGE OF PARTICIPANTS
WHO IMPROVED IN VARIOUS SCHOOL ADJUSTMENT FACTORS
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Figure 15 2006/07 Statewide EMHI DataTarget
Versus Comparison Group Percentile Scores
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Figure 16 Statewide EMHI DataFall Versus
Spring Group Percentile Scores
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PIP and PEI A Discussion
Presentation by
Spence Rundberg