From Policy to Practice: Using Community Science to Promote School-Based Mental Health

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From Policy to Practice Using Community Science
to Promote School-BasedMental Health

• Symposium Presentation at the Annual Meeting of
  the American Psychological Association
• August 18, 2005

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• Presenters
• Paul Flaspohler
• Center for School-Based Mental Health Programs,
  Miami University
• Carl E. Paternite
• Center for School Based Mental Health Programs,
  Miami University
• Steve Evans
• Dept. of Psychology, James Madison University
• Elaine Clanton Harpine
• Dept. of Psychology, Kent State University
• Discussant
• Mark Weist
• Center for School Mental Health Analysis and
  Action, U. of Maryland

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Tovas Perspective on Mental Health and School
SuccessOhio Shared Agenda Legislative Forum
TestimonyOctober 9, 2003
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Community Science

• A means and a method for bridging this gap
  between research and practice
• An interdisciplinary framework for strengthening
  communities by improving the quality of practice
  in treatment, prevention, health promotion, and
  education

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The Gap between research and practice
Prevention Science Intervention Basic
research Efficacy Effectiveness Services
Research
Practice Community Organizational Systems 1)
Schools 2) Health Agencies 3) Community
Coalitions


GAP
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The preventive intervention research cycle
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Pasteurs Quadrant
Yes
No
Yes
No
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Bridging the Gap
Prevention Science Intervention Basic
research Efficacy Effectiveness Services
Research
Practice Community Organizational Systems 1)
Schools 2) Health Agencies 3) Community
Coalitions

• Green Characteristics
• Process
• Control
• Self-Evaluation
• Tailoring Process and new Technology
• 5) Synthesizing Research

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Larry Green From Research to Best Practices

• Best Practice as Process
• Control by practitioner, client, or community
• Local evaluation and self-monitoring
• Research in the Tailoring Process and new
  technology
• Consumer driven Synthesis and Translation

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Promoting Effective School-Based Mental Health
Programs and Services

• Carl E. Paternite, Ph.D.
• Center for School-Based Mental Health Programs
• Miami University (Ohio)
• Steven Adelsheim, M.D.
• Health Sciences Center
• University of New Mexico

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The Crisis of Youth Mental Health in the U.S.

• About 20 of youth, ages 9 to 17 (15 million),
  have diagnosable mental health disorders, (and
  many more are at risk or could benefit from help)
• Between 9-13 of youth, ages 9-17 years, meet the
  federal definition of serious emotional
  disturbance (SED)

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The Crisis of Youth Mental Health in the U.S.
(cont.)

• Less than 30 of youth with diagnosable disorder
  receive any service, and, for those who do, the
  services are often inadequate
• For the small percentage of youth who do receive
  services, most actually receive them in schools

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The Crisis of Youth Mental Health in the U.S.
(contd)

• These realities raise questions about the mental
  health fields insufficient attention to delivery
  of ecologically sensitive and effective services
• And they reinforce the importance of
• a community-based continuum of mental health
  supports,
• commitment to a public health model of mental
  health, and
• expanded school mental health programs and
  services.

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Growing Focus on School Mental Health (SMH) in
the U.S.

• U.S. Surgeon General Reports (1999, 2000)
• Presidents New Freedom Commission on Mental
  Health Report (2003)
• Mandates of No Child Left Behind and
  Individuals with Disabilities Education Act
  (IDEA)
• Progress in localities and states
• Collaborative research-practice-training networks

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Schools The Most Universal Natural Setting

• Over 52 million youth attend 114,000 schools
• Over 6 million adults work in schools
• Combining students and staff, one-fifth of the
  U.S. population can be found in schools
• From New Freedom Commission (2003)

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Public Policy ContextSMH and the No Child Left
Behind MandateTwo Important Interrelated Goals
Achievement and Wellbeing

• 1) Achievement promotes wellbeing
• 2) Wellbeing promotes achievement
• School accountabilities often acknowledge 1 but
• fail to sufficiently acknowledge 2

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Report of Presidents New Freedom Commission on
Mental Healthhttp//www.mentalhealthcommission.go
v

• 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

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Based On a Growing KnowledgeBase, Schools That
PromoteMental 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)

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Strengthening Policy and Practice Ohios Shared
Agenda and Mental Health Network for School
Success

• Paul Flaspohler, Ph.D.
• Center for School-Based Mental Health Programs,
  Miami University (Ohio)
• Noelle Duvall, Ph.D.
• Childrens Resource Center, Bowling Green, OH
• Kay Reitz, Ph.D.
• Office of Children's Services and Prevention
  .Ohio Department of Mental Health
• Michael Armstrong
• Director, Office for Exceptional Children, Ohio
  Department of Education

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Infrastructure for Ohios SharedAgenda 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

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Mission
To help Ohios 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.
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Ohios Mental Health, Schools, and Families
Shared Agenda Initiative http//www.units.muohio.e
du/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
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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)

From Zins (in progress).
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Legislative Forum On Mental Health and School
SuccessCreating A Shared Agenda In OhioOctober
9, 2003
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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.
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Pre- and In-service Training to Promote
Interdisciplinary Collaboration in SBMH

• Jennifer L. Axelrod, Steven W. Evans, Robert
  Burke

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Nature of the Problem

• National crisis regarding behavioral health
  workforce (The Annapolis Coalition)
• Inadequate training in graduate programs.
• Ineffective methods of continuing education
  (e.g., symposiums).
• Those with most client contact frequently have
  least training.
• Little to no family education provided nor is
  their experience considered in training.

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Examples of Problem

• Many graduate programs do not teach students
  about productivity and dealing with managed care
  which are primary measures of competency in many
  jobs.
• There is little pre-service or in-service
  training about evidence based practices and how
  to fit them into a real practice.
• Training in evidence based practices frequently
  barely resembles actual EBP.

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School Mental Health

• In addition to basic competencies required to be
  a qualified mental health provider, school based
  mental health providers require additional
  competencies
• Understanding of education system
• Advanced consultation and collaboration skills
• Techniques for using meaningful outcome measures
• Creativity and flexibility

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School Mental Health

• Educators also wish to gain knowledge and skills
  in childrens mental health
• Awareness of meaningful variations in behavior
• Methods for improving classroom management and
  educational strategies for children with mental
  health problems
• Techniques for supporting appropriate social
  development
• Approaches for fostering resilience and coping

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Mental Health-Education Integration Consortium
MHEDIC

• Collaboration of educators and mental health
  providers with goal of advancing pre-service and
  in-service training on mental health issues.
• Establish core competencies of professions that
  are unique to school mental health
• Educators
• Mental health providers
• Develop training methods for helping
  professionals achieve these competencies.

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Methods

• Competencies
• Collect information from professionals
• Identify core competencies for educators and
  school mental health providers
• Training
• Modify university training programs
• Update technical assistance centers
• Develop methods for effective training
• Examine impact on education and mental health
  outcome measures when professionals in school
  achieve competencies.

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After-School Community-Based Prevention Projects

• Elaine Clanton Harpine, Ph.D.
• Kent State University Geauga

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Portable Play Therapy Room

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From Policy to Practice Using Community Science
to Promote School-Based Mental Health

• Discussant
• Mark Weist
• Center for School Mental Health
• Analysis and Action
• Department of Psychiatry
• University of Maryland

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Center for School Mental Health Analysis and
Action
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CSMHA

• Established in 1995 with a grant from the Health
  Resources and Services Administration (HRSA)
• Renewed 5-year funding in 2000 from HRSA, with
  co-funding from the Substance Abuse and Mental
  Service Administration (SAMHSA)
• Renewed 5-year funding in 2005 from HRSA and
  SAMHSA with a focus on policy analysis and
  dissemination

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Factors Necessary to Achieve Desired Outcomes
for Youth Through SBMH Programs and Services
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The IDEA Partnership
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The Big Picture A Shared Agenda

• Achievement and Well Being as Dual Goals
• Address both academic and non-academic barriers
  to achievement
• Share work across education, mental health and
  family organizations
• Make explicit the shared interests of school
  mental health, general education and special
  education
• Grow state-based examples
• Develop and nurture multi-scale learning loops
• Build a national Community of Practice on
  school-based mental health that unites
  stakeholders around shared interests across
  organizational boundaries
• see www.ideapartnership.org

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2nd Community Building Forum, and 10th Annual
Conference on Advancing School Mental Health

• Federal funders, HRSA, SAMHSA, OSEP
• Major Partners IDEA Partnership, NASDSE, CSMHA,
  Ohio Mental Health Network for School Success
• Cleveland Ohio, October 26 (Community Building
  Forum) 29, 2005
• Come to Cleveland, the City that Rocks!!
• See http//csmha.umaryland.edu or contact
  Christina at chuntley_at_psych.umaryland.edu

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Practice Groups

• Mental Health Education Integration
• Developing a Common Language
• Connecting Education and Systems of Care
• Connecting School Mental Health (SMH) and
  Positive Behavior Support
• Improving SMH for Youth with Disabilities

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Practice Groups (cont.)

• SMH, Juvenile Justice and Drop-Out Prevention
• Family Partnerships
• Youth Involvement and Leadership
• Faith Community Partnerships
• Quality and Evidence-Based Practice

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INTERCAMHSInternational Alliance for Child
andAdolescent Mental Health and Schools
www.intercamhs.org
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UCLA Center for Mental Health in Schools

• Directed by Howard Adelman and Linda Taylor
• Phone [phone]
• Enews listserv_at_listserv.ucla.edu
• web http//smhp.psych.ucla.edu