New Levels of Work Together for School-Wide PBIS and School Mental Health, Part 2
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Transcript of New Levels of Work Together for School-Wide PBIS and School Mental Health, Part 2
New Levels of Work Together for New Levels of Work Together for School-Wide PBIS and School School-Wide PBIS and School
Mental Health, Part 2Mental Health, Part 2
Mark D. Weist, Ph.D.Mark D. Weist, Ph.D.Center for School Mental HealthCenter for School Mental Health
University of Maryland University of Maryland 10.9.0910.9.09
Center for School Mental Health* Center for School Mental Health* University of Maryland School of MedicineUniversity of Maryland School of Medicine
http://csmh.umaryland.eduhttp://csmh.umaryland.edu*Supported by the Maternal and Child Health Bureau of HRSA *Supported by the Maternal and Child Health Bureau of HRSA
and numerous Maryland agenciesand numerous Maryland agencies
““Expanded” School Mental HealthExpanded” School Mental Health
Full continuum of effective mental health Full continuum of effective mental health promotion and intervention for students in promotion and intervention for students in general and special educationgeneral and special education
Reflecting a “shared agenda” involving Reflecting a “shared agenda” involving school-family-community system partnershipsschool-family-community system partnerships
Collaborating community professionals (not Collaborating community professionals (not outsidersoutsiders) ) augmentaugment the work of school- the work of school-employed staffemployed staff
Fundamental Three-Part RationaleFundamental Three-Part Rationale
Schools are under-resourced for mental health Schools are under-resourced for mental health promotion and interventionpromotion and intervention
Connections between people and traditional Connections between people and traditional community mental health centers are difficultcommunity mental health centers are difficult
By coming together in the most universal By coming together in the most universal natural setting for youth, there are advantages natural setting for youth, there are advantages for both systems, and synergies enhance for both systems, and synergies enhance opportunities to achieve valued outcomes opportunities to achieve valued outcomes
RolesRoles
10-20% Broad Environmental Improvement 10-20% Broad Environmental Improvement and Mental Health Promotion (CHANGE and Mental Health Promotion (CHANGE AGENT ROLE)AGENT ROLE)
50-60% Prevention and Early Intervention 50-60% Prevention and Early Intervention (PREVENTION SPECIALIST ROLE)(PREVENTION SPECIALIST ROLE)
20-30% Intensive Assessment and Treatment 20-30% Intensive Assessment and Treatment (CLINICIAN ROLE)(CLINICIAN ROLE)
Roles, cont. Roles, cont.
Tier 1 Tier 2 Tier 3
Sch. Psy. XOXOXO XXXXXX XX
Sch. SW. XOXOXO XXXXXX
Sch. Co. XOX0 OOO
Com. St. XO OOOOOO OOOOOOGEN.ED=O SPEC.ED=X
Expanded School Mental Health Expanded School Mental Health Services in Baltimore CityServices in Baltimore City
1989: 4 schools1989: 4 schools2009: 105 schools2009: 105 schools
– 42 Elementary schools42 Elementary schools
– 41 Middle/K-8 schools41 Middle/K-8 schools
– 22 High schools22 High schools
Baltimore ESMH Funding 2009Baltimore ESMH Funding 2009
Baltimore City Public School
System, $1,450,000
Baltimore Substance Abuse
Systems, Inc., $383,000
Family League of Baltimore, Inc.,
$177,000
Baltimore City Health
Department, $235,950
Department of Labor Grant,
$105,000
Baltimore Mental Health Systems, Inc., $768,000
47%
25%
12%
3%
6%7%
Themes Helping ESMH in Baltimore Themes Helping ESMH in Baltimore to Move to the Next Levelto Move to the Next Level
A strategic planA strategic plan
One network with common expectationsOne network with common expectations
A prominent and diverse advisory boardA prominent and diverse advisory board
Strong cross-agency connectionsStrong cross-agency connections
Strong state, national and federal connectionsStrong state, national and federal connections
Embracing “mental health”Embracing “mental health”
Informal ‘Mental Health’ DefinitionInformal ‘Mental Health’ Definition
““Healthy thoughts, feelings and actions that Healthy thoughts, feelings and actions that help you be successful”help you be successful”
A positive concept like ‘physical health’A positive concept like ‘physical health’
Prince George’s School Mental Health Prince George’s School Mental Health Initiative (PGSMHI)Initiative (PGSMHI)
Funding from the State Department of EducationFunding from the State Department of Education
Intensive, evidence-based mental health intervention Intensive, evidence-based mental health intervention for students in special education in 2 and then 6 for students in special education in 2 and then 6 schools schools
Training and support to 11 schools with specialized Training and support to 11 schools with specialized programs for youth presenting emotional problemsprograms for youth presenting emotional problems
Broader training and support county wide (e.g., for all Broader training and support county wide (e.g., for all school psychologists) school psychologists)
Family Needs AddressedFamily Needs Addressed
Food, health insurance, medical needs, Food, health insurance, medical needs, clothing, transportation, utilities, substance clothing, transportation, utilities, substance abuse services, mental health services, abuse services, mental health services, tutoring, mentoring, recreational programstutoring, mentoring, recreational programs
Absences by QuarterAbsences by Quarter
0
1
2
3
4
5
6
7
8
9
10
INV 4.24 6 6.06 5.35
Non INV 2.69 5.25 10 9.88
1st Qtr 2nd Qtr 3rd Qtr 4th Qtr
Data on Non-Public PlacementsData on Non-Public Placements
Between September, 2006 and January, 2009, Between September, 2006 and January, 2009, 78 students were seen for more intensive 78 students were seen for more intensive services in the four schoolsservices in the four schools
All met multiple criteria for placement in non-All met multiple criteria for placement in non-public programspublic programs
3/78 students were placed in a non-public 3/78 students were placed in a non-public programprogram
Economic ImplicationsEconomic Implications
Non public cost per student/year above special Non public cost per student/year above special education cost = $39,038education cost = $39,038Cost of program per student/year = $7,212Cost of program per student/year = $7,212Difference = $31,826 saved per student/yearDifference = $31,826 saved per student/year102 nonpublic placement years diverted102 nonpublic placement years divertedFOR A NET SAVINGS OF AROUND FOR A NET SAVINGS OF AROUND $3.2 MILLION$3.2 MILLION– Slade et al, 2009, Advances in School Mental Slade et al, 2009, Advances in School Mental
Health PromotionHealth Promotion
Anne Arundel School Anne Arundel School Mental Health InitiativeMental Health Initiative
Began in 2008-09 school yearBegan in 2008-09 school year
Operating in two regions of the county, north Operating in two regions of the county, north and westand west
Services in north focused on youth in the red Services in north focused on youth in the red zone at risk of more restrictive placements (6 zone at risk of more restrictive placements (6 schools)schools)
Services in west focused on early intervention Services in west focused on early intervention (3 schools near Army base)(3 schools near Army base)
Referrals and EnrollmentReferrals and Enrollment61 Referrals 61 Referrals
44 Enrolled 44 Enrolled 34 with 4+ sessions 34 with 4+ sessions
1815
11
43
2924
61
44
34
0
10
20
30
40
50
60
70
North West Total
Referred
Enrolled
4+ Sessions
Student Outcomes: Total (n=34)Student Outcomes: Total (n=34)
Prior to 1Prior to 1stst sessionsession
From the 4From the 4thth session on*session on*
ChangeChange
AttendanceAttendance 24 students24 students 24 students24 students 0%0%
Informal Informal ReferralsReferrals
18 students18 students 15 students15 students 16% 16%
Suspensions Suspensions (# times)(# times)
9 students9 students 5 students5 students 44% 44%
* The average length of time to complete four sessions is approximately one month.
Student OutcomesStudent Outcomes
Primary and intermediate elementary students demonstrated decreases Primary and intermediate elementary students demonstrated decreases in absences and tardies, with the exception of increased tardies among in absences and tardies, with the exception of increased tardies among
intermediate students.intermediate students.
Absences and Tardies: West County
7.7
6.5
3.8
2.3
6.55.8
2.93.4
0123456789
Before After Before After
Absences Tardies
Ave
rage
# o
f Tim
es
Primary
Intermediate
A National Community of PracticeA National Community of Practice
CSMH and IDEA Partnership (CSMH and IDEA Partnership (www.ideapartnership.orgwww.ideapartnership.org) providing support) providing support
30 professional organizations and 12 states30 professional organizations and 12 states
12 practice groups12 practice groups
Providing mutual support, opportunities for Providing mutual support, opportunities for dialogue and collaborationdialogue and collaboration
Advancing Advancing multiscale learning systemsmultiscale learning systems
Sign up at Sign up at www.sharedwork.orgwww.sharedwork.org
Next CSMH ConferenceNext CSMH Conference
1414thth Annual Conference on Advancing School Annual Conference on Advancing School Mental HealthMental Health. Minneapolis, November 1-4. Minneapolis, November 1-4
Sunday evening – Community Share FareSunday evening – Community Share Fare
Monday – Community Meetings/Intensive Monday – Community Meetings/Intensive TrainingTraining
Tuesday, Wednesday – Conference ProgramTuesday, Wednesday – Conference Program
See See http://csmh.umaryland.eduhttp://csmh.umaryland.edu, , www.sharedwork.orgwww.sharedwork.org or call 410-706-0980 or call 410-706-0980
www.schoolmentalhealth.orgwww.schoolmentalhealth.org
Website developed and maintained by the Website developed and maintained by the CSMH with funding from the Baltimore City CSMH with funding from the Baltimore City Health Department and Maryland Departments Health Department and Maryland Departments of Education and Mental Healthof Education and Mental Health
User-friendly school mental health User-friendly school mental health information and resources for caregivers, information and resources for caregivers, teachers, clinicians, and youthteachers, clinicians, and youth
Two New JournalsTwo New Journals
Advances in School Mental Health Advances in School Mental Health Promotion Promotion – The Clifford Beers Foundation and the University The Clifford Beers Foundation and the University
of Marylandof Maryland– www.schoolmentalhealth.co.uk www.schoolmentalhealth.co.uk
School Mental HealthSchool Mental Health– www.springer.comwww.springer.com
Advances in School Advances in School Mental Health PromotionMental Health Promotion
Contact InformationContact Information
Center for School Mental Health Center for School Mental Health Department of Psychiatry University Department of Psychiatry University of Maryland 737 W. of Maryland 737 W. Lombard Street, 4Lombard Street, 4thth Floor Baltimore, Floor Baltimore, MD 21201 PH: 410-706-MD 21201 PH: 410-706-0980 FX: 410-0980 FX: 410-706-0984 706-0984 [email protected]@psych.umaryland.edu http://csmh.umaryland.eduhttp://csmh.umaryland.edu