Building Child Serving Systems: Connecting Health and Education

1. Making Connections with Kids through School Health Presenters: Cynthia Cook, Carlynn Nichols and Crystal Palmer June 19, 2015

2. Systems

3. System Definition noun: • an assemblage or combination of things or parts forming a complex or unitary whole. • a coordinated body of methods or a scheme or plan of procedure; organizational scheme.

4. Solar System

5. Respiratory System

6. Nervous System

7. Systems of Service Provision Each Child Serving System is unique • Policy • Protocol • Programming • Staff Credentials • Unique Culture • Goals or Focus Consider all of the parts that interconnect together to make a system work properly

8. Child Serving Systems • Juvenile Justice – Community Safety • Public Health – Community Health and Wellness • Child Welfare - Child Well Being and Child Safety • Schools – Educational Achievement • Behavioral/Mental Health – Emotional and Mental Wellness and Well being • Primary Care – Physical Health Care • Community Centers – Community Well Being

9. Child Serving System Each System is focused on improving function of children AND we have differences in orientation, categorical funding, culture that challenges our ability to attending to the overall needs of children, youth and their families

10. How do we get systems to create a system to serve children, youth and families? Schools Primary Care Churches Public Health Courts Mental Health Recreation/Community Centers

11. Is student health the missing piece in School Reform?

12. Former Surgeon GeneralDr. Antonia Novello “Health and education go hand in hand: one cannot exist without the other. To believe any differently is to hamper progress. Just as our children have a right to receive the best education available, they have a right to be healthy. As parents, legislators, and educators, it is up to us to see that this becomes a reality.” • Healthy Children Ready to Learn: An Essential Collaboration Between Health and Education, 1992

13. American Cancer Society “[Children] …who face violence, hunger, substance abuse, unintended pregnancy, and despair cannot possibly focus on academic excellence. There is no curriculum brilliant enough to compensate for a hungry stomach or a distracted mind.” • National Action Plan for Comprehensive School Health Education, 1992.

14. Good Health is Necessary forAcademic Success

15. It is difficultfor students to be successful in school if they are: depressed tired being bullied stressed sick using alcohol or other drugs hungry abused

16. Systems • A system is a group of independent but interrelated and interacting elements – individuals, institutions, and infrastructure that form a unified whole. • Systems change attempts to make the environment favorable for an individual and/or group. • A favorable change in the environment can promote voluntary and favorable changes in behavior. • Nutrition Education: Linking Research, Theory, and Practice By Isobel R. Contento, 2011

17. Systems Change • Health and education often exist in silos, but they must work together to make needed changes • Schools offer the perfect setting, but they can’t do it alone • Schools are unique systems • Systems change is long-term and takes time

18. The Coordinated School Health (CSH) Model & The Whole School, Whole Community, Whole Child (WSCC) Model 

19. History • In 1987, the coordinated school health program was introduced. • In 2011, ASCD published The Healthy School Communities Model: Aligning Health and Education in the School Setting. • In 2013, ASCD and the CDC convened leaders from the fields of health, public health, education, and school health to develop the next evolution of school health to ensure that the health of the student, the teacher, and the school are taken seriously by educators and, in particular, by those involved in the school improvement process. • The result is the 2014 launch of the WSCC model. • http://www.ascd.org/programs/learning-and-health/wscc-model.aspx

20. Comprehensive School Health Education Family & Community Involvement Physical Education School-site Health Promotion for Staff School Health Services Nutrition Services Healthy School Environment Counseling, Psychological & Social Services Coordinated School Health

21. Coordinated School Health Goals • Increase health knowledge, attitudes, and skills. • Increase positive health behaviors and health outcomes. • Improve education outcomes. • Improve social outcomes. • http://www.cdc.gov/healthyyouth/cshp/goals.htm

22. The WSCC Model Combines and builds on elements of the traditional coordinated school health model and the whole child framework by: • Responding to the call for greater alignment, integration, and collaboration between education and health to improve each child's cognitive, physical, social, and emotional development. • Incorporating the components of a coordinated school health program around the tenets of a whole child approach to education. • Providing a framework to address the symbiotic relationship between learning and health. • http://www.ascd.org/programs/learning-and-health/wscc-model.aspx

23. Whole Child Tenets • Each student enters schoolhealthy and learns about and practices a healthy lifestyle. • Each student learns in an environment that is physically and emotionallysafe for students and adults. • Each student is actively engaged in learning and is connected to the school and broader community. • Each student has access to personalized learning and is supported by qualified, caring adults. • Each student is challenged academically and prepared for success in college or further study and for employment and participation in a global environment. • http://www.ascd.org/whole-child.aspx

24. The WSCC Model

25. Stages of System Change • Maintenance of the Old System • Awareness • Exploration • Transition • Emergence of New Infrastructure • Predominance of the New System • http://www.ascd.org/publications/educational-leadership/sept93/vol51/num01/The-Stages-of-Systemic-Change.aspx ; Beverly L. Anderson.

26. Key Elements to System Change • Vision • Public and Political Support • Networking • Teaching and Learning Changes • Administrative Roles and Responsibilities • Policy Alignment The process is akin to remodeling a building while people are still using it; redesign and reconfiguration need to be carefully staged to keep the building functional. • http://www.ascd.org/publications/educational-leadership/sept93/vol51/num01/The-Stages-of-Systemic-Change.aspx; Beverly L. Anderson.

27. Comprehensive School Health Education Family & Community Involvement Physical Education School-site Health Promotion for Staff School Health Services Nutrition Services Healthy School Environment Counseling, Psychological & Social Services The Old Model

28. The New and Improved Model

29. What does this all mean?

30. ANSWER: Healthy children make better students, and better students make healthy communities.

32. Systems of Care

33. System of Care History • 1978 President’s Commission on Mental Health • Jane Knitzer’s Unclaimed Children: The Failure of Public Responsibility to Children and Adolescents in Need of Mental Health Services, published in 1982 • Child and Adolescent Service System Program in 1984

34. Definition Systems of care is not a program — it is a concept and philosophy of how care should be delivered www.systemsofcare/samsha.gov

35. System of Care System of Care is an approach to services that recognizes the importance of family, school and community, and seeks to promote the full potential of every child and youth by addressing their physical, emotional, intellectual, cultural and social needs.   systemsofcare/samsha.gov

36. System of Care Systems of care helps parents and caregivers address the mental health needs of their children and youth while managing the demands of day-to-day living. Adequately meeting these needs requires multiple strategies and agencies. systemsofcare/samsha.gov

37. System of Care Families and youth work in partnership with public and private organizations to design mental health services and supports that are effective, that build on the strengths of individuals, and that address each person's cultural and linguistic needs. A system of care helps children, youth and families function better at home, in school, in the community and throughout life. www.systemsofcare/samsha.gov

38. Framework for System of Care Stroul, B. & Friedman, R. (1986). A system of care for children and youth with severe emotional disturbances (rev. ed., p. 30)

39. Core Values Family Driven and Youth Guided, with the needs of the child and family determining the types and mix of services and supports provided. Community based, with the locus of services as well as system management resting within a supportive, adaptive infrastructure of structures, processes, and relationships. Culturally and Linguistically competent, with agencies, programs, and services that reflect the cultural, racial, ethnic and linguistic differences of the populations they serve to facilitate access to and utilization of appropriate services supports and eliminate disparities in care. Stroul,B., Blau, G. and Friedman, R. (2010) Issue Brief: Updating the System of Care Concept and Philosophy. Washington DC: Georgetown University Center for Child and Human Development, National Technical Assistance Center for children’s Mental Health

40. GuidingPrinciples A comprehensive array of services & supports Individualized services to meet the unique needs & potential guided by an individualized service plan Services in the least restrictive environment Family participation in ALL aspects of planning, service delivery, and evaluation Integrated services with coordinated planning across the child-serving systems.Modified from: Pires, 2007

41. Guiding Principles Continued • Case Management or service coordination with linkage between child-serving agencies and programs • Prevention, early identification & intervention promoted by SOC to enhance positive outcomes • Smooth transitions among agencies, providers, and to the adult service system • Promote human rights protection & advocacy • Nondiscrimination in access to services Modified from: Pires, 2007

42. Multiple Levels of a SOC Services Support, services, resources for families Community Community collaboration and partner projects Governance Interagency collaborative decision making body

43. Human Services Community Collaborative Parent & Youth Advisory Council Governance FAMILY AND YOUTH INVOLVEMENT Community Collaboration Children’s Initiatives Family Driven - Youth Guided - Community Based - Cultural and Linguistic Competence 6/3/2015

44. Key Elements A Collaborative Body Interagency Collaboration Memorandum of Understanding Parent-Professional Partnerships Youth Involvement/Voice Evidence Based/Informed Practice Clinical Excellence & Workforce Development Cultural and Linguistic Competence Access to Services A Strategic Plan/Direction

45. Critical Components • Cross System Training • Mechanism for Access to Services • Collaboration • Resource Sharing

46. Systems Transformation Lessons • Understanding systems within systems • Respecting the goals and the roles all partners • Interpersonal relationships • Champions are mandatory • Ongoing process of change • Ongoing Evaluation

47. References • American Cancer Society. National Action Plan for Comprehensive School Health Education. Atlanta, GA: American Cancer Society; 1992:4-7. • Anderson, B. L. (1993). The Stages of Systemic Change. Educational Leadership, 14-17. • ASCD. (2015, June 16). Learning and Health. Retrieved from ASCD: http://www.ascd.org/programs/learning-and-health/wscc-model.aspx • ASCD. (2015, June 16). The Whole Child Initiative. Retrieved from ASCD: http://www.ascd.org/whole-child.aspx • Centers for Disease Control and Prevention . (2015, June 16). Goals of Coordinated School Health. Retrieved from Adolescent and School Health: http://www.cdc.gov/healthyyouth/cshp/goals.htm • Contento, I. R. (2007). Nutrition Education: Linking Research, Theory, and Practice . Sudbury: Jones and Bartlett Publishers. • Novello, A.C., Degraw, C., Kleinman, D. (1992). Healthy children ready to learn: An essential collaboration between health and education. Public Health Reports, 107 (1),3-15. • Stroul,B. and Friedman, R. (1986). A System of Care for children and youth with Severe Emotional disturbances. (Revised Edition). Washington DC: Georgetown University Child Development Center, CASSP Technical Assistance Center. • Stroul,B., Blau, G. and Friedman, R. () Issue Brief: Updating the System of Care Concept and Philosophy. Washington DC: Georgetown University Center for Child and Human Development, National Technical Assistance Center for children’s Mental Health • Pires, S. (Spring 2002). Building Systems of Care: A Primer. Washington DC: Georgetown University Center for Child and Human Development, National Technical Assistance Center for children’s Mental Health

48. For more information contact: Cynthia Cook, Ph. D. Wayne RESA Health Consultant cookc@resa.net 313-334-1367 Carlynn Nichols, LMSW The Children’s Center Chief Clinical Officer cnichols@thechildrenscenter.com 313-262-1193 Crystal Palmer, LMSW Detroit Wayne Mental Health Authority Director, Children’s Initiatives cpalmer@dwmha.com 313-833-1996