Building and Sustaining District Conditions for Effective School Mental Health

1. Building and Sustaining District Conditions for Effective School Mental Health Suggestions for Supporting Student Mental Health and Well-Beingin your district school board DRAFT School Mental Health ASSIST Webinar Series School Mental Health ASSIST

2. School Mental Health ASSISTÉquipe d’appui en santé mentale pour les écoles is a provincial team designed to help Ontario school boards to support student mental health and well-being School Mental Health ASSIST

3. Three Areas of Focus • Organizational Conditions for Effective School Mental Health • Mental Health Capacity-Building for Educators • Implementation of Evidence-Based Mental Health Promotion and Prevention Programming School Mental Health ASSIST

4. School Mental Health ASSISTwill help ALL school boards to support student mental health & well-being By providing hands-on resources to build Mental Health Awareness and to support effective decision-making in school mental health School Mental Health ASSIST

5. It is part of Ontario’s Mental Health and Addictions Strategy Open Minds, Healthy Minds is the comprehensive, 10-year strategy designed to address mental health and addictions needs in Ontario http://www.health.gov.on.ca/english/public/pub/mental/pdf/open_minds_healthy_minds_en.pdf School Mental Health ASSIST

6. Strategy Priorities for the Next 3 Years • Close Critical Service Gaps • Increase availability of culturally appropriate services and serve more children and youth • in Aboriginal, remote and underserved communities • With complex mental health needs • At the key transition point from secondary to post-secondary education • Fast Access to High Quality Services • Build capacity in the community-based sector • Reduce wait times • Meet community needs • Link education, child and youth mental health, youth justice, health care, and the community • Identify & Intervene Early • Provide tools and support to those in contact with children and youth so they can identify mental health issues sooner • Provide resources for effective responses to mental health issues • Build mental health literacy and local leadership • Support System Change • Support development of an effective and accountable service system for all Ontarians • Build on efforts that promote evidence-informed practice, collaboration, and efficiencies • Develop standards and tools to better measure outcomes for children and youth School Mental Health ASSIST

7. Starting with Child and Youth Mental Health Our Vision: An Ontario in which children and youth mental health is recognized as a key determinant of overall health and well-being, and where children and youth reach their full potential. Identify and intervene in kids’ mental health needs early Professionals in community-based child and youth mental health agencies and teachers will learn how to identify and respond to the mental health needs of kids. Close critical service gaps for vulnerable kids, kids in key transitions, and those in remote communities Kids will receive the type of specialized service they need and it will be culturally appropriate Provide fast access to high quality service Kids and families will know where to go to get what they need and services will be available to respond in a timely way. THEMES • Fewer hospital (ER) admissions and readmissions for child and youth mental health • Reduced Wait Times • Reduced child and youth suicides/suicide attempts • Educational progress (EQAO) • Fewer school suspensions and/or expulsions • Higher graduation rates • More professionals trained to identify kids’ mental health needs • Higher parent satisfaction in services received • Decrease in severity of mental health issues through treatment • Decrease in inpatient admission rates for child and youth mental health INDICATORS Implement Working Together for Kids’ Mental Health Implement standardized tools for outcomes and needs assessment Enhance and expand Telepsychiatry model and services Provide support at key transition points Pilot Family Support Navigator model Y1 pilot Improve public access to service information Develop K-12 resource guide for educators Improve service coordination for high needs kids, youth and families Amend education curriculum to cover mental health promotion and address stigma Funding to increase supply of child and youth mental health professionals Increase Youth Mental Health Court Workers Hire new Aboriginal workers Implement Aboriginal Mental Health Worker Training Program Outcomes, indicators and development of scorecard Expand inpatient/outpatient services for child and youth eating disorders Hire Nurse Practitioners for eating disorders program Implement school mental health ASSIST program &mental health literacy provincially Provide designated mental health workers in schools Reduce wait times for service, revise service contracting, standards, and reporting Strategy Evaluation Implement Mental Health Leaders in selected School Boards Create 18 service collaboratives Provide nurses in schools to support mental health services OVERVIEW OF THE MENTAL HEALTH & ADDICTIONS STRATEGY - FIRST 3YEARS INITIATIVES 7 School Mental Health ASSIST

8. MCYS MH Workers with Schools Working Together SSLI MOHLTC Nurse Leaders MHA Nurses in DSB program Service Collaboratives SSLI EDU SMH ASSIST SSLI Interconnected Initiatives School Mental Health ASSIST

9. What Can School Boards Expect? • Resources to support mental health awareness • Web space related to School Mental Health in Ontario http://smh-assist.ca/ • Decision-making tools • Support for Local Planning • Presentations and Workshops • An Educator Guide to Student Mental Health • 2011-2012 access to MyHealthMagazine http://www.myhealthmagazine.net/ • Interministerial Coordination of Initiatives School Mental Health ASSIST

10. Webinar Series – Session 2 Building and Sustaining District Conditionsfor Effective School Mental Health School Mental Health ASSIST

11. Webinar Series Overview • Mental Health Awareness in Ontario School Boards • Audiences: All Education Sector Audiences • Building and Sustaining District Conditions for Effective School Mental Health • Audiences: Trustees, Directors, Superintendents, Chief Social Workers / Psychologists • Building and Sustaining School Conditions for Effective School Mental Health • Audiences: Superintendents, School Administrators, School Mental Health Professionals, Guidance, Student Success, Special Educators • Building and Sustaining Classroom Conditions for Effective School Mental Health • Audiences: Teachers, Educational Assistants School Mental Health ASSIST

12. Suggested Uses for Webinar Series • Designed to be a flexible resource for educators • Could be used as part of a visioning meeting, a professional development session, or self-study • Select the Webinar that is right for you! Deliver as a Webinar OR Use/Tailor the Slide Deck Draw on the Facilitation Guide for Ideas for Creating an Engaging Staff Development Session School Mental Health ASSIST

13. Mental Health Awareness Webinars Mental Health Awareness is Not an Event • It is an iterative deepening of knowledge that is embedded within school board life • The tools in the School Mental Health ASSIST Webinar Series can be a helpful start, or an enhancement, to board initiatives in this area • The Mental Health Awareness session can be offered in isolation, or as a precursor to any of the sessions in the Series School Mental Health ASSIST

14. The Mental Health Capacity Continuum • The right information, to the right people, in the right way, at the right time School Mental Health ASSIST

15. Creating District Conditions Session Overview • A Vision for Student Mental Health and Well-Being • The Importance of Organizational Leadership • Top 10 List of Research-Based Conditions for Effective School Mental Health • Recommendations and Next Steps School Mental Health ASSIST

16. Ontario students are flourishing, with a strong sense of belonging at school, ready skills for managing academic and social/emotional challenges, and surrounded by caring adults and communities equipped to identify and intervene early with students struggling with mental health problems A Vision for Student Mental Health and Well-Being in Ontario Schools School Mental Health ASSIST

17. To Achieve this Vision, we need to: • Support educators with knowledge and resources to help them to create mentally healthy classrooms • Provide mental health promotion and prevention programming in schools • Equip educators to identify and support students with mental health needs • Work with families and community partners to create seamless pathways to care for students with significant mental health problems School Mental Health ASSIST

18. A Tiered Model of Support for School Boards Our focus, in District School Boards, is to create mentally healthy environments for students, to provide universal mental health promotion programs in areas of need, and to build skills amongst students who are vulnerable through prevention programming Intensive Intervention Targeted Prevention Universal Mental Health Promotion, Social-Emotional Learning School Mental Health ASSIST

19. This is familiar! Key Concepts • Universal Design for Learning • Differentiated Instruction • The Tiered Approach School Mental Health ASSIST

20. Our Community Partners in MCYS and MOHLTC Universal Mental Health Promotion The focus for our colleagues in the Ministry of Child and Youth Services and the Ministry of Health and Long-Term Care is to provide therapeutic support to children and families with significant mental health problems Targeted Prevention Intensive Intervention School Mental Health ASSIST

21. Tiered Support in a Systems Framework Community Indicated Intervention Universal Mental Health Promotion Targeted Prevention Targeted Prevention Universal Mental Health Promotion, Social-Emotional Learning Indicated Intervention School Boards We are better together! School Mental Health ASSIST

22. What Would This Look Like? • Universal (Tier 1)- A school district made up of caring classrooms and schools, where students learn to build skills for coping, and know where to turn when life becomes challenging • Targeted (Tier 2)- A school district with a range of professional supports and prevention programs that can be implemented with vulnerable students • Intensive(Tier 3)- A school district with clear protocols in place to ensure that students who are struggling are identified early and receive support at school, and within the community if necessary A school district with a Tiered Support Strategy School Mental Health ASSIST

23. Getting from Here to There • While many boards have aspects of a Tiered Support Model in place, including a dedicated focus on promotion and prevention activities may require a change in thinking (and possibly a change in structures, a change in roles, a change in partnership relationships) • We need to pay attention to staff mental health and well-being during the change process • We need to continue to tend to our most distressed students as we make this shift School Mental Health ASSIST

24. Reflecting on the Tiered Support Model Where is our board currently in moving towards a Tiered Support Model for student mental health? What are the benefits of moving further towards this model? What are the challenges that would emerge for our board in moving further towards this model? How might these challenges be approached? School Mental Health ASSIST

25. The Importance of Organizational Leadership School Mental Health ASSIST

26. Managing Complex Change Vision Skills Incentives Resources Action Plan = Change Adapted from Knoster, T. (1991) Presentation at TASH Conference, Washington DC (Adapted by Knoster from Enterprise Group Ltd.) School Mental Health ASSIST

27. Skills Incentives Resources Action Plan = Confusion Vision Incentives Resources Action Plan = Anxiety Vision Skills Resources Action Plan = Resistance Vision Skills Incentives Action Plan = Frustration Vision Skills Incentives Resources = Treadmill Managing Complex Change Adapted from Knoster, T. (1991) Presentation at TASH Conference, Washington DC (Adapted by Knoster from Enterprise Group Ltd.) School Mental Health ASSIST

28. Self-Assessment • Does your board have a clear vision for school mental health? Does your BIPSA address student well-being? • Do educators and central office staff have the skills they need to provide effective mental health supports? • Are the incentives for a tiered model of mental health service delivery clear to board staff? • Are there sufficient resourcesto support effective school mental health? • Do you have an action plan related to school mental health? Does the plan include a clear pathway to care? School Mental Health ASSIST

29. System Leaders • Have a pivotal role in: Highlighting the importance of student mental health at school Communicating about the Tiered Support Model Co-Creating a Board Vision for School Mental Health Recognizing the foundational work of school mental health professionals Developing required infrastructure and protocols to facilitate effective tiered support Encouraging a systematic approach to educator mental health awareness / literacy Encouraging a systematic approach to the selection of promotion / prevention programs Co-creating a Board Mental Health Strategy and Action Plan Promoting local evaluation of programs and services School Mental Health ASSIST

30. The Special Role of Leaders Supporting the mental health and well-being of staff Although educators have been dealing with student mental health problems throughout their careers, it may feel like a new area of responsibility Educators feel ill-prepared to deal with student emotional and behavioral problems at school (Taking Mental Health to School, 2009) Mental health is a sensitive area for some School Mental Health ASSIST

31. Leadership is a lever we are using to support large scale system improvement to enhance achievement and well-being for our 2 million students in 5000 schools. The Ontario Leadership Framework is relevant to our work with student mental health and well-being. Ontario Leadership Framework School Mental Health ASSIST

32. Ontario Leadership Framework • 5 Domains: • Setting Directions • Building Relationships and Developing People • Developing the Organization • Leading the Instructional Program • Securing Accountability 5 Core Leadership Capacities: • Promoting Collaborative Learning Cultures • Aligning Resources with Priorities • Using Data • Setting Goals • Engaging in Courageous Conversations School Mental Health ASSIST

33. Ontario LeadershipFramework 33

34. Core Leadership Capacities The ministry has identified five core leadership capacities derived from the OLF to be the key focus for capacity building for principals School Mental Health ASSIST

35. System Leaders • Have a pivotal role in: Setting Directions for Student Mental Health e.g., Co-Creating a Board Vision for School Mental Health Building Relationship and Developing People e.g., Recognizing the foundational work of school mental health professionals Developing the Organization to be Proactive about Student Mental Health e.g., Developing required infrastructure and protocols to facilitate effective tiered support Leading the Mental Health Promotion / Prevention Programming in Schools e.g., Encouraging a systematic approach to the selection of promotion / prevention programs Securing Accountability for Student Mental Health and Well-Being e.g., Promoting local evaluation of programs and services School Mental Health ASSIST

36. Organizational Conditions for Effective School Mental Health School Mental Health ASSIST

37. 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.) School Mental Health ASSIST

38. 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 School Mental Health ASSIST

39. Condition #1 Commitment • Board leaders view child and youth mental health as a priority, and communicate this through action • Board leaders commit to the 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 mental health team meetings • Board leaders provide visible, strategic and tangible support for needed infrastructure, resources, staffing School Mental Health ASSIST

40. Condition #2 School Mental Health Leadership Team • 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 School Mental Health ASSIST

41. Condition #3 Clear and Focused Vision • 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 School Mental Health ASSIST

42. Condition #4 Shared Language • 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 School Mental Health ASSIST

43. Condition #5 Assessment of Initial Capacity • 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 School Mental Health ASSIST

44. Condition #6 Standard Processes • 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 School Mental Health ASSIST

45. Condition #7 Protocols for Professional Development • 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 Tools + Training + Technical Assistance + Quality Assurance School Mental Health ASSIST

46. Condition #8 Mental Health Strategy / Action Plan • 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 School Mental Health ASSIST

47. Condition #9 Broad Collaboration • 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 School Mental Health ASSIST

48. Condition #10 Ongoing Quality Improvement 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 School Mental Health ASSIST

49. Support for Ontario School Boards School Mental Health ASSIST

50. Creating these Conditions… • Takes Time • Takes Knowledge • Takes Partnership • Takes Support School Mental Health ASSIST is here to support Ontario School Boards to create conditions necessary for effective delivery of the Tiered Support Model School Mental Health ASSIST