Interconnecting School Mental Health and PBIS

1. Interconnecting School Mental Health and PBIS Mark D. Weist,1 and Lucille Eber2 University of South Carolina1 Illinois PBIS Network2 National PBIS Forum; 10.27.11

2. Center for School Mental Health* University of Maryland School of Medicinehttp://csmh.umaryland.edu*Supported by the Maternal and Child Health Bureau of HRSA and numerous Maryland agencies

5. “Expanded” School Mental Health • Full continuum of effective mental health promotion and intervention for students in general and special education • Reflecting a “shared agenda” involving school-family-community system partnerships • Collaborating community professionals (not outsiders) augment the work of school-employed staff

6. Positive Behavior Intervention and Support (www.pbis.org) • In 16,000 plus schools • Decision making framework to guide selection and implementation of best practices for improving academic and behavioral functioning • Data based decision making • Measurable outcomes • Evidence-based practices • Systems to support effective implementation

7. SMH and PBIS Framework Intensive Intervention 1-5% Targeted Individual, Group, Family Intervention 5-15% Selective Prevention Universal Prevention Relationship Development Systems for Positive Behavior Diverse Stakeholder Involvement Climate Enhancement All Students

8. Interconnected Systems Framework (ISF) for SMH-PBIS • Grant submitted to the Institute of Education Sciences, September, 2010 • Three Collaborating States (IL, PA, SC, with an invitation to MT) • Reflecting 3 Years of Work Together

9. ISF, Building From 4 Stages of Implementation • EXPLORATION (e.g., identifying and organizing the most useful tools, conducting needs assessments and resource mapping) • INSTALLATION (e.g., developing interdisciplinary and cross system teams, identifying challenges and ways to overcome challenges to effective team functioning) • INITIAL IMPLEMENTATION • IMPLEMENTATION

10. ISF, Multilevel Game Plan • Project management team, research leaders and leaders from each state • Within each state, two districts and a team including a site coordinator, 3 system leaders (from education, mental health and family advocacy) and 2 ISF coaches (from EDU and MH) focused on state and district policies and procedures and a demonstration project in 2 schools

11. ISF, School Readiness Assessment • 1) High status leadership and team with active administrator participation • 2) School improvement priority on social/emotional/behavioral health for all students • 3) Investment in prevention • 4) Active data-based decision making • 5) Commitment to SMH-PBIS integration • 6) Stable staffing and appropriate resource allocation

12. ISF, Indicators of Team Functioning • Strong leadership • Good meeting attendance, agendas and meeting management • Opportunities for all to participate • Taking and maintaining of notes and the sense of history playing out • Clear action planning • Systematic follow-up on action planning

13. ISF, Ongoing Qualitative Research • Examples of questions: • “To what extent do PBIS and SMH providers work jointly to coordinate services for youth and families?” • “What are the barriers to their active collaboration?” • “How can those barriers be overcome?”

14. Big Ideas • Challenges in SMH and in PBIS • Overcoming Challenges by Coming Together • Enhancing Depth and Effectiveness in all Three Tiers of a Multi-tiered Systemic Approach • Connecting to a Community of Practice Framework • Multiscale Learning and Progress at Building, District, State, National and Federal Levels • Very High Policy Significance

15. Some “Big Picture” Challenges • Low intensity, low fidelity, non evidence-based interventions for behavior/emotional needs • Underused implementation structure for PBIS, no clear implementation structure for SMH • Related to these, habitual use of restrictive settings (and poor outcomes) for youth with disabilities • Ongoing (worsening) capacity problems • Moving people from the status quo of entrenched and ineffective practices

16. Problem Innovative practices do not fare well in old organizational structures and systems Organizational and system changes are essential to successful use of innovations Expect it Plan for it © Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008

17. Interconnected Systems Framework for SMH and PBIS • Tier I: Universal/Prevention for All • Coordinated Systems, Data, Practices for Promoting Healthy Social • and Emotional Development for ALL Students • School Improvement team gives priority to social and emotional health • Mental Health skill development for students, staff, families and communities • Social Emotional Learning curricula for all students • Safe & caring learning environments • Partnerships between school, home and the community • Decision making framework used to guide and implement best practices that consider unique strengths and challenges of each school community • Tier 2: Early Intervention for Some • Coordinated Systems for Early Detection, Identification, • and Response to Mental Health Concerns • Systems Planning Team identified to coordinate referral process, decision rules and progress monitor impact of intervention • Array of services available • Communication system for staff, families and community • Early identification of students who may be at risk for mental health concerns due to specific risk factors • Skill-building at the individual and groups level as well as support groups • Staff and Family training to support skill development across settings • Tier 3: Intensive Interventions for Few • Individual Student and Family Supports • Systems Planning team coordinates decision rules/referrals for this level of service and progress monitors • Individual team developed to support each student • Individual plans may have array of interventions/services • Plans can range from one to multiple life domains • System in place for each team to monitor student progress Adapted from the ICMHP Interconnected Systems Model for School Mental Health, which was originally adapted from Minnesota Children’s Mental Health Task Force, Minnesota Framework for a Coordinated System to Promote Mental Health in Minnesota; Center for Schol Mental Health , Interconnected Systems for Meeting the Needs of All Youngsters.

18. Old Approach  New Approach Each school works out their own plan with MH agency A MH counselor is housed in a school building 1 day a week to “see” students No data to decide on or monitor interventions “Hoping” that interventions are working District has a plan for integrating MH at all buildings CSCT and other MH staff participates in teams at all 3 tiers CSCT and other MH staff leads small groups based on data CSCT and other MH staff co-facilitates FBA/BIP or wrap individual teams for students

19. A National Community of Practice (COP); www.sharedwork.org • CSMH and IDEA Partnership (www.ideapartnership.org) providing support • 30 professional organizations and 16 states • 12 practice groups • Providing mutual support, opportunities for dialogue and collaboration • Advancing multiscale learning

20. Knowledge/Practice Domains in the Field • Cross Cutting: • 1) Language • 2) Culture • 3) Quality • 4) Family-School-Community Partnerships • 5) Youth Involvement and Leadership

21. Practice Domains 2 • Cross System/Initiative: • SCHOOL MENTAL HEALTH AND • 6) Special Education • 7) Positive Behavior Support • 8) Systems of Care • 9) Juvenile Services • 10) Child Welfare • 11) Psychiatry

22. Practice Domains 3 • Rapidly Developing: • 12) Supporting Military Families

23. Hawaii Illinois New Hampshire North Carolina Maryland Minnesota* Missouri Montana* New Mexico Ohio Pennsylvania South Carolina South Dakota Utah* Vermont West Virginia Sixteen States

24. Ohio Mental Health Network for School Success(http://www.omhnss.org) • Since 2001 • Ohio Department of Mental Health • Ohio Department of Education • Center for School-Based Mental Health Programs at Miami University (http://www.units.muohio.edu/csbmhp) Mission To help Ohio’s 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

25. Effective Practice Partners Miami University Ohio University Bowling Green State University Case Western Reserve University Ohio State University Kent State University Disciplines Clinical, Community and School Psychology Criminal Justice Public Health Social Work Education Leadership

26. Ohio Network Teams • Communications • Quality and Evidence-Based Practice • Training and Technical Assistance • Advocacy and Policy Improvement

27. Montana shows Promise for National Leadership in SMH and PBIS

28. 16th Annual SMH ConferenceCharleston, SCSeptember 22-24, 2011

29. 17th Annual SMH ConferenceSalt Lake City, UtahSeptember 27-29, 2012

30. www.schoolmentalhealth.org • Website developed and maintained by the University of Maryland CSMH • User-friendly information and resources for parents/caregivers, teachers, clinicians, and youth

31. Contact Information • Department of Psychology University of South Carolina 1512 Pendleton St., Room 407 • Columbia, SC 29208 Ph: 803 777 8438 weist@mailbox.sc.edu

32. U-46 School and Community Alliance Pamela Horn/U-46 PBIS External Coach Michele Capio/ IL PBIS Network

33. Vision Casting

34. It Takes a Community • Improving student achievement • Working towards mental wellness helps our students to be more accessible to learning…improving academic achievement • Helping families…

35. Getting People Started

36. Logistics • Who to invite? District? Agencies? • When and where? Meeting three times a year • Our first year… successes and stumbles • Defining our purpose? • Finding a common agenda? • Working collaborating? • Staying together….some yes, some no? • Collaborating on our mission

37. MISSION • The mission of the U-46 School and Community Alliance is to • create, integrate and leverage existing and new school/community • partnerships that develop a full continuum of systematic interventions • based on data. It encompasses three intervention tiers: • Systems for promoting healthy development and preventing problems • Systems for responding to problems as soon after onset as is feasible • Systems for providing intensive care

38. Invites Inviting Participation

39. Getting the right people at the table • Agencies: • Existing partners and expanding the list • District: • District administration • Special education administration • Representatives from elementary, middle, and high schools • Clinician representation • PBIS External Coaches • Illinois PBIS Network

40. Trust Building

41. Trust Building…a journey • District Clinicians • Communicating clear purpose of partnership • Respecting sensitivity • PBIS training opportunities • Agency Partners • Working through the “fit” • Staying at the table • Creating communication opportunites

42. U-46 School & Community Alliance • December 10, 2010 • 9:00-11:30 • Agenda • Welcome: Greg Walker, Assistant Superintendent, Secondary • PBIS Continuous Improvement Plan: Nan Ochs, Director of Instruction, • Secondary Implementation of Positive Behavior Interventions and Supports (PBIS) in U-46 • Robert Hawkins, Ed.D., Technical Assistance Coordinator IL PBIS Network • Michele Capio-Collins, Technical Assistance Coordinator IL PBIS Network • Jennifer Alberts: Example in partnering • Agency Information Form • Break • Work Groups Action Planning • Report backs • Work group time • Identify 1-3 targeted activities • Sharing of Work Group Action Items • Questions, concerns, comments, new needs • Next meeting of the U-46 School Community Alliance April 7, 2011 The mission of the U-46 School and Community Alliance is to create, integrate and leverage existing and new school/community partnerships that develop a full continuum of systematic interventions based on data. It encompasses three intervention tiers: Systems for promoting healthy development and preventing problems, Systems for responding to problems as soon after onset as is feasible and Systems for providing intensive care.

43. ACTION PLAN

45. Work Groups

46. Operations Work Group • External coach, Chief of Family and Community Engagement, and agency partners • Setting meeting times and purpose • Timeline for completion…..a moving target • Developing documents for school and agency to work together • legal considerations • building relationships • 1 ½ year to completion….a journey • sending to Tier 2/3 work group Community Alliance Forms.doc • Scheduling PBIS trainings for agencies

47. High School Violence Prevention Work Group • Many challenges • Getting the right people at the table • Setting a clear purpose • Adjusting to changes • Year 2 • Finding its identity • Moving towards Alternatives to Suspension • Involving the necessary people • Adjusting to staff changes again

48. Tier 2/3 Work Group • Year 1 Goals • Agency partners sitting on Tier 2 PBIS teams at four sites • Training agency partners in PBIS overview • Training agency partners in Tier 2 small groups interventions (common data points and progress monitoring using DPR card) • Expanding partnerships Taylor Family YMCA Streamwood Behavioral Healthcare

49. Tier 2 Agency Example • Training opportunities • Mental Health Organization on PBIS Secondary Systems team • Building relationships and trust…a journey • Co-facilitating targeted small groups • -common data points (anger management, pro-social) • -progress monitoring • Sharing & Communicating • -Agency and School Staff

50. Tier 1 Agency Example • Community agency partner sitting on school Secondary Systems Team • Training opportunities • Participated in team’s self assessment BAT • Expanding naturally: • Agency and School partnership grant • Universal partnership including families