Connection Company Bryant School District SBMH

1. Connection CompanyBryant School District SBMH Susan Jones, MSE,LPC Coordinator

2. Mission and Purpose

3. The Problem: • In a typical high school classroom, it’s likely that at least three students have made a suicide attempt within the past year (Center for Disease Control - CDC). (214 Bryant students) • To coincide with this, the CDC has also reported that 17% of students in grades 9-12 have seriously considered attempting suicide within the past 12 months (363 Bryant students)

4. The Problem-Cont’d • Trauma-Students exposed to trauma have lower grade point, more write-ups & absences. • Violence-1 in 12 High school students threatened with a weapon each year.(178 Bryant Students) • People 12 to 24 years of age have the highest risk of being a victim

5. Problem, Cont’d • Approximately 2.2 million adolescents aged 12 to 17 reported a major depressive episode in the past year and nearly 60% of them did not receive any treatment (Substance Abuse and Mental Health Services Administration, 2005a). • According to the U.S. Surgeon General, in the course of a year approximately 20% of children and adolescents in the U.S. experience signs and symptoms of a mental health problem and 5% experience “extreme functional impairment” (U.S. Department of Health and Human Services, 1999). (20%=1533.4 Bryant Students, 5%=383 Bryant Students)

6. The Problem-Cont’d • The dropout rate for students with severe emotional and behavioral needs is approximately twice that of other students (Lehr et al., 2004) • Two thirds of school districts reported in the 2002-03 school year that the need for mental health services had increased since the previous year, and one third reported that funding for mental health services had decreased in that time (Foster et al, 2005). • Attention problems, negative behavior of peers, and disruptive & aggressive behavior predict lower test scores and grades (Fleming et al., 2005)

7. In The Bryant School District: • 07/08 School Year 55 Students were admitted to Rivendell 10 were admitted 2 times 3 were admitted 3 times 1 was admitted 4 times 2 were admitted 5 times Acute stays are 5 to 10 days. If there are more than 2 or 3 stays, this often becomes a residential stay of 3 to 6 months

8. Assuming an Acute Stay of 5-10 Days: This resulted in a cumulative loss of: 390-780 Instructional Days For the 07-08 Bryant School Year

9. SBMH-The Solution • Students who receive social-emotional support & prevention services achieve better in school (Greenberg et. al., 2003, Welsh et al., 2001; Zins et al, 2004) • A recent major study revealed that higher levels of school bonding and better social, emotional, and decision-making skills predict higher standardized test scores and grades. (Fleming et al., 2005)

10. SBMH-The Solution • Expanded school mental health services in elementary schools have been found to reduce special education referrals, improve aspects of the school climate(Bruns et al., 2004) • They produce declines in disciplinary referrals, suspensions, grade retention and special education referrals among at-risk students(Substance abuse and Mental Health Administration, 2005b)

11. SBMH-The Solution • School-based mental health programs for elementary school children experiencing severe and emotional & behavioral difficulties have demonstrated reductions in conduct disordered behavior, attention deficit/hyperactivity, and depression (Hussey &Guo, 2003) • Added benefit: The Seattle Social Development Project, targeting elementary students, has been estimated to provide net benefits of $9, 837 per student in averted long term-social problems (Aos et al, 2004) ($ 1,426,365.00)

12. Connection Company Mission Statement • Connection Company will provide the services needed to help the district with it’s mission of creating an emotionally safe environment that allows individual students to attain the academic, emotional, physical and social skills necessary to become lifelong learners with an intention and ability to positively contribute to society. Adopted November 2009 by the Connection Company Advisory Board

13. Counseling on Campus at Bryant Guidance Counseling Juvenile Justice RSPMI Agency or Private

14. School Based Mental Health • School based mental health is: • Referred based on the effect emotional & behavioral issues have on academic achievement • Requested by the school faculty & staff (Parents request services through the guidance counselor) • Must be delivered on school campus • The School is the “Payee” to outside payer sources

15. School Linked Mental Health Agency Juvenile Justice RSPMI • School linked mental health is: • Referred based on the emotional & behavioral issues of the individual & family • Requested by the parent or legal authority • May be delivered on school campus or many other locations • The agency or Therapist is the “Payee” for outside payer sources

16. “A long, long time ago in a school district not so far away . . .” 1999 2005 2009 A Therapist 2003 CSMH CC Advisory Dr. A ! 2001 2003 2006 Case Managers & ARMEA The Connection Company Time Line

17. Levels of License of Community Professionals • The 10-11 School Year will begin with 8 therapists with the following credentials • LPC • LMFT • LCSW • LSPS

18. Some of the faces of our Connection Company Community Professionals Kathy McKee Katherine Daniels Heather LPC LPC Chapman-Henry LCSW 10 years 3 years 7 years And counting . . .

19. Connection Company Office Staff • Full Time Bryant School District Employees • SBMH Coordinator • Elementary Case Manager-Grant Funded • Secondary Case Manager-Grant Funded

20. Service Overview

21. Bryant’s Positive Support Pyramid 70%70% • Academic Systems Behavioral Systems 2-3% 2-3% 10% 10% 12% 12%

22. Referral Process

23. Services • Individual Therapy • Group Therapy • Family Counseling • iD3-3 day Drug Prevention Academy • Consultation with Educational Team • Assessment and Treatment Planning • Liaison with outpatient community counseling service • Transition from residential & day school settings • Referral source for psychiatric evaluations & hospitalizations • CISM (Critical Incident Stress Management) • Case Management Services

24. Guidelines • 3-1: Assess for initial screening of problems, as well as diagnosis planning and intervention-Guidance Counselor engages in the first line of screening • 3-2: Refer, Triage and monitor/manage care-Guidance counselor refers to our program; students are assessed with initial assessment form, progress notes are maintained, 90-day treatment plans reviews are conducted, case managers assist students, families and therapists during the course of treatment.

25. Guidelines • 3.3 offer direct service-Social Skills by Guidance, School Wide Disciple Programs, CAPS-Career Planning, Classroom rules and handbook, Family Involvement, Health, Drug Prevention, Connection Company provides individual, family, group and case management as direct services. 3.4 Coordinate and provide leadership-BSD and Connection Company participate in the community at the local, county, state and national level. We establish growth goals-establishment of case managers & Advisory Board

26. Guidelines • 3-5 Consult, supervise with a cross disciplinary focus-Therapists provide in-service to the district, the district provides in-service to the therapists, consultation goes on daily. • 3-6 Enhance connection with and involvement of home and community-Our case managers are essential for this; utilize strengths that therapist bring with them (sailing, autoharp, etc) to connect with the school community and de-stigmatize the process. Utilize community services for our students.

27. Demographics

28. Connection Company Demographics • Out of 145 Students: • 89 are Special Education Students • 56 are Regular Education Students • 63 Medicaid Eligible

29. Diagnoses Addressed • Attention Deficit Hyperactivity Disorder • Oppositional Defiant Disorder • Major Depressive Disorder • Behavior Disorder • Disruptive Disorder • Autism

30. Diagnoses Addressed • Asperger’s Syndrome • Pervasive Developmental Disorder • Dysthymic Disorder • Impulsive Control Disorder • Conduct Disorder • Post Traumatic Stress Disorder • Generalized Anxiety Disorder

31. Diagnoses Addressed • Mood Disorder • Adjustment Disorder • Intermittent Explosive Disorder • Bipolar Disorder • Separation Anxiety Disorder • Schizophrenia • Obsessive Compulsive Disorder

32. Levels of Care and Community Involvement

33. Connection Company’s place in the BDS Systems of Care Model • Social Skills by Guidance • School Wide Disciple Programs • CAPS-Career Planning • Classroom rules and handbook • Family Involvement • Health, Drug Prevention • Awareness Groups • Pals-Pre-Referral Teams • ALE • Wrap Around Services Individual Family Group LINKS & ALE iD3 Drug Academy + Family Group Case Management

34. Role of Family • Families are included in every step of the Connection Company Continuum including: • Contact with Families at Pals Teams recommendations and Guidance Referrals • Key input in completing the Initial Assessment and Treatment plan • Direct Service with Individual Families • Regular Monthly Family Groups with iD3 members • Regular contact with case managers

35. Connection Company Community Participant • Local Involvement • Work with RSPMI (community outpatient counseling services requested by parents) & other community mental health providers to coordinate services when appropriate.

36. Connection Company Community Participant • County Wide Involvement We function as a member of the Saline County Coordinating Care Council to access wraparound services for our students.

37. Connection Company Community Participant • State Involvement • Connection Company serves as a facilitator for other districts seeking to start a SBMH program. • BSD has received training through DBHS required to participate in the process of utilizing Arkansas Wraparound Flexible Funds

38. Connection Company Community Participant • State Involvement • BSD provides input into Systems of Care subcommittees working on Case Management & SBMH regulations. • Working with the state program for Coordinated School Health to establish mental health procedures in schools

39. Connection Company Community Participant • National Involvement The Annual Conference on Advancing School Mental Health Center for School Mental Health University of Maryland School of Medicine Division of Child and Adolescent Psychiatry

40. Quality Assurance

41. Evaluation and Assessment for Program Effectiveness • A central system of file maintenance • Case Managers review treatment progress weekly • Periodic APS audits as required by Medicaid • Annual Satisfaction Surveys measuring school satisfaction with services provided • Beginning NASBHC national survey measuring school capacity for SBMH

42. Connection Company Community Advisory Board • Meets Quarterly • Comprised of : • Family members • Community Leaders • School Board • Administration • Faculty

43. Bryant Satisfaction Survey Results

44. Bryant Satisfaction Survey Results

45. Bryant Satisfaction Survey Results

46. Bryant Satisfaction Survey Results

47. Bryant Satisfaction Survey Results

48. Bryant Satisfaction Survey Results • Comments • “I am very thankful to have the Connection Company available for our students and only wish we could secure more therapists.” • “I see more and more students every year needing more intensive mental health services than school generally tend to offer.”

49. Bryant Satisfaction Survey Results • Comments • “I feel that Connection Company plays a very vital role to our students. It would be detrimental to not have such a service” • “Awesome service top notch increase staff” • “The only real problem I have with the therapist is lack of adequate space to meet with the students”

50. Hospitalization Rates