Integrating Mental Health Across All Three Tiers of SW-PBS

1. Integrating Mental Health Across All Three Tiers of SW-PBS SW-PBS National Implementer’s Forum Hyatt O’Hare Rosemont, IL October 30-31, 2008 Session C-7 Lucille Eber, Statewide Director, IL PBIS Network Kenley Wade, IL PBIS State Leadership Team Member Jose Tores, Superintendent, Elgin School District

2. Why do schools need Mental Health and other community partners? How can Mental Health and other community partners effectively collaborate with schools? Perspectives of an Education and a Mental Health Leader.

3. Shared Goals • Success for all youth at school, home, community: academic/social/emotional • Safe, effective, supportive learning environments • Systemic approaches that are prevention based

4. Challenges : • Fragmentation of efforts on behalf of youth • Lack of early interventions for students at-risk of developing MH problems • Lack of effective behavior practices in schools • Lack of data-based decision making • Low fidelity or low dosage interventions

5. Examples of Ineffective Practices: • Referrals to Special Education seen as the “intervention” • FBA seen as required “paperwork” vs. a needed part of designing an intervention • Interventions the system is familiar with vs. ones likely to produce an effect • (ex: student sent for insight based counseling at point of misbehavior)

6. A Key Question Does School-wide PBIS increase a school’s capacity to : • identify and support MH needs of students; • effectively support families in a timely manner?

7. Schools Need Partners: MH and other agencies serving youth/families Families Other community members Community leaders Policy makers

8. KS-IL Tertiary Demonstration Project (OSEP/ISBE) Enhance SOC integration into SW-PBS • Wraparound practices • data-based decision-making as part of wraparound intervention • Connect schools with MH and other community providers • Development of strength-needs data tools • Web-based data system

9. Tier 1/Universal School-Wide Assessment School-Wide Prevention Systems Assessment Intervention Positive Behavior Interventions & Supports:A Response to Intervention (RtI) Model Tier 2/Secondary Tier 3/ Tertiary Small Group Interventions(CICO, SSI, etc) ODRs, Attendance, Tardies, Grades, DIBELS, etc. Group Interventions with Individualized Focus(CnC, etc) Daily Progress Report (DPR) (Behavior and Academic Goals) Simple Individual Interventions (Simple FBA/BIP, Schedule/ Curriculum Changes, etc) Competing Behavior Pathway, Functional Assessment Interview, Scatter Plots, etc. Multiple-Domain FBA/BIP SIMEO Tools: HSC-T, RD-T, EI-T Wraparound Illinois PBIS Network, Revised May 15, 2008 Adapted from T. Scott, 2004

10. Summary of FY 2008SIMEO Student Demographics-StudyCohort • 10.3 years Mean Age • 70% male students • 45% (14) in 2-4 grade • 41% (18) Special Education Identified; • 65% (29) in General Ed Placement 100% of day

11. 74% of students were “discharged” in June, July, August or September of School Year Transition from middle school to high school was a time period likely to result in “discharge” from wraparound Families in vulnerable situations were more likely to “opt out” of participation having a family member struggling with a mental illness having a child transition from Foster Care (where wrap was started) back to biological family Summary of “Discharge” Findings (n=20 students left wraparound from June-Dec.2007)

12. Summary of FY 2008 Office Referrals:Mean Numberof Office Discipline Referralsper SIMEO Student N=44 N=44 IL PBIS Network

13. Summary of FY 2008 Office Referrals:Mean Numberof Office Discipline Referralsper SIMEO Student for Students with Same Data Points N=19 N=19 N=19 IL PBIS Network

14. High Risk Low/No Risk (n = 19) Wraparound-07 Immediate & Sustainable Change Noted in Placement Risk n =19 n=19

15. Why Schools Need Partnerships with Mental Health • One in 5 youth have a MH “condition” • About 70% of those get no treatment • School is “defacto” MH provider • JJ system is next level of system default • 1-2% identified by schools as EBD • Those identified have poor outcomes • Suicide is 4th leading cause of death among young adults

16. We Need to Go Beyond Use of Office discipline Referrals (ODRs)? • High rate of unidentified MH problems • Youth get identified only after “crisis” which makes it harder and more “costly” to intervene.

17. Capacity to go beyond ODR’s… • Apply RtI process to mental health “status” • SSBD • Teen Screen • Other? • Engage community partners and families in the 3-tiered system/process • Explore other data points to consider/pursue

18. Data about School “L” • High rates of poverty • Students with incarcerated parents • Grandparents functioning as parents • Trauma experiences • Neglect, abuse, murder/death, violence, etc • Families have history of negative school experiences

19. Useful Questions about School “L” • What information and support do teachers need to be effective? • What information and support do families need? • What services and interventions are likely to increase student’s successful engagement in instruction? • What other data could be helpful to this school?

20. Useful Questions: School “L” 4. What preventive MH interventions can be provided • to ALL students, families, teachers? • To targeted groups (10%) of students, families, teachers? • How can mental health assist schools in providing comprehensive supports to the 1-5% of students, and their families and teachers?

21. How can Community Agencies support SW-PBS? Assist with gaps: • Family partnerships at all three tiers • Universal screening (beyond ODR’s) • Universal MH supports integrated into the curriculum for all • Targeted interventions for some students when data indicates they are at-risk • Coaching support for wraparound and behavioral interventions

22. Mental Health/Community Support at the Universal Level Promoting healthy development of all students • Family involvement in school activities • Community outreach activities • Family support activities • School-wide events that support learning • Participate in PBIS Universal team planning • Development of community-based support networks

23. Assist on problem-solving team Assist with classroom-based interventions Assist with individual or group interventions Assist with behavior support planning Family outreach and support Linkages with community resources Access to clinical services for students, families Social support needs of students, families, and teachers Mental Health/Community Support :Examples at the targeted/tier 2 Level

24. Mental Health Involvementwith Students with Complex Needs (1-5%) • Role of Mental Health/Community Providers: • intensifies in scope and strategy • is flexibly designed per each student’s plan • reflects unique needs, culture of family • Mental Health/Community Providers: • as team facilitators, co-facilitator, or team members • linkages with community supports • provide clinical services per students’ individual plan • provide support to teachers and families

25. Where to begin? • Share Information about PBIS • “Way to Go” Report • www.pbis.org • www.pbisillinois.org • Form a community leadership team • Identify partners at the school level • Be willing to use data and design and deliver based on a 3-tiered model

26. Resources: • Fixen, et al, 2005.“Implementation Research: A Synthesis of the Literature http://mim.fmhi.usf.edu • Kutash et al, 2006. “School-based Mental Health: An Empirical Guide for Decision-Makers” http://rtckids.fmhi.usf.edu • (Bazelon Center, 2006)“Way to Go”….School Success for Children with Mental Health Care Needs www.bazelon.org • Freeman, R., Eber, L., Anderson C, Irvin L, Bounds M, Dunlap G, and Horner R. (2006). “Building Inclusive School Cultures Using School-wide PBS: Designing Effective Individual Support Systems for Students with Significant Disabilities”. The Association for Severe Handicaps (TASH) Journal, 3 (10), 4-17. (www.pbis.org) • www.pbisillinois.org • www.pbis.org