Resources for the Delivery of School Mental Health Services

1. Resources for the Delivery of School Mental Health Services LADSE Continuing Education: Mental Health in the Schools (February 27 & April 21, 2010) Rosario C. Pesce, Ph.D., NCSP School Age Committee, Illinois Children�s Mental Health Partnership, Loyola University Chicago

2. Three Graduate Textbooks Transforming School Mental Health Services: Population-Based Approaches to Promoting the Competency and Wellness of Children (Doll and Cummings, 2008) School Social Work: An Evidence Informed Framework for Practice (Kelly et al., 2010) Safe and Healthy Schools: Practical Prevention Strategies (Sprague and Walker, 2005)

3. Transforming School Mental Health Services Doll, B. & Cummings, J. A. (Eds.). (2008). Transforming mental health services: Population-based approaches to promoting the competency and wellness of children. Thousand Oaks: Sage.

4. Transforming School Mental Health Services Epidemiology: Study of Disease/Health Descriptive- provides objective information about a condition Analytic- builds on the findings from descriptive epidemiology to investigate possible causes of and influences on the problem or condition in the population (host, agent, environment) Behavioral-looks at the distribution of health-related or education, or mental health related behaviors in a population in order to identify population-wide problems and develop effective population-wide interventions Social-adds the dimension of investigating the social determinants of health, disease, and well-being Host factors are intrinsic characteristics of an individual that cause him or her to be more susceptible to a condition. Agent factors were originally inferred to infectious microorganisms that had to be present for the disease to occur, things such as bacteria, viruses, and parasites. In the case of behavioral and social epidemiology agent factors are less clear and often indistinguishable from environmental factors. Nonetheless, it is productive to examine causal factors as agents when clear and specific links can be demonstrated between such factors and the conditions. For example, although not infectious and not actually a disease agent, maternal alcohol use is a causal agent for fetal alcohol syndrome. Environmental factors can affect the host, the agent, or the interaction between host and agent.Host factors are intrinsic characteristics of an individual that cause him or her to be more susceptible to a condition. Agent factors were originally inferred to infectious microorganisms that had to be present for the disease to occur, things such as bacteria, viruses, and parasites. In the case of behavioral and social epidemiology agent factors are less clear and often indistinguishable from environmental factors. Nonetheless, it is productive to examine causal factors as agents when clear and specific links can be demonstrated between such factors and the conditions. For example, although not infectious and not actually a disease agent, maternal alcohol use is a causal agent for fetal alcohol syndrome. Environmental factors can affect the host, the agent, or the interaction between host and agent.

5. Developing and Evaluating Empirically Derived Prevention Programs Investigate incidence and prevalence rates School practitioners can identify potential positive and negative correlates (risk and protective factors) from the literature and/or the site These relationships can be evaluated and tested in reference to the school population of concern Interventions can be devised and implemented aimed at influencing the risk and protective factors Evaluate the change in morbidity rate Explain incidence and prevalence rates: Incidence rates + New cases in a time period Divided by the Population in the same time period X 10 50 pregnancies over 3,200 students X 10 in one semester .02 or 2 out of 100 Prevalence = New and existing cases in the same time period divided by Population in the same time period. Assuming that the stats have been pretty consistent, then in that same semester there were already 300 students with completed pregnancies, therefore the prevalence rate is 350 divided by 32,000 = 11% or 11 out of 100. Explain incidence and prevalence rates: Incidence rates + New cases in a time period Divided by the Population in the same time period X 10 50 pregnancies over 3,200 students X 10 in one semester .02 or 2 out of 100 Prevalence = New and existing cases in the same time period divided by Population in the same time period. Assuming that the stats have been pretty consistent, then in that same semester there were already 300 students with completed pregnancies, therefore the prevalence rate is 350 divided by 32,000 = 11% or 11 out of 100.

6. Putting it into Practice So what are some issues at your school(s) that you may have given serious thought to address? Ask participants state problems write them down and see if there are some commonalities. Pick one and use it with the next slide. Hopefully some people will talk about a heightened level of maladaptive behavior. Pass out handout and say that we will be using this in this sectionAsk participants state problems write them down and see if there are some commonalities. Pick one and use it with the next slide. Hopefully some people will talk about a heightened level of maladaptive behavior. Pass out handout and say that we will be using this in this section

7. An Example of Behavioral & Social Epidemiology in School Practice Operationalize target conditions and risk and protective factors Generate risk models Define risk in terms of child/environment transactions Differentiate the characteristics of universal, selected, and indicated prevention Propose temporal frames Specify and prioritize primary prevention efforts Monitor and evaluate prevention outcomes

8. Intervention Chapters Partnering With Families to Enhance Students� Mental Health School-Wide Approaches to Behavior Problems RtI: A School-Wide Approach for Promoting Academic Wellness for All Students Social Emotional Learning: A School-Wide Approach to Intervention for Socialization, Friendship Problems, and More

9. Intervention Chapters (cont.) School-Wide Approaches to Intervention for School Aggression and Bullying School-Wide Approaches to Prevention of and Intervention for Depression and Suicidal Behaviors

10. School Social Work Kelly, M. S., Raines, J. C., Stone, S. & Frey, A. (2010). School social work: An evidence-informed framework for practice. New York: Oxford

11. Evidence Informed Framework The need: Recent Illinois survey data indicate that the overwhelming majority of school social workers report their main job consists of providing counseling and other intervention work with individuals and small groups (p. 4) National survey data is consistent with these findings and further suggest that individual risk factors are addressed rather than those at the classroom, school, home, or community level. Risk factor examples might include anxiety, depression, attention, social skill deficits, and others. Ask participants for others that they might be involved with.Risk factor examples might include anxiety, depression, attention, social skill deficits, and others. Ask participants for others that they might be involved with.

12. New Directions School Based Prevention and Intervention Research Integrated, Sustainable Intervention Efforts that Emphasize Primary Prevention Screening and Intervention Comprehensive Approaches Bullet 1- There is a general lack of coordination among prevention and intervention efforts because no comprehensive strategic plan for coordinating and linking behavioral supports exists at the school or district level. Interventions that promote participation in positive academic and social groups, enhance school bonding or connectedness, and create positive and safe learning environments appear to be most promising approaches for promoting behavioral and academic success; these approaches are typically implemented schoolwide over the course of several years. Bullet 2-Systemwide screening, particularly for emotional and behavioral indicators leading to school failure, may be the single most promising and cost-effective strategy to improve educational outcomes. Bullet 3- Interventions that assume multiple causes for a problem and conceptualize their clients as not only the student but also the teacher, the parents, and the school are more effective than those that assume a singular problem or client.Bullet 1- There is a general lack of coordination among prevention and intervention efforts because no comprehensive strategic plan for coordinating and linking behavioral supports exists at the school or district level. Interventions that promote participation in positive academic and social groups, enhance school bonding or connectedness, and create positive and safe learning environments appear to be most promising approaches for promoting behavioral and academic success; these approaches are typically implemented schoolwide over the course of several years. Bullet 2-Systemwide screening, particularly for emotional and behavioral indicators leading to school failure, may be the single most promising and cost-effective strategy to improve educational outcomes. Bullet 3- Interventions that assume multiple causes for a problem and conceptualize their clients as not only the student but also the teacher, the parents, and the school are more effective than those that assume a singular problem or client.

13. New Directions (continued) Contemporary Educational Models Response to Intervention (RtI) Shares with SWPBS or PBIS or PBS The multitiered system of support Empirically supported intervention Data based decision making The Clinical Quadrant