New Levels of Work Together for School-Wide PBIS and School Mental Health, Part 2

1. New Levels of Work Together for School-Wide PBIS and School Mental Health, Part 2 Mark D. Weist, Ph.D. Center for School Mental Health University of Maryland 10.9.09

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

3. “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

4. Fundamental Three-Part Rationale • Schools are under-resourced for mental health promotion and intervention • Connections between people and traditional community mental health centers are difficult • By coming together in the most universal natural setting for youth, there are advantages for both systems, and synergies enhance opportunities to achieve valued outcomes

5. Roles • 10-20% Broad Environmental Improvement and Mental Health Promotion (CHANGE AGENT ROLE) • 50-60% Prevention and Early Intervention (PREVENTION SPECIALIST ROLE) • 20-30% Intensive Assessment and Treatment (CLINICIAN ROLE)

6. Tier 1 Tier 2 Tier 3 Sch. Psy. XOXOXO XXXXXX XX Sch. SW. XOXOXO XXXXXX Sch. Co. XOX0 OOO Com. St. XO OOOOOO OOOOOO GEN.ED=O SPEC.ED=X Roles, cont.

7. Expanded School Mental Health Services in Baltimore City • 1989: 4 schools • 2009: 105 schools • 42 Elementary schools • 41 Middle/K-8 schools • 22 High schools

8. Baltimore ESMH Funding 2009 6% 12% 7% 3% 25% 47%

9. Themes Helping ESMH in Baltimore to Move to the Next Level • A strategic plan • One network with common expectations • A prominent and diverse advisory board • Strong cross-agency connections • Strong state, national and federal connections • Embracing “mental health”

10. Informal ‘Mental Health’ Definition • “Healthy thoughts, feelings and actions that help you be successful” • A positive concept like ‘physical health’

11. Prince George’s School Mental Health Initiative (PGSMHI) Funding from the State Department of Education Intensive, evidence-based mental health intervention for students in special education in 2 and then 6 schools Training and support to 11 schools with specialized programs for youth presenting emotional problems Broader training and support county wide (e.g., for all school psychologists)

12. Family Needs Addressed Food, health insurance, medical needs, clothing, transportation, utilities, substance abuse services, mental health services, tutoring, mentoring, recreational programs

13. Absences by Quarter

14. Data on Non-Public Placements Between September, 2006 and January, 2009, 78 students were seen for more intensive services in the four schools All met multiple criteria for placement in non-public programs 3/78 students were placed in a non-public program

15. Economic Implications • Non public cost per student/year above special education cost = $39,038 • Cost of program per student/year = $7,212 • Difference = $31,826 saved per student/year • 102 nonpublic placement years diverted • FOR A NET SAVINGS OF AROUND $3.2 MILLION • Slade et al, 2009, Advances in School Mental Health Promotion

16. Anne Arundel School Mental Health Initiative • Began in 2008-09 school year • Operating in two regions of the county, north and west • Services in north focused on youth in the red zone at risk of more restrictive placements (6 schools) • Services in west focused on early intervention (3 schools near Army base)

17. Referrals and Enrollment 61 Referrals 44 Enrolled 34 with 4+ sessions

18. Student Outcomes: Total (n=34) * The average length of time to complete four sessions is approximately one month.

19. Student Outcomes Primary and intermediate elementary students demonstrated decreases in absences and tardies, with the exception of increased tardies among intermediate students.

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

21. Next CSMH Conference 14thAnnual Conference on Advancing School Mental Health. Minneapolis, November 1-4 Sunday evening – Community Share Fare Monday – Community Meetings/Intensive Training Tuesday, Wednesday – Conference Program See http://csmh.umaryland.edu, www.sharedwork.org or call 410-706-0980

22. www.schoolmentalhealth.org • Website developed and maintained by the CSMH with funding from the Baltimore City Health Department and Maryland Departments of Education and Mental Health • User-friendly school mental health information and resources for caregivers, teachers, clinicians, and youth

23. Two New Journals • Advances in School Mental Health Promotion • The Clifford Beers Foundation and the University of Maryland • www.schoolmentalhealth.co.uk • School Mental Health • www.springer.com

24. Advances in School Mental Health Promotion

25. Contact Information • Center for School Mental Health Department of Psychiatry University of Maryland 737 W. Lombard Street, 4th Floor Baltimore, MD 21201 PH: 410-706-0980 FX: 410-706-0984 mweist@psych.umaryland.eduhttp://csmh.umaryland.edu