Educator Roles in Promoting Mental Health and School Success for PreK-12 Students

1. Educator Roles in Promoting Mental Health and School Success for PreK-12 Students Carl E. Paternite, Ph.D. Center for School-Based Mental Health Programs Department of Psychology Miami University (Ohio) http://www.units.muohio.edu/csbmhp Presented at Mental Health Services and Schools Creating a Shared Vision Ellicottville, NY August 19th, 2003

2. Educator Roles in Promoting Mental Health and School Success for PreK-12 Students • Instructional Objectives For Presentation: • Increase participant awareness of the importance of educators in school-based mental health programming. • Increase participant knowledge of effective approaches to enhance educator – mental health professional collaboration. • Increase knowledge of ways to infuse "mental health education" into the school milieu.

3. Educator Roles in Promoting Mental Health and School Success for PreK-12 Students • Themes Addressed in Presentation: • Program development. • Interdisciplinary collaboration and partnership. • Prevention. • Research, training and education.

4. Mental Health Needs of Youth and Available Services • About 20% of children/adolescents (15 million), ages 9-17, have diagnosable mental health disorders (and many more are at risk or could benefit from help). • Less than one-third of youth with diagnosable disorders receive any service, and, of those who do, less than half receive adequate treatment (even fewer at risk receive help). • For the small percentage of youth who do receive service, most actually receive it within a school setting. • These realities raise questions about the mental health field’s over-reliance on clinic-based treatment, and have reinforced the importance of alternative models for mental health service — especially expanded school-based programs.

6. Leading Causes of Death in 15-19 Year Olds in the United States in 2000— U N I T E D S T A T E S, 2000 — 1631 CAUSE # OF DEATHS Accidents 6573 Homicide 1861 Suicide 1574 Cancer/Leukemia 759 Heart Disease 372 Congenital Anomalies 213 Lung Disease 151 Stroke 60 Diabetes 40 Blood Poisoning 36 HIV 36 From Weist & Adelsheim, 2003

7. Report of President’s New Freedom Commission on Mental Healthhttp://www.mentalhealthcommission.gov “…the mental health delivery system is fragmented and in disarray…leading to unnecessary and costly disability, homelessness, school failure and incarceration.” Unmet needs and barriers to care include (among others): • Fragmentation and gaps in care for children. • Lack of national priority for mental health and suicide prevention. July, 2003

8. Report of President’s New Freedom Commission on Mental Health: Six Goals for a Transformed System • Americans understand that mental health is essential to overall health. • Mental health care is consumer and family driven. • Disparities in mental health services are eliminated. • Early mental health screening, assessment, and referral to services are common practice. • Excellent mental health care is delivered and research is accelerated. • Technology is used to access mental health care and information. July, 2003

9. Four Recommendations Supporting Goal 4: Early Mental Health Screening, Assessment, and Referral to Services are Common Practice Promote the mental health of young children. Improve and expand school mental health programs. Screen for co-occurring mental and substance use disorders and link with integrated treatment strategies. Screen for mental disorders in primary health care, across the lifespan, and connect to treatment and supports. July, 2003

10. Expanded School-Based Mental Health Programs • National movement to place effective mental health programs in schools, serving youth in general and special ed. • To promote the academic, behavioral, social, emotional, and contextual/systems well-being of youth, and to reduce “mental health” barriers to school success. • Programs incorporate primary prevention and mental health promotion, secondary prevention, and intensive intervention,joining staff and resources from education and other community systems. • Intent is to contribute to building capacity for a comprehensive, multifaceted, and integrated system of support and care.

11. University of Maryland Center for School Mental Health Assistance Mark Weist (http://csmha.umaryland.edu) ESBMH

12. UCLA Center for Mental Health Assistance Howard Adelman & Linda Taylor (http://smhp.psych.ucla.edu) “Barriers to Learning” (see handout)

13. Interconnected Systems for Meeting the Needs of All Students CONTINUUM OF SCHOOL AND COMMUNITY PROGRAMS AND SERVICES (From Adelman & Taylor, http://smhp.psych.ucla.edu)

15. Potential of Schools as Key Points of Engagement • Opportunities to engage youth where they are. • Unique opportunities for intensive, multifaceted approaches and are essential contexts for prevention and research activity.

16. Schools: The Most Universal Natural Setting • Over 52 million youth attend 114,000 schools • Over 6 million adults work in schools • Combining students and staff, one-fifth of the U.S. population can be found in schools From Weist, 2003

17. Center for School-Based Mental Health Programs (at Miami University) • Overarching Goals • Build collaborative university-school district relationships to address the mental health needs of children and adolescents through multifaceted programming. • Promote mental health and school success for youth through: • Primary prevention and mental health education • Early direct intervention for identified at-risk children and adolescents, and treatment for thosewithsevere/ chronic mental health problems • Action research, training, and consultation

18. Center for School-Based Mental Health Programs (at Miami University) • Ohio Mental Health Network for School Success • Six affiliate organizations working together in regional and state-wide activities (including “Shared Agenda” initiative) • Butler County School-Based Mental Health Program • School-based mental health promotion, prevention, intervention, and applied research activities. • Addressing Barriers to Learning Program • Annual conferences to initiate and sustain local, school-based projects that reduce mental health barriers to learning and enhance the development of healthy school communities.

19. Center for School-Based Mental Health Programs (at Miami University) • Behavioral Health Advisor • Mental health newsletter for elementary and secondary school educators, focusing on issues related to child mental health and school success. • Evaluation of Alternative Education/ Discipline Programs • Ongoing formative evaluation of 11 alternative programs in Butler County,OH. • Mental Health for School Success • Special project with Ohio Department of Education to promote mental health — education integration.

20. Center for School-Based Mental Health Programs (at Miami University)Funding History (current in bold) • Butler County Mental Health Board • The Health Foundation of Greater Cincinnati • Ohio Department of Mental Health • The Center for Learning Excellence • Butler County Family and Children First Council • Talawanda and New Miami School Districts • Ohio Department of Education • Miami University cost sharing

21. School-Based Mental Health Partnerships Many individuals have been instrumental to our school-based mental health partnerships since 1998. To name just a few: University-Based (3 universities, 5 academic divisions, 6 departments) Faculty/Staff: Carl E. Paternite, Karen Schilling, Julie Rubin, Denise Fox-Barber, Amy Wilms, Betty Yung, David Andrews, Al Neff, Diana Leigh, Alex Thomas, Randy Flora, Doris Bergen, Valerie A. Ubbes, Raymond Witte, Joan Fopma-Loy … Psychology interns and graduate assistants: Lynne Knobloch, Becky Hutchison, Sally Phillips, Leslie Baer, Linda Gal, Derek Oliver, Mike Imhoff, Julie Cathey, Liz Morey, Chris Dyszelski, Chris Mauro, Nancy Pike, Jessica Donn, Sandra Kirchner, LaTasha Mack, Ann-Marie Bixler, Jari Santana-Wynn, Jeanene Robinson, Gloria Oliver, Francesca Dalumpines, Jamie Williamson, Jill Thomas, Jennifer Malinosky, Jason Kibby, Julia Pemberton, Ann Marie Lundberg, Marc McLaughlin, Robin Graff-Reed, Melissa Maras, Chris Reiger, Julie Swanson … Community-Based John Staup, Kay Rietz, Saundra Jenkins, Barbara Perez, Susan Smith, Valerie Robinson, Jolynn Hurwitz, Kate Keller, Terri Johnston, Charlie Johnston, Kathy Oberlin, Ellen Anderson, Noelle Duval, Linda Maxwell, Greg Foster, Teresa Jullian-Goebel, Suzanne Robinson, Terre Garner, Bryan Brown, Greg Rausch, Carolyn Jones, David Turner … School-Based Teacher consultants: Sherie Davis, Marilyn Elzey, Tom Orlow, Teresa Abrams, Sarah Buck, Jim Carter, Julie Churchman, Amy Gibson, Joy Boyle, Chris Carroll, Mary Hessling, Joan Parks, Joanne Williamson, Jaimie Pribble, Pam Termeer, Pat Stephens, Patricia Scholl, Martha Slamer, David Wood, Susan Meyer, Monna Even, Ginny Paternite, Connie Short, Terri Hoffmann, Karen Shearer … Guidance counselors, school psychologists, school nurses, and administrators: Marianne Marconi, Sandy Greenberg, Tom O’Reilly, Roberta Perlin, Betsy Esber, MaryBeth Bergeron, Greg Rausch, Ann Schmitt, Alice Bonar, Stephanie Johnson, Marcia Schlichter, Susan Cobb, Phil Cagwin, Bob Bierly, Martha Angello, Bill Miller, Bob Phelps, Dan Milz, Dave Isaacs, Mark Mortine, Rhonda Bohannon, Clint Moore, Cathy Keener, Mary Jane Roberts, Jean Eagle, Alice Eby, Kathy Jonas, David Greenburg, Candice McIntosh, Sharon Lytle, Terri Fitton, Steve Swankhaus, Melissa Kessler, Mary Jacobs .. Action-Project Teams: Fourteen 2-4 person teams from ten schools in five school districts, each with a university faculty/graduate student liaison.

22. The Ohio Mental Health Network for School Success 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, including pupils participating in alternative education programs.

23. The Ohio Mental Health Network for School Success Action Agenda • Create awareness about the gap between children’s mental health needs and “treatment” resources, and encourage improved and expanded services (including new anti-stigma campaign). • Encourage mental health agencies and school districts to adopt mission statements that address the importance of partnerships. • Conduct surveys of mental health agencies and school districts to better define the mental health needs of children and to gather information about promising practices.

24. The Ohio Mental Health Network for School Success Action Agenda (continued) • Provide technical assistance to mental health agencies and school districts, to support adoption of evidence-based and promising practices, including improvement and expansion of school-based mental health services. • Develop a guide for education and mental health professionals and families, for the development of productive partnerships. • Assist in identification of sources of financial support for school-based mental health initiatives. • Assist university-based professional preparation programs in psychology, social work, public health, and education, in developing inter-professional strategies and practices for addressing the mental health needs of school-age children.

26. Policy Maker Partnership (PMP) at the National Association of State Directors of Special Education (NASDSE) and the National Association of State Mental Health Program Directors (NASMHPD) Concept Paper Mental Health, Schools and Families Working Together for All Children and Youth: Toward A Shared Agenda (2002)

27. “Encourage state and local family and youth organizations, mental health organizations, education entities and schools across the nation to enter new relationships to achieve positive social, emotional and educational outcomes for every child.” Purpose of the Concept Paper

28. The concept paper is available online at:www.nasdse.org/sharedagenda.pdfwww.ideapolicy.org/sharedagenda.pdfwww.nasmhpd.org

29. Policy Maker Partnership (PMP) at the National Association of State Directors of Special Education (NASDSE) and the National Association of State Mental Health Program Directors (NASMHPD) Shared Agenda Seed Grant Awards to Six States: Missouri, Ohio, Oregon, South Carolina, Texas, and Vermont

30. Additional Funding for Ohio’s Shared Agenda Initiative Ohio Department of Mental Health Ohio Department of Education Ohio Department of Health and Numerous Additional State-level and Regional Organizations

31. Infrastructure for Ohio’s Shared Agenda Initiative The Shared Agenda seed grant is being implemented in Ohio within the collaborative infrastructure of the Mental Health Network

32. Three Phases of Ohio’s Shared Agenda Initiative Phase 1—Statewide forum for leaders of mental health, education, and family policymaking organizations and child-serving systems (March 3, 2003) Phase 2—Six regional forums for policy implementers and consumer stakeholders (April-May, 2003) Phase 3—Legislative forum involving key leadership of relevant house and senate committees (October, 2003)

33. Phase 1 and Phase 2Shared Agenda Forums Logo Here Columbus, OH — Statewide Forum, March 3, 2002 Athens, OH—Southeast Wooster, OH—North Central April 15, 2003 April 28, 2003 Columbus, OH—Central Bowling Green, OH—Northwest April 29, 2003 April 29, 2003 Cleveland, OH—Northeast Hamilton, OH—Southwest May 5, 2003 May 5, 2003

34. Strategies and Features of Various Shared Agenda Forums • Keynote presentations by national and state experts: • Mark Weist, Center for School MH Assistance, U. of Maryland • Steve Adelsheim, New Mexico School MH Initiative • Howard Adelman & Linda Taylor, UCLA School MH Project • Kimberly Hoagwood, Columbia University • Howie Knoff, Project Achieve • Joseph Johnson, Ohio Department of Education • Eric Fingerhut, Ohio State Senator

35. Strategies and Features of Various Shared Agenda Forums • Promising work in Ohio showcased • Youth and parent testimony • Cross-stakeholder panel discussions • Facilitated discussion structured to create a collective vision, build a sense of mutual responsibility for reaching the vision, instill hope that systemic change is possible, and problem-solve regarding implementation issues • Appreciative Inquiry model for promotion of systems-level change and transformation informed the process

36. Outcomes and Recommendationsfrom Phases 1 and 2 of Ohio’s Shared Agenda Initiative • Approximately 725 participants • Report being compiled that will inform the Fall, 2003 Shared Agenda Legislative Forum • Through Legislative Forum raise public awareness and build advocacy for policy and fiscal support for better alignment for education and mental health in the next biennial budget process • Website created to track and publicize Ohio’s Shared Agenda initiative (http://www.units.muohio.edu/csbmhp/sharedagenda.html)

37. Ten Emerging Recommendationsfrom Phases 1 and 2 of Ohio’s Shared Agenda Initiative Logo Here 1. Promote EFFECTIVE mental health and educational practices in schools 2. Increase family and community involvement in school mental health and educational programs 3. Actively solicit and appreciate student input in program planning and operation 4. Reduce stigma for children who need mental health services

38. Ten Emerging Recommendations from Phases 1 and 2 of Ohio’s Shared Agenda Initiative (cont’d) Logo Here 5. Maintain focus on all children, not just students in special education 6. Promote a better understanding of children’s mental health needs in schools 7. Expand cross-discipline training (preservice and inservice) for mental health/family-serving providers, educators and parents

39. Ten Emerging Recommendations from Phases 1 and 2 of Ohio’s Shared Agenda Initiative (cont’d) Logo Here 8. Work more effectively to reduce “turf issues” that interfere with children’s mental health service delivery and with mental health-education collaboration 9. Coordinate more effectively between state-level and regional/local efforts in the area of school mental health and in promotion of mental health and school success 10. Develop organizational structures (e.g., 501C3) that will promote strong coalitions and facilitate funding

40. Creating and Maintaining Ongoing, Empowering Dialogue with Educators • Multi-level, formal and informal dialogue with policy makers, formulators, enforcers, and implementers. • Programs for school board members and administrators. • Newsletter for teachers. • Website resources. • Extensive “contact time” with educators in their school buildings. • “Joining” the school community. • Key opinion leaders.

41. Assessing and Responding To Educator-Identified Needs and Concerns • Careful, detailed, local needs assessments from the perspective of educators, and a commitment to be responsive to identified needs. • Results used in advocacy efforts and as guideposts for ongoing work.

42. Perceived Problems And Teamwork Exercises

46. Teacher Consultants • Teacher consultants develop and implement special projects related to school-based mental health enhancement. • Teacher consultants serve as liaisons to the schools in efforts to promote school-based mental health programming. • Teacher consultants serve as informal advisers/mentors to school staff on matters related to social-emotional adjustment and learning needs of children and school/climate issues.

47. Incentives For Teacher Consultants Leadership opportunity Training opportunity Academic credit Stipends (“supplemental contracts”) Empowerment Demystification

48. Addressing Barriers to Learning: Annual Conference and Action Projects Program • Goal • Conduct annual conferences, to help initiate planned local public school-based projects that reduce mental health-related barriers to learning and enhance the development of healthy school communities.

49. Objectives of Addressing Barriers to Learning Program • Demonstrate, produce and assess school-based mental health practices (classroom-based, classroom-linked) that address barriers to desired academic outcomes and personal and social skill development. • Put into continuing practice that which participants learn in conference activities and projects. • Increase the effectiveness of school district collaboration and system support for school-based mental health practices. • Disseminate findings.

50. Resources for Addressing Barriers to Learning Program • Researchers and practitioners whose work on the conference theme evidences quality and the potential for successful application locally. • Web-site support. • Resource packets. • Small grants to support action projects. • Ongoing consultation with action teams with graduate students/faculty.