Addressing the Challenges of Mental Health and Trauma: A Systemic Approach for Schools

1. Addressing the Challenges of Mental Health and Trauma: A Systemic Approach for Schools National Title I Conference Philadelphia, PA February 9, 2018

2. The Learning Supports Pathway

3. How are Mental Health Issues Impacting Your Schools?

4. Data Courtesy of CDC Data from the Centers for Disease Control and Prevention's National Health and Nutrition Examination Survey (NHANES) show that approximately half (50.6 percent) of children with mental disorders had received treatment for their disorder within the past year.

5. Purpose • Review key elements needed when working with wounded students. • Provide strategies needed to make a positive impact on the wounded student. • Understand major issues impacting schools related to mental health. • Identify barriers that impact positive health of students. • Develop an initial list of strategies to improve mental health in schools.

6. The Learning Supports PathwayProfessional Development to Address Barriers to Learning • Based on the foundational work of Drs. Linda Taylor and Howard Adelman of the University of California, Los Angeles • Professional Development offered by Scholastic Education • Offers Trauma-Informed Strategies and social-emotional supports • Integrates instruction and leadership with supports for students impacted by mental health issues

7. Key Elements in Addressing Mental Health Issued • Collaboration/relationships among parents-families, teachers, administrators, community health professionals, and students • An infrastructure processwith clearly defined roles for team members • School–based personnel provide wellness, education, and prevention • Community-based personnel are activated for more intensive services such as crisis intervention, evaluation, and medication management. The Learning Supports Pathway provides the INFRASTRUCTURE and STRATEGIES.

8. Infrastructure:Organizing and Integrating Learning Supports

9. A Fully-Integrated Infrastructure

10. Fragmented Learning Support Activities

11. Transform Fragmented Learning Support Activities Into a Fully-Integrated Continuum

12. Working In 3 ComponentsProvides Organization for Trauma Sensitive Approaches Instruction • Deliver standards in a meaningful and engaging way. • Monitors data • Analyzes “why?” – root cause of underperformance. • Who works in this area? Learning Supports • Identify strategies to address root causes of trauma and strategies to address them. • Collaboratively implements through the six practice areas. • Who works in this area? Leadership & Management • Provides resources (i.e., human, fiscal, operational) and to support schools in implementing strategies. • Who works in this area? School Plan and Action

13. Learning Supports Practice Areas

14. Activity: How could you organize your infrastructure to better serve students impacted by mental health issues?

15. Put in 3 circle activity

16. What are your school’s current mental health services?How do you collaborate with district support personnel?

17. The Relationship:Learning Supports and Mental Health Mental health is a state of successful performance of mental function resulting in productive activities, fulfilling relationships with people and the ability to adapt to change and cope with adversity. (Seligman, et. al.) The Learning Supports System is a systematic, multi-tiered approach using a range of services and supports to PROMOTE and PREVENT mental health challenges form impacting learning. • Supports for ALL Students = Promotion of Mental Health • Supports for SOME Students = Prevention of Mental Health • Supports for FEW Students = Intensive Response to Mental Health The Learning Supports Practice Areas address the family, the child, and the environment (community) in which they function.

18. October 2014, Report of the Provostial Advisory Committee on Student Mental Health, The University of Toronto Student Mental Health Strategy and Framework. RS

19. Applying the Framework for Improved Mental Health

20. Learning Supports for Mental Health

21. Classroom-Based Supports • Use of language-based approaches to help students process information and alleviate fears • Using multiple forms of communication; children pay more attention to non-verbal cues • Maintain predictable routines and expectations • Teach consistent rules and consequences • Model respectful, nonviolent relationships • Give students choice and praise positive choices. • Non-punitive grading practices; provide support and feedback. • The National Center for Trauma-Informed Care (http://www.samhsa.gov/nctic/about.asp) • The National Child Traumatic Stress Network (http://www.nctsn.org) “Trauma Toolkit for Educators”.

22. Improvement Strategies:Classroom-Based Supports • Caring relationship with teachers and peers • Purposeful classroom placement of students • Structure of regular routines and procedures • Clearly and regularly communicated positive messaging of expectations • Quality intervention programs that focus child on positive learning experiences • Inclusion of children in all aspects of the school day • Use of language-based approaches to help

23. Addressing Triggers 1. Acknowledging that the student behavior we are seeing may be a traumatic response to something bigger and more complex than what we are seeing in our classrooms 2. Acknowledging and respecting boundaries. 3. Assuming that there is a plausible link between some stimulus (or stimulus configuration) in the classroom and the complex behavior of the student. 4. Looking for that stimulus configuration and figuring out how it might be a representation of a current day form of a threatening thought or memory. 5. Playing a role in removing the trigger. . Whenever possible, we do this by providing thestudent with choices. There are three ways to do this. In this domain we address the first two: either removethestimulusorhelpthestudentremovethestimulus 6. Remembering that compassionate strategies for traumatized students tends to be useful for most students. 7.Monitoring student progress, and providing alternatives as needed.

24. Student & Family Interventions • Build non-academic relationships with students • Support and facilitate participation in extra-curricular activities • Involve open-communication and relationship building with families • Obtain a trauma history • Respect and assure confidentiality • Identify and connect with outside supports • Prevention and support team • The National Center for Trauma-Informed Care (http://www.samhsa.gov/nctic/about.asp) • The National Child Traumatic Stress Network (http://www.nctsn.org) “Trauma Toolkit for Educators”.

25. Improvement Strategies:Student & Family Interventions • Make personal contact that is respectful and caring to families. • Assess family needs through a social worker or counselor. • Link families to community mental health counseling services. • Communicate with school counselors across feeder patterns of schools so as to not duplicate services for the family. • Assist families in enrolling children in quality after school care programs. • Make frequent personal contacts to express support and share information.

26. Transitions • Establish protocols for Counselors and Social Workers transferring critical information • Follow up on student transcript records request to inform needs for evaluation and services • Connect with family to obtain a trauma history • Develop a resident expert team of teachers and staff who receive additional training to serve wounded students • Strive for seamless, uninterrupted services • Consistent disciplinary procedures from school to school • The National Center for Trauma-Informed Care (http://www.samhsa.gov/nctic/about.asp) • The National Child Traumatic Stress Network (http://www.nctsn.org) “Trauma Toolkit for Educators”.

27. Improvement Strategies:Transitions • Provide training and professional development for cadre of teachers and staff who will serve students with intensive mental health needs. Consider cadre of K-12 teachers. • Place students with teachers in cadre and align schedules for support. • Deliberately place student with peers who exhibit caring and inclusive attitudes and values. • Develop a plan for student to have a safe haven when unable to cope in the classroom. i.e.: “time out” space • Conference with parent and teachers in transitions grades prior to start of school year. • Ensure that all service providers, i.e.: PT, OT, after school, are trained and prepared.

28. Crisis Intervention • Ensure there is a well-trained crisis team • Provide immediate assistance in emergencies so students can resume learning • Provide follow-up care as necessary • Mobilize staff, students, and families to anticipate response plans and recovery efforts • Work with the local community to integrate planning for response and prevention • The National Center for Trauma-Informed Care (http://www.samhsa.gov/nctic/about.asp) • The National Child Traumatic Stress Network (http://www.nctsn.org) “Trauma Toolkit for Educators”.

29. Improvement Strategies:Crisis Intervention • Referral process to community mental health agencies. • Assess for medical issues or concerns, i.e.: medications, hearing, vision, signs of abuse. • Provide support for additional family needs, i.e.: clothing, school supplies, etc. • Assess housing needs and home environment. • Develop or refer to family-parent support groups.

30. Community Collaboration • Build school-community partnerships with mental health agencies • Inform community and faith-based organizations of the need for trauma informed practices • Include after-school providers in training and planning • Assist supports for children to participate in extracurricular activities • Include community agencies in regular meetings to share information and resources • The National Center for Trauma-Informed Care (http://www.samhsa.gov/nctic/about.asp) • The National Child Traumatic Stress Network (http://www.nctsn.org) “Trauma Toolkit for Educators”.

31. Improvement Strategies:Community Collaboration • Educate community agencies, clubs, churches on the role of mental health in schools. • Partner to provide needed supports for families, i.e.: food, clothing, medical care, job opportunities. • Utilize mental health professionals and physicians to train and support the teacher cadre. • Include after school providers in training and awareness.

32. Family Engagement • Unconditional positive regard in communication • Maintain high expectations and share ways to support • Assure trauma sensitive, safe, and healthy school environment • Communicate possibilities for hope, i.e: resources, career and job, financial counseling • The National Center for Trauma-Informed Care (http://www.samhsa.gov/nctic/about.asp) • The National Child Traumatic Stress Network (http://www.nctsn.org) “Trauma Toolkit for Educators”.

33. Improvement Strategies:Family Engagement • Do a needs assessment with the family to determine needs. • Explicitly explain and demonstrate with how WE will work together to help their child. • Offer parent support groups that assist families in developing strategies for the home. • Ensure positive relationships and an inclusive environment.

34. Family Engagement Engagement is what keeps families working in the long and sometimes slow process of positive change. Engagement is the result of relationship development. Engage families IN services: • Ensuring access and overcoming barriers to seeking services • Involvement in assessment, treatment and care planning Engage collaborative WITH families to ensure quality mental health services for children.

35. …”The soft side of students’ lives, the social side, runs their brains, their feelings, and their behaviors—and those three run their cognition!” (Jensen, Teaching, 20)

36. Harmful Factors • Non-inclusion of students with mental health or other disabilities in all functions of the school day • Unprepared faculty and staff that sees every situation as a crisis and needing intensive services • Faculty and staff that does not collaborate or proactively plan to serve students • Unstructured, disjointed, and incoherent school routines and procedures • Lack of empathy from students and teachers • Teachers or staff who break confidentiality and discuss students inappropriately

37. The Shelby County Story Using the Learning Supports Framework to Address Mental Health Issues

38. Shelby County, Alabama • 20,833 students • Population 210,622 over 810 square miles • 31 schools in 7 community zones • Community poverty zones vary widel

39. Implementing the Learning Supports Framework • Conducted needs assessment for all 7 community zones • Identified the Montevallo community for a targeted area of focus • Conducted resource mapping • Implemented in one zone then extended it to all schools • Have integrated Learning Supports as a strategic area with a Goal Action Team

40. Mental Health Issues Revealed • Needs assessment and resource mapping continue to reveal the need for mental health supports • Year 2- Contracted with Gateway to provide school mental health services • Year 5- Revealed that further supports for mental health were needed • Need for more preventative supports

41. Shelby County Mental Health Plan • Foundational work: Needs Assessment, Stakeholder Surveys • System-wide launch • Includes students, parents, staff, administrators, central office staff, and school Board Members • Our vision for implementing the Mental Health Plan- Where do we hope to be in a year? 2 years? 3 years?

42. Research Base Adelman, H. and Taylor, L. (2010) The School Leader’s Guide to Student Learning Supports. Corwin Press. American Occupational Therapy Association, Inc. (2011) Mental Health Promotion, Prevention, and Intervention for Children and Youth: A Guiding Framework for Occupational Therapy. Positive Psychology Progress: Empirical Validation of Interventions. American Psychology Today, 60, 410-421, Seligman, M.E, Steen, T.A., Park, N., and Peterson, C. Bayzk, S. Every Moment Counts, www.everymomentcounts.org Office of Exceptional Children, Ohio Department of Education. PBS New Hour (2015) www.pbs.org./newshour/bb/kindergarteners-good-social-skills-turn-successful-sdults-study-finds/ www.casel.org/federal-legislation-to-promote-social-and-emotional-learning/ U.S. Department of Education (2008) Partners in Education: A Dual Capacity-Building Framework for Family-School Partnerships. U.S. Department of Education, Retrieved from https://www2.ed.gov/documents/family-community/partners-education.pdf Zacarian,D., Ortiz-Alvarez, and L., Haynes, J. (2017). Teaching to Strengths: Supporting Students Living with Trauma, Violence, and Chronic Stress. ASCD

43. Research Base Centers for Disease Control and Prevention's National Health and Nutrition Examination Survey (NHANES), Retrieved April 23, 2017, https://www.nimh.nih.gov/health/statics/prevalence/use-use-of-mental-health-services-and-treatment-among-children.shtml NPR: A Silent Epidemic. Our public schools are struggling to handle millions of students with mental health problems. Retrieved from www.apps.npr.org/mental-health / Richwood, D. (2007) Connecting Social and Emotion Leaning with Mental Health. Conceptual framework for PPEI and applications in general practice. www.promoteprevent.org/sites/www.promoteprevent.org/files/resources/ConnectingSEL_2.pdf The University of Toronto Student Mental Health Strategy and Framework (2014) Report of the Provostial Advisory Committee on Student Mental Health President’s New Freedom Commission on Mental Health (2003) Achieving the promise: Transforming mental health care in America. Final Report (DHHS Pub. No SMA-03-3832). Rockville, MD:U.S. Department of Health and Human Services Jensen, E. (2009) Teaching with Poverty in Mind. ASCD. NCES (2002) NCSPA (2011) SBMH Subcommittee

44. Contact Information Dr. Merrianne Dyermdyer@scholastic.com770-539-0678 Melissa Youngblood myoungblood@shelbyed.org 205-682-7044