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“Every child deserves a champion –An adult who will NEVER give up on them, who understands the power of connection and insists that they become the best that they can possibly be.”-Rita Pierson

MENTAL HEALTH NEEDS IN THE SCHOOL SETTING: MEETING IN THE MIDDLE

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IntroductionsWe are so happy to meet you!

Mackenzie Leachman, PHDSchool/Licensed Psychologist

Antonio Melton, MA.Ed.School Counselor 

Kristin Jewell, MA.Ed.School Counselor

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What are your learning targets for today?

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Participants will increase their awareness of school-based mental health initiatives in Kentucky

schools.

Participants will demonstrate an understanding of diverse levels of care and roles within the

school-based setting.

Participants will demonstrate an understanding of school-based data to help measure outcomes, as

well as understanding the roles of school-based professionals supporting mental health needs.

Participants will review best practices regarding collaborative care and practical ethical/legal

considerations when using a collaborative model and participate in discussion regarding next steps.

Workshop Objectives

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Objective 1: Participants will increase their understanding of school-based mental health initiatives in Kentucky schools.

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CHECKPOINT 1.1

Objective 1: Participants will increase their understanding of school-based mental health initiatives in Kentucky schools.

Before today, how aware were you regarding the presented initiatives in Kentucky to increase school-based mental health?

(A) Not aware  (B) Somewhat aware  (C) Very aware

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BACKGROUND

• Adverse Childhood Experiences Study 1995-1997, published in 1998

• Obama’s “Now Is The Time” Plan in response to 2012 Sandy Hook• Project AWARE• Elementary and Secondary School Counseling Grant— “A Positive Vision”

• Kentucky Barometer 2015 http://www.samhsa.gov/data/sites/default/files/2015_Kentucky_BHBarometer.pdf

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“Now Is The Time”

Photo: WFPL Newshttps://goo.gl/images/7k7HrN

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“Now Is The Time” Plan

• Health & Human Services Department--$99 million in mental health grants• US Department of Education--$70 million in school climate grants• Kentucky’s Cabinet for Health and Family Services is receiving $1 million, which may be

awarded each year for up to five years• Partner with community health center providers and Seven Counties Services to create youth

drop-in centers that will offer non-traditional mental health targeting youth in need

• Jefferson County Public Schools

• Fayette County Public Schools

• (WFPL, September 29, 2014) http://wfpl.org/jcps-kentucky-agencies-benefit-from-youth-mental-health-grants/

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“Now Is The Time”Project AWARE: Advancing Wellness and Resilience Education

Goal: To expand capacity of State Education Agencies (SEA) and Local

Education Agencies (LEA):• Increase awareness of mental health issues among school aged youth• Train school personnel and other adults who interact with school-aged youth so

they can detect and respond• Connect children, youth and families with services

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“Now Is The Time”Project AWARE: Advancing Wellness and Resilience Education

Project AWARE meets these goals by expanding or implementing:

• Access to existing funding systems that support mental health services for school-age youth

• Access to school- and community-based mental health services

• Capacity and leadership to sustain community-based mental health promotion, illness prevention, early identification, and treatment services and initiatives

• Collaboration among families, schools, and communities during program planning

• Coordination among state and local youth-serving systems

• Culturally specific and developmentally appropriate mental health services

• Mental Health First Aid (MHFA) and Youth Mental Health First Aid (YMHFA) training for adults who interact with school-age youth

• Outreach to youth and families, behavioral health promotion, and mental illness prevention strategies

• Systems for identifying signs and symptoms early and linking families to existing services

• Use of a multi-tiered behavioral framework

• Youth violence prevention strategies

http://www.samhsa.gov/nitt-ta/project-aware-grant-information

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Elementary and Secondary Counseling Grant:“A Positive Vision”

A comprehensive program that aims to expand mental health counseling services for students; reduce disciplinary referrals and increase academic achievement while reducing achievement gaps; increase teacher skills; reduce teacher turnover; and increase parent and community involvement.

 

The funds will support additional counselors at the participating schools and will implement “Positive Action,” a research-based, SAMHSA (Substance Abuse & Mental Health Services Administration) Model program with an integrated, comprehensive, coherent program for schools, families and communities. 

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RESILIENCE

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ACES STUDY

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Adverse Childhood Experiences Study

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ACE questions refer to the first 18 years of life

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ACES: Lasting effects

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Kentucky 2015 Mental Health National Outcomes Measures (NOMS)

Community Mental Health Hospitalization• Age 0-17 35.7% 0.2%• Age 18-20 4.2% 4.8%• Age 21-64 56.6% 88.4%• Age 65+ 3.5% 6.7%

http://www.samhsa.gov/data/sites/default/files/Kentucky.pdf

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Kentucky 2015 Mental Health National Outcomes Measures (NOMS)

Where are these children living?

Private residence 95.6% 54002

Children Foster Homes 2.9% 1657

Residential Care 0.7% 380

Institutional Setting 0.0% 18

Jail 0.1% 31

Homeless 0.5% 124

Total: 100% 56515 Children

http://www.samhsa.gov/data/sites/default/files/Kentucky.pdf

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Nine Elements of Effective School Community Partnerships to Address Student Mental Health, Physical Health, and Overall Wellness

1. A leadership team comprised of school and community stakeholders.

2. Assets and needs assessment to address student health and wellness, and a framework for results.

3. A designated person located at the school to lead the coordination of school–community partnerships.

4. Clear expectations and shared accountability for the school and community partners.

5. High-quality health and wellness services that leverage school and community resources.

6. Ongoing comprehensive professional development for all school leaders, staff, and community partners.

7. A detailed plan for long-term sustainability. Successful partnerships plan for sustainability from the beginning.

8. Regular evaluation of effectiveness through a variety of measures. Partners are chosen based on data that highlight their fit with the current needs of the school and community.

9. Communication plan to share progress and challenges. It is important to share the successes and challenges of each school–community partnership to highlight what is working and ways to overcome challenges to educate others hoping to improve school community partnerships.

http://www.nasponline.org/documents/Research%20and%20Policy/Advocacy%20Resources/Community%20Schools%20White%20Paper_Jan_2016.pdf

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Objective 2: Participants will demonstrate an understanding of diverse levels of care and roles within the school based setting.

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CHECKPOINT 2.1

Objective 2: Participants will demonstrate an understanding of diverse levels of care and roles within the school-based settings.

All school settings have a school counselor and school psychologist.

(A) True  (B) False

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Behavior Coach FRYS Coordinator Principal School Counselor

School Psychologist

School Safety Officer

Teacher

School Based Support

School Social Worker

 

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CHECKPOINT 2.2

Objective 2: Participants will demonstrate an understanding of diverse levels of care and roles within the school-based settings.

Social workers are primary contacts for community mental health services.

(A) True  (B) False

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CHECKPOINT 2.3

Objective 2: Participants will demonstrate an understanding of diverse levels of care and roles within the school-based settings.

School Support Services staff receive mandatory professional development hours and training specific to mental health.

(A) True  (B) False

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Triage

Treatment

Therapy

Medical Model

The primary focus in schools is still achievement and college/career readienessTypical school based services might include:

versus

versus

versus

versus

Crisis Management

Crisis Community Referral

Brief/Solution-focused

Prevention/Proactive/Responsive

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Professional competency, school/district structure

Challenge #1

Challenge #4

District policies

Challenge #2

Community resources and collaboration

Challenge #3

Job description and expectations

The primary focus in schools is still achievementServices can be limited by…

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3

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Objective 3: Participants will demonstrate an understanding of school-based data to help measure outcomes, as well as understanding the role of school-based professionals supporting mental health needs.

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CHECKPOINT 3.1

Objective 3: Participants will demonstrate an understanding of school-based data to help measure outcomes, as well as understanding the role of school-based professionals supporting mental health needs.

How often do you contact schools for data to inform mental health practices?

(A) Never (B) Sometimes (C) Often (D) Always

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ACADEMICDATA

BEHAVIORDATA

OTHERDATA

THE WHOLE STUDENT

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ACADEMIC DATA

In-progress Grades Credit Summary 504/IEP Data

A detailed summary of a

students CURRENT grades

by class. Can be expanded

to include scores on all

assignments, projects,

quizzes, and exams.

Testing/Assessments

All credits students have

received split into credit

categories such as Math,

Science, Humanities,

Electives, etc.

A detailed summary of

accommodations and

services provided to

students through active

504 plans and Individual

Education Plans.

A summary of all

standardized test

administrations including

percentile rankings and

dates administered.

SCHOOL-BASED DATA

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BEHAVIOR DATA

Attendance Profile Behavior Referrals PBIS Interventions

A listing of all absences

including excused,

unexcused, and skipping

events. Absences are listed

by day and by class period.

A summary of behavior

referrals made for students

including cause for referral.

A list of positive behavioral

interventions and supports

currently offered to the

student.

SCHOOL-BASED DATA

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OTHER DATA

Contact Logs Small Group Data Past Referrals

A list of individual or group

sessions held by a

counselor, social worker, or

other support service

individual in the

building. Notes may or may

not be included.

Attendance and outcome

data from small group

interventions in which a

student participates.

A list of referrals made to

community agencies and/or

mental health professionals.

SCHOOL-BASED DATA

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CHECKPOINT 3.2

Objective 3: Participants will demonstrate an understanding of school-based data to help measure outcomes, as well as understanding the role of school-based professionals supporting mental health needs.

How often do you collaborate with school-based professionals to address client mental health needs?

(A) Never (B) Sometimes (C) Often (D) Always

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TIER 35%

TIER 215%

TIER 180%

TIER 3 INTENSIVE: Wrap-around services (school-based community mental health services; Referrals and collaboration to outside community based mental health services; Drug and alcohol assessments; emergency assessments); Crisis response

TIER 2 TARGETED: GAIN-SS; Groups (Grief and loss; trauma;coping skills; social skills)

TIER 1 UNIVERSAL: Universal screeners e.g. (FAST-Behavior); Bully prevention curricula; social emotionallearning (character education); Violence preventioncurricula; social skill curricula; etc.

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TIER 35%

TIER 215%

TIER 180%

SCH

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ASE

D P

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NA

L IN

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LVM

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PARTNER WITHCOMMUNITY PROFESSIONALS

IN WRAP AROUND SERVICES

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STUDENT REFERRAL

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GUARDIANCONTACT

CRISISRESOURCES

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PARTNER WITHCOMMUNITY PROFESSIONALS

IN WRAP AROUND SERVICES

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CHECKPOINT 3.3

Objective 3: Participants will demonstrate an understanding of school-based data to help measure outcomes, as well as understanding the role of school-based professionals supporting mental health needs. 

In a word or two, what is the key to effective collaboration between school-based and mental health professionals?

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Objective 4: Participants will review best practices regarding collaborative care and practical ethical/legal considerations when using a collaborative model.

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CHECKPOINT 4.1

Objective 4: Participants will review best practices regarding collaborative care and practical ethical/legal considerations when using a collaborative model and participate in discussion regarding next steps 

How confident are you in your ability to identify potential ethical dilemmas when collaborating with schools to provide mental health services?

(A) Not confident  (B) Less confident  (C) Neutral  (D) More confident  (E) Very confident

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Barriers to Interdisciplinary Communication & Collaboration(Parproski & Haverkamp, 2000)

Client ProtectionVariation in Training and ProfessionalismTime ConstraintsReluctanceLack of knowledge & awarenessLack of coordination & case management

Ethical considerations:-Ensuring client informed consent-Maintaining client confidentiality-Involving other professionals, paraprofessionals & family into the process

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Potential Ethical Dilemmas

Minors who self-refer

Suicidality of students >18 requiring hospitalization

Confidentiality

Competency

Mental Health Records/Storage of Records

FERPA/HIPAA

Multiple Relationships

Conflict of Interest

Instructional Support vs. Clinical Treatment

Minimize the Impact of Treatment on Student’s Day

Sharing Records

Technology/Digital (New York Office of Mental Health, Division of Integration of Community Services for Children and Families, 2015)

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Abbreviated Ethical Decision Making Model

• Describe the situation

• Define the potential ethical/legal issues. Review the guidelines.  Consult others

• Evaluate rights, responsibilities & welfare of all clients

• Identify alternative actions & consequences

• Make the decision.  Take responsibility.  Monitor outcomes.

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CHECKPOINT 4.2

Objective 4: Participants will demonstrate an understanding of school-based date to help measure outcomes, as well as understanding the role of school-based professionals supporting mental health needs.

Discuss and describe an ethical dilemma you may encounter when considering collaboration with schools.

Pass your dilemma to another group to problem solve.

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Benefits of School and Mental Health Collaboration

Increase access to mental health supports has an enormous impact:

School Engagement→College Career Readiness→Employability→Health benefits and Economy benefits

Reduce risk of juvenile justice/incarceration→increased community safety

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Social emotional learning curriculums are effective when they teach skills related to:

Self-Awareness identifying/recognizing emotions, accurate self-perception, strengths, needs, values, self-efficacy

Self-Management impulse control, stress management, self-motivation/discipline, goal setting, organization skills

Social Awareness perspective taking, empathy, difference recognition, respect for others

Relationship Skills communication, social engagement, relationship building, working cooperatively, negotiation, refusal, conflict management and help seeking

Responsible Decision Making problem identification, situation analysis, problem solving, evaluation and reflection, personal/social responsibility

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Social-Emotional Learning Curriculums and Mental Health Interventions

● Second Step: Skills for Social and Academic Success ● Why Try? Resilience Education ● Incredible Years (Webster-Stratton)● PATHS (Promoting Alternative THinking Strategies (Kusche)● Zones of Regulation (Kuypers)● The Incredible 5-Point Scale (Buron)● Strong Kids Grades 3-5: A Social Emotional Learning Curriculum (Kenneth Merrell)● Skillstreaming in the Elementary School (McGinnis)● Social Detective (Garcia Winner & Crooke)● Coping Cat Anxiety Workbook (Kendall & Hedtke)● Think FIRST (Jim Larson)● Trauma-Focused Cognitive Behavioral Therapy (Cohen, Mannarino & Deblinger, 2006)● Cognitive Behavioral Intervention for Trauma in Schools (Jaycox)● Mindfulness strategies

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#gratitude #bettertogether #prevention #gocats

THANK YOU

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Resources

American Counseling Association www.counseling.org

American Psychological Association www.apa.org

National Association of School Psychologists www.nasponline.org

Project Aware http://www.samhsa.gov/nitt-ta/project-aware-grant-information

Substance Abuse and Mental Health Services Administration www.samhsa.gov

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References

Cowan, K. C., Vaillancourt, K., Rossen, E., & Pollitt, K. (2013). A framework for safe and successful schools [Brief]. Bethesda, MD: National Association of School Psychologists. https://www.nasponline.org/resources-and-publications/resources/school-safety-and-crisis/a-framework-for-safe-and-successful-schools

Felitti, V.J., Anda, R. F., Nordenberg, D., Williamson, D.F., Spitz, A.M., Edwards, V., Koos, M. & Marks, J. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. American Journal of Preventive Medicine, 14 (4), 245-258. http://www.ajpmonline.org/article/S0749-3797(98)00017-8/pdf

Fisher, C. (2012). Decoding the Ethics Code: A Practical Guide for Psychologists. (3rd Edition). Thousand Oaks, CA: SAGE.

Jacob, S., Decker, D., & Hartshorne, T. (2016). Ethics and Law for School Psychologists (7th Edition). Hoboken, NJ: Wiley.

Office of Mental Health, NY. (2015). School and mental health partnerships: improving school and community outcomes for children and adolescents with emotional and behavioral challenges. http://www.omh.ny.gov/omhweb/Childservice/docs/school-based-mhservices.pdf

Parposki, D.C. & Haverkamp, B.E. (2000). Interdisciplinary collaboration: ethical issues and recommendations. Canadian Journal of Counseling, 34 (2), 85-97.

Substance Abuse and Mental Health Services Administration (SAMHSA). (2015). Behavior Health Barometer, Kentucky 2015.

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