From Awareness to Public Policy to Local Action in Promoting a Mental HealthSchoolsFamilies Shared A

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From Awareness to Public Policy to Local Action
in Promoting a Mental Health-Schools-Families
Shared Agenda Ohios Experience
Carl E. Paternite Center for School-Based Mental
Health Programs Department of Psychology Miami
University (Ohio) paternce_at_muohio.edu (513)
529-2416 Facilitated Strategic Planning Session
for School-Based Mental Health Services in North
Carolina Raleigh, NC August 11, 2005
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Key Shared Agenda Partners in Ohio
Mike Armstrong, Ohio Department of Education
(Columbus) Noelle Duvall, Childrens Resource
Center (Bowling Green) Stephanie Falor, Ohio
Department of Education (Columbus) Paul
Flaspohler, Center for School-Based Mental Health
Programs (Miami U., Oxford) Terre Garner, Ohio
Federation for Childrens Mental Health
(Cincinnati) Terri Johnston, Positive Education
Program (Cleveland) Diana Leigh, Center for
Learning Excellence (Ohio State U.,
Columbus) Paul Liley, Alcohol, Drug Addiction,
and MH Services Board of Hancock Co.
(Findlay) Linda Maxwell, Childrens Hospital
(Columbus) Sue Mikolic, National Alliance for the
Mentally Ill of Ohio (Eastlake) Kathy Oberlin,
Heartland Behavioral Health (Cuyahoga Falls) Kay
Rietz, Ohio Department of Mental Health
(Columbus) Mary Lou Rush, Center for Learning
Excellence (Ohio State U., Columbus) Amy Wilms,
Center for School-Based Mental Health Programs
(Miami U., Oxford) AND MANY OTHERS
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From Awareness to Public Policy to Local Action
in Promoting a Mental Health-Schools-Families
Shared Agenda Ohios Experience

• Learning Objectives
• Increase knowledge of strategies for enhancing
  collaboration
• Increase knowledge of strategies for jointly
  mobilizing policy makers, policy implementers,
  and consumer stakeholders
• Provide examples of ongoing local, state level,
  and national action

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Legislative Forum On Mental Health and School
SuccessCreating A Shared Agenda In OhioTovas
TestimonyOctober 9, 2003
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Infrastructure for Ohios Shared Agenda
Initiative
Hearing on Mental Health and School Success
(February 8, 2001) Presided over by Ohios First
Lady Hope Taft and convened by Ohio Department
of Mental Health (ODMH) Center for Learning
Excellence Ohio Department of Education
(ODE) Governors Office Publication of Mental
Health and School Success Hearing Summary and
Resource Guide (Spring, 2001)
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Infrastructure for Ohios SharedAgenda Initiative

• Formation in 2001 of the Ohio Mental Health
  Network for School Success (OMHNSS)
• Action Networks spearheaded by affiliate
• organizations in six regions of the State

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Ohios Positive Behavior Support Initiative

• Collaborative efforts of
• Special Education Regional Resource Centers
• The Ohio Association of Elementary School
  Administrators
• The Ohio Association of Secondary School
  Administrators

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Policymaker Partnership (PMP, now IDEA
Partnership) 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)
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Purpose of the Concept Paper
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.
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The Aim
The aim is to align systems and ensure the
promise of a comprehensive, highly effective
systemic collaboration to coordinate and
integrate programs and services for children and
youth and their families.
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The Framework

• The framework encompasses a continuum of
  interventions,
• including
• Positive development of child, youth, families
  and communities and prevention of problems
• Early identificationinterventions for children
  and youth at risk or shortly after the onset of
  problems and
• Intensive interventionswith a focus on
  integrated approaches.

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Integrated Systems to Support the Development of
All Children

• Systems of
  Prevention and Promotion
• 
  All Students (universal)
• Systems of Early Intervention
• Students At-Risk (selected)

From Zins (in progress).
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Best Practice Principles of Expanded School
Mental Health (ESMH) (Weist et. al., 2005)

• All youth and families are able to access
  appropriate care regardless of their ability to
  pay.
• Programs are implemented to address needs and
  strengthen assets for students, families,
  schools, and communities.
• Programs and services focus on reducing barriers
  to development and learning, are student and
  family friendly, and are based on evidence of
  positive impact.
• Students, families, teachers and other important
  groups are actively involved in the program's
  development, oversight, evaluation, and
  continuous improvement.
• Quality assessment and improvement activities
  continually guide and provide feedback to the
  program.

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Principles of ESMH (contd)

• A continuum of care is provided, including
  school-wide mental health promotion, early
  intervention, and treatment.
• Staff hold to high ethical standards, are
  committed to children, adolescents, and families,
  and display an energetic, flexible, responsive,
  and proactive style in delivering services.
• Staff are respectful of and competently address
  developmental, cultural, and personal differences
  among students, families, and staff.
• Staff build and maintain strong relationships
  with other mental health and health providers and
  educators in the school, and a theme of
  interdisciplinary collaboration characterizes all
  efforts.
• Mental health programs in the school are
  coordinated with related programs in other
  community settings.

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Factors Necessary to Achieve Desired Outcomes
for Youth Through ESMH Programs and Services
(Weist, Paternite Adelsheim, 2005)
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A Strategy to Promote ESMH(Paternite, Weist,
Burke Flaspohler, 2005)
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2002 Shared Agenda Seed Grant Awards to
Missouri, Ohio, Oregon, South Carolina, Texas,
and Vermont With Ongoing Across-State
Networking Facilitated by PMP(IDEA
Partnership)/NASDSE
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Additional Funding for Ohios Shared Agenda
Initiative
Ohio Department of Mental Health Ohio Department
of Education Ohio Department of
Health and Numerous Additional State/Regional
Organizations
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Mission
To help Ohios 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.
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The Ohio Mental Health Network for School Success

• Action Agenda
• Create awareness about the gap between childrens
  mental health needs and treatment resources,
  and encourage improved and expanded services
  (including anti-stigma campaign).
• Partner with regional action networks to enhance
  within-region implementation of the action
  agenda, actively soliciting student and family
  input. Also, contribute to statewide efforts
  (e.g., training institutes, workshops, research,
  etc.).
• Conduct surveys of mental health agencies,
  families, and school districts to better define
  the mental health needs of children and to gather
  information about promising practices.

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The Ohio Mental Health Network for School Success

• Action Agenda (continued)
• Provide training and 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.

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The Ohio Mental Health Network for School Success

• Action Agenda (continued)
• 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.

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Ohios Mental Health, Schools, and Families
Shared Agenda Initiative http//www.units.muohio.e
du/csbmhp/sharedagenda.html
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
9, 2003) Phase 4 Development and release of
Shared Agenda report Phase 5 Ongoing
policy/funding advocacy and technical assistance
to promote attention to the crucial links
between mental health and school success
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Strategies and Features of Phase 1 and 2 Shared
Agenda Forums

• Approximately 725 participants
• Keynote presentations by national and state
  experts
• Promising work in Ohio showcased (Appreciative
  Inquiry, D.L. Cooperrider)
• 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

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Following Phase 1 and 2 Forums

• Materials compiled and developed to 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, in summer 2003, to track and
  publicize Ohios Shared Agenda initiative
  (http//www.units.muohio.edu/csbmhp/sharedagenda.h
  tml)

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Legislative Forum Preparation October 9, 2003

• Development of format for forum, and selection
  of date
• Commitment of participation from ODMH and ODE
• leadership
• Identification and preparation of legislative
  co-chairs
• Invitation to additional legislative panelists
• Invitation to stakeholders throughout the state

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More Legislative Forum Preparation October 9, 2003

• Promotional work
• Selection of students for written and oral
  testimony and
• identification of facilitator
• Selection of adults (parents, educators, and
  mental health
• providers) for written and oral testimony and
  identification
• of facilitator
• Development of written materials for the
  legislators
• Plan for pre-forum events with student and
  adult participants

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Legislative Forum On Mental Health and School
SuccessCreating A Shared Agenda In OhioOctober
9, 2003
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Legislative Forum On Mental Health and School
SuccessCreating A Shared Agenda In OhioOctober
9, 2003
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Legislative Forum On Mental Health and School
SuccessCreating A Shared Agenda In OhioOctober
9, 2003
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Legislative Forum On Mental Health and School
SuccessCreating A Shared Agenda In OhioTovas
TestimonyOctober 9, 2003
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Legislative Forum On Mental Health and School
SuccessCreating A Shared Agenda In
OhioKristins TestimonyOctober 9, 2003
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Comments from Legislators Following the Adult
Testimony
From Representative Joyce Beatty (Member House
Education Committee) In a question/challenge to
fellow legislative panelists Is there
legislation that we should be looking at?
From Representative Arlene Setzer (Chair, House
Education Committee) In response to
Representative Beatty During this whole
process I was also taking notesbecause, as you
indicated there have been some specifics provided
to us which we truly need many times when looking
at legislationas most of you know currently the
House and the Senate are working on Senate Bill 2
which is forteacher success and identifying
highly qualified teachers...I am going to guide
that discussion around some of the things that I
have heard today about the idea that teachers
need to understand regardless of what their
teaching assignment might be
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Comments from Legislators Following the Student
Testimony
From Senator Bill Harris (Chair, Senate Finance
Committee) I listened to the very brave and
courageous young people tell us about things of
their life. And as you were explaining that to us
I am thinking about my sons, I am thinking about
my grandchildren, I am thinking about other
people that I know and some of the struggles that
they have
From Representative Joyce Beatty (Member, House
Education Committee) All of the student panel
members, I dont think I have ever heard anything
so compelling and moving and informative and
educating in my entire life. So let me say to you
thank you and let me give it to you with that
smile that can be comforting because you have
helped us
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Phase 4 of Ohios Shared Agenda Initiative

• ODMH and ODE jointly formed an ad hoc workgroup
  to develop Shared Agenda recommendations/action
  steps and to issue a report addressing
• Public Awareness and Advocacy
• Professional Development/Training and Service
  Delivery
• Policy and Funding

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Phase 4 of Ohios Shared Agenda Initiative
The workgroup met three times between November
(2003) and March (2004) A final report with
recommended goals and objectives released August
2004
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Guiding Principles for a Mental Health, Schools,
Families Shared Agenda

• Mental health is crucial to school success
• There are shared opportunities for mental health,
  schools, students and families to work together
  more effectively

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Phase 5 An Immediate Legislative Outcome
Senate Bill 2 Section 3319.61(E) (effective June
9, 2004) The standards for educator
professional development developed under division
(A) (3) of this section shall include standards
that address the crucial link between academic
achievement and mental health issues.
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Crucial Links Between Mental Health and School
Success
Carl E. Paternite Center for School-Based Mental
Health Programs (Miami University)and Ohio Mental
Health Network for School Success Kay Rietz Ohio
Department of Mental Health (Columbus) Presenta
tion to the Educator Standards BoardColumbus,
Ohio December 6, 2004 PowerPoint Slides
Available at http//www.units.muohio.edu/csbmhp/r
esources/presentations.html
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Mental Health Issues and theNo Child Left Behind
MandateTwo Important Interrelated Goals
Achievement and Wellbeing

• 1) Achievement promotes wellbeing
• 2) Wellbeing promotes achievement
• School philosophy often acknowledges 1 but
• fails to sufficiently acknowledge 2

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Report of Presidents New Freedom Commission on
Mental Healthhttp//www.mentalhealthcommission.go
v

• Critical Importance of Partnership with Schools
• The mission of public schools is to educate all
  students. However, children with serious
  emotional disturbances have the highest rates of
  school failure. Fifty percent of these student
  drop out of high school, compared to 30 percent
  of all students with disabilities.
• While schools are primarily concerned with
  education, mental health is essential to learning
  as well as to social and emotional development.
  Because of this important interplay between
  emotional health and school success, schools must
  be partners in the mental health care of our
  children.
• July, 2003, p. 58

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Based On a Growing Knowledge Base, Schools That
Promote Mental Health Report

• Assistance in reaching underserved youth
• Strong satisfaction by diverse stakeholder groups
  (e.g., teachers, students, families)
• Improved student outcomes (e.g., higher academic
  achievement higher attendance fewer behavior
  problems increased sense of connectedness to
  school)
• Improved school outcomes (e.g., more supportive,
  inclusive, and safe school climate fewer special
  education referrals)

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In Addition to Parents, Teachers are On the
Mental Health Front Line

• Yet, teachers/educators are very poorly trained
  in problem recognition and mental health
  promotion
• Significant need to enhance teacher/educator
  training based on analysis of issues confronted
  in the classroom/school

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Non-academic Conditions (barriers) That Exert
Powerful Influences On Learning, Achievement, and
School Success

• Environmental
• Poor nutrition
• Family stress
• Family conflict
• Peer influences
• Exposure to violence
• Abuse, Neglect
• Poor school environment

• Personal
• Attentional difficulties
• Behavioral problems
• Depression
• Anxiety
• Social problems
• Trauma reactions

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What Teachers/Educators Need

• Basic Current Knowledge About
• Role of stress in students lives and impacts on
  learning
• Signs and symptoms of mental illness diagnoses
  (e.g., depression, ADHD, anxiety disorders,
  conduct disorders)
• Risk factors and warning signs for suicide
• Protective factors that promote resilience in
  students
• Effective, culturally-informed treatments and
  supports for students with mental health problems
• Medications and effects (intended and side
  effects) on learning and behavior
• How to access community support and referral
• Impacts of stigma

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What Teachers/Educators Need

• Effective Strategies and Skills for
• Promoting mental health (well-being) and academic
  achievement through instructional techniques and
  curriculum
• Creating a positive classroom climate that offers
  a healthy learning environment and promotes
  academic, social, and emotional development for
  all students
• Creating a positive, inclusive and safe school
  culture and climate
• Working with students displaying typical
  emotional and behavior problems
• Interacting with parents in empowering and
  affirming ways
• Listening to students

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Phase 5 Mental Health and School Success Ongoing
Efforts in Ohio
All connected to the Ohio Mental Health Network
for School Success, through implementation of the
action agenda and special targeted work.
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Phase 5 Mental Health and School Success Ongoing
Efforts in Ohio
NASDSE National Satellite Teleconference School-
Based Mental Health Broadcast from Pittsburgh,
PA May 5, 2004
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Phase 5 Mental Health and School Success Ongoing
Efforts in Ohio

• Network participation in planning and
  implementation of Ohios across-agency Access to
  Better Care (ABC) Initiative
• Designed to increase and improve behavioral
  healthcare for children and families
• Focusing on prevention, early intervention and
  treatment services

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Phase 5 Mental Health and School Success Ongoing
Efforts in Ohio

• ODMH and the Network leading Ohios Eliminating
  Barriers Initiative, focusing on the school age
  population.
• Pilot testing SAMHSA-developed in-service
  curriculum for teachers
• Developing a youth speakers bureau/panel

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Phase 5 Mental Health and School Success Ongoing
Efforts in Ohio

• Expansion of evidence-based programs like Ohios
  Positive Behavior Support Initiative are
  continuing through collaborative efforts of
• Special Education Regional Resource Centers
• The Ohio Association of Elementary School
  Administrators
• The Ohio Association of Secondary School
  Administrators
• Ohio Mental Health Network for School Success

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Phase 5 Mental Health and School Success Ongoing
Efforts in Ohio

• Extended Seed Grant from IDEA Partnership to
• Develop guidance document and collaboration
  guide for families and professionals to
  contribute to school wide Positive Behavior
  Support
• Field test, revise and disseminate the document
  and
• collaboration guide

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Phase 5 Mental Health and School Success Ongoing
Efforts in Ohio

• Linkage and consultation related to work of
• Mental HealthEducation Integration Consortium
• (MHEDIC)
• Bringing to together national experts and
  Ohio-based
• university faculty and practitioners in education
  and mental
• health fields to address
• pre-service workforce preparation issues
• development of effective in-service training
  curricula and strategies

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Phase 5 Mental Health and School Success Ongoing
Efforts in Ohio

• Linkage and consultation related to
• Ohios Community Collaboration Model for School
  Improvement (which is currently being pilot
  tested by ODE see Anderson-Butcher, Lawson,
  H.A., D., Bean, J., Boone, B., Kwiatkowski, A.,
  Cash, S., et al. (2004). Ohio community
  collaboration model for school improvement.
  Columbus, OH Ohio Department of Education)
• Ohio School Climate Guidelines (which were
  recently Adopted by the Board of Education)

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ODEs Logic Model (Fall, 2004)
Students receive high quality instruction aligned
with academic content standards
HIGHER ACHIEVEMENT FOR ALL STUDENTS
Students have the right conditions and motivation
for learning
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Ohio Community Collaboration Model for School
Improvement
Conditions Resource Assessment
Family Community
Collaborative Leadership Sustainability
Evaluation Feedback
District
Building
Academic Instruction
Student Achievement
and Learning
Youth Development
Community Partnerships
Health Social Services
Parent/Family Engagement Support
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Academic Outcomes
Getting the Conditions Right!!!!
ODEs new and expanded version for school
improvement...
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OCCMSI Pilots
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Bridging Research and Practice

• Implementation guide
• Tools and resources
• OCCMSI liaisons providing on-site technical
  assistance
• Professional development and training
  opportunities
• Cross-site networking and sharing

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Examples of Network Special Projects (2003-2005)

• Southwest University-Community Partnership in
  Effective Implementation of the Olweus Bullying
  Prevention Program
• Northwest Wood County Cross Training Initiative
  Olweus Program Implementation
• Northeast Intensive Positive Behavior and
  Support Training and TA
• Central Development and Use of an Intensive
  School District Survey
• Southeast Expansion of Youth Experiencing
  Success in Schools (Y.E.S.S.) Program
• North Central See Me Hear My Feelings and
  related youth experience initiative SBMH needs
  surveys in schools

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Phase 5 Mental Health and School Success Ongoing
Efforts in Ohio
Networks new SAMSHA-funded School-Based Mental
Health Effective Practice Integration Council
(EPIC)
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Mental Health and School Success
Websites National National Association of State
Directors of Special Education (www.nasdse.org) I
DEA Partnership (www.ideapartnership.org) Center
for School Mental Health Assistance (CSMHA,
http//csmha.umaryland.edu) Center for Mental
Health in Schools (http//smhp.psych.ucla.edu) Oh
io Center for School-Based Mental Health
Programs (http//www.units.muohio.edu/csbmhp) Cen
ter for Learning Excellence, Alternative
Education and Mental Health Projects (http//alted
mh.osu.edu/omhn/omhn.htm) Ohios Shared Agenda
Initiative (http//www.units.muohio.edu/csbmhp/sha
redagenda.html)
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This PowerPoint presentation will be posted on
the Ohio Mental Health Network for School Success
website http//www.units.muohio.edu/csbmhp/netwo
rk.html