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From Policy to Practice: Using Community Science to Promote School-Based Mental Health

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Title: From Policy to Practice: Using Community Science to Promote School-Based Mental Health


1
From Policy to Practice Using Community Science
to Promote School-Based Mental Health
  • Symposium Presentation at the Annual Meeting of
    the American Psychological Association
  • August 18, 2005

2
  • Presenters
  • Paul Flaspohler
  • Center for School-Based Mental Health Programs,
    Miami University
  • Carl E. Paternite
  • Center for School Based Mental Health Programs,
    Miami University
  • Steve Evans
  • Dept. of Psychology, James Madison University
  • Elaine Clanton Harpine
  • Dept. of Psychology, Kent State University
  • Discussant
  • Mark Weist
  • Center for School Mental Health Analysis and
    Action, U. of Maryland

3
Tovas Perspective on Mental Health and School
Success Ohio Shared Agenda Legislative Forum
Testimony October 9, 2003
4
Community Science
  • A means and a method for bridging this gap
    between research and practice
  • An interdisciplinary framework for strengthening
    communities by improving the quality of practice
    in treatment, prevention, health promotion, and
    education

5
The Gap between research and practice
Prevention Science Intervention Basic
research Efficacy Effectiveness Services
Research
Practice Community Organizational Systems 1)
Schools 2) Health Agencies 3) Community
Coalitions


GAP
6
The preventive intervention research cycle
7
Pasteurs Quadrant
Use Use
Understanding Use Inspired Basic Research Pure Applied Research
Understanding Pure Basic Research
Yes
No
Yes
No
8
Bridging the Gap
Prevention Science Intervention Basic
research Efficacy Effectiveness Services
Research
Practice Community Organizational Systems 1)
Schools 2) Health Agencies 3) Community
Coalitions

  • Green Characteristics
  • Process
  • Control
  • Self-Evaluation
  • Tailoring Process and new Technology
  • 5) Synthesizing Research

9
Larry Green From Research to Best Practices
  • Best Practice as Process
  • Control by practitioner, client, or community
  • Local evaluation and self-monitoring
  • Research in the Tailoring Process and new
    technology
  • Consumer driven Synthesis and Translation

10
Promoting Effective School-Based Mental Health
Programs and Services
  • Carl E. Paternite, Ph.D.
  • Center for School-Based Mental Health Programs
  • Miami University (Ohio)
  • Steven Adelsheim, M.D.
  • Health Sciences Center
  • University of New Mexico

11
The Crisis of Youth Mental Health in the U.S.
  • About 20 of youth, ages 9 to 17 (15 million),
    have diagnosable mental health disorders, (and
    many more are at risk or could benefit from help)
  • Between 9-13 of youth, ages 9-17 years, meet the
    federal definition of serious emotional
    disturbance (SED)

12
The Crisis of Youth Mental Health in the U.S.
(cont.)
  • Less than 30 of youth with diagnosable disorder
    receive any service, and, for those who do, the
    services are often inadequate
  • For the small percentage of youth who do receive
    services, most actually receive them in schools

13
The Crisis of Youth Mental Health in the U.S.
(contd)
  • These realities raise questions about the mental
    health fields insufficient attention to delivery
    of ecologically sensitive and effective services
  • And they reinforce the importance of
  • a community-based continuum of mental health
    supports,
  • commitment to a public health model of mental
    health, and
  • expanded school mental health programs and
    services.

14
Growing Focus on School Mental Health (SMH) in
the U.S.
  • U.S. Surgeon General Reports (1999, 2000)
  • Presidents New Freedom Commission on Mental
    Health Report (2003)
  • Mandates of No Child Left Behind and
    Individuals with Disabilities Education Act
    (IDEA)
  • Progress in localities and states
  • Collaborative research-practice-training networks

15
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 New Freedom Commission (2003)

16
Public Policy Context SMH and the No Child Left
Behind Mandate Two Important Interrelated Goals
Achievement and Wellbeing
  • 1) Achievement promotes wellbeing
  • 2) Wellbeing promotes achievement
  • School accountabilities often acknowledge 1 but
  • fail to sufficiently acknowledge 2

17
Report of Presidents New Freedom Commission on
Mental Health http//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

18
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)

19
Strengthening Policy and Practice Ohios Shared
Agenda and Mental Health Network for School
Success
  • Paul Flaspohler, Ph.D.
  • Center for School-Based Mental Health Programs,
    Miami University (Ohio)
  • Noelle Duvall, Ph.D.
  • Childrens Resource Center, Bowling Green, OH
  • Kay Reitz, Ph.D.
  • Office of Children's Services and Prevention
    .Ohio Department of Mental Health
  • Michael Armstrong
  • Director, Office for Exceptional Children, Ohio
    Department of Education

20
Infrastructure for Ohios Shared Agenda 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

21
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22
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.
23
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
24
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).
25
Legislative Forum On Mental Health and School
Success Creating A Shared Agenda In Ohio October
9, 2003
26
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.
27
Pre- and In-service Training to Promote
Interdisciplinary Collaboration in SBMH
  • Jennifer L. Axelrod, Steven W. Evans, Robert
    Burke

28
Nature of the Problem
  • National crisis regarding behavioral health
    workforce (The Annapolis Coalition)
  • Inadequate training in graduate programs.
  • Ineffective methods of continuing education
    (e.g., symposiums).
  • Those with most client contact frequently have
    least training.
  • Little to no family education provided nor is
    their experience considered in training.

29
Examples of Problem
  • Many graduate programs do not teach students
    about productivity and dealing with managed care
    which are primary measures of competency in many
    jobs.
  • There is little pre-service or in-service
    training about evidence based practices and how
    to fit them into a real practice.
  • Training in evidence based practices frequently
    barely resembles actual EBP.

30
School Mental Health
  • In addition to basic competencies required to be
    a qualified mental health provider, school based
    mental health providers require additional
    competencies
  • Understanding of education system
  • Advanced consultation and collaboration skills
  • Techniques for using meaningful outcome measures
  • Creativity and flexibility

31
School Mental Health
  • Educators also wish to gain knowledge and skills
    in childrens mental health
  • Awareness of meaningful variations in behavior
  • Methods for improving classroom management and
    educational strategies for children with mental
    health problems
  • Techniques for supporting appropriate social
    development
  • Approaches for fostering resilience and coping

32
Mental Health-Education Integration Consortium
MHEDIC
  • Collaboration of educators and mental health
    providers with goal of advancing pre-service and
    in-service training on mental health issues.
  • Establish core competencies of professions that
    are unique to school mental health
  • Educators
  • Mental health providers
  • Develop training methods for helping
    professionals achieve these competencies.

33
Methods
  • Competencies
  • Collect information from professionals
  • Identify core competencies for educators and
    school mental health providers
  • Training
  • Modify university training programs
  • Update technical assistance centers
  • Develop methods for effective training
  • Examine impact on education and mental health
    outcome measures when professionals in school
    achieve competencies.

34
After-School Community-Based Prevention Projects
  • Elaine Clanton Harpine, Ph.D.
  • Kent State University Geauga

35
Portable Play Therapy Room

36
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37
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38
From Policy to Practice Using Community Science
to Promote School-Based Mental Health
  • Discussant
  • Mark Weist
  • Center for School Mental Health
  • Analysis and Action
  • Department of Psychiatry
  • University of Maryland

39
Center for School Mental Health Analysis and
Action
40
CSMHA
  • Established in 1995 with a grant from the Health
    Resources and Services Administration (HRSA)
  • Renewed 5-year funding in 2000 from HRSA, with
    co-funding from the Substance Abuse and Mental
    Service Administration (SAMHSA)
  • Renewed 5-year funding in 2005 from HRSA and
    SAMHSA with a focus on policy analysis and
    dissemination

41
Factors Necessary to Achieve Desired Outcomes
for Youth Through SBMH Programs and Services
42
The IDEA Partnership
43
The Big Picture A Shared Agenda
  • Achievement and Well Being as Dual Goals
  • Address both academic and non-academic barriers
    to achievement
  • Share work across education, mental health and
    family organizations
  • Make explicit the shared interests of school
    mental health, general education and special
    education
  • Grow state-based examples
  • Develop and nurture multi-scale learning loops
  • Build a national Community of Practice on
    school-based mental health that unites
    stakeholders around shared interests across
    organizational boundaries
  • see www.ideapartnership.org

44
2nd Community Building Forum, and 10th Annual
Conference on Advancing School Mental Health
  • Federal funders, HRSA, SAMHSA, OSEP
  • Major Partners IDEA Partnership, NASDSE, CSMHA,
    Ohio Mental Health Network for School Success
  • Cleveland Ohio, October 26 (Community Building
    Forum) 29, 2005
  • Come to Cleveland, the City that Rocks!!
  • See http//csmha.umaryland.edu or contact
    Christina at chuntley_at_psych.umaryland.edu

45
Practice Groups
  • Mental Health Education Integration
  • Developing a Common Language
  • Connecting Education and Systems of Care
  • Connecting School Mental Health (SMH) and
    Positive Behavior Support
  • Improving SMH for Youth with Disabilities

46
Practice Groups (cont.)
  • SMH, Juvenile Justice and Drop-Out Prevention
  • Family Partnerships
  • Youth Involvement and Leadership
  • Faith Community Partnerships
  • Quality and Evidence-Based Practice

47
INTERCAMHS International Alliance for Child
and Adolescent Mental Health and Schools
www.intercamhs.org
48
UCLA Center for Mental Health in Schools
  • Directed by Howard Adelman and Linda Taylor
  • Phone 310-825-3634
  • Enews listserv_at_listserv.ucla.edu
  • web http//smhp.psych.ucla.edu
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