Addressing the Crucial Links Between Mental Health and School Success: Public Policy and Local Action

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Addressing the Crucial Links Between Mental
Health and School Success Public Policy and
Local Action
Carl E. Paternite, Center for School-Based Mental
Health Programs (Miami University) and the Ohio
Mental Health Network for School Success Diana
Leigh, Center for Learning Excellence (The Ohio
State University) and the Ohio Mental Health
Network for School Success Kay Rietz, Ohio
Department of Mental Health (Columbus) Terri
Johnston, Ohio Mental Health Network for School
Success (Cleveland) Kathy Oberlin, Ohio Mental
Health Network for School Success (Cuyahoga
Falls) Charlotte, Kristin, and Rachel, Ohio
students Workshop presented at the 4th Annual
School Health Interdisciplinary ProgramEllicott
City, MD August 3, 2004
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Addressing the Crucial Links Between Mental
Health and School Success Public Policy and
Local Action

• Learning Objectives
• Increase awareness of the rationale and
  strategies for addressing the crucial links
  between mental health and school success
• Increase awareness of the key role of teachers
  and other school personnel as members of the
  mental health team
• Increase awareness of strategies for enhancement
  of collaboration of teachers, mental health
  professionals, and families

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Addressing the Crucial Links Between Mental
Health and School Success Public Policy and
Local Action
Schedule for the day 830-1000 Background and
Context (Carl, Kay, Diana) 1000-1015 Break 1015
-1130 Positive Behavior Support
(Terri) 1130-1230 Lunch 1230-130 Crucial
Links for ImplementationSWOT (Terri) 130-200
See Me, Hear My Feelings (Kathy,
students) 200-215 Break 215-245 See Me, Hear
My Feelings (continued) 245-300 Youth Speaker
Panel (Kathy, Terri, students) 300-330 All
Tied Up and No Where to Go (Kathy,
students) 330-345 Wrap-up
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Enhancing Collaborations to Promote a Mental
HealthSchoolsFamilies Shared Agenda in Ohio
Background and Context Carl E. Paternite,
Diana Leigh, and Kay Rietz
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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 new 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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What is Expanded School Mental Health (ESMH)?

• Partnership between schools and community
  health/mental health organizations
• Build on existing school programs
• (CSMHA)

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What is Expanded School Mental Health (ESMH)?

• Full array of mental health care for youth in
  special and regular education
• Assessment
• Treatment
• Case Management
• Prevention
• Related Services
• Consultation
• Training with school staff, families, and
  community participants
• School Wide Initiatives (e.g., media, outreach,
  climate)
• (CSMHA)

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ESMH Continuum of Care

• 10-20 Broad Environmental Improvement and Mental
  Health Promotion
• 50-60 Prevention and Early Intervention
• 20-30 Intensive Assessment and Treatment
• (CSMHA)

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ESMH Advantages

• Access to youth
• Clinical efficiency and productivity
• Outreach to youth with internalizing problems
• Enhanced capacity for prevention
• Enhanced ability to promote generalization
• Reduced stigma
• Broadened roles for clinicians
• (CSMHA)

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ESMH Outcomes

• Improved grades, attendance, and behavior in
  students
• Decreased inappropriate referrals to special
  education
• Decreased high intensity use of mental health
  services
• Improved school climate
• Improved awareness of mental health issues
• (CSMHA)

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Public Policy ContextNew Freedom Commissionon
Mental Health

• Established in 2002 by President Bush to address
  problems with mental health service delivery
• Goal Identify ways that the mental health
  system could be improved to address the needs of
  individuals with emotional disturbances

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Vision Statement for the New Freedom Commission

• We envision a future when everyone with a mental
  illness will recover, a future when mental
  illnesses can be prevented or cured, a future
  when mental illnesses are detected early, and a
  future when everyone with a mental illness at any
  stage of life has access to effective treatment
  and supports essentials for living, working,
  learning, and participating fully in the
  community.

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New Freedom Commission on Mental Health

• Improvements in service delivery are dependent on
  two ideals
• 1. Services and treatments must be consumer and
  family centered
• 2. The nature of care provided to consumers
  should be broadened to include a focus on
  building consumer self-capacities, and not simply
  management of symptoms

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

• the mental health delivery system is fragmented
  and in disarrayleading 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

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Report of Presidents 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

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New Freedom Commission and School Mental Health

• How does the New Freedom Commission relate to
  School Mental Health?
• Utilizing school mental health resources provides
  a means to begin to address many of the changes
  needed in the mental health system

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New Freedom CommissionGoals and Recommendations

• Several goals and recommendations of the New
  Freedom Commission highlight the important role
  of school mental health approaches
• Goal 1 Americans understand that mental health
  is essential to overall health
• Recommendation 1.1 Advance and implement a
  national campaign to reduce stigma of seeking
  care and a national strategy for suicide
  prevention
• July, 2003

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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

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ESMH and the No Child Left Behind MandateTwo
Important Goals Achievement and Wellbeing

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

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Non-academic barriers to learning exert a
powerful negative influence

• 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
• (CSMHA)

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School Effectiveness in Promoting Achievement and
the NCLB Mandate

• Least effective Limited focus on academic and
  nonacademic barriers
• More effective Focus on academic barriers
• Most effective Integrated Focus on academic and
  nonacademic barriers
• (CSMHA)

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See Handout
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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
• There currently are over 700 building teams and
  10,000 educational staff trained in Positive
  Behavior Supports

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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)
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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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Shared Agenda Seed Grant Awards to
Missouri, Ohio, Oregon, South Carolina, Texas,
and Vermont With Ongoing Across-State
Networking Facilitated by PMP/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-level and
Regional Organizations
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Ohios Mental Health, Schools, and Families
Shared Agenda Initiative http//www.units.muohio.e
du/csbmhp/sharedagenda.html
Phase 1Statewide forum for leaders of mental
health, education, and family policymaking
organizations and child-serving systems (March 3,
2003) Phase 2Six regional forums for policy
implementers and consumer stakeholders
(April-May, 2003) Phase 3Legislative forum
involving key leadership of relevant house and
senate committees (October 9, 2003) Phase
4Ongoing policy/funding advocacy and technical
assistance to promote attention to the crucial
links between mental health and school success
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Ohios Mental Health, Schools, and Families
Shared Agenda Initiative http//www.units.muohio.e
du/csbmhp/sharedagenda.html
Legislative Forum Fact Sheet and
Recommendations (see Handout)
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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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Comments from Legislators Following the 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 Steps for Ohios Shared Agenda Initiative

• 1. ODMH and ODE jointly formed an ad hoc
  workgroup to address action steps related to the
  Shared Agenda Recommendations
• Public Awareness and Advocacy
• Professional Development/Training and Service
  Delivery
• Policy and Funding

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Phase 4 Steps for Ohios Shared Agenda Initiative
The workgroup met three times between November
(2003) and March (2004) A final report with
recommended goals and objectives has just been
released (see Handout)
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Phase 4 Steps for Ohios Shared Agenda Initiative
NASDSE National Satellite Teleconference School-B
ased Mental Health Broadcast from Pittsburgh,
PA May 5, 2004 Listening to Family, Service
Provider, and Teacher Perspectives
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Phase 4 Steps for Ohios Shared Agenda Initiative
2. Ohio is one of eight states selected to
participate in a SAMHSA-funded 3-year
Elimination of Barriers Initiative (EBI) to
identify effective approaches in addressing the
stigma and discrimination associated with mental
illness.
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Phase 4 Steps for Ohios Shared Agenda Initiative

• ODMH is leading Ohios EBI effort, focusing on
  the school age population. Contact strategies
  include
• Youth speaker panel/bureau
• Resource kit for in-service training with
  educators

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Phase 4 Steps for Ohios Shared Agenda Initiative

• 3. Expansion of Ohios Positive Behavior Support
  Initiative will continue through 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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Phase 4 Steps for Ohios Shared Agenda Initiative
4. Ongoing work of the Ohio Mental Health Network
for School Success will continue through
implementation of the action agenda and through
special targeted efforts.
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Phase 4 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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Mental Health and School Success
Websites National National Association of State
Directors of Special Education (www.nasdse.org) C
enter for School Mental Health Assistanc (CSMHA,
http//csmha.umaryland.edu) Center for Mental
Health in Schools (http//smhp.psych.ucla.edu) O
hio 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 is posted on Ohios
Shared Agenda website http//www.units.muohio.edu
/csbmhp/sharedagenda.html