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Mental Health Promotion in Schools


Elementary School Example, CHAT. Secondary School Example, SBMH Learning Forum ... health issues perform less well in school, and frequently disengage over time ... – PowerPoint PPT presentation

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Title: Mental Health Promotion in Schools

Mental Health Promotion in Schools
  • Issues, Examples, and Possibilities

Canadian Safe School Network Behind the Mask
Examining Mental Health in Schools April 2009
  • Issues in School-Based Mental Health (SBMH)
  • SBMH in Action
  • Elementary School Example, CHAT
  • Secondary School Example, SBMH Learning Forum
  • SBMHA Consortium Seeking your input…

Issues in School-Based Mental Health
SBMH is Not New…
  • Schools and communities have been dealing with
    these issues for decades
  • Inconsistent, fragmented approaches, with pockets
    of excellence…
  • Whats new is the galvanizing of efforts to reach
    an integrated solution to a complex problem

All children can benefit from building skills for
coping with stress, managing relationships, and
Opportunity to reach many children and youth who
wouldnt normally seek help
Why the heightened focus on SBMH?
Educators can help to identify students that
require more intensive intervention
Programs can be delivered universally, minimizing
stigma and maximizing the advantage of peer
There is a significant relationship between
mental health and achievement
If we are serious about narrowing the gap, we
need to understand that students with mental
health issues perform less well in school, and
frequently disengage over time
The Current Landscape in Schools
  • Educators tell us
  • They are seeing escalating mental health problems
    and crisis situations in schools
  • Current systems cannot manage the increasing need
    for service (more untreated students, longer wait
  • They have questions about their role in student
    mental health
  • They want to help but are feeling ill-prepared to
    respond to the mental health needs of students

International Principals Survey, 2008
  • 90 principals think that mental health is very
    important for academic achievement
  • Greatest areas of concern bullying, impulse
    control, anger management
  • Many see a need to increase and strengthen policy
    related to SBMH
  • Principals are seeking resources and staff
    training in
  • mental health promotion
  • prevention strategies
  • support to students in distress

What is the role of schools in mental health
  • Build a culture where mental health is valued and
  • Create basic mental health literacy amongst staff
    and students
  • Implement school- and class-wide programs to
    support positive emotional and behavioral
  • Use evidence-based approaches

What is the role of schools in prevention?
  • Be aware of risk and protective factors for
    mental health problems
  • Assess the needs in your school
  • Implement programs to prevent emotional and
    behavioral problems for at-risk students
  • Use evidence-based approaches

What is the role of schools in supporting
distressed students?
  • Recognize signs of mental health problems
  • Know where,
  • how,
  • and when
  • to refer to a mental health professional
  • With training, perform Mental Health First Aid,
    when necessary

Use Evidence-Based Approaches
  • Social Emotional Learning is not neutral
  • Important to use evidence-based approaches for
    student mental health issues
  • Many examples of programs that are unproven
  • Some examples of programs that harm
  • We should be evaluating
  • local programs and
  • strategies, especially if
  • they are untested

What Works in Mental Health Promotion?
  • Mental Health Promotion programs are most likely
    to be effective if they
  • involve the whole school
  • change school culture
  • Include personal skill development
  • Involve parents and the wider community
  • Last for a year or more
  • Stewart-Brown, 2006

What Works in SBMH Prevention?
  • National Research Council and Institute of
    Medicine Report (2009), Preventing Mental,
    Emotional and Behavioral Disorders among Young
    People Progress and Possibilities
  • Social Emotional Learning programs increase
    academic performance (Durlak et al., 2007)
  • School-based violence prevention programs can
    reduce aggression by 25-33 (Wilson Lipsey,
  • Life Skills Training decreases poly-drug use 3
    years after the intervention (Botvin, 2000)

And many more…
What Works in Supporting Distressed Students?
  • Mental Health First Aid
  • Assess risk of suicide or harm
  • Listen non-judgmentally
  • Give reassurance and information
  • Encourage student to get appropriate professional
  • Encourage self-help strategies

Kitchener Jorm, 2002 Note Involved 9 hour
manualized training course focus was adult
mental health
Response to Mental Health at School
Domain of Student Engagement and Mental Health

Tier 1
Mental Health Promotion Student Engagement
Efforts School/Class-wide social-emotional
learning (Universal)
Tier 2
Prevention for at-risk students (Targeted)
Domain of Mental Health Treatment
Tier 3
Support for distressed students (Clinical)
Response in the Community
Tier 1

Mental Health Promotion
Tier 2
Targeted for at risk children and youth
Tier 3
Clinical Interventions for students with mental
health problems
We need to work together!
Tier 1

Tier 1

Tier 2
Tier 2
Tier 3
Tier 3
Getting our Acts Together, 2009
School-Based Mental Health in Action!
Evidence-Based Education and Services Team E-BEST
An evidence-promoting research service housed
within an Ontario school district
  • Mission
  • Coordinates and facilitates research in schools
  • Enhances capacity for evidence-informed
  • Tests innovations in education and mental
  • Fosters collaboration with community
  • Contributes to the evidence-base
  • Core Services
  • Bottom-Line Actionable Messages
  • Evidence Bank
  • Knowledge Mobilization Lab
  • Program Evaluation
  • Consultation via Office Hours
  • System Data Reporting
  • Research Showcase
  • Key Strategies for promoting EIP
  • Encouraging early adopters
  • Building capacity for evaluation
  • Using technology as a bridge
  • Job-embedded evidence promotion
  • Positioning research strategically
  • History
  • From idea to department over 8 years (1999-2007)
  • Evolved from .5 to 5.5 FTE
  • Currently situated in the Office of the Director

Visit Us
Choosing Healthy Actions Thoughts
  • An Elementary School Example

  • Based on an treatment program for depressed
    children (ACT ADAPT, Weisz et al.)
  • Revised to create a prevention program
  • Mapped onto Ontario Curriculum expectations
  • Program manual, student workbook, DVD series
  • Co-facilitated by the grade seven teacher,
  • and a school-based mental health
  • professional

CHAT Program Components
There are two main parts to the program
Healthy Ways to ACT when stressed
and Healthy Ways to THINK when stressed
CHAT History in HWDSB
  • It began with an idea…
  • Core multidisciplinary team
  • Development work with UCLA
  • 3 classroom pilot
  • Series of video-version pilots
  • Randomized Trial

CHAT in Swedish Schools
(Mood Thermometer)
CHAT Research Overview
  • 3 phases of pilot testing
  • 2003 3 classes, program content
  • 2004 10 classes, video version, measures
  • 2005 6 classes, higher needs sample, control
  • 2 year Randomized Controlled Trial
  • 2006 19 classes, cohort 1, randomized trial
  • 2007 16 classes, cohort 2, randomized trial
  • Consumer Preference Modeling Study

CHAT Findings
  • There is a significant correlation between
    student mood and student report card grades
  • Depressed mood is also associated with lower
    ratings on student learning skills, like
    initiative and goal-setting
  • Awaiting trajectory analysis, collecting 12-
    month follow-up for 2nd cohort

CHAT Enablers
  • Evidence-based intervention
  • Engaging for students
  • Dedicated and passionate team
  • Alignment with curriculum
  • Communication with schools and communities
  • Co-facilitation model
  • Support and seed funding from HWDSB
  • Research funding from Provincial Centre of

  • McMaster University/Offord Centre
  • Drs. Chuck Cunningham, Michael Boyle, Caroline
  • Harvard University
  • Dr. John Weisz
  • Michelle Bates, Anne Chaffee, Lesley Cunningham
    many SBMH co-facilitators and teachers, Tracy
    Weaver, Kathy Short

School-Based Mental Health in Action! Part Two
Knowledge Mobilization Lab
The KM Lab aims to determine, via systematic
study, optimal ways to mobilize research
knowledge to facilitate the sustained integration
of evidence-informed practices within schools,
and to share learnings with others.  
How can we assist education professionals to use
evidence-based practices to promote student
mental health?
How can we use practice-based evidence to
encourage timely and relevant research about
student mental health?
School-Based Mental Health Learning Forum
  • A Secondary School Example

Learning Forum Mission
  • The Learning Forum is designed to create a
    platform for dialogue amongst scientists and
    school-based practitioners in the area of student
    mental health.

The Research-Practice Relationship
World of Research
World of Schools
Adapted from Riley, 2005
Bringing the Worlds Closer Together
Enhance educator knowledge and use of
evidence-based strategies
Enhance scientist knowledge and use of
practice-based information
Adapted from Riley, 2005
Model for Mental Health Promotion
Enhanced mental health literacy Changed
attributions for student behavior Increased use
of evidence-based strategies (Mental Health First
Feasibility Pilot, 2009
  • One Secondary School
  • 4 Main Exchange Vehicles
  • Full Staff Learning Forum Sessions
  • Study Group Sessions
  • E-Forum
  • Communiqué (e-newsletter)
  • Soft evaluation

Full Staff Learning Forum
  • Offord Scientist interactive lecture
  • Dr. Peter Szatmari, Mental Health Overview
  • Dr. Jean Clinton, The Adolescent Brain
  • Dr. Kathy Georgiades, Adolescent Depression
  • Scientist-Educator Dialogue
  • Issues, application to classroom practice,
    alignment with initiatives (e.g., Caring Adult)
  • Development of a School Mental Health Strategy

School Mental Health Strategy
Build a school culture where is it safe to
discuss mental health
Give teachers tools and knowledge to promote
positive mental health
Find ways to ensure students cant fall through
the cracks
Link with researchers and clinicians to support
evidence-based care
Build a school culture where is it safe to
discuss mental health
  • Poster campaigns
  • Student-Led Mental Health video
  • Offord scientist lecture
  • Youth Net
  • Classroom follow-up

Give teachers tools and knowledge to promote
positive mental health
  • Signs and symptoms
  • Etiology
  • Classwide strategies
  • Mental Health First Aid
  • Listen, be the Caring Adult
  • Give reassurance and information
  • Encourage professional assistance
  • Assist with self-help strategies
  • When to refer
  • Where to refer

Find ways to ensure students cant fall through
the cracks
  • Ways to flag, track and support at-risk students
    across teachers
  • Ways to communicate what works with a
    particular student amongst colleagues
  • Working through challenges with respect to
    privacy and confidentiality issues

Link with researchers and clinicians to support
evidence-based care
  • Full Staff Learning Forum Sessions
  • Study Group
  • E-Forum
  • Educator Mental Health Information Sheets (CYMHIN
    and SSLI)
  • Readings

Learning Forum Enablers
  • Passionate, and flexible, steering committee
  • Enthusiastic school team, shared leadership
  • Supportive administration
  • Dynamic speakers
  • Identified need at the school level
  • Keen interest from scientists
  • Funding, use of PD Days
  • KM Lab consultation

Learning Forum Evaluation
  • Mental Health knowledge, attitudes, and behavior
  • Evaluation of collaborative process
  • Documentation of KM processes, tools
  • Measurement of outcome (towards uptake of
    evidence-based programming and strategies, mutual

Mental Health Literacy
Josh is in grade 10. He attends your second
period class, most days. Josh is quiet in class,
and doesnt really stand out one way or another.
Your biggest complaint about him is that
sometimes he seems lost in thought and may not be
following your instruction. You assess him to be
an average student, but you have heard he got
very high marks in grade 9. He also played
football last year, but showed no interest in
trying out in grade 10. He doesnt have a lot of
patience for the other kids in the class, and
seems abit irritable in his interactions with
them, when he bothers to talk to them. He
previously did most assignments on time, but for
the past 3 weeks seems to be putting forth a
pretty minimal effort. He doesnt seem sad or
nervous, but looks tired and may be losing
Mental Health Literacy
  • What, if anything, is wrong with Josh?
  • What makes you think so?
  • What could be done to help Josh? What could you,
    as a teacher, do to help?

SBMH Learning Forum Team
Dr. Scott Davies (Co-Chair, Offord) Sam Gardner
(Co-Chair, Offord) Dr. Caroline Parkin (Co-Chair,
Offord) Dr. Kathy Short (Co-Chair, HWDSB)
Dr. Kathy Bennett (Offord) Julie Bodden
(Offord) Don Buchanan (Offord) Dr. Jean Clinton
(Offord) Patricia Colton (Offord) Lawrie Cook
Supt. Vicki Corcoran (HWDSB) Supt. Krys Croxall
(HWDSB) Angela Ferguson (HWDSB) Dale Pyke
(HWDSB) Supt. Pam Reinholdt (HWDSB) School
Directions Team (HWDSB)
National SBMHA Consortium
  • Mental Health Commission of Canada

Consortium Membership
Provincial Centre of Excellence for Child and
Youth Mental Health at CHEO
  • 15 member Core Team
  • 25 member Stakeholder Committee
  • National representation
  • National and provincial organizations,
    universities / research
  • centres, school districts

Consortium Mandate
  • Overall Objective
  • Through a synthesis of the national and
    international literature, an environment scan of
    Canadian programs and services, and a national
    survey of school districts, the Consortium will
    develop a broad framework and practice
    recommendations related to School-Based Mental
    Health and Addictions in Canada.

Consortium Teams
  • Review and Synthesis Team
  • Co-Leads Canadian Council on Learning, Hospital
    for Sick Children
  • Environment Scan Team
  • Co-Leads Provincial CoE, Hospital for Sick
    Children, Fraser Mustard/University of Calgary
  • National Survey Team
  • Co-Leads - Canadian Council on Learning, Hospital
    for Sick Children
  • Knowledge Transfer and Exchange Team
  • Co-Leads HWDSB, Hospital for Sick Children, CASH

Knowledge Transfer Exchange
  • Share project deliverables with a variety of
    knowledge user audiences
  • Validation and study phases to facilitate input
    and dialogue
  • Blueprint for a national symposium to launch
    the next phase of implementation of SBMHA in

Requesting your Input…
  • Would you like to be part of our Validation
  • Provide suggestions for how you might like to
    receive information, comment on early drafts and
    pilot products, etc.

Sign up today, or email me Kathy.Short_at_hwdsb.on.c
Mental Health Promotion in Schools
Contact Kathy Short, Ph.D., C.Psych. Clinical
Child Psychologist Manager, Evidence-Based
Education and Services Team 905-304-8722,