An Overview of California Mental Health Services in Schools

Senate Mental Health CaucusMay 21, 2014

County Superintendents Educational Services Association

Sacramento County Office of EducationCalifornia Mental Health Directors Association

California Mental Health Services Authority

County offices of education 58School districts 1,043 Schools 10,300Teachers300,000 Students in grades K-12 6,221,000

California’s Public Education System

Mental Health Programs and Services in California Schools

Services for Special Education Students Students with Individualized Education Plans (IEPs) Specified mental health needs 5-10% of population Formal, regulated processes and services to ensure student needs are

met

Services for the General Student Population Students who could benefit from basic supports,

social/emotional instructional programs and positive school climate – 100% of population

Students who need short-term or lower level supports and interventions that can be provided at school - 15 to 25% of population

A variety of programs and services provided by districts and schools

School-based Mental Health – a young and tenuously supported field

Current Programs and Practices in

California SchoolsEvidence-based Prevention & Early Intervention Programs

• School Climate – Positive Behavioral Interventions and Supports (PBIS) and similar programs

• Bullying/Cyberbullying Prevention and Intervention

• Suicide Prevention and Supports

• Social-Emotional Skills Instruction

• Counseling Services

• Parent Education and Supports

• Related instruction and supports, including prevention/intervention of alcohol and other drugs; eating disorders; violence or aggressive behavior

Regional PreK-12 Student Mental Health Initiative

Statewide Project of CalMHSA and CCSESA

Statewide Infrastructure

• 11 CCSESA Regions covering all 58 California counties

• 11 Regional Lead County Offices of Education

• Collaboration with districts, schools and local mental health agencies

• Common goals and focus areas for all 11 regions

• Regional/county level activities to meet local needs

• Sacramento County Office of Education coordinates regional activities for the state

Fulfilling the Promise of School-Based Mental Health

• The Vision: Comprehensive System of School-Based Mental Health Programs and Services in each California school

• Aimed at providing evidence-based programs and services as early as possible to help prevent more critical needs in the future

• Include a continuum of programs and services from prevention and early identification to early identification and supports to referral to intensive services when needed

• Train teachers, staff and parents in early identification of mental health needs

• Include system navigators and practitioners to provide services and help students stay in school

CCSESA’s Regional PreK-12 Student Mental Health Initiative

Cross-System Collaboration• 837 Consortium Meetings Annual Statewide Cross-System Collaboration

Survey• 12,907 Cross-System Participants Demonstrated improvement in collaboration

Clearinghouse Activity• 274 Resources - best practices www.regionalk12smhi.org• 11,096 pages views per quarter 315 Registered Users total• 3,470 Visits to the site per quarter

School-Based Demonstration Programs• 272 Programs in 11 Regions• Directly involve 23,782 adults and 109,693 students• Estimated reach to 2,415,107students – 40% of California’s students

Education and Training• 1,396 Trainings Topics Including: Bullying Prevention; Suicide Prevention;

School Climate• 49,542 Participants Youth Mental Health First Aid; Trauma-Informed Care; Parent

Education• 9,039 Training Evaluations Mental Health Awareness; PBIS; Eliminating Barriers to

Learning

Statewide Report: January 2013-March 2014

County Mental Health Departments

• Administer a broad continuum of services for individuals of all ages, including children and youth

• Key areas of school collaboration– Medi-Cal Specialty Mental Health

Services (EPSDT mental health services)– Mental Health Services Act (Prop. 63)

EPSDT: A Broad Federal Medicaid Benefit

• Early & Periodic Screening, Diagnosis, and Treatment (EPSDT) for all Medicaid beneficiaries under age 21

• Comprehensive screening and preventive health, dental, vision, and developmental services.

• Screenings offered through CA’s Child Health & Disability Prevention Program (CHDP)

• Most diagnostic and treatment services are provided by Medi-Cal managed care plans

Medi-Cal Managed Care plans and their contracted pediatricians are critical partners in identifying and

screening for children’s mental health issues.

EPSDT Mental Health: Managed Care Plans’ Role

• Mental health benefits for mild/moderate conditions were expanded in California’s implementation of health reform

• For all Medi-Cal enrollees, including children, the managed care plans now offer:– Individual/group mental health evaluation and treatment

(psychotherapy)– Psychological testing – Outpatient services to monitor drug therapy– Outpatient laboratory, drugs, supplies and supplements– Psychiatric consultation

MOUs between Medi-Cal managed care plans and county mental health plans are key to collaboration and cross-

referrals.

EPSDT Mental Health:Counties’ Role

• Medi-Cal enrollees who meet medical necessity criteria must access EPSDT specialty mental health services through their local county mental health plan. (See handout for description of eligibility, services)

• Collaboration with schools – Schools may refer children to the county– Mobile mental health, rehabilitative, and case

management services may be provided on school sites by counties and subcontract providers

Prop. 63 Programs: Collaboration with Schools

• Education stakeholders participate in each county’s planning for Prop. 63 implementation

• Outreach includes schools to help identify program participants

• A key goal of Prop. 63 programs is to improve children’s school attendance and academic performance, and reduce school failure/drop-out

• A few local examples:– Training school personnel on suicide prevention– Cognitive behavioral therapy on school site for children

exposed to trauma– Law enforcement/school/county partnership to prevent

school violence– Improving the school climate and anti-bullying programs

School-County Partnerships Reflect Local Needs

• Local needs, priorities, demographics, and historical relationships contribute to the partnerships between schools and counties throughout California– Referrals– School-based mental health services– Targeted populations– Special education students’ mental

health services

Innoculation Campaign

9-13yrs

Websites•FAQs for youth and

parents•Storytelling

•Information and resources

School-Based Performances

•31Counties•Over 18,000 Youth

reached•Over 1,200 online

views

Personal Stories

from Youth

Activities •Over 2,500 shoes

made

Evaluation

2,469 Shoes Made

50,130 web visits

The 2013 contest films have been viewed online 31,235 times

and downloaded 434 times between April 2013 – April 2014

Contact InformationCheryl RaneyDirector, Prevention & Student Services Dept.Sacramento County Office of Education(916) 228-2201

Sandra S. MoralesAssistant Executive DirectorCounty Superintendents Educational Services Association(916) 203-9016

More information online:

www.regionalk12smhi.orgwww.cmhda.orgwww.calmhsa.orgwww.walkinourshoes.comwww.directingchange.orgwww.reachouthere.comwww.sactobullyprevention.org

Terence Rooney, Ph.DBehavioral Health DirectorColusa County (530) 458-0520

Ann CollentineProgram DirectorCalifornia Mental Health Services Authority(916) 859-4806

Stephanie WelchSenior Program ManagerCalifornia Mental Health Services Authority(916) 859-4816

Kirsten BarlowAssociate Director, Legislation & Public PolicyCalifornia Mental Health Directors Association(916) 556-3477, ext. 112