WVDE School Counselor WorkshopsOctober 2, 9, and 14

2008 1

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Increase awareness of current state level efforts to define and implement a model for expanded school mental health services in WV.

Increase knowledge of the PATH process.

Increase understanding of the concept and components of an expanded school mental health (ESMH) model from a national perspective.

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Studies estimate that 20% - 38% of youth need active mental health intervention.

Between 9-13% of youth ages 9-17 meet the federal definition of serious emotional disturbance (SED). (Goodman, 1997; Marsh, 2004)

9% (2.2 million) of adolescents 12 – 17 years experienced at least one major depressive episode in the past year.(SAMHSA,2006)

Half of all mental illness begins by age 14, three-fourths by age 24.

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As few as one sixth to one third of youth with diagnosable disorders receive any treatment. (Burns, et al 1995; Leaf et al, 1996)

 Of those who do receive treatment, less than half receive adequate treatment.

And even fewer of the youth “at risk” receive any help whatsoever. (Weisz, 2004)

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Children with chronic physical problems are much more likely to have emotional and behavioral health needs.

The WV BBHF estimates the prevalence of serious emotional disturbance (SED) among youth at 13% and in any given year:

-only 28% of youth with serious emotional problems are receiving any care at all.

-This does not include youth with short term, acute problems or those at risk

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1994 – School-based health center Initiative – WV Bureau for Public Health

1999 - System of Care – SAMHSA grant – WV Bureau Behavioral Health

2000 – School-based mental health funding through block grant

2006 - West Virginia Behavioral Health Commission

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2007WV Bureau for Behavioral Health and WV Dept. Of Education meet

MOU signed by commissionersPlanning process beginsSteering team organizedStrategic planning process begins

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SOC – SAMHSA Grant SBMH WVCBHC MOU

SBMH PATH (strategic planning process)

ESMH Steering Team

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Schools often acknowledge 1 but historically Schools often acknowledge 1 but historically have failed to acknowledge 2have failed to acknowledge 2

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Typically limited to assessment and consultation

Minimal treatment only for those youth in special education or those with 504 accommodations

Some students may receive brief counseling Referrals to community settings usually do

not occur or fail (Catron, Harris,&Weiss, 1998)

 

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Is the model by President’s New Freedom Commission on Mental Health

Emphasizing shared responsibility of schools and community

Is a partnership between schools and community health/mental health organizations.

(Weist, 1997; Weist, Paternite, & Adelsheim, 2005)

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Build on existing school programs/services

Programs/services are for all students

Include full array of programs/services from prevention through intensive intervention

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Reduces stigma for help-seeking(Nabors & Reynolds, 2000);

Promotes generalization/maintenance of intervention gains

Enhances capacity for prevention/MH promotion

Fosters clinical efficiency and productivity(Flaherty & Weist , 1999)

Promotes a natural, ecologically grounded approach to helping youth and families

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Several studies document evidence of strong positive associations between school mental health services, access to care, and academic success.

Strong satisfaction by diverse stakeholder groups (Nabors, Reynolds & Weist, 2000)

Improvement in school outcomes (e.g., climate, special education referrals, reduced bullying, fewer suspensions) (Nabors, Reynolds & Weist, 2000)

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Increased student attendance and reduced drop out rates (Drake, 1995; Schargel & Smink, 2001; )

Enhanced motivation and sense of competence (Christenson, Rounds & Gorney, 1992; Grolnick & Slowiaczek, 1994)

Increased access (Dial, et al, 2002; Weist, Myers, Hastings, Ghuman, and Han, 1999)

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Increases student connectedness to school which is associated with improvement in many areas including academic performance, decreased incidence of fighting, bullying, vandalism, absenteeism, substance use, early sexual engagement, disruptive behaviors, and graduation rates and school attendance

(Blum & Libbey, 2004; CD(Blum & Libbey, 2004; CDC’s Wingspread study, Declaration on School Connections, 2004)

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SATESMESM

HH

PBIS

IDEAIDEA

NCLBNCLB

SafeSafe

SchoSchoolsols

HealthHealth

EvidenceEvidence

BasedBased

RTI

SystemSystemssof of

CareCare

Social & Social & EmotionaEmotiona

l l LearningLearning

SchoolSchool

ClimateClimate

Family Family supportsupport

AssetsAssets

BuildingBuilding

Multi

System

SharedShared

AgendaAgenda

School School BasedBased

StudentStudentSupports Supports

MentalMentalHealthHealth

ServicesServices

Faculty

Psy..

Psy..

Services

Services

to achieve a comprehensive

system of le

arning supports

and expanded mental health

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Parent Network RepWVDE – EBD, Healthy Schools,

CounselorsWVBBH – Children’s Division,

Substance AbuseAfrican -American churchesDirector, Community Mental Health

AgencySchool SuperintendentMarshall TAWill add others 19

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collaborative committed state stakeholders

timing couldn’t be better (PCG & Behavior Health Com. rec.)

resources dedicated to awareness

PBS Network relationships & connections

WV System of Care

Children’s Outreach Liaison within comprehensives

background readiness training

Developing a Service Array Process in DHHR

nearly 50 SBHC with 2/3 have mental health

DHHR (top-down) vs. DOE (local control)

We haven’t selected a model or structure

Unclear about state level role vs. local control (Educ.)

lack of consistent programming

children are not historically a focus of comprehensives

BCF federal review in 2004-05 cited deficiencies

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beginning a new school

year for pilot project

developing a statewide System of Care

children’s outreach liaisons

new school in Marion

Co. w/ Valley

time is right to

take action

service array

process

Cultural attitudes about mental health

Unclear focus for state agencies

Not taking action

Willingness of school counselors and mental health counselors to partner (territorial issues)

Changes in education and DHHR institutional cultures

Competing priorities of schools

Steering Committee formed and functioning Steering Committee

drives the 5 year plan for ESMH

Model designed Outcomes established

“start with the end in mind”

Strategies for 5 year plan implementation

Gap analysis completed

Illinois PBIS Network Center for School Based Mental

Health Programs – Miami University, Ohio

Center for School Mental Health - U of Maryland - Baltimore

University of Southern Florida Research and Training Center for Children’s Mental Health

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To learn more about what currently exists in WV’s schools

What agencies are in the schools and where

What EBPs are being implementedWhat are the greatest needs re MHWhat are their top 5 MH/BH problems

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Survey designed by ESMH Committee; used similar surveys from other states (Mass., MD)

On line: surveymonkey.com Letter from State Superintendent to

all schoolsData compiled and analyzed by

Marshall University TA

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364 schools out of 701 in the state

Schools in 51 counties responded

Representative in terms of regions, demographics, and school level

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Table 1. Response Rate by RESA and for State

RESA

# Schools Reporting

Total #Schools

% Schools Reporting

1 45 85 53%2 64 101 63%3 51 111 46%4 29 70 41%5 36 65 55%6 29 55 53%7 68 131 52%8 42 83 51%

TOTAL 364 701 52%

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External Agencies in SchoolsN=307

% of School

sCommunity Health Center or School Health Center 20%

Behavioral Health Center 29

Regional Drug Prevention Specialist 5

Local Hospital/Health Dept 15

Private therapist/counselor/social worker 25

No outside agencies 39

Other 19

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Prevention programs provided at the school

Pre K – Elementary

N=193

Mid– Jr. HighN=84

HighSchoolN=68

State TotalUnduplicate

dN=320

Developmental Guidance Lessons 88% 81% 59 % 254 79%

Anti Bullying Programs 77 68 45 219 68%

School-Wide Positive Behavior Supports 51 69 48 170 53%

Other Programs 27 26 35 95 30%

Comprehensive Health Screenings 32 25 15 85 27%

Respect and Protect 15 25 18 56 18%

PRIDE Youth Programs 8 14 24 41 13%

Too Good for Drugs 12 7 0 27 8%

Suicide Prevention 1 9.5 6 15 5%

Teen Institute 3 8 4 15 5%

BABES 5 0 0 9 3%

Mental Health Screening 1 2 6 7 2%

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Intervention services available

(programs targeted to specific groups or individual students who are considered to be at risk)

Pre K – Elem.

N=189

%

Mid– Jr. High

N=82%

HighSchool

N=68%

State TotalUnduplicated

N=316 %

Individual Counseling/Therapy 85 85 91 85

Referrals to Community Resources 75 78 81 77

Small Group Activities 55 52 39 52

Student (Individual) Focused PBS 24 33 25 25

Staff/faculty Development 16 22 21 18

Mental Health Screening 13 20 30 18

Family Mental Health Outreach 18 10 15 17

Crisis Response 12 16 46 16

Family Counseling/Therapy 14 15 21 16

Clinical Intakes/Evaluations 11 24 18 15

Psychiatric Consultation 4 11 12 10

Other 0 4 8

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Is a frameworkBuilds on the core servicesRecognizes emotional /academic learning

link Is a shared responsibilityProvides the full continuum of careComplements, supports and is linked with

school counselors, PBS, SOC, SBHCs and SAT

Incorporates a public health approach35

Population based – organized, interdisciplinary, scientific data drives decisions

Promotion of mental health and prevention of challenges or illness. Interventions to improve and enhance the quality of life.

Engages the whole community to assure the optimal physical and mental health of children and families.

Promotes social and emotional well-being and the optimal mental health for all

Creates supportive and nurturing environments

Develops skills and knowledge

Promotes mental health and prevents and intervenes early in the pathways to mental illness

Comprehensive, evidence based, integrated,

Seeks to eliminate disparities

Cross systems and multi-disciplinary ““Caring for Every

Caring for Every

Child’s Mental Health”,

Child’s Mental Health”,

All children, youth and their families All children, youth and their families

live, learn, work and participate fully in live, learn, work and participate fully in

communities where they experience joy, communities where they experience joy,

health, love and hope.health, love and hope.

Assuring the Assuring the Conditions Conditions

for Populationfor PopulationHealth-Including Health-Including

Mental HealthMental Health

Employersand Business

Academia

GovernmentalPublic Health Infrastructure

The Media

Health & Mental Health

care system

Community

Families, Primary

CaregiversIndividuals

The Mission of Public Health is to “fulfill society’s interest in assuring conditions in which people can be healthy.” (IOM) 1988

The Public Health SystemThe Public Health System for Mental Health is Complex

MCOs

Recreation

Parks

Economic Development

Mass Transit

Employers

Social Supports

Mental Health

Drug Treatment

Civic GroupsEarly

ChildhoodPromotion

and Prevention

Hospitals

EMS Community Centers

Doctors/Psyciatrists

Health Department

Faith-Communities

Philanthropist

Elected Officials

Tribal Health

Schools

Families

Fire-Police

Juvenile Justice

Environmental Health

Adapted From George R. Flores, MD, MPHCommittee on Assuring the Health of the Public in the 21st Century

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41Created by Ohio Dept of Ed

MH crucial to school successMH shared responsibilityESMH focuses on reducing barriers to

learningAll students accessAll stakeholders are involved in

development/oversight/ evaluation

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Uses evidence-based & strengths-based practices

Develops school connectednessIs sensitive to developmental,

cultural, and personal differencesFosters interdisciplinary

collaboration and coordination

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A functioning ESMH model that fits WV.

Every county with at least one ESMH program.

Trained personnel in each county to support ESMH at all levels.

A statewide reporting/performance system.

A TA center established to support and sustain ESMH.

Legislative appropriation. 44

Center For School Mental Health Action and Analyses, University of Maryland: http://csmha.umaryland.edu

Center for School Mental Health Programs, Miami University, Ohio http://www.units.muohio.edu/csbmhp/

National Assembly on School Based Health Care (NASBHC) http://nasbhc.org/

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Questions?For additional information contact:

Jackie Payne: jackiepayne@wvdhhr.org

Linda Anderson:landerson@marshall.edu