Transcript Preventive Services Improvement Initiative

School Mental Health
Capacity Building Partnership
Oregon Stakeholder Discussion Groups
A project funded through a Cooperative Agreement with the
Centers for Disease Control and Prevention,
Division of Adolescent and School Health (DASH)
Promoting School Mental Health
through Capacity Building
to
State and Local Education
Agencies (SEAs and LEAs)
Goal 1: Strengthening Intersections

Strengthen collaborative national efforts to
improve mental health services in schools
by increasing intersections between mental
health, health, and schools.
Goal 2: Fact finding and Organizing

Develop, organize, and synthesize key
documents and resources related to best
practices for SEA and LEA improvement
and expansion of effective SMH services.
Goal 3: Capacity Building
Using fact finding knowledge, materials, and
resources developed in Goals 1 & 2…

Provide technical assistance, resources,
and professional development to aid
SEAs and LEAs in implementing
effective school mental health programs.
Statewide Stakeholder Discussion
Groups: PURPOSE
To gain a deeper understanding of how
school mental health works at the state and
local level
 Through these groups, we learned about
successes, challenges, and “lessons
learned” related to school mental health
policies, programs, and services

Statewide Stakeholder Discussion
Groups: PROCESS

Four “early adopter” states selected

Selection criteria:
– Shared mental health/education/family agenda
– Strong state level collaboration
– Vision of how to integrate health into school mental
health agenda

Four discussion groups per state
– Three with state and local leaders in education, family
advocacy, health, and mental health
– One youth only discussion group
SBHC’s & Early Adopter States
Oregon
Ohio
Missouri
STAKEHOLDER
DISCUSSION GROUPS:
Ohio: December 2006
Maryland: February 2007
Missouri: May 2007
Oregon: August 2007
Maryland
Oregon Stakeholder
Discussion Groups
Adult Discussion Groups
Process:

August 14th and 15th, 2007

Three 2-hour discussion groups
– Two school mental health stakeholder groups (Salem, Portland)
– One Coordinated School Health Group (Monmouth)

32 total participants
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Education: 12
Health: 9
Mental Health/Social Services: 7
Youth development: 2
Family members/advocates: 1
Business 1
Results

Responses to Questions
– Themes
– Key Quotations

Challenges

Opportunities
Participant awareness of Oregon’s vision
or agenda for school mental health
The school mental health vision varies
greatly, reflecting how mental health
services in Oregon vary greatly by county.
 While the Children’s System Change
Initiative reflects a vision of mental health
for Oregon’s youth, it has not been fully
implemented, and it is not inclusive of all
youth.

What would make it a stronger
agenda?
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Additional, blended funding
Statewide summit of legislators and
policymakers
Financial incentives to schools to implement
school mental health
Wraparound services
Increased family involvement; incentives to
work with families
Public relations/social marketing campaign
Efforts to de-stigmatize and demystify mental
health
What would make it a stronger
agenda? (cont.)
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Legislation supporting both public health and
mental health
Educating teachers about early identification and
referral
Full-time mental health provider in each school
State guidelines for mental health in
schools/school-based health centers
Mechanisms for prioritization
Research/Data
More school-based health centers
More school nurses
What would make it a stronger
agenda? (cont.)
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Partnership between schools and community
resources to reduce burden on schools
Comprehensive models that include positive
behavior support and integrate academic
support
Enhanced focus on prevention
Mental health training in higher education
curriculum for educators
Coordination of efforts
Communication systems for sharing
information
More consideration of diverse cultures
State funding
Major Themes

Memoranda of Understanding (MOUs)
between schools and community
providers promote mental health services
in schools, but are often challenged by
issues of FERPA/HIPAA.

Schools need to be informed about issues
of legality related to mental health
services, in order to reduce the fear
associated with addressing these issues.
Major Themes (cont.)

Efforts to bridge the gap between
educators and mental health providers,
including role clarification and
interdisciplinary training, is critical to
breaking down communication barriers.

Family organization and engagement
needs to be strengthened in Oregon which
includes schools adopting a familycentered approach.
Major Themes (cont.)

There is a need for a public relations campaign
to advance the school mental health agenda.

All schools would benefit from at least one fulltime, school-based mental health provider.

Coordination of school and community-based
mental health efforts is strengthened by the
presence of a case manager or counselor familiar
with the array of available services, as well as by
the presence of behavioral teams involving
multiple stakeholders.
Challenges

Public health and mental health in Oregon
are not well coordinated at the state level,
and the coordination varies greatly across
regions.
 School-based health centers have been part
of Oregon’s school mental health agenda,
but have not systematically included
mental health and have not always been
promoted due to lack of funding and/or
misconceptions about their purpose.
Challenges (cont.)

Oregon’s school mental health efforts often
exclude youth who do not receive
Medicaid.

There is significant difficulty recruiting
and hiring a workforce that represents the
community.
Challenges (cont.)


Understanding what is happening in
Oregon related to school mental health is
challenging, and requires identifying “the
right people”.
Despite several legislative and other efforts
to advance evidence-based practices, there
is not consensus on the definition of
evidence-based practices and there is a
lack of accountability and monitoring of
the use of evidence-based practices.
Opportunities

Oregon’s leadership in the “Wraparound”
framework presents a critical opportunity
to advance school mental health efforts,
and serves as a model for successful youth
and family engagement.

A statewide summit of stakeholders,
legislators, and policymakers would
inform the decision-makers about best
practices and resource allocation related to
school mental health.
Opportunities (cont.)

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Increased partnerships between schools, families,
and communities would strengthen school mental
health efforts and reduce the burden on schools.
Youth engagement models, including a new
model for “action research” could be applied to
the school mental health field.
School-based health centers, funded through
public health, reflect a model of coordinating
between health and mental health.
Opportunities (cont.)

Oregon has utilized several strategies to successfully
meet the needs of students from diverse cultural
backgrounds, including
– hiring bilingual staff
– using interpreters
– conducting in-home parent and family mental health training to
families with Limited English Proficiency
– providing mental health training to front-line school staff
– utilizing family resource centers and a home-school contact
person.

Oregon’s Positive Behavioral Supports and Response to
Intervention efforts may be linked to offer a
comprehensive model of school mental health.
Oregon Youth
Discussion Groups
Youth Discussion Groups
Purpose:

To identify, from a youth perspective, the
most effective strategies for providing
mental health services in schools and for
engaging youth in the development of
school mental health policies and
programs.
Youth Discussion Group: Method
August 13, 2007
 One 1.5-hour discussion group
 Six students; Grades 9-12; four schools
 Four students identified as having
emotional disabilities
 Recruited from Oregon Family Support
Network and Columbia River Wrap
Around
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Youth Discussion Groups:
Process
SAMPLE QUESTIONS:
1.
2.
3.
How can adults at your school make all
students feel supported both in school as well
as other areas of their life?
What can schools do to better understand the
different cultures or backgrounds a student
comes from?
How well do you think that adults in your
school respond to students with mental health
problems?
Youth Discussion Groups:
Major Themes
School mental health prevention/promotion:
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Schools can improve the physical environment
by making the school more colorful and the
classroom more comfortable.
Adults should not hold biases or judge youth.
Teachers should engage students more in
discussion.
Teachers who speak more openly with students
and ask questions seem to have a better
understanding of cultures.
Youth Discussion Groups:
Major Themes
Staff Development:
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Adults have a better understanding of physical
health problems than of mental health
problems.
Teachers should try to understand students with
mental health problems.
Adults should make sure that students with
mental health problems don’t get picked on.
Teachers should receive mental health training
and have access to a mental health consultant.
Youth Discussion Groups:
Major Themes
Mental Health Services
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not believing it is confidential
lack of availability of a professional
perception that counselors are for academic (not mental health)
problems.
Students would prefer to go to someone they
trust to talk about a problem.
Keeping confidentiality is important unless:
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Barriers to accessing counseling services
include:
a student gives specific permission to tell someone, or
if student makes a direct threat to someone’s life or their own
life
Youth Discussion Groups:
Major Themes
Benefits of extracurricular activities include:
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Feeling good about helping others
They have improved self esteem
Gaining a new perspective
Leadership Opportunities
Students are more likely to participate in adult
led activities when:
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there are incentives (e.g. food, money, activities)
interactive activities
when their friends are participating
Bringing Health Care to Schools for Student Success
Laura Hurwitz
Director, School Mental Health Programs
[email protected]
202-638-5872, x205
1-888-286-8727 - toll free