Transcript Leading for Effective School Mental Health - SMH

School Mental Health ASSIST
Summit on Children and Youth Mental Health 2012
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Session Agenda
Activity
Overview Presentation – SMH ASSIST
Time Frame
10:00-10:45
Top 10 Carousel Rotation #1 – MH Leaders
10:50-11:20
Top 10 Carousel Rotation #2 – MH Leaders
11:25-11:55
Lunch
12:00-12:55
Top 10 Carousel Rotation #3 – MH Leaders
1:00-1:30
Top 10 Carousel Rotation #4 – MH Leaders
1:35-2:05
Closing Keynote - Dr. John Malloy
2:15-3:00
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LEADERSHIP
With an elbow
partner, or two…
What does
effective
leadership look
like at a School
or Board level?
Paint a Picture…
3
Leadership is a lever to support large
scale system improvement to enhance
achievement and well-being. The
Ontario Leadership Framework is
relevant to our work with student
mental health and well-being.
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Ontario Leadership Framework
5 Domains:
1. Setting Directions
2. Building Relationships and
Developing People
3.
Developing the
Organization
4. Leading the Instructional
Program
5. Securing Accountability
5 Core Leadership Capacities:
1.
Promoting Collaborative
Learning Cultures
2.
Aligning Resources with
Priorities
3.
Using Data
4.
Setting Goals
5.
Engaging in Courageous
Conversations
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Jot down a few
ideas….
What are some of
the qualities of an
effective leader?
Which of these
do you possess,
and value most
strongly?
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Overview
 The Promise of School Mental Health
 Provincial, National and International Initiatives
 Acknowledging Past (and present) Challenges
 Ontario’s Mental Health & Addictions Strategy
 School Mental Health ASSIST
 Top 10 Conditions for Effective School Mental Health
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The
Promise of
School
Mental
Health
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Mental Health is…
“A state of complete physical, mental, and social wellbeing, and not merely the absence of disease or
infirmity”
World Health Organization
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Mental Health Exists on a
Continuum
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Mental Health Problems are
Common
Roughly one in five
students in Canadian
schools struggle with a
mental health problem
that interferes with their
day to day functioning.
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What are Mental Health Problems?
Mental health problems are emotional, behavioural and brainrelated disturbances that interfere with development, personal
relationships, and functioning
Disturbances that are severe and persistent enough to cause
significant symptoms, distress, and impairment in one or more
areas of daily life are termed mental health disorders/mental
illness.
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Mental Health Problems include a
Range of Difficulties
Mental health problems are characterized by
many different signs and symptoms,
and present in various forms
Some mental health problems manifest outwardly (externalizing)
 Students appear aggressive, impulsive, non-compliant
Some mental health problems manifest inwardly (internalizing)
 Students appear withdrawn, lonely, anxious, depressed
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The Good News
 Proven strategies and supports
 Psychosocial and pharmacological treatments are most
common, and are often used together
 While many mental disorders are chronic, we can help with
coping
 Early identification and intervention improves prognosis
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But Most Do Not Receive the Help
They Need
 Up to 80% of children and youth who
experience a mental health problem
will not receive treatment
 Major barriers include:
 Lack of, difficulty accessing, or long
waitlists for local services
 Stigma
 Misidentification or lack of
identification of symptoms
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Schools Have a Unique Opportunity
Schools are an optimal
setting in which to:






Reduce stigma
Promote positive mental health
Build student social-emotional
learning skills
Prevent mental health
problems in high risk groups
Identify students in need
Build pathways to care
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School Mental Health
is Not New…
 Schools and communities in Canada and elsewhere have
been dealing with these issues for decades
 Inconsistent, fragmented approaches, with pockets of
excellence…
 What’s new is the galvanizing of research, policy and
practice to reach an integrated solution to a complex
problem
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Moving Forward on the Promise of School Mental Health
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OUT OF THE SHADOWS AT LAST
The Standing Senate Committee on Social Affairs, Science and
Technology
The Honourable Michael J. L. Kirby, Chair
May 2006
Making the school a site for the effective
delivery of mental health services involves
several key steps. First, its potential must
be recognized.
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National Initiatives
Related to School Mental Health
 School-Based Mental Health & Substance Abuse Consortium
 Canada’s Mental Health Strategy (MHCC)
 Evergreen
 National Infant Child & Youth Mental Health Consortium
 Opening Minds
 Joint Consortium for School Health
 Public Health Agency of Canada
 Canadian Association for School Health
 Health Canada
 Canadian Centre for Substance Abuse
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SBMHSA Consortium
 40 member team of researchers, education professionals, school
mental health professionals, etc.
 3 year project
 Led by Ontario Centre of Excellence for Child & Youth Mental Health
 Synthesis of Research
 Scan of Nominated Practices
 National Survey
Findings:
 Research gives us clear direction
 Programming does not consistently reflect research
 Organizational and systemic barriers impede
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International Initiatives
in School Mental Health
 International Alliance for Child and Adolescent Mental Health in
Schools (Intercamhs) http://www.intercamhs.net/
 US – Canada Alliance for School Mental Health
 SBMHSA webinar - international initiatives (Aus, Germany, US)
 Advances in School Mental Health Promotion
 Key international conferences featuring School Mental Health
 17th Annual Conference on Advancing School Mental Health, October
25-27, Salt Lake City, Utah --- see Mark Weist at CMHO!
 26th Annual Children’s Mental Health Research and Policy Conference,
March 3-6, Tampa, Florida
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Provincial Initiatives in
School Mental Health
 Emergence of government strategies (e.g., BC, MN, NS, ON)
 Development of provincial coalitions (e.g., BC, ON)
 Funded provincial initiatives related to mental health
capacity building (e.g., AB, QB, NS, ON)
 Cross-sectoral initiatives, infrastructure, protocols (e.g., BC, NB,
ON)
 Student mental health in provincial curriculum
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Learning from past and present
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Taking Mental Health to School
 Different models of mental health service delivery across Ontario
boards (Taking Mental Health to School, 2009)
 Variable leadership structures, levels/types of professional support,
relationship with community, range of services
 Acknowledgement of promising supports (e.g., Student Support
Leadership Initiative)
 Need for
 leadership,
 coordination,
 access to evidence-based approaches,
 implementation support,
 evaluation
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Past (present) Systemic Challenges
 School boards are complex systems
 Infrastructure, processes and protocols lacking
 Lack of clarity re: roles and responsibilities
 Special services are…special
 Inconsistencies across Boards with respect to:
 Leadership
 Programming
 Funding
 Access to services
 Collaboration
Structural Challenges
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Past (present) Systemic Challenges
 Mental Health is not well understood
 Not traditionally part of educator training
 PD as a “one time event”
 Links to high pressure achievement agenda unclear
 Stigma, Attitudinal Biases
 Discomfort and fear
 Sometimes seen as outside of educator role
 Worry about making a mistake, getting too close
Knowledge Challenges
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Mental Health Literacy
Concern about Mental Health…
100
90
80
70
60
50
40
30
20
10
0
not at all
a little
somewhat
very
extremely
Educator Preparedness…
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Past (present) Systemic Challenges
 Inconsistent access to high-quality programming
 Evidence-based programs are expensive
 Regional differences (in services, access, needs)
 Funding shortfalls
 Competing demands
 Academic achievement agenda, with inherent pressures and
supports, occupy most of time
 Plates are full and increasing
 Fragmented systems
 Service pathways and protocols are not well-defined
Implementation Challenges
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Ontario Ministry of Education
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Strategy Priorities for the Next 3 Years
Fast Access to High
Quality Services
•Build capacity in the
community-based sector
•Reduce wait times
•Meet community needs
•Link education, child and
youth mental health,
youth justice, health
care, and the community
Identify & Intervene Early
•Provide tools and support
to those in contact with
children and youth so
they can identify mental
health issues sooner
•Provide resources for
effective responses to
mental health issues
•Build mental health
literacy and local
leadership
Close Critical Service Gaps
•Increase availability of
culturally appropriate
services and serve more
children and youth
• in Aboriginal, remote and
underserved
communities
• With complex mental
health needs
• At the key transition
point from secondary to
post-secondary education
Support System Change
• Support development of an effective and accountable service system for all Ontarians
• Build on efforts that promote evidence-informed practice, collaboration, and efficiencies
• Develop standards and tools to better measure outcomes for children and youth
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INDICATORS
THEMES
OVERVIEW OF THE MENTAL HEALTH &
ADDICTIONS STRATEGY
- Mental
FIRST
3 YEARS
Starting with Child and Youth
Health
Our Vision:
An Ontario in which children and youth mental
healthand
is recognized
a key
determinantClose
of overall
health
andgaps
well-being,
and where
Identify
intervene inaskids’
mental
critical
service
for vulnerable
Provide fast access to high quality
children and
youth
reach
their
full
potential.
health needs early
kids, kids in key transitions, and those in
service
remote communities
Professionals in community-based child and youth
Kids and families will know where to go to get what
they need and services will be available to respond
in a timely way.
• Reduced child and youth suicides/suicide
attempts
• Higher graduation rates
• Educational progress (EQAO)
• More professionals trained to identify
kids’ mental health needs
• Fewer school suspensions and/or
expulsions
• Higher parent satisfaction in services
received
Improve public access to
service information
INITIATIVES
mental health agencies and teachers will learn how to
identify and respond to the mental health needs of kids.
Pilot Family Support
Navigator model
Y1 pilot
Implement Working
Together for Kids’
Mental Health
Kids will receive the type of specialized service they need
and it will be culturally appropriate
• Fewer hospital (ER) admissions and
readmissions for child and youth mental
health
• Decrease in inpatient admission rates
• Decrease in severity of mental health
issues through treatment
for child and youth mental health
Implement
standardized tools for
outcomes and needs
assessment
• Reduced Wait Times
Enhance and expand
Telepsychiatry model
and services
Provide support at key
transition points
Funding to increase supply
of child and youth mental
health professionals
Increase Youth Mental
Health Court Workers
Amend education
curriculum to cover
mental health promotion
and address stigma
Develop K-12 resource
guide for educators
Hire new Aboriginal workers
Implement Aboriginal Mental
Health Worker Training
Program
Improve service
coordination for high needs
kids, youth and families
Reduce wait times for service,
revise service contracting,
standards, and reporting
Outcomes, indicators and
development of scorecard
Implement School
Mental Health ASSIST
program &mental health
literacy provincially
Provide designated
mental health
workers in schools
Expand inpatient/outpatient
services for child and youth
eating disorders
Hire Nurse Practitioners for
eating disorders program
Implement Mental
Health Leaders in
selected School Boards
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Provide nurses in schools
to support mental health
services
Create 18 service
collaboratives
Strategy Evaluation
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Interconnected Initiatives
Community
Settings
Health Care
Settings
School Boards
MCYS
MH Workers with Schools
Working Together
Student Support Leadership
Initiative (SSLI)
MOHLTC
Nurse Leaders
MHA Nurses in DSB program
Service Collaboratives
SSLI
EDU
SMH ASSIST
SSLI
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EDU Strategy Commitments
 Amend the education curriculum
 Develop a K-12 Resource Guide/Website
 Provide support for professional learning in mental
health for all Ontario educators
 Fund and support Mental Health Leaders
 Implement School Mental Health ASSIST
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School Mental Health
ASSIST
is a provincial implementation
support team designed to help
Ontario school boards to promote
student mental health and wellbeing, through leadership, practical
resources and systematic researchbased approaches to school mental
health.
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Leadership Structure

Ontario Ministry of Education Lead


School Board Lead


Hamilton-Wentworth District School Board
SMH ASSIST Core Team


Special Education Policy & Programs Branch
Director, and 4+ P/T Implementation Coaches (3 Senior School Mental Health
Professionals, 1 Superintendent),.5 Research Associate (new!)
Cross-Sector Partners



Interministerial Staff Team
Hospital for Sick Children, Ontario Centre of Excellence for Child & Youth MH
Provincial Stakeholder Organizations
 Evaluation and Implementation Consultation Team

Drs. Michael Boyle, Bruce Ferguson, Tom Kratochwill, Robert Lucio, Ian Manion,
Doris McWhorter, Karen Milligan, Caroline Parkin, Joyce Sebian, Mark Weist
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Support to ALL Ontario Boards
Resources
• Webinar series, other staff
development materials
• Decision support tools
• Templates
• School Administrators’ Toolkit
Consultation
Workshops
Representation on
provincial reference groups
& committees
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Focus Boards
 15 Focus Boards in 2011-2012
 Another 15 announced for 2012-2013
 Boards receive 1 FTE Mental Health Leader and SMH ASSIST
support
 Reciprocal relationship with SMH ASSIST
 ASSIST provides leadership & implementation support
 Focus Boards help with piloting resources that will be rolled out
to all boards in time
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First Priorities
1. Organizational Conditions for
Effective School Mental Health
(addressing structural challenges)
2. Mental Health Capacity-Building
(addressing knowledge challenges)
3. Implementation of Evidence-Based
Mental Health Promotion and
Prevention Programming
(addressing implementation challenges)
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Organizational Conditions for
Effective School Mental Health
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Organizational Conditions
1.
Commitment
2.
School Mental Health
Leadership Team
3.
6.
Standard Processes
7.
PD Protocols
8.
School Mental Health
Clear & Focused Vision
4.
Shared Language
5.
Assessment of Initial
Capacity
Strategy / Action Plan
9.
Broad Collaboration
10.
Ongoing Quality
Improvement
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Self Reflection
 Where is your board currently, TODAY, along
each of the conditions…
 Feel free to discuss, leave blank…
 For your records…
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Condition #1
Commitment
 Board leaders view child and youth mental health
as a priority, and communicate this through action
 Board leaders commit to Tiered Support Model
 Help board staff to understand the rationale for the model,
emphasizing the focus in schools on mental health promotion and
prevention and the need to work with community partners for help
with students with significant mental health concerns
 Board leaders consistently attend community
liaison meetings and internal MH team meetings
 Board leaders provide visible, strategic and tangible
support for needed infrastructure, resources,
staffing
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Tiered Support in Systems of Care
E-B Clinical
Intervention
Community
Evidence-Based Clinical
Intervention
Targeted
Evidence-Based
Prevention
Universal Evidence-Based
Mental Health Promotion, SocialEmotional Learning
School Districts
Targeted EvidenceBased Prevention
Universal E-B Mental
Health Promotion
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School Mental Health Leadership Team
Condition #2
 Board has a multidisciplinary, multi-layered
mental health leadership team
 All of the right people are at the table (in terms
of expertise, influence, relationships,
representation)
 Parent and youth voice are critical
 Team has meaningful liaison with community
partners
 Team is focused on vision-setting, leadership,
collaboration, strategy/program selection,
problem-solving
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Condition #3
Clear and Focused Vision
 Board has shared, realistic goals
 Vision is aligned with AOP, BIPSA, Strategic
Directions
 Vision is aligned with key principles in
school mental health (e.g., preventive,
linked with instruction, evidence-based,
connected with partners at home and
school, strong use of data)
 Vision and goals are created collaboratively
 Vision is the basis for decision-making
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Condition #4
Shared Language
 The Board Vision for school mental health is
communicated clearly across the organization
 Foundational knowledge about student mental
health is conveyed
 Terms are defined consistently
 Where differences in language occur (e.g.,
across sectors), there is translation
 Use of early identification tools can be helpful
for finding common ways to speak of problem
areas
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Condition #5
Assessment of Initial Capacity
 Assessment data informs the development of
the board mental health strategy
 Before setting priorities, an assessment of
organizational strengths, needs, and resources
(resource mapping) can be very helpful
 This assessment includes a scan of resources,
in the form of people, processes, and programs
 Staff and student voice data can deepen
understanding of needs
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Condition #6
Standard Processes
 Board has standard processes for school
mental health:
 Who does what (role clarification)
 Selection of school and classroom evidencebased programs
 Delivery of training and coaching on programs
and strategies
 Standards and tools for monitoring progress
 Partnerships with community
 Pathways to service
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Condition #7
Protocols for Professional
Development
 Board has a systematic approach to capacity
building in mental health that includes:
 Mental Health Awareness for all
 Mental Health Literacy for those with students
 Mental Health Expertise for those delivering specialized assessment
& intervention services
 High quality training protocols, delivered by an
engaging expert
 Job-embedded, with ongoing coaching
Tools + Training + Technical Assistance + Quality Assurance
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Condition #8
Mental Health Strategy / Action Plan
 The Board Mental Health Strategy is aligned with
system goals
 The Strategy is founded on evidence-based
practices in school mental health
 The Strategy is tailored to local context and data
with respect to board needs and strengths
 The Strategy is focused on measureable outcomes
 An implementation support plan is clearly
articulated
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Condition #9
Broad Collaboration
 The Board has several established platforms for
dialogue and collaboration:
 Across departments and schools
 With community and health agencies
 With universities and other research
organizations
 With parents
 With students
 With other boards
 With government
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Condition #10
Ongoing Quality Improvement
The board has a system of ongoing quality
improvement, that includes measurement:
 Of program / strategy implementation
 Of teacher perceptions and knowledge
 Of student perceptions and knowledge
 Of student outcomes
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Visit SMH ASSIST
http://smh-assist.ca/
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Kathy Short, Ph.D., C.Psych.
Director, School Mental Health ASSIST
[email protected]
905-527-5092, x2634
School Mental Health
ASSIST
Questions???
Équipe d’appui en santé mentale pour les écoles
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