Building the Research Agenda in School Mental Health

Mark D. Weist, Ph.D.

Center for School Mental Health University of Maryland 11.05.09

Center for School Mental Health*

University of Maryland School of Medicine http://csmh.umaryland.edu

*Supported by the Maternal and Child Health Bureau, Health Resources and Services Administration, and numerous Maryland agencies

“Expanded” School Mental Health

Full continuum of effective mental health promotion and intervention for students in general and special education Reflecting a “shared agenda” involving school-family-community system partnerships Collaborating community professionals (not

outsiders

)

augment

the work of school employed staff

Fundamental Three-Part Rationale

Schools are under-resourced for mental health promotion and intervention Connections between people and traditional community mental health centers are difficult By coming together in the most universal natural setting for youth, there are advantages for both systems, and synergies enhance opportunities to achieve valued outcomes

Access Advantages

Reduced initial stigma of services Reduced burden of initial help seeking Increased likelihood of early problem identification Reduced stigma for ongoing service use Reduced burden of ongoing service use

Promotion/Prevention Advantages

Increased ability for environmental enhancement and universal prevention Enhanced ability for prevention Increased support to educational staff

Service Implementation Advantages Increased interdisciplinary collaboration Increased involvement of diverse stakeholders More efficient (and less costly) services Enhanced ability for assessment and intervention in multiple settings, enhanced maintenance/generalization

Research Supported Programs

Substance Abuse and Mental Health Service Administration’s National Registry of Effective Programs and Practices www.nrepp.samhsa.com

On October 24, 2009, 147 research supported interventions were reported, with 54 coming up with the search term “schools”

Research Supported Programs Involve Strong training Fidelity monitoring Ongoing technical assistance and coaching Administrative support Incentives Intangibles

Practice in the trenches

Involves NONE of these supports

Other Critical Issues

Contingencies related to financing Absence of accountability mechanisms School fluidity Crowded agendas in schools Jadedness of school systems and staff

Central Theme of CSMH

Bridging research and practice in school mental health to enhance the implementation of high quality, evidence-based programs leading to improvements in outcomes valued by families and schools

Four Themes in Quality Services

Systematic Quality Assessment and Improvement Family Engagement and Empowerment Modular, Evidence-Based Skill Training Implementation Support

Working Effectively with Students and Families Early on focus on engagement, e.g., through candid discussions about past experiences Emphasize empowerment and the potential for improvement Provide pragmatic support Emphasize mutual collaboration

Modular Intervention

Chorpita, B.F., & Daleiden, E.L. (2007).

2007 Biennial Report: Effective Psychosocial Intervention for Youth with Behavioral and Emotional Needs

. Child and Mental Health Division, Hawaii Department of Health (Reviews most important treatment foci for Anxiety, Attention Problems, Autism, Depression, Disruptive Behavior Disorders, Substance Use, and Traumatic Stress) http://hawaii.gov/health/mental health/camhd/library/pdf/ebs/ebs012.pdf

Anxiety: Practice Components

Exposure Modeling Cognitive/Coping Relaxation 0 97 44 39 20 31 40 60 80 100 % of EBP w/ Practice Component

Implementation Support Interactive and lively teaching Off and on-site coaching, performance assessment and feedback, emotional and administrative support Peer to peer support – User friendliness see Dean Fixsen, Karen Blasé, National Implementation Research Network (NIRN)

Another Triangle

Desired Outcomes Effective mental health promotion and intervention Outstanding staff and program qualities Ongoing training, technical assistance & support School and community buy-in and investment Resources Awareness raising, advocacy, policy improvement

A National Community of Practice CSMH and IDEA Partnership ( www.ideapartnership.org

) providing support 30 professional organizations and 13 states 12 practice groups Providing mutual support, opportunities for dialogue and collaboration Advancing

multiscale learning systems

Sign up at www.sharedwork.org

Next Meeting of the National (International) Community In conjunction with the

15 th Annual Conference on Advancing School Mental Health

Albuquerque, New Mexico October 6-9, 2010 See http://csmh.umaryland.edu

www.schoolmentalhealth.org

Website developed and maintained by the CSMH with funding from the Baltimore City Health Department and Maryland Departments of Education and Mental Health User-friendly school mental health information and resources for caregivers, teachers, clinicians, and youth

www.schoolmentalhealth.co.uk

Contact Information

Center for School Mental Health, Department of Psychiatry University of Maryland 737 W. Lombard Street, 4 th Floor Baltimore, MD 21201 PH: 410-706-0980 FX: 410-706-0984 [email protected]

http://csmh.umaryland.edu