Transcript 12th Annual Conference on

12th Annual Conference on
Advancing School Mental Health
What Works in Schools: Sustaining a National Community of
Practice on Collaborative School Behavioral Health October
25-27, 2007
THE IMPLEMENTATION OF POSITIVE BEHAVIORAL INTERVENTIONS (PBIS) AND
SUPPORTS IN MARYLAND’S SCHOOLS
• Andrea Alexander, Maryland State Department of
Education
• Susan Barrett, Sheppard Pratt Health System
• Phil Leaf, Johns Hopkins University
Bills in Congress aim to strengthen, coordinate PBS efforts
• State positive behavior support programs would get a boost in funding
and federal support under two proposals being considered in Congress.
They are under committee review.
• The Reducing Barriers to Learning Act of 2007 (H.R. 3419) would establish
an Office of Specialized Instructional Support Services in the Education
Department that would award grants to states to hire coordinators to
oversee specialized instructional support services, which could include all
types of related services, such as speech, behavior and counseling therapy.
• The Positive Behavior for Effective Schools Act (H.R. 3407 and S. 2111)
would add PBS language into a reauthorized NCLB, encouraging states and
districts to use Title I money for PBS efforts.
• The proposals also would amend current programs that focus on
substance abuse and violence to focus on prevention and improving
school climates through positive behaviors. These bills also propose the
creation of an Office of Specialized Instructional Support Services.
• Related service providers and supporters of PBS programs are thrilled with
the bills, both of which promise to coordinate general and special
education services aimed at improving non-academic programs that
contribute to students' academic success
Stacy Skalski, Director of Public Policy, National
Association of School Psychologists
quote from Education Week interview on
Student Mental Health: The School’s Role April 25, 2007
“There are numerous school-based interventions that
have proven effectiveness. SAMHSA has a great online
listing of evidenced based intervention model programs
for children and adolescents that can be used in schools.
Perhaps the most promising currently is Positive Behavior
Interventions and Supports (PBIS). Research on PBIS
shows that when schools engage in system wide efforts to
provide positive behavior supports, students are more
engaged and successful in school.”
What SW-PBS is…
•
Evidenced based practices imbedded in a
systems change process
•
A prevention continuum
•
A process with conceptual foundations in
Applied Behavior Analysis (ABA)
•
A framework for organizing mental health
supports and services
PBS Systems Implementation Logic
Visibility
Funding
Political
Support
Leadership Team
Active Coordination
Training
Coaching
Evaluation
Local School Teams/Demonstrations
Maryland PBIS
Partnership and Collaboration
Positive Behavioral
Interventions and Supports
Maryland State
Department of
Education
Sheppard Pratt
Health
System
Johns
Hopkins
University
Local
School
Systems
PBIS Maryland - Our 9th Year!!!
• 3.5 State
Coordinators
• 8 District
Coordinators
• 700 schools
projected to be
involved by 2010
• 2.5 million hits on
www.pbismaryland.
org since March
2006
Maryland Organizational Model
School Level
Student
– 559 PBIS Teams (one per school)
- Team leaders (one per school)
- Behavior Support Coaches (383)
District Level (24)
– Regional Coordinators
State Level
– State Leadership Team
Classroom
School
District
State
- Maryland State Department of Education (MSDE)
- Sheppard Pratt Health System
- Johns Hopkins Center for Prevention of Youth Violence
- 24 Local school districts
- Department of Juvenile Services, Mental Health Administration
– Management Team
– Advisory Group
National Level
– National PBIS Technical Assistance Center
- University of Oregon & University of Connecticut
Maryland’s Annual
PBIS Training Events
• Spring Forum
– March 27, 2007
• Coaches and New Team Institute
– Coaches ~ July 9, 2007
– Elementary ~ July 10 – 11, 2007
– Secondary ~ July 11 – 12, 2007
• Returning Team by Region
– Central Region 1 ~ July 16 – 17, 2007
– Eastern Shore ~ July 17 – 18, 2007
– Western Region ~ July 18 – 19, 2007
– Central Region 2 ~ July 19 – 20, 2007
– Southern Region ~ August 2 – 3, 2007
• Coaches Meetings (4/year)
• Regional Team Leader/Coach Meetings (2/year)
• Schools serving students with special needs - MANSEF
(2/year)
• High Schools – (2/year)
PBIS Maryland’s Evaluation Processes
Establishing Measurable Outcomes
1. What schools have been trained and are
active?
2. How well are schools implementing PBIS?
3. What impact does PBIS have on student
behavior? Achievement?
Monitoring Outcomes
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Team Implementation Checklist
SWIS
SET
Coaches Checklist
Staff Survey
Satisfaction Surveys
Implementation Phases Inventory (IPI)
Evaluation Tools
Access 2003 Database
• Data entry/storage
• Report Generation
Evaluation Tools
Maryland website www.pbismaryland.org
Various levels:
Any user
Team/coach
LSS Point of Contact
State Team
Maryland Forms Matrix
Access Database
SWIS
PBS surveys (www.pbssurveys.org)
How Well are Schools Implementing?
• Systems-wide Evaluation Tool (SET)
– Annually
– 7 Features of SW Implementation
• Implementation Phases Inventory (IPI)
– Semi-annually
– Levels of SW: Preparation, Initiation,
Implementation, and Maintenance
School-Wide Evaluation Tool
35 Coaches trained as SET assessors
15 Contractual SET assessors
•
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97 SETs completed 2004
154 SETs completed 2005
157 SETs completed 2006
104 schools have at least two SET scores
80% Total score is considered Maintenance Phase
(IPI)
• All regions met 80% criterion across schools
• 69% increase after one year of implementation
DATA
SET Scores by Region
100
88.44
92.90
86.60
95.58
91.04
80
60
42.52
40
42.00
25.00
29.00
Eastern
Southern
20
0
Central
Pre
Post
Special
Western
% at phase
11.32%
9.47%
56.05%
23.16%
Preparation
Initiation
Implementation
Maintenance
Cost Benefit:
Middle School
Base Line - Office Referrals=2277
Year One - Office Referrals=1322
Decrease in Office Referrals = 955
(42%)
Cost Benefit:
Middle School
If one Office Referral takes 15 minutes for an
administrator to process, then
955 x 15 = 14,325 minutes
238.75 hours or
40 days
of administrator time recovered and reinvested.
Cost Benefit:
Middle School
If a student misses 45 minutes of instructional
time/Office Referral, then
955 x 45 minutes=
42,975 minutes
716.25 hours or
119 days
of instructional time recovered!!!!!
Next Steps in Evaluation
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Shifting to the BOQ-MD
PBIS Plus-MD
Continuous Improvement re: forms-MD
National sharing of expertise is sustainability of
PBIS-National
• Continued funding and support of the National
Center’s ongoing research and evaluationNational
• APBS’ focus on research--National
Commonalities between SchoolBased Mental Health and SW-PBS
Shared Goals
 Success for all youth at school, home,
community
 Academic/social/emotional success
 Safe, effective, supportive learning
environments
 Systemic approaches that are prevention
based
 Culturally Relevant interventions
 Focus on building skills and building on
strengths
Shared Challenges
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Quality of the fidelity of implementation of
interventions
Low capacity for utilizing data-based decision
making
Fragmentation of efforts on behalf of youth
Few and/or inconsistent behavior practices in
schools that are proven to be effective
Environments that are “toxic” for youth with
MH challenges (in the home, school, or
community)
Shared Frustrations
 Behavior Support only structured in Special
Education
 Proactive approaches are considered and
implemented only after many failures
 Interventions are often based on what we have
instead of what the youth and family needs
 Related initiatives become new “silos” with
separate funding, training and implementation
structures (i.e RtI, SEL, SBMH…)
Efforts to Build on Existing Initiatives
in Maryland
USDE’s Mental Health Integration
Grant-Round 1
• “Grants for the Integration of Schools and Mental
Health Systems will provide funds to increase
student access to high-quality mental health care by
developing innovative approaches that link school
systems with the local mental health system.”
• Call for proposals posted in April 2005
• Grant Due in May 2005
• Notified of award in September 2005
 1 of 20 funded projects (84 total applicants)
Maryland’s Strengths
• Commitment from key local, state, and national
partners to collaborate and form an Alliance to advance
school-mental health system integration in Maryland
• Strong support for children’s mental health and school
mental health in the state
• A strong PBIS structure within the state and an interest
in enhancing mental health support and resources for
red and yellow zone youth
• State-wide needs assessment data indicated need for
additional mental health training
Required Grant Components
• Enhance collaboration between schools and mental
health systems to improve prevention, diagnosis and
treatment for students
• Enhance crisis intervention, appropriate referrals and
ongoing mental health services
• Training for school personnel and mental health
providers
• Technical assistance and consultation to the school
system, mental health agencies and families
• Provide linguistically appropriate and culturally
competent services
• Evaluate the effectiveness of increasing student access
to quality mental health services
Maryland School Mental Health
Alliance (MSMHA)
• Maryland State Department of Education
• Center for School Mental Health Analysis and Action - University
of Maryland
• Center for Prevention and Early Intervention - Johns Hopkins
University
• Governor’s Office for Children
• Maryland Assembly on School-Based Health Care
• Maryland Coalition of Families for Children’s Mental Health
• Maryland Department of Juvenile Services
• Mental Hygiene Administration Department of Health and
Mental Hygiene
• Mental Health Association of Maryland
County Integration Teams
• Comprised of families, educational staff, PBIS leaders,
child and adolescent mental health system
representatives, leaders from the Department of
Juvenile Services, and other community partners
• Responsible for pursing improved school-mental
health system integration in their county through:
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Active communication
Needs assessment
Resource sharing
Problem solving
What does my county receive?
• Train-the-Trainer Trainings for PBIS Coaches/Leaders to Enhance
Mental Health Identification and Referral and Effective Classroom
Management for Students with Mental Health Concerns
• Access to the MSMHA website
• Technical Assistance/Consultation from the CSMHA and other
Management Team Agenices/Organizations
• Newsletter Highlighting the Five County Initiative
• A Voice in Improving Mental Health Integration into PBIS Schools
in Maryland
• More Focus on Red and Yellow Zone Youth
• Resources to advance mental health identification and referral
and family involvement within the school setting
• Hopefully Improved Academic and Emotional/Behavioral
Outcomes
• Funding, $10,000
Creating and Sustaining Environments to
Support Teaching and Learning in
Baltimore City
COLLABORATIVE
COMPREHENSIVE
April Lewis, Baltimore City
Public School System
Philip J. Leaf, Ph.D. Johns
Hopkins Bloomberg School
of Public Health
COMMITTED
COORDINATED
PLAN NECESITATED BY
CORRECTIVE ACTION
MANDATED BY MSDE
BCPSS required to partner with
Johns Hopkins University,
Sheppard Pratt Health System,
Inc., or another agency
approved by MSDE to develop a
comprehensive safety plan.
BCPSS Goal 4: All students will be
educated in learning environments
that are safe, drug-free, and
conducive to learning.
While the student is the central
focus of the Baltimore City Public
School System’s (BCPSS) efforts
to create safe and supportive
schools, BCPSS chose to develop
a plan that considers the roles of
staff, families, and community
members in creating positive
learning environments.
Parameters of the Plan
The Plan…
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Focuses on changing the behaviors of adults
Recommends specific research-based strategies
Uses a multi-component approach
Includes universal prevention, targeted
prevention, and remedial efforts
• Focuses on teaching and student support
• Targets strategies at specific, identified needs
• Identifies roles and responsibilities for
implementation and establishes a system-level
management team to meet weekly to review data
Comprehensive Safety Plan Development
Collaboration and coordination are
inherent in the process…
• A written plan was developed and approved by a
Steering Committee chaired by the Student Services
Officer and Dr. Leaf (JHU Center for the Prevention of
Youth Violence) and including school system CEO,
Mayor, State’s Attorney, Police and Health
Commissioners, union representatives, community and
parent advocates, local service providers and university
faculty
• Includes workgroups work groups have school system
and non-school system co-chairs
• Implementation is concurrent with development and
emphasizes coaching and mentoring
• Involves a nine component prevention and intervention
strategy
Comprehensive Safety Plan Development
Collaboration and coordination are
inherent in the process…
• Supported training and mentoring of
school teams
• Implementation is concurrent with
development and emphasizes coaching
and mentoring
• Involves a nine component prevention
and intervention strategy
• Utilizes multiple data sources to
determine strengths, gaps, and needs
STRUCTURES TO
SUPPORT
CITYWIDE
IMPLEMENTATION
OF THE PLAN Agency Partners COLLABORATION
Academic Collaborators
Crisis Management Teams
Steering Committee
Workgroups
Management Team
DISTRICT-WIDE COORDINATION
CAO Cabinet
Executive
PCAB
Leadership
Staff Unions
Team
Office for Safe and
Supportive
Learning Environments
SCHOOLS, FAMILIES,
NEIGHBORHOODS
Crisis Management
Teams
Student Support
and School
Improvement
Teams
Student Organizations
Parent
Organizations
PBIS
Team
Community-based
Organizations
Key External Collaborators
• Johns Hopkins Center for Youth Violence
Prevention
• Baltimore Mental Health Systems, Inc.
• Family League of Baltimore City, Inc.
• Baltimore Community School Connections
• Department of Juvenile Services
• Sheppard Pratt Health System, Inc.
• Office of the State’s Attorney
• Open Society Institute
• Baltimore City Health Department
• Mayor’s Office
• Baltimore City Police Department
• Department of Social Services
• Towson University
• Maryland State Department of Education
Key Internal Collaborators
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Chief Executive and Academic Officers
School Police
Office of Teacher Principal Quality
Office of Parent Involvement and School, Family,
Community Connections
Division of Research, Evaluation, Accountability,
and Assessment
Office of Student Support Services
Suspension Services Unit
Curriculum and Instruction and Multicultural and
Diversity Programs
Related Services Unit
Office of School Improvement
Office of Early Childhood Programs
Area Officers, Principals, Teachers, and Students
Implementation Progress
• Development of Plan, Steering Committee,
Management Team, and Workgroups
• Professional development in positive behavioral
strategies given increase emphasis in system-wide
and school professional development activities
• Workshops and coaching on Data-Driven Decisionmaking and Utilization of Interventions for SSTs,
SITs, and PBIS Teams in 95 schools in school
improvement
• Strategy for sharing data between School Police and
other departments
• Conference planning for transition of youth from
Department of Juvenile Services facilities
Implementation Progress
• Expansion of PBIS
• Enhanced incentives including work
stipends for over-age students in middle
school and high school students
• Increased assessment capacity for truant
students or with juvenile justice
involvement
• Increased community support including
mentoring of students
Comprehensive Safety Plan Components
Implementation is concurrent with development…
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Data-based Decision-making
School-Family Engagement
Policies and Procedures
Curriculum and Instruction
Professional Development
Youth Development and Leadership
Intervention Services and Supports
Community Involvement
Safe Facilities
Unsafe School Choice Option
Most Sections Contain…
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A Guiding Principle;
Background Information;
Applicability to the BCPSS;
Key Implementation Tips;
Shared Roles and Responsibilities;
Recommendations for Continued
Planning; and
• Fiscal Status
THEMES…
Cut across all workgroups
• Data-based Decision-making
• Emphasis on Creating Positive
Learning Environment and
Rewording Positive Behaviors
• Family and Community Involvement
• Professional Development
• Communication
• School Police Activities Integration
into Overall Plan
Development of Action Plans
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Strategies and Activities
Timelines for Implementation
Duties and Responsibilities
Oversight Responsibilities
Identified
• Data and Evaluation Procedures
School-based Plans
• Integrated into the School Improvement Plan
• Developed by teams including parents
• Include an assessment of progress and needs
and must include/parent/family involvement
• Utilize data for effective decision-making and
resource allocation
• Should be viewed as dynamic rather than static
Resources:

(Fixen, et al, 2005)“Implementation Research: A Synthesis of the
Literature http://mim.fmhi.usf.edu

(Kutash et al, 2006) “School-based Mental Health: An Empirical
Guide for Decision-Makers” http://rtckids.fmhi.usf.edu

(Bazelon Center, 2006)“Way to Go”….School Success for Children
with Mental Health Care Needs www.bazelon.org

www.pbismaryland.org

www.pbis.org

http://csmha.umaryland.edu,
Maryland State PBIS Coordinators:
Andrea Alexander, MSDE
[email protected]
Susan Barrett, SPHS
[email protected]
Phil Leaf, JHU
[email protected]