Building a Continuum of Mental Health Supports in Schools

HEIDI CLOUTIER, MSWJOANNE MALLOY, PH.D.

UNIVERSITY OF NEW HAMPSHIRE INSTITUTE

ON DISABILITY

5/8/2019

Northeast PBIS Forum May 2019

• Why it is important to address behavioral

health and wellness in schools?

• How can we respond?

• What can you do?

• What supports and resources are available?

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Wh

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ess in

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ols? According to high school students:

▪ 13% report living with someone who has/had a problem with alcohol or drugs.

▪ 20% were offered, sold or given an illegal substance on school property.

▪ 25% report going hungry at some point because there was not enough food at home.

▪ 9% report having at least one parent or other adult in jail or prison.

▪ 14% report hearing adults in their home slap, hit, kick, punch, or hurt each other.

▪ 17% report seriously considering attempting suicide.

Schools are on the front lines.

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COMMUNITY

FAMILIES

SCHOOLS

YOUTH

Funding

Climate

Culture

Diversity

Economy

Substance Misuse

Food Security

Staffing

Scheduling

Engagement

Mental Health

ViolenceACES

Bullying

Achievement

Housing Stability

Social Emotional Skills

School Discipline

Risk Factors

Vocation

Current National Data: Principals’ Concerns

Said No Teen Ever

Youth Mental Health First Aid Training : https://www.mentalhealthfirstaid.org/take-a-course/

SAID NO TEEN EVER

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ers • High rates of exposure to trauma and

violence• High rates of behavior problems, school

discipline• Lack social resources and positive

relationships• High dropout rates• High rates of juvenile justice involvement &

incarceration• Disengaged from school, support services,

and treatment programs• Disproportionate punishment - African

American youth, youth with disabilities, Native youth

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"It takes a village

to raise a child" - African Proverb

State

Region

Community

Family

Student

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Supports for Behavioral Health &

wellness

Social Emotional Learning

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Universal Supports

for ALL- 100%✓ Focus on prevention

✓ Improves education, coping skills and

communication for ALL students

✓ Fosters pro-social behavior

✓ Encourages collaboration

among educators, families

and community-members

Representative of all staff & students

Foundational Best Practices

Explicitly Teaching Important Skills

Social skills

Relationship skills

Conflict resolution

Healthy choices/ habits, including information about brain research, drug and alcohol addiction

Coping/ stress management skills

Perseverance

Acceptance/tolerance of others

Mindfulness exercises SCHOOLWIDE

Led by Margreta Doerfler, a clinical social worker from Riverbend Community Mental Health, fourth-graders learn about mindfulness in class at Broken Ground School in Concord on Tuesday, May 16, 2017. (ELIZABETH FRANTZ / Monitor staff) http://www.concordmonitor.com/mindfulness-in-concord-elementary-schools-9654266

Universal Behavioral Health Practices

Suicide Prevention

Signs of Suicide Prevention

Universal prevention strategies are designed to reach the entire population, without regard to individual risk factors and are intended to reach a very large audience. The program is provided to everyone in the population, such as a school or grade, with a focus on risk reduction and health promotion.

Reach a broad range of adolescents

Reduces stigma

Promotes learning and resiliency in all students

Overrides implementer assumptions

https://mentalhealthscreening.org/programs/sos-signs-of-suicide

SOS Signs of Suicide® Prevention Program Goals

Decrease suicide and attempts by increasing knowledge and adaptive attitudes about depression.

Encourage individual help-seeking and help-seeking on behalf of a friend.

Reduce stigma: mental illness, like physical illness, requires treatment.

Engage parents and school staff as partners in prevention through education.

Encourage schools to develop community-based partnerships.

Connors Climbhttp://www.connorsclimb.org/

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Targeted Supports for

SOME- 15%

✓ Early identification & screening

✓ Function based supports

✓ Small group instruction

✓Additional time, intensity and

frequency of supports

Representative of some staff & students

Targeted Supports

Tier II Supports: Social or Coping Skills, Alateen, Check in –Check Out, Increased Academic Support, Parenting Engagement and Training

Turn to the person next to you and tell them 1 targeted or small group support your school is using to support the behavioral health and wellness of all students or share an idea you have for implementing a targeted/ small group support

Turn and Talk

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Intensive/ Individual

Supports for FEW - 5%

✓ Assessment based supports

✓ Driven by family and youth’s

input and needs

✓ Individualized team to monitor

student-progress frequently

Few Students or Staff

Individualized Supports

RENEW

Individualized Supports: RENEW, Wraparound, Behavior Support Plans, FBA’s, Substance Misuse Counseling, Cognitive Behavior Therapy (CBT), Dialectical Behavior Therapy (DBT), START

RENEW: Rehabilitation, Empowerment, Natural Supports, Education & Work

J O A N N E M A L L O Y

J O N A T H O N D R A K E

H E I D I C L O U T I E R

K A T H Y F R A N C O E U R

Shorter-Term Improvements In:

RENEW Facilitators Provide:

• Personal futures transition planning

• Individualized team development and facilitation

• Facilitation for career development and vocational supports

• Braided resource development

• Flexible education program

• Employment and work-based learning

• Mentoring

• Community connections

Self-DeterminationCapacity & Opportunity

Student EngagementBehavioral,

Cognitive, & Affective

Social SupportSource & Type

Longer-Term Outcomes

• Improved emotional & behavioral functioning

• School graduation

• Employment

• Community Integration

• Post-secondary Education

RENEW Theory of Change (i.e., why are we doing this?)

RENEW Goals

•High School Completion

•Employment

•Post-secondary Education

•Community Inclusion

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RENEW PRINCIPLES

•Self-Determination

•Unconditional Care

•Strengths-Based Supports

•Flexible Resources

•Natural Supports

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RENEW Strategies

•Personal Futures Planning

•Individualized Team Development and Wraparound

•Braided (individualized) Resource Development

•Flexible, or Alternative Education Programming

•Individualized School-to-Career Planning

•Naturally Supported Employment

•Mentoring

•Sustainable Community Connections

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Child & Adolescent FunctioningScale Data

RENEW Youth Average GPA, by Semester

RENEW Average Percent of Credits Earned Out of Credits Taken

School & Mental Health Partnerships•Students access RENEW either through a CommnityMental Health Facilitator at school [these are scheduled on weekly basis], or through a Middle/High school Facilitator.

•Mental Health Counselors provide consultation to teams/ teachers

•Facilitated referrals

RENEW Website www.RENEW.unh.edu

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tLike us on Facebook: https://www.facebook.com/IOD.RENEW

Follow us on Twitter: https://twitter.com/RENEW_IOD

Website: www.renew.unh.edu

For further questions please contact us at iod.renew@unh.edu

Educator Mental Health

61% of teachers reported that they were “always” or “often” dealing with high-stress over a 30-day period.

1.86 million FTE US teachers describe their mental health as “not good”.

46% are diagnosed with excessive sleepiness and 51% with poor sleep quality. Due to chronic stress and physical exhaustion, teachers commonly show biologically abnormal cortisol activity and overactive adrenal glands otherwise known as adrenal fatigue also called “burn out”

Apply Your Own Oxygen Mask Before Attending to Children

Self Care

Questions

Map out what you have in place that is working now and identify gaps

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Objectives of Our Secondary Leadership Academy

•Create a forum to discuss critical issues related to implementation of PBIS in the unique contexts of middle and high schools,

•Share best practices and implementation examples with respect to:

•Develop tools and information that will promote best practice in PBIS leadership.

•http://apbs.org/hs-academy-meeting-info.html

Next Call: June 6, 2019, 12 noon -1:30 pmTopic: Aligning community mental health supports within schools

Contact InformationName: Heidi Cloutier

Role: RENEW & MTSS Trainer, Coach

Organization: UNH Institute on Disability

Best Contact Information: ◦ Phone: (603) 228-2084 X 41

◦ Email: Heidi.Cloutier@unh.edu

Resources•California Safe and Supportive schools Culture and Climate toolkit: https://data.calschls.org/resources/ClimateConnectionToolkit_2ndedition.pdf

•Mental Health First Aid: https://www.mentalhealthfirstaid.org/

•Screening for mental health https://mentalhealthscreening.org/programs

•RENEW www.renew.unh.edu

•START https://www.centerforstartservices.org/

Resources

•Ala- Teen/ Alanon https://al-anon.org/for-members/group-resources/alateen/

•CVS https://www.cvs.com/content/prescription-drug-abuse

•CASEL SEL https://casel.org/

•NH Wraparound https://iod.unh.edu/projects/new-hampshire-wraparound-practice-model

•Operation Prevention https://www.operationprevention.com/classroom

•Technical Assistance Center for PBIS https://www.pbis.org/

•NAMI NH https://www.naminh.org/

•Youth Move NH http://www.youthmovenh.org/

•Youth Risk Behavior Survey information & data for NH schools: https://www.dhhs.nh.gov/dphs/hsdm/yrbs.htm

•Bureau of Student Wellness https://www.nhstudentwellness.org/

Resources

ReferencesLipari, R.N. and Van Horn, S.L. Children living with parents who have a substance use disorder. The CBHSQ Report: August 24, 2017. Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, MD. Retrieved from https://samhsa.gov/data/

University of Maryland School of Medicine. (n.d.) The Impact of School Mental Health: Educational, Social, Emotional, & Behavioral

Outcomes Retrieved from http://csmh.umaryl&.edu/media/SOM/Microsites/CSMH/docs/CSMH-SMH-Impact-Summary-July-2013-.pdf

Lehr, C. A., Johnson, D. R., Bremer, C. D., Cosio, A., & Thompson, M. (2004). Increasing Rates of School Completion: Moving from Policy & Research to Practice. A Manual for Policymakers, Administrators, & Educators. Essential Tools. National Center on Secondary Education & Transition, University of Minnesota (NCSET).

Bazelon Center for Mental Health Law, Fact Sheet #1 Why states & communities should implement school-wide positive behavior support integrated with mental health care www.bazelon.org

U.S. Department of Education’s Office of Special Education Programs, www.pbis.org