WVDE School Counselor Workshops
October 2, 9, and 14
2008
1
Increase awareness of current state
level efforts to define and implement a
model for expanded school mental
health services in WV.
Increase knowledge of the PATH
process.
Increase understanding of the concept
and components of an expanded school
mental health (ESMH) model from a
national perspective.
2
3
 Studies
estimate that 20% - 38% of youth need
active mental health intervention.
 Between
9-13% of youth ages 9-17 meet the
federal definition of serious emotional
disturbance (SED). (Goodman, 1997; Marsh, 2004)
 9%
(2.2 million) of adolescents 12 – 17 years
experienced at least one major depressive
episode in the past year.(SAMHSA,2006)
 Half
of all mental illness begins by age 14,
three-fourths by age 24.
4
As
few as one sixth to one third of
youth with diagnosable disorders
receive any treatment. (Burns, et al
1995; Leaf et al, 1996)

Of those who do receive treatment,
less than half receive adequate
treatment.
And
even fewer of the youth “at
risk” receive any help whatsoever.
(Weisz, 2004)
5
 Children
with chronic physical problems are
much more likely to have emotional and
behavioral health needs.
 The
WV BBHF estimates the prevalence of
serious emotional disturbance (SED) among
youth at 13% and in any given year:
-only 28% of youth with serious emotional
problems are receiving any care at all.
-This does not include youth with short term,
acute problems or those at risk
6
1994
– School-based health center
Initiative – WV Bureau for Public
Health
1999
- System of Care – SAMHSA grant –
WV Bureau Behavioral Health

2000 – School-based mental health
funding through block grant
2006
- West Virginia Behavioral Health
Commission
7
2007
WV
Bureau for Behavioral Health
and WV Dept. Of Education meet
MOU
signed by commissioners
Planning
process begins
Steering
team organized
Strategic
planning process begins
8





SOC – SAMHSA Grant
SBMH
WVCBHC
MOU
SBMH PATH (strategic
planning process)
ESMH Steering Team
9
Achievement promotes
well being
Well being promotes
achievement
Schools often acknowledge 1 but historically
have failed to acknowledge 2
10
 Typically
limited to assessment and
consultation
 Minimal
treatment only for those youth in
special education or those with 504
accommodations
 Some

students may receive brief counseling
Referrals to community settings usually do
not occur or fail (Catron, Harris,&Weiss,
1998)
11
 Is
the model by President’s New Freedom
Commission on Mental Health
 Emphasizing
shared responsibility of schools
and community
 Is
a partnership between schools and
community health/mental health
organizations.
(Weist, 1997; Weist, Paternite, & Adelsheim, 2005)

12
Build
on existing school
programs/services
Programs/services
are for all students
Include
full array of programs/services
from prevention through intensive
intervention
13
 Reduces
stigma for help-seeking(Nabors &
Reynolds, 2000);
 Promotes
generalization/maintenance of
intervention gains
 Enhances
capacity for prevention/MH
promotion
 Fosters
clinical efficiency and
productivity(Flaherty & Weist , 1999)
 Promotes
a natural, ecologically grounded
approach to helping youth and families
14
Several studies document evidence of strong
positive associations between school mental
health services, access to care, and
academic success.
 Strong
satisfaction by diverse stakeholder
groups (Nabors, Reynolds & Weist, 2000)
 Improvement
in school outcomes (e.g.,
climate, special education referrals, reduced
bullying, fewer suspensions) (Nabors,
Reynolds & Weist, 2000)
15
 Increased
student attendance and reduced
drop out rates (Drake, 1995; Schargel &
Smink, 2001; )
 Enhanced motivation and sense of
competence (Christenson, Rounds & Gorney,
1992; Grolnick & Slowiaczek, 1994)
 Increased access (Dial, et al, 2002; Weist,
Myers, Hastings, Ghuman, and Han, 1999)
16
 Increases
student connectedness to school
which is associated with improvement in
many areas including academic
performance, decreased incidence of
fighting, bullying, vandalism,
absenteeism, substance use, early sexual
engagement, disruptive behaviors, and
graduation rates and school attendance
(Blum & Libbey, 2004; CD(Blum & Libbey, 2004; CDC’s
Wingspread study, Declaration on School Connections,
2004)
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Multi
School
Assets
System
Climate
Building
PBIS
Mental
Health
Services
Student
Supports
ESMH
SAT
Family support
Safe
Social &
Emotional Evidence
Learning
Schools
Based
Shared
Agenda
School
Based
IDEA
Faculty
18
RTI
 Parent
 WVDE
Network Rep
– EBD, Healthy Schools, Counselors
 WVBBH
– Children’s Division, Substance
 African
-American churches
Abuse
 Director,
Agency
 School
Superintendent
 Marshall
 Will
Community Mental Health
TA
add others
19
20
Reduced
barriers to
learning
Improved
academic
performance
Improved
school
functioning /
behavior
Improved
Attendance
21
collaborative committed state stakeholders
 timing couldn’t be better (PCG & Behavior
Health Com. rec.)
 resources dedicated to awareness
 PBS Network relationships & connections
WV System of Care
Children’s Outreach Liaison within
comprehensives
background readiness training
Developing a Service Array Process in
DHHR
 DHHR (top-down) vs. DOE (local control)
 We haven’t selected a model or structure
 Unclear about state level role vs. local
control (Educ.)
 lack of consistent programming
 children are not historically a focus of
comprehensives
 BCF federal review in 2004-05 cited
deficiencies
nearly 50 SBHC with 2/3 have mental
health
22
Cultural attitudes
about mental health
service
array
process
time is
right to
take
action
Unclear focus for state agencies
new school
in Marion
Co. w/
Valley
beginning a
new school
year for pilot
project
children’s
outreach
liaisons
Not taking action
Willingness of school counselors and
mental health counselors to partner
(territorial issues)
Changes in education and DHHR
institutional cultures
developing a
statewide
System of
Care
Competing priorities of schools




Steering Committee
formed and functioning
 Steering Committee
drives the 5 year plan for
ESMH
Model designed
 Outcomes established
“start with the end in
mind”
Strategies for 5 year plan
implementation
Gap analysis
completed
 Illinois
PBIS Network
 Center
for School Based Mental Health
Programs – Miami University, Ohio
 Center
for School Mental Health - U of
Maryland - Baltimore
 University
of Southern Florida Research
and Training Center for Children’s Mental
Health
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 To
learn more about what currently exists
in WV’s schools
 What
agencies are in the schools and
where
 What
EBPs are being implemented
 What
are the greatest needs re MH
 What
are their top 5 MH/BH problems
26
 Survey
designed by ESMH Committee;
used similar surveys from other states
(Mass., MD)
 On
line: surveymonkey.com
 Letter
from State Superintendent to all
schools
 Data
compiled and analyzed by Marshall
University TA
27
364
schools out of 701 in the state
Schools
in 51 counties responded
Representative
in terms of regions,
demographics, and school level
28
Table 1. Response Rate by RESA and
for State
RESA
1
2
3
4
5
6
7
8
TOTAL
#
Total
%
#
Schools
Schools
Reporting Schools Reporting
45
85
53%
64
101
63%
51
111
46%
29
70
41%
36
65
55%
29
55
53%
68
131
52%
42
83
51%
364
701
52%
29
External Agencies in Schools
N=307
Community Health Center or School
Health Center
% of
Schools
20%
Behavioral Health Center
29
Regional Drug Prevention Specialist
5
Local Hospital/Health Dept
15
Private therapist/counselor/social
worker
25
No outside agencies
39
Other
19
30
Pre K –
Elementary
N=193
Mid– Jr.
High
N=84
High
School
N=68
88%
81%
59 %
254
79%
Anti Bullying Programs
77
68
45
219
68%
School-Wide Positive Behavior
Supports
51
69
48
170
53%
Other Programs
27
26
35
95
30%
Comprehensive Health Screenings
32
25
15
85
27%
Respect and Protect
15
25
18
56
18%
PRIDE Youth Programs
8
14
24
41
13%
Too Good for Drugs
12
7
0
27
8%
Suicide Prevention
1
9.5
6
15
5%
Teen Institute
3
8
4
15
5%
BABES
5
0
0
9
3%
Mental Health Screening
1
2
6
7
2%
Prevention programs
provided at the school
Developmental Guidance Lessons
State Total
Unduplicated
N=320
31
Intervention services
available
Pre K –
Elem.
Mid– Jr.
High
High
School
N=189
%
N=82
%
N=68
%
Individual Counseling/Therapy
85
85
91
85
Referrals to Community Resources
75
78
81
77
Small Group Activities
55
52
39
52
Student (Individual) Focused PBS
24
33
25
25
Staff/faculty Development
16
22
21
18
Mental Health Screening
13
20
30
18
Family Mental Health Outreach
18
10
15
17
Crisis Response
12
16
46
16
Family Counseling/Therapy
14
15
21
16
Clinical Intakes/Evaluations
11
24
18
15
4
11
12
10
0
4
8
(programs targeted to specific groups
or individual students who are
considered to be at risk)
Psychiatric Consultation
Other
State Total
Unduplicated
N=316
%
32
Problems/Needs in
School
Anger
Bullying
Emotional /MH
Attendance/Drop-Out
Family abuse/ violence
Violence
Living needs
Drug /alcohol abuse
Peer Dating
Grief Loss
Sex/Pregnancy
Smoking
Self-harm
Eating Disorders /Weight
Cultural /racial issues
Gender Identity
Suicide
N
%
232
220
177
176
140
135
112
104
56
51
49
40
22
18
16
6
0
64%
60%
49%
48%
38%
37%
31%
29%
15%
14%
13%
11%
6%
5%
4%
2%
0%
33
Increase School Counseling Services
37%
Expand Community Services in…
12%
Parent Involvement
12%
Other
11%
Better collaboration with…
8%
Improve system issues/access…
Transportation
6%
3%
Better access outside of school
4%
School based clinic/services
2%
More time with students
3%
More school staff training
2%
0%
10%
20%
30%
34
40%
 Is
a framework
 Builds
on the core services
 Recognizes
 Is
emotional /academic learning link
a shared responsibility
 Provides
the full continuum of care
 Complements,
supports and is linked with
school counselors, PBS, SOC, SBHCs and SAT
 Incorporates
a public health approach
35





Population based – organized,
interdisciplinary, scientific data
drives decisions
Promotion of mental health and
prevention of challenges or
illness. Interventions to
improve and enhance the
quality of life.
Engages the whole community
to assure the optimal physical
and mental health of children
and families.
Promotes social and emotional
well-being and the optimal
mental health for all
Creates supportive and
nurturing environments





Develops skills and knowledge
Promotes mental health and
prevents and intervenes early in
the pathways to mental illness
Comprehensive, evidence based,
integrated,
Seeks to eliminate disparities
Cross systems and multidisciplinary
Community
Governmental
Public Health
Infrastructure
Health &
Mental
Health
care system
Assuring the
Conditions
for Population
Health-Including
Mental Health
Academia
Employers
and Business
The Media
Families,
Primary
Caregivers
Individuals
The Mission of Public Health is to “fulfill society’s interest in assuring
conditions in which people can be healthy.” (IOM) 1988
The Public Health System for
Mental Health is Complex
Families
EMS
Recreation
Community
FaithJuvenile
MCOs
Centers
Communities Justice
Health
Department
Parks
Schools
Doctors/Psy Hospitals
ciatrists
Philanthropist
Elected
Officials
Social Mass Transit
Supports
Environmental
Civic Groups
Health
Early
Fire-Police
Childhood
Tribal Health
Economic
Promotion
Employers
Drug
Mental
Development
and
Treatment
Adapted Health
From George R. Flores, MD, MPH
Prevention
Committee on Assuring the Health of the Public in the 21st Century
40
Created by Ohio
Dept of Ed
41
 MH
crucial to school success
 MH
shared responsibility
 ESMH
focuses on reducing barriers to
learning
 All
students access
 All
stakeholders are involved in
development/oversight/ evaluation
42
Uses
evidence-based & strengthsbased practices
Develops
school connectedness
Is
sensitive to developmental,
cultural, and personal differences
Fosters
interdisciplinary
collaboration and coordination
43
A
functioning ESMH model that fits WV.
 Every
county with at least one ESMH
program.
 Trained
personnel in each county to
support ESMH at all levels.
A
statewide reporting/performance
system.
A
TA center established to support and
sustain ESMH.
 Legislative
appropriation.
44
 Center
For School Mental Health Action and
Analyses, University of Maryland:
http://csmha.umaryland.edu
 Center
for School Mental Health Programs,
Miami University, Ohio
http://www.units.muohio.edu/csbmhp/
 National
Assembly on School Based Health
Care (NASBHC) http://nasbhc.org/
45
Questions?
For additional information contact:
Jackie Payne:
jackiepayne@wvdhhr.org
Linda Anderson:
landerson@marshall.edu
46