Interconnected Systems Framework
Local Implementation Sites
Experiences and Lessons Learned
Lucille Eber, Illinois PBIS Network
Jill Johnson, Illinois PBIS Network
Kelly Perales, Community Care Behavioral Health
Bob Stevens, Charleston South Carolina
Mark Weist, University of South Carolina
October 25, 2012
Center for School Mental Health
National Conference

• How Multi-tiered Systems of Support
(MTSS) can enhance mental health in schools
• Installing SMH through MTSS in Schools
• The Interconnected Systems Framework
(ISF)

• One in 5 youth have a MH “ condition ”
• About 70% of those get no treatment
• School is “ defacto ” MH provider
• JJ system is next level of system default
• Suicide is 4th leading cause of death among young adults

• At least twice as many youth need high levels of support than identified as EBD.
• Youth who are identified as EBD have experienced very poor outcomes
• Schools can’t do it alone; partnerships with communities are needed for success

Advancing Education Effectiveness:
Interconnecting School Mental Health
& School-wide Positive Behavior Support
June 2012 – September 2013
Collaborative effort of the OSEP TA Center of PBIS,
Center for School Mental Health, and IDEA
Partnership(NASDE) bringing together national-level experts in the SMH and PBIS, state and district leaders, and selected personnel from exemplar sites currently implementing collaborative initiatives.

Advancing Education Effectiveness:
Interconnecting School Mental Health
& School-wide Positive Behavior Support (cont.)
Publish a monograph that provides a summary and framework for interconnection, documents examples of success, and lays out a research, policy, and technical assistance agenda for the future.

• Over 18,000 schools engaged in implementation of SWPBIS (MTSS ) prevention based system
• Current focus on capacity to scale-up
• MTSS as platform to install effective interventions for youth w/or at-risk of EBD

(cont.)
• Emphasis now on scaling with expansion and connection to other systems
– i.e. academic, juvenile justice, mental health
• Emphasis on deliberate actions that foster connections w/families & community

• Full continuum of effective mental health promotion and intervention for ALL students
• Reflecting a “shared agenda” involving school-family-community partnerships
• Collaborating community professionals (augment the work of school-employed staff

Positive Behavior Intervention and Support
(www.pbis.org)
• Decision making framework to guide selection and implementation of best practices for improving academic /behavioral functioning
• Data-based, measurable outcomes, evidencebased practices, systems to support effective implementation

• Investment in prevention, screening and early intervention for students not at “benchmark”
• Multi-tiered intervention approach
• Use of progress monitoring and problem-solving process at all 3-tiers
• Research-based practices and active use of data for decision-making at all 3-tiers
• Use of progress monitoring and problem-solving process at all 3-tiers

– structure and process for education and mental health systems to interact in most effective and efficient way.
– key stakeholders in education and mental health system who have the authority to reallocate resources, change role and function of staff, and change policy.
– strong interdisciplinary, cross-system collaboration.
– tiered prevention logic as the overall organizer to develop an action plan.
– cross system problem solving teams that use data to decide which evidence based practices to implement.
– ongoing progress monitoring for both fidelity and impact.
– active involvement by youth, families, and other school and community stakeholders.

Structure for Developing an ISF:
A District/Community leadership that includes families, develops, supports and monitors a plan that includes:
– Community partners participating in all three levels of systems teaming in schools: Universal, Secondary, and
Tertiary
– Team of SFC partners review data and design interventions that are evidence-based and can be progress monitored
– MH providers from both school and community develop, facilitate, coordinate and monitor all interventions through one structure


• Each school works out their own plan with Mental
Health (MH) agency;
• District has a plan for integrating MH at all buildings
(based on community data as well as school data);


• A MH counselor is housed in a school building 1 day a week to
“see” students;
• MH person participates in teams at all 3 tiers;


• No data to decide on or monitor interventions;
• MH person leads group or individual interventions based on data;

Jill Mathews-Johnson, MSW, LCSW
IL PBIS Network jill.johnson@pbisillinois.org

• Exploration and Adoption
• Installation Phase
• Initial Implementation
• Full Implementation
• Innovation and Sustainability
Fixsen, 2010

• Youth and Family Service Director and IL PBIS
TAC passion for ISF
– Relationship built four years earlier in writing a
SSHS grant in Urbana
• SAMSHA grant, Champaign County
• Local leaders and administrators belief in need for integration to address all students’ needs

Exploration and Adoption
• At the building level
– Admin team was meeting weekly and looking at the data to determine needs
• Gaps were identified – mental health
– Administrators, Community Elements Director for Youth
Services and PBIS TAC met to determine intervention to meet needs and continued meeting every few weeks to set up system features
– Secondary Systems Team was formed

Administrative
Team Centennial
HS &
Secondary Systems
Team
Liaisons
Jill & Juli
Community
Elements
(United Way/708
Board/ACCESS

• SPARCS – Structured Psychotherapy for
Adolescents Responding to Chronic Stress
– Mission of SPARCS: To enhance trauma focused services available to traumatized children and adolescents (complex trauma)
– Group members – history of chronic interpersonal trauma, living with significant ongoing stressors, may or may not meet full criteria for PTSD and exhibit functional impairment. http://sparcstraining.com/

SPARCS
• Evidenced informed intervention
• 16-one hour groups
• Adolescents 12-21
• History of trauma (broadly defined)
• Living with ongoing stressors
• Exhibit functional impairment
• Trauma Screening (TESI)

• Exploration and Adoption
• Installation Phase
• Initial Implementation
• Full Implementation
• Innovation and Sustainability

Systems Features
– Community mental health staff (Director and Program
Coordinator) with the assistance of the PBIS TAC set up meetings with key school administrators (Principal, AP’s) to introduce SPARCS to them
• Follow-up meetings periodically to deal with larger system issues
– PowerPoint presentation of key program features presented to admins, school social workers, school psychologist and counselors
• Shifting of school-based staff roles/responsibilities discussed

– Discussion of potential target population and how data would be used to identify students
– Discussion on how referral process to community provider would happen and who would communicate with student’s parents
– Referral form and program flyers developed for school staff to share with parents
– One school contact person was identified for on-going communication
(mostly by email) and problem solving as issues arose
• This person was key as she was responsive and reliable
– Community Elements workers were added to secondary systems team

Organizational Structures
Identifying Students with Needs
• Data-based Decision Rules for Entrance
– At Centennial, students are referred for SPARCS because they are freshman/freshman status and
• They have been through two tier two interventions and have not responded
• They are READY (alternative school) students transitioning back to Centennial**
• They have had multiple SASS contacts
• Meet criteria for trauma experience as screened using the TESI-SR (
Traumatic Events Screening Inventory-Self Report)
** READY, Juvenile Detention & MH providers also providing across the community

Organizational Structures
Funding
• SAMHSA SOC Cooperative Agreement
– ACCESS Initiative
• United Way of Champaign County
• Medicaid billing (future)
• Probation/Court Services (future

Organizational Structure
Assessing Personnel Skills/Talents
• Community Elements personnel hired specifically to provide school-based supports
• School-based staff, with behavioral background, are present during group
• SPARCS trained
– Ongoing support by national SPARCS trainers

• Exploration and Adoption
• Installation Phase
• Initial Implementation
• Full Implementation
• Innovation and Sustainability

System Features
• Secondary Systems Team meetings
– Meeting twice a month
• to talk through systems response
• to work through system implementation issues
• to build rapport and building relationship
• to communicate and implement with fidelity
• Liaisons that understand and can build relationships between the two systems

Systems Features
– The school staff initiated the referrals to the program by first identifying appropriate youth, contacting parents and receiving permission to provide student’s name to community provider
– Community mental health staff completed all intake paperwork and screenings with students/families and subsequent follow-up information
– School staff made sure each student arrived to the group on time
– Community mental health works facilitated groups and one school social worker sat in on the groups to assist with any issues as they may be related to school policy and staying connected with the students
– School staff tracked data to report at year end

• School
– ODRs
– ISS
– OSS
– Credits/Grades
– Attendance
– Additional SASS calls (future)
• Mental Health
– Youth group survey results
– (2012-2013) Strengths and Difficulties Questionaire, TESI-R and YOQ

7
6
5
4
1
0
3
2
10
9
8
100%↑
Student 1
School Data – Office Discipline Referrals
ODR Comparison 14 Weeks Before Intervention and 14 Weeks on Intervention
45%↓
Student 2
23%↓
25%↓
Student 4
66%↓
Student 5
37%
Reduction
Overall
Student 3
Students
ODR Total 14 Weeks Before Intervention
ODR Total 14 Weeks On Intervention

15
10
5
0
25
20
School Data – In-School and Out-of-School Suspension
ISS and OSS 14 Weeks Before vs 14 Weeks During Intervention for
Group
23%↓
25% ↓
Total Number ISS Total Number OSS
Offenses
Before
After

School Data – Tardies and Absences
70
60
50
40
30
20
10
0
Unexcused Tardies by
Semester
First Semester
Unexcused Tardies
Second Semester
Unexcused Tardies
Students
30
25
20
15
10
5
0
Absences by Semester
Excused and Unexcused
First Semester
Absences
Second Semester
Absences
Students

School Data - Grades
3
2
1
0
5
4
Student 1 Grades by
Semester
3
2
1
0
5
4
A B C
Grades
D F
Student 4 Grades by
Semester
Total Semester 1
Total Semester 2
10
Student 3 Grades by
Semester
5
0
A B C D F
Grades
Total Semester
1
Total Semester
2
4
3
2
1
0
Total Semester 1
Total Semester 2
A B C
Grades
D F
A
Student 2 Grades by
Semester
B C
Grades
D F
Total Semester 1
Total Semester 2
0
5
Student 5 Grades by
Semester
A B C D F
Grades
Total Semester
1
Total Semester
2

• Mental Health Providers
– Positives
• Being part of Tier II team helpful
• Having school staff facilitate arrival/departures from group very helpful
– Future Improvements
• Need to improve communication with school staff when events occur with students in group
• Having one dedicated administrator is essential to coordination
• Need more time prior to group start to get to know students/families

Student Survey Results
1=strongly agree 2=disagree 3= don’t know 4=agree 5=strongly agree
Skills were helpful to me: a) Mindfulness 3.8
b) Self-sooth/distract 4.4
c) LET ‘M GO d) MAKE A LINK
4.0
4.2
Have used skills outside of group 4.4

• What was the best part of group?
 “It helped me to make better choices and not get into trouble”
 “That you can talk about stress level and feelings”
 “It allowed me to share”
 “It helped me to identify my sources of anger”
 “I liked that it had structure, that we had a lesson plan that we followed and I liked the handbook”
 “Food”

• Exploration and Adoption
• Installation Phase
• Initial Implementation
• Full Implementation
• Innovation and Sustainability

• Feeder middle school
• Other Champaign high school
• Alternative school (that Centennial refers out to or receives students back from
• Additional sites in: Rantoul and Urbana

SPARCS

Lessons Learned
• Stakeholders
Decision
Makers
Field
Staff
Student
Outcomes
Liaisons
Administrators • Liaisons who:
– understand both systems
– are open to integration
– have “power” in at least one system

Lessons Learned
• Schedule meetings with stakeholders
– Bi-monthly “Secondary Systems” meetings
– Monthly/Quarterly administrative meetings
• Allows all stakeholders to have voice
• Keeps communication lines open
• Establish procedures and protocols
• System where academic and behavior interventions linked
• Create true partnerships
– Stakeholders need to be seen as viable members in both settings (team membership, professional development)
• Student and family voice
• Make interventions sustainable
– Funding
– Part of system of support

PAPBS Network
Tertiary Demonstration Project
• Community Care as affiliated partner in the PA
Positive Behavior Support (PBS) Network
• History of PA SBBH Community of Practice
• History of Community Care transformation of children’s behavioral health services

Pennsylvania’s Community of Practice (CoP) on
School Based Behavioral Health (SBBH)
The CoP on SBBH was initially established in 2006 through the Bureau of Special Education (BSE) as a means by which to address schoolbased behavioral health.
Presently, the CoP includes membership of approximately 52 individuals including representatives from the Pennsylvania
Departments of Education, Health, and Public Welfare in addition to youth serving provider agencies, managed care organizations, advocates, and youth and family members.

54
• Local control for counties and school districts
• Behavioral health managed care organizations
– Carve out
– County choice
• Community Care
– Over half of the counties
– Oversight from stakeholders
• Office of Mental Health and Substance Abuse Services
(OMHSAS)
– Systems of Care
– Integrated Children’s Service Planning
© 2010 Community Care

Inpatient
Residential Treatment Facility (RTF)
Individualized Residential Treatment (IRT)/TFC/CCR Host Home
Behavioral Health Rehabilitation
Services (BHRS)
Family Based Mental Health Services
(FBMHS)
Family Based Partial Hospital School-Based Mental Health (SBMH)
Outpatient
Intensive Case Management/Resource Coordination (ICM/RC)
Crisis Services (Mobile Crisis, Emergency Room, and Walk-in Crisis Centers)

History of the Development of
School Based Behavioral Health (SBBH) Team Service
A Clinical Home Model
• Stakeholder input regarding current BHRS and children’s service delivery
– Families
– Educators
– County partners – child serving systems
• Unique opportunity to partner with Department of Welfare and OMHSAS
• Transformation of children’s services
– Partnership with oversight
– Stakeholder input
– Development of program description template
56 © 2010 Community Care

• Accountable TO the family and FOR the care
• Accessible, coordinated, and integrated care
• Comprehensive service approach
• Increased accountability and communication
• Single point of contact for behavioral health
• School is “launching pad” for services delivered in all settings
• Youth continue on the team with varying intensity of service

C LINICAL
I NTERVENTIONS
C ASE
M ANAGEMENT
C RISIS
I NTERVENTION
C ASE
C ONSULTATION AND
T RAINING for educational staff

L ICENSED
M ASTER ’ S P REP
C LINICIANS (MHP)
E XPERIENCED
B ACHELOR ’ S P REP
W ORKERS (BHW)
A DMIN A GENCY
S UPPORT
C ONSULTATION TO
MHP S PRN

Community Care Support of SBBH Teams
LEARNING
COLLABORATIVE
T RAINING
COACHING
M ODEL F IDELITY
TECHNICAL
ASSISTANCE
E VIDENCE BASED
P RACTICES
CARE
MANAGEMENT

61
Learning Collaborative
A Community of Practice for Providers
• Training, case consultation, coaching – stability of workforce, integrity of practices, fidelity to model
• Platform –
– Family systems theory and interventions
– Resiliency/recovery principles and supports
– Trauma informed care
– Identification of co-occuring disorders
– Positive behavior interventions and supports
© 2010 Community Care

• Quarterly meetings
• Stakeholder representation – System of Care
• Implementer’s blueprint
• Systems, data and practices
• Scaling and sustainability

School Year
2008-09
2009-10
2010-11
2011-12
Activity
• Community Care engaged district through ICSP regarding SBBH
Team
• SBBH Team begins work within district – September 2009
• District and Community Leadership Team is established, district commitment signed, tertiary demonstration project begins – spring
2010
• Tier One SWPBIS is fully implemented with kickoff at the start of the school year
• Tier Two training begins in the spring of 2011 with some implementation
• All three tiers are being implemented at both elementary schools
• Montrose Junior High receives Tier One training in fall, with “soft” kickoff in January 2012
• Discussion of SBBH Team model expanding into Junior and Senior
High

• Jr High implementation
• SBBH and school collaboration – doing more with less – reallocation of resources
• Fiscal and clinical responsibility
• Community connections and partners
– ICSP - SOC

Montrose Elementary Schools
K-6 th Grade
Data
Tertiary, Tier 3, Individual
Child Outcomes Survey
Strengths and Difficulties Q.
Teacher feedback
Academic data
Secondary, Tier 2
Group/Individual
Data from Tier One team
Progress monitoring
Data decision rules
Universal, Tier 1
Whole School
ODRs, teacher nominations,
Card system, MMS,
(lessons learned)
80-90%
5-10%
1-5% 1-5%
5-10%
Practices
Tertiary, Tier 3, Individual
• Guidance counselors see individual students
• SBBH Team
80-90%
Secondary, Tier 2
Group/Individual
• Guidance counselors run
Targeted groups
• IST
• CICO
• mentoring
Universal, Tier 1,
Whole school
• Guidance counselors teach
“I Can Problem Solve” lessons
• Treehab D and A awareness
• Bully prevention/Character Ed
• Peer Mediation

Scranton School District
Year One
2009-10
Year Two
2010-11
District and Community Leadership Team established.
District commits to implementing SWPBIS with fidelity across the district.
Year Three
2011-12
Year Four
2012-13
SBBH Teams begin implementation at Frances Willard Elementary, George Bancroft Elementary, and Scranton High. A Tier Three support.
Frances Willard Elementary, George
Bancroft Elementary, and Scranton High all receive training to implement Tier
One SWPBIS.
Frances Willard Elementary, George Bancroft Elementary, and Scranton High all implement Tier One SWPBIS.
Year Five
2013-14
Year Six
2014-15
Frances Willard Elementary reaches implementation fidelity.
Frances Willard Elementary receives training for implementation of Tier Two and begins implementation.
Frances Willard Elementary implements three tiers of Interconnected Systems Framework.
Isaac Tripp Elementary, McNichols Plaza
Elementary, and South Scranton
Intermediate all receive training to implement Tier One SWPBIS.
Isaac Tripp Elementary, McNichols Plaza Elementary, and South Scranton
Intermediate all implement Tier One SWPBIS.
George Bancroft Elementary and Scranton High receive training for implementation of Tier Two and begin implementation
Scranton High receives training and begins implementation of RENEW.
SBBH Teams begin implementation at Northeast Intermediate, John F. Kennedy Elementary, McNichols Plaza Elementary, and
John G. Whittier Elementary.
John F. Kennedy Elementary, John G.
Whittier Elementary, and Northeast
Intermediate all receive training to implement Tier One SWPBIS.
John F. Kennedy Elementary, John G.
Whittier Elementary, and Northeast
Intermediate all implement Tier One
SWPBIS.

Needs
School-Wide Systems for Student Success:
A Response to Intervention (RtI) Model:
Tier 3/Tertiary Interventions
Tier 2/Secondary Interventions
Tier 1/Universal Interventions80-90%
5-15%
1-5%
Resources
1-5% Tier 3/Tertiary Interventions
•SBBH Team
•Outpatient therapy
•SB Partial
•Guidance – individual support
5-15%
•SAP
•Guidance – groups
•Community Partners – groups
•Resource Officer
80-90% Tier 1/Universal Interventions
•SWPBIS
•Drug and Alcohol
Prevention
Illinois PBIS Network, Revised May 15, 2008.
Adapted from “What is school-wide PBS?”
OSEP Technical Assistance Center on Positive
Behavioral Interventions and Supports.
Accessed at http://pbis.org/school-wide.htm

• Systems
– District and building teaming models
– Facilitation, technical assistance, coaching
– Stakeholder participation and buy-in
• Practices
– Mental health and school staff work in an integrated way to support students across tiers
– Using assessment and screening in order to determine which
EBPs to use, progress monitor
– One plan for both education and mental health
• Data
– Shared decision rules
– Used for decision making with all stakeholders at the table – school, mental health, other child serving systems, family

0.6
0.4
0.2
0.0
1.2
1.0
0.8
1.8
1.6
1.4
Change at 3 mos
Not Implementing
Change at 6 mos
Low Fidelity
Change at 9 mos
High Fidelity

1.2
1.0
0.8
0.6
0.4
0.2
0.0
1.8
1.6
1.4
Change at 3 mos
Not Implementing
Change at 6 mos
Low Fidelity
Change at 9 mos
High Fidelity

-0.5
-1.0
-1.5
-2.0
-2.5
-3.0
-3.5
1.0
0.5
0.0
Change Q1 Change Q2
Not Implementing Low Fidelity High Fidelity

-1.0
-1.5
-2.0
-2.5
-3.0
-3.5
-4.0
1.0
0.5
0.0
-0.5
Change Q1 Change Q2
Not Implementing Low Fidelity High Fidelity

• Jason was referred to the SBBH Team in November. He is a seven-year-old first grader who was having difficulty coming to school and being separated from his mother.
• When he was four, Jason and his family were in a car accident in a rural area. The members of the family were taken to different hospitals and Jason did not know where his mom was or if she was okay.
• Every day, since the first day of school, Jason’s mom would bring him into the school and the school staff would literally have to peel Jason off of his mother and hold him so she could leave.

• Once referred to the team, they were immediately able to work with Jason and his family to create strategies to help him separate more smoothly.
• Jason found the SBBH Team office/room a safe place to be. His mother also spent time there to help create a nice transition area.
• After the Holiday break, Jason began riding the bus for the fist time, accompanied by one of the BHWs from the team.
• Soon, Jason was able to ride the bus on his own, increasing his confidence and allowing him some relief from his anxiety.

Child Outcomes Survey (COS) Family Functioning:
Child X
10
9
8
7
6
5
4
3
2
1
0
Solve Problems Shared Decisions

Child Outcomes Survey (COS) Child Functioning and
Therapeutic Inventory: Child X
10
9
8
7
6
5
4
3
2
1
0
FAMILY PEERS SCHOOL TASKS ave inventory

Child Outcomes Survey (COS) Overall Wellness:
Child X
14
12
10
8
6
4
2
0

Strength and Difficulties-Parent Report: Child X
10,00
9,00
8,00
7,00
6,00
5,00
4,00
3,00
2,00
1,00
0,00
11.1.11
Emotional Symptoms
Peer Problems
Conduct Problems
ProSocial
2.1.12
Hyperactivity

Strength and Difficulties-Teacher Report: Child X
10
9
8
7
6
3
2
5
4
1
0
11.1.11
Emotional Symptoms
Peer Problems
Conduct Problems
ProSocial
2.1.12
Hyperactivity

Lessons Learned
• Return on investment
• Funding efficiency
• Scaling and sustaining SBBH Teams – size
• Community “politics”

Bob Stevens, Charleston, SC

• 45,000 students in 78 schools.
• Over 100 miles from the most distant schools
• Rural, inner city, and suburban schools
• Student Population: 46% African American; 46% Caucasian;
3% Mixed; Asian 2%; 1% Native Amer.; 1% other
• 14% Identify themselves as Latin or Hispanic
• 60% receive free or reduced meals
• 9.5% have IEP’s
• 6% not English proficient
• Historically in CCSD schools; nurses, guidance counselors, a few contracted mental health counselors, para-professional behavior support staff; school psychologists not school based.

School-Wide Systems for Student Success:
A Response to Intervention (RtI) Model
Academic Systems
Tier 3/Tertiary Interventions
•Individual students
•Assessment-based
•High intensity
Tier 2/Secondary Interventions
•Some students (at-risk)
•High efficiency
•Rapid response
•Small group interventions
• Some individualizing
5-15%
1-5%
Tier 1/Universal Interventions 80-90%
•All students
•Preventive, proactive
1-5%
5-15%
Behavioral Systems
Tier 3/Tertiary Interventions
•Individual students
•Assessment-based
•Intense, durable procedures
Tier 2/Secondary Interventions
•Some students (at-risk)
•High efficiency
•Rapid response
•Small group interventions
•Some individualizing
80-90% Tier 1/Universal Interventions
•All settings, all students
•Preventive, proactive
Illinois PBIS Network, Revised May 15, 2008.
Adapted from “What is school-wide PBS?”
OSEP Technical Assistance Center on Positive
Behavioral Interventions and Supports.
Accessed at http://pbis.org/schoolwide.htm

Old Mental Health Provider Job Description
• Provides services on IEP
• Maintains channels of communication with principals and teachers
• Provides assistance in crisis situations
• Maintains communication with students, parents, educational personnel, and community
• Provides and participates in in-service
• Conducts seminars for parents
• Other duties as assigned.

• Participate in building based activities that support the School Improvement Plan
• Participate in Secondary and Tertiary intervention planning meetings
• Participate in development and implementation of strategies and activities related to PBIS
• Use data to determine effectiveness of research based intervention (pre and post)
• Use the three tiered approach to intervention planning to enter, progress monitor, and exit youth from interventions (based on data)
• Providing coaching and professional development for staff

• Provide conflict resolution training, drug and alcohol education, and social skills training based on secondary or tertiary team
• Provide direct services to children in crisis
• Provide school social work services to children as determined in the
IEP process based on a continuum of preventative interventions
• Develop and maintain working relationships with students, parents, educational personnel, and community
• Participate in the development of Tertiary interventions in the form of
FBA/BIP or wraparound teams

• Moving from reactive to preventative
• Time efficient and least restrictive
• Moving from Tier 1 to leading Tier 2/3
• Facilitating Tier 3 Interventions
• Serving students needs vs. “labeled” populations
• Systems approach
• Intervention vs. Referral to Professional

Low Level
Communication between Providers
To
Collaboration with Providers
To
High level
Integration of Providers

Developing an Integrated Systems Framework
School-based Mental Health in Charleston SC

Developing an Integrated Systems Framework
School-based Mental Health in Charleston SC

Developing an Integrated Systems Framework
School-based Mental Health in Charleston SC

• Mental health counselors when supported by
Medicaid
• Part-time guidance in many schools which focused primarily on academic counseling.
• Very limited number of social workers in the district office working in the Office of Exceptional Children supporting identified students
• School psychologists assigned to multiple schools with “testing” as priority.

• Federal Counseling Grant
• Charleston Promise Neighborhood
• Medical University of South Carolina
• Climate Grant
• Gear Up Grant
• Allocation from General Operating Fund
• Community In Schools Support

• SSW, MH, CIS developing new roles in CCSD schools
• Integrating with current systems, creating new systems
• Existing Teams – School Leadership
– PBIS
– TEAM Two
– CORE (Tier 3)
• External Partners

• Data that will lead to intervention before referral
– At-Risk Alert System
– SWIS
– Social Emotional Measures

• ARAS
(pronounced “air-us”) is the At-Risk Alert System: a data tool developed by Charleston County School
District as part of a federal Safe Schools/Healthy
Students grant.
• Helps identify students potentially at-risk by using existing academic & behavior data.
• Transforms data into reports to support effective decision making.
• Provides composite views of magnitudes of risk factors existing for students and schools.
• Supports a variety of student support models.

Risk Indicators
• ARAS uses student academic and behavior data currently available in PowerSchool and other district data bases as indicators to assess potential risk.
• For each of eight indicators, students are assigned to one of three levels:
– Level 1 (Motivated/Low Risk)
– Level 2 (Vulnerable/Moderate Risk)
– Level 3 (Critical; High Risk)

Tier
Three
Tier Two
Tier One
Academic Social
Emotional
Mental
Health
Physical

120
100
80
60
40
20
0
180
160
140
# of Services

120
100
80
60
40
20
0
# of Level 1 Services by Month
# of Services

1. Establish Ground Rules
2. Start with Data
3. Match Practices to Data
4. Align Resources to Implement Practices
Lewis, PBIS Missouri

• Moving from reactive to preventative
• Time efficient and least restrictive
• Moving from Tier 1 to leading Tier 2/3
• Facilitating Tier 3 Interventions
• Serving students needs vs. “labeled” populations
• Systems approach
• Intervention vs. Referral to Professional