Enhancing Mental Health Services in CMS The School-Based Mental Health Program Cotrane Penn, Ph.D Student Services Department Current State of Mental Health Services in CMS • School Counselors • 1 per elementary school • 2 – 3 per middle school • 1 for approximately 400 high school students • • • • School Psychologists – one for 2 to 3 schools Social Workers – 44 assigned to high needs schools Substance Abuse Counselors- 3 in CMS Mental Health Therapists – 2 agencies serving 30 schools 2 Current State of Mental Health Services in CMS • Mental Health Agency Services • Concentrated in Title I Schools • Primarily serve Medicaid-eligible students • Primarily serve elementary schools 3 The Future State of Mental Health Services in CMS • • • • CMS holds consistent expectations across agencies Agency work in CMS is contingency-based Students served based on need, not ability to pay True collaborative relationship between district, schools, and agencies • Expanded continuum of care available in all CMS schools 4 The CMS Vision for School-Based Mental Health Services To increase the availability of evidence-based mental health services for the purpose of improving student’s emotional well-being and enhancing their ability to access and benefit from instruction. 5 6 Increase the Availability of Services • Increase the number of agencies serving CMS schools • Increase the number of schools receiving agency services • Eliminate barriers that prevent students from accessing agency services 7 Mental Health Services Available • District mental health staff: Short-term individual and group counseling, limited longterm individual counseling • Mental health agencies: Psychological evaluations, intensive outpatient therapy, family therapy, intensive in-home services, medication management 8 School-Based Mental Health Agency Services CMS Student Services School-Based Service Provider Primary Referral Need Individual Support Group Support Family Support Consultation with school staff and/or student* Classroom guidance Parent conference Mentorship Short-term opportunities group Short-term counseling (6 counseling or < sessions) Long-term counseling (6 or < sessions) Long-term group Behavior intervention counseling plans Check-n-Connect Individual therapy Medication evaluation/Medication monitoring Home visit Family assessment Parent consultation Referral to or utilization of community resources+ Community agency coordination Parent training Family therapy Group therapy CommunityBased Support Intensive inhome services Referral to day treatment or inpatient behavioral health facility 9 Access Instruction • Formal monitoring of overall student attendance pre- and post- therapy • Formal monitoring of out-of-school suspensions and in-school suspensions preand post- therapy 10 Improved Well-Being • All agencies use the same assessment of student behavior pre- and post- services • BASC-2 Online • Streamlines therapy goal development • Allows for teacher rating of student internalizing and externalizing behaviors • Allows CMS to see typical improvement rates and better understand agency efficacy 11 Benefit from Instruction • Formal monitoring of short-term & long-term achievement growth pre- and post- therapy Elementary Short-Term Progress Long-Term Progress MAP EOG Reading 3D benchmarks Middle High School MAP EOG Credit Accrual/Semester Credit Accrual/School Year 12 Authorized School-Based Agencies • The New Providers • Family First Community Services • Mélange Health Solutions • The Continuing Providers • Carolinas Healthcare System • Thompson Child and Family Focus 13 Agency Assignments • Posted on SBMH program website • Questions? cotrane.penn@cms.k12.nc.us • One agency per school model • Based on a number of factors, none schoolspecific • Goal is to develop consistent practice and quality of care across agencies and school 14 15 Agency Responsibilities • • • • • Provide master’s level clinicians Regular, schedule-based presence at schools Work collaboratively with teachers and staff Attend individual student meetings Maintain contact with student and school when student placed in a facility • Provide consultation and education to school staff 16 School Responsibilities • Support and promote provision of agency services • Work collaboratively with agency staff • Invite agency staff to pertinent planning and intervention meetings • Obtain parent permission for agency presence at student meetings • Conduct regular review meetings to get status and progress updates on agency students • Designate a point person to manage agency protocol within the school 17 Collaborative Responsibilities • • • • • Ensure access to services for all students in need Use a “warm hand-off” for parent permission Crisis intervention for agency clients Bi-directional sharing of information Shared school behavior goals 18 19 Requesting SBMH Services • Google Forms will be used to make requests • It is a secured site • Any student who will be referred for agency services needs a request submitted • Only the designated CMS staff can make requests • Authorization is needed for service oversight and budget management • The Soft Start Referral process steps 20 Orienting the Agency Therapist • Introduce therapist to critical staff • Administrators • Secretaries • Student Services Staff & EC staff • Share school-specific norms • Sign-in/sign-out expectations • Classroom visit norms • Staff arrival/departure times 21 Orienting the Agency Therapist cont. • Special tips • Staff dress code • Tour of school & provide school map • Help therapist understand various schedules • Elementary grade level/classroom • Middle & High school S1/S2 & A-day/B-day schedules • Testing calendars and related restrictions • How to schedule meeting space 22 23 What will be done before the “hard start” in the fall? • Comprehensive training of agency staff on: School staff roles and responsibilities School-based team processes Referral to services process Agency responsibilities in the school setting Interacting with clients in the school setting 24 Preparing for the “hard start” cont. Working in educational settings (general overview of school practices, procedures, and the day-to-day work of schools, importance of the master schedule)* Agency effectiveness review process Agency entry plan development*- present entry plan concept to agencies • Acquire and train on BASC-2 usage • Meet with all school leaders to address Q & As 25 School-Based Mental Health Therapy as an RtI Intervention • All students receiving school-based mental health services are considered to be in tier 2 or 3 of the district’s RtI model • Placing a student at tier 2 or 3 denotes that he or she is at-risk and requires additional school-based behavioral supports • Starting in the Fall of 2014, the regular education intervention process guidelines will apply to SBMH Program services 26 Agency Contact Information Agency Name Agency Contact Information Family First Community Services John Waller, Clinical Director jwaller@fam1stcom.com Mélange Health Solutions Brenda Kendrick bkendrick@melangehs.com Carolinas Healthcare System Candice Whiteside Candice.Whiteside@carolinashealthcare.org Thompson Child and Family Focus Debra Shuler, Clinical Supervisor dshuler@thompsoncff.org 27 28