The West Virginia Expanded
School Mental Health Initiative
History, Status, Tools and Resources
Linda Anderson, MPH
WV Student Success Summit
August 2-3,2011
Objectives
Participants will be able to
1. Describe at least two aspects of the
history of the ESMH Initiative
2. Identify at least three characteristics
of successful school mental health
programs
3. Identify at least three resources for
information and technical assistance
Outline
• Define ESMH
• Links between mental health and
school success
• History of school mental health in
West Virginia
• Factors for success
• Resources
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The Conundrum
Academic
Performance
School
Mental
Health
Links Between Mental Health and
School Success
Facts
• 5-9 % of children and teens have a
serious emotional disturbance. (US
Surgeon General’s Report, 1999)
• 20% of children and adolescents at any
given time have a diagnosable mental
disorder which interferes with their
functioning.(US Surgeon General’s
Report, 1999)
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Facts
• 1-2 children in every classroom have a
diagnosable mental health concern
which hinders functioning. (President’s
New Freedom Commission Report)
• Less than 50% of children and
adolescents with a mental illness
receive adequate (or any) services .
(Kataoka, Shang, Wells, 2002)
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Mental Health & Academic Outcomes Connection
Poor health
Physical illness
High-risk behaviors Health & Mental
Health Factors
(e.g. Substance use )
Mental illness
Graduation/Drop-out
Grades
Standardized test
scores
Teacher Retention
Developmental
issues
Low self-esteem
Family problems
Attendance
B Behavioral Problems
Educational motivation
Attitudes toward schoolwork
School Connectedness
SMH
ADAPTED FROM: Geierstanger, S. P., & Amaral, G. (2004). School-Based Health Centers and Academic Performance: What is the
Intersection? April 2004 Meeting Proceedings. White Paper. Washington, D.C.: National Assembly on School-Based Health Care. 11
Why MH in Schools?
• Evidence clearly demonstrates that
addressing mental health needs is
associated with positive school
outcomes
• School mental health promotion
activities create a positive learning
environment
Why MH in Schools?
• School mental health programs and
services improve teaching
conditions for teachers and staff
• Schools are where children are
located – efficient use of resources
• Reduces costs for treatment
• Contributes to the economy
Academic Performance
• Is negatively affected by:
– Alcohol, tobacco, and other drug use
– Emotional problems
– Health risk behaviors (e.g. obesity, sexual behavior,
poor diet)
– Low self-esteem, risky sexual behavior
– Lack of access to health and mental health care
– Poor home life
• Is positively affected by:
– High levels of resiliency, developmental assets, and
school connectedness
(work of CASEL, Search Institute; and others)
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Graduation Rates
SMH strategies can improve graduation rates
by addressing factors that interfere with a
student’s ability to succeed in school, such as :
–Exposure to violence
–Anxiety disorders
–Other unmet mental health needs
(Black, et al, 2003, Woodward & Ferguson, 2001; and others)
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“
School Connectedness
Definition: the extent to which a student feels
welcomed, accepted and respected in his or
her school. Students who feel connected to
their school:
–Better achievement
–Better school attendance
–Stay in school longer
–Less likely to engage in many risk behaviors
(Fletcher et al., 2008; Shochet et al., 2006; Anderman, 2002; and
others)
WV Educators Speak:
Mental Health & School Success
Definition
Expanded School Mental Health refers to programs
that build on the core services typically provided
by schools. It is a three-tiered framework that
includes the full continuum of:
Prevention
Early intervention
Treatment
Serves all students
Emphasizes shared responsibility between
schools and community mental health providers
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A Comprehensive System of Learning Supports
School
Systems
Behavioral Health
Systems
Intensive
1-5%
Targeted
5-15%
Universal
80-90%
TIER 1 - UNIVERSAL PREVENTION
A SCHOOL WIDE FOUNDATION
Creating a caring school environment
Teaching appropriate behaviors and
problem solving skills
Positive behavioral support
Effective academic instruction
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TIER 2 - TARGETED
IDENTIFY & INTERVENE EARLY
Interventions that occur early for
individual students or small groups of
students at risk
Examples of programmatic interventions
include social skills groups, anger
management; family support; grief and
loss, suicide / depression screening;
short term counseling and stress
management.
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TIER 3 - INTENSIVE
TREATING SEVERE & CHRONIC PROBLEMS
Individualized therapeutic interventions
for high risk students with severe,
chronic or pervasive concerns that may
or may not meet diagnostic criteria
Services might include crisis intervention,
cognitive behavioral therapy, and family
therapy; and may be community or
school - based.
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What does School Mental Health look like?
Systems of Prevention and Promotion
All Students (universal)
Systems of Early Intervention
Students At-Risk (selected)
Systems of Treatment
Students with Problems (indicated)
School, Family, and Community Partnerships
From work of Joe Zins
What Does Quality ESMH Look Like?
• Emphasize access
• Tailor to local needs
and strengths
• Active involvement of
diverse stakeholders
• Full continuum from
promotion to
treatment
• Committed and
energetic staff
• Developmental and
cultural competence
• Coordinated in the
school and connected
in the community
• Emphasize quality
and empirical support
(Center for School Mental Health)
WV HISTORY
Prior to 2000
• Coordinated School Health Program Initiated
• School-based Health Center Initiative
• System of Care – SAMHSA grant
2000
• School mental health funding – BHHF block
grant
• Sisters of St Joseph Health and Wellness
Foundation funds mental health services in
SBHCs
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WV MILESTONES
2006
•West Virginia Behavioral Health Commission
convenes
•First meeting with WVDE
2007
•ESMH steering team organized
•Strategic planning process begins (Dec.)
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WV MILESTONES
2008
• ESMH Team recognized as subcommittee of
Behavioral Health Commission
• MOU signed by Commissioners
2009
• Planning grants awarded by BHHF
• Selected by NASBHC as pilot state for their
Mental Health Capacity Building Project
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WV MILESTONES
2011
• Website
• Ten Components of Universal Tier defined
• Analysis of county improvement plans
• Second statewide ESMH conference
• School policies reflect increased focus on
social-emotional learning and mental
health
• ESMH Implementation grants
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MISSION
To develop and strengthen policies, practices
and services that promote learning and social-
emotional well-being for all of WV’s youth
through a collaborative process that engages
schools, families, and community-based
agencies.
VISION
Every student in WV will benefit from a school
environment that supports social and
emotional well-being to achieve his/her full
potential.
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WV Educators Speak:
Building A Successful ESMH Program
Steering Team Goals
1. Strengthen the infrastructure
2. Define ESMH Tiers 2 and 3
3. Ensure quality
4. Develop a reporting system
5. Regionalize training and TA
6. Sustain and increase programs
TIER 1 - UNIVERSAL PREVENTION
TEN RECOMMENDATIONS
1. An infrastructure that supports and
sustains a comprehensive school mental
health model
2. A systemic approach to early identification
of students at risk
3. An effective, classroom-based
developmental guidance curriculum that is
consistent and reinforced within and
outside of the classroom
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Tier 1 Recommendations - Cont’d
4.
A school-wide positive behavior program
based upon evidence /promising practices
5.
Annual training for all staff to improve their
skills in identifying and addressing mental
health needs of students
6.
Policies and practices to strengthen student
connectedness
7.
Policies and practices to strengthen parent
and family involvement
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Tier 1 Recommendations - Cont’d
8.
A program to address school climate, based
upon evidence and promising practices
9.
School safety plans that incorporate both
crisis prevention and response
10. Specific activities and programs that
support families and students as they
negotiate transitions such as grade and
school changes
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Response to Intervention
PBIS
Student Assistance Team
Student Mental Health Initiative
Safe Schools, Healthy Students
Special Education
Crisis management
Systems of Care
Social and Emotional Learning
School linked
Wrap around
Shared Agenda
Family support services
NCLB
Cultural competence
Multiculturalism
Risk and protective factors
School based
Strengths based
Multi system approach
School linked
Student Support Services
Suicide Prevention
Mental Health Services Act
School climate
School connectedness
Coordinated school health program
Peer-to-Peer Support
Evidence based practice
IDEA
Mental Health Planning and Evaluation
Template
• www.nasbhc.org/mhpet
• Developed in partnership with the Center for
School Mental Health
• Used in planning and evaluating activities and
services for new or established SMH programs
• Eight dimensions, 34 indicator measure
• Web-based, completed by teams, computer
generated scores
Community Coordination and
Collaboration
• RATIONALE: Coordination and collaboration
with community-based mental health and childserving agencies
– enhances resources
– maximizes efficiencies
– reduces fragmentation and duplication
Community
Coordination
and Collaboration
• A collaboration is a “formal or informal agreement
among participants to establish a process and structure
for achieving goals that no one member can achieve
independently.” (EDC)
– Linkages between school and a particular agency
– Coalitions that serve youth in the community
– School coalitions of community partners
Community Coordination and
Collaboration: Key Strategies
• Support and leadership from the school principal is
essential
• Establish a school level leadership team
• Build a school-community partnership with community
agencies that serve youth
• Conduct an inventory of needs and resources
• Determine a leadership structure and formalize
relationship with an Memo of Understanding (MOU)
• Engage group in small scale strategic planning process
School Coordinating
Teams
• Composed of multiple stakeholders, convened by school
health coordinator/school counselor
– Conduct planning and quality improvement process
– Conduct assessment of needs and resources related to school
health and mental health
– Act collectively in providing guidance and leadership on school
policies (e.g. discipline) that promote school health/ mental
health
– Coordinate, implement, train and evaluate ESMH activities
– Link to community health services and resources
– Oversee collection and analysis of student health data
– Implement crisis prevention and intervention
A Word About Funding….
• Diversified funding base
– Local Community
– School system sources: Title 1, Safe and
Supportive Schools, other
– Third party insurance
• BHHF – new planning grants (maybe)
• FQHCs/SBHCs
Recommended Reading
• Realizing the Promise of the WholeSchool Approach to Children’s Mental
Health: A Practical Guide for Schools
National Center for Mental Health Promotion and
Youth Violence Prevention:
http://promoteprevent.org/Publications/
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www.promote.prevent.org
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National Resources
Center for School Mental Health
U of Maryland
www.csmh.umaryland.edu
National Assembly on School Based Health
Care
www.nasbhc.org
Resources for schools, parents, students,
communities
Directory of SMH programs
Tool Kits
www.schoolmentalhealthwv.org
landerson@marshall.edu
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RESOURCES
Tool Kits
• Guide for developing an ESMH program
• Community and school needs assessment tools
• Sample Forms/MOUs
• Family Engagement
• Stigma reduction
• Quality/Standards
• Sample educational handouts for school staff,
parents, students
• CBT core skills
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4/6/2011
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WV Educators Speak:
Impact of ESMH on One WV Student
Contact Info
Linda Anderson, MPH
Coordinator
School Health Technical Assistance Center
RC Byrd Center for Rural Health
Marshall University
304-544-3917
landerson@marshall.edu
Resources, assistance, and training related to SBHCs, schoolbased behavioral and oral health programs.
Linda Anderson, MPH
Mental Health
304-544-3917
landerson@marshall.edu
Paula Fields, MSN, RN
Clinical Issues
304-846-9739
pfields4@yahoo.com
Stephanie Montgomery
Data and Evaluation
304-634-1008
smontgom@marshall.edu
Bobbi Jo Muto, RDH, BS
Oral Health Coordinator
304-542-9592
bjmuto.steele@marshall.edu
Richard Crespo, PhD
Director
304-691-1193
crespo@marshall.edu
Thank You for your
attention!
Questions?
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