Understanding Implementation and Leadership in School Mental Health

Module #1 focus is on implementation Specifically, our role as leaders in implementation To begin, we need to understand our own biases about mental health, and change Changing values, not just behaviours To obtain the mental health outcomes we want for our students need to change the knowledge AND attitudes and values of adults who support students 2

“ For every increment of performance I demand from you, I have an equal responsibility to provide you with the capacity to meet that expectation” (R. Elmore, 2002) 3

Clear vision – we will do literacy, math, mental health this way Unwavering instructional/mental health leadership and support Good communication plan with consistent messages Effective supports in place to help Principals, teachers, and staff follow through and “do it” 4

Assure consistent supports across buildings Do not depend so much on unique principals or teachers who come and go Achieve more consistent student outcomes, across teachers, buildings, and years 5

Evidence-based Actual Supports Years 1-3 Outcomes Years 4-5 Every Teacher TrainedFewer than 50% of the teachers received some training Fewer than 10% of the schools used the CSR as intended Every Teacher Continually Supported Fewer than 25% of those teachers received support Vast majority of students did not benefit Aladjem & Borman, 2006; Vernez, Karam, Mariano, & DeMartini, 2006 Longitudinal Studies of Comprehensive School Reforms Implementation Science 6

An intervention is one thing Implementation is something else altogether Like serum and a syringe Each is necessary Neither one is useful without the other 7

Effective intervention practices X Effective implementation practices = Good outcomes 8 Disproportional Impact: Students benefit 8 to 12 times more

EffectiveNOT Effective Effective NOT Effective INTERVENTION Actual Benefits IMPLEMENTATION (Institute of Medicine, 2000; 2001; 2009; New Freedom Commission on Mental Health, 2003; National Commission on Excellence in Education,1983; Department of Health and Human Services, 1999) Inconsistent; Not Sustainable; Poor outcomes Poor outcomes Poor outcomes; Sometimes harmful 9

Letting it happen Recipients are accountable Helping it happen Recipients are accountable Making it happen Implementation Teams are accountable 10 Based on Greenhalgh, Robert, MacFarlane, Bate, & Kyriakidou, 2004

Implementation Science Impl. TeamNO Impl. Team Effective Effective use of Implementation Science & Practice IMPLEMENTATION INTERVENTION 80%, 3 Yrs14%, 17 Yrs Balas & Boren, 2000Fixsen, Blase, Timbers, & Wolf, 2001 Letting it Happen Helping it Happen 3X to 12X Return on Investment 11

Best Data Show These Methods, When Used Alone, Do Not Result In Uses of Innovations As Intended: Diffusion/ Dissemination of information Training Passing laws/ mandates/ regulations Providing funding/ incentives Organization change/ reorganization About 5% to 20% Return on Investment 12

OUTCOMES (% of Participants who Demonstrate Knowledge, Demonstrate new Skills in a Training Setting, and Use new Skills in the Classroom) TRAINING COMPONENTS Knowledge Skill Demonstration Use in the Classroom Theory and Discussion 10% 5%0%..+Demo in Training 30% 20% 0% …+ Practice & Feedback in Training 60% 5% …+ Coaching in Classroom 95% Joyce and Showers,

© Fixsen & Blase, 2008 Performance Assessment Coaching Training Selection Integrated & Compensatory Competency Drivers Systems Intervention Facilitative Administration Decision Support Data System Organization Drivers AdaptiveTechnical Leadership Drivers Implementation Drivers Reliable Benefits Consistent uses of Innovations 14

Implementation Team Executive Management Team Teachers Innovations Students System Change Adaptive Challenges Duplication Fragmentation Hiring criteria Salaries Credentialing Licensing Time/ scheduling Union contracts RFP methods Federal/ Prov. laws “External” System Change Support Practice Informed Policy Policy Enabled Practice System Reinvention 15

16 Board Implementation Team EDU MH Leaders SMH Professionals Teachers System Change Adaptive Challenges Duplication Fragmentation Hiring criteria Salaries Credentialing Licensing Time/ scheduling Union contracts RFP methods Federal/ Prov. laws School MH ASSIST Support Practice Informed Policy Policy Enabled Practice System Reinvention

Effective Tiered implementation Teams Provincial ASSIST District MH Teams, with MH Leaders School MH Teams Homework Assignment We will send a link to the PACE modules People Advancing Change through Evidence Review and participate in on-line dialogue 17