School-Based Mental Health Services in Alabama Gayla Caddell – Coordinator, Child & Adolescent Mental Illness Services 334-353-7832 gayla.caddell@mh.alabama.gov ADMH Contact Information Tina Sanders – Education Specialist, Special Education Services 334-242-8114 tsanders1@alsde.edu ALSDE Contact Information

Overview of Mental Health Services in Alabama MENTAL HEALTH OVERVIEW Commissioner (Governor’s Cabinet) Three Areas of Services (MI/SA/ID) Adult Pre-occupied Less than 10% of DMH dedicated dollars spent on C&A services Why? MI Division serves 100,000+ consumers. Of this 25,000+ are C&A C&A has partners for blended funding with DOE, DHR, DYS, etc.

Overview of Mental Health Services in Alabama Started in the 1980s through a Federal Planning Grant. Mandated other State Agencies participate with planning and this planning body still exists today – Child and Adolescent Task Force. Multiple Needs Child Legislation developed and continues to be a strong relationship Children Services

Mental Health Continuum of Care – SED Services Early Childhood MH (0-5) Mental Health Prevention Outpatient Individual Group Family Psychiatric/Nursing Telepsychiatry Consultation Crisis Outreach Respite Case Management In-Home Intervention Meaningful Day Day Treatment School-Based Mental Health (SBMH) Collaboration

Mental Health Continuum of Care – SED Services Housing/Residential Short-term Evaluation Treatment STTEP (6-12 years) Group Home/Unlocked Residential Transitional Age Group Home Locked Residential Psychiatric Stabilization Private Inpatient Acute DMH Unit at EAMC

Why Does Mental Health Matter in Schools? Addressing mental health needs in school is critically important because 1 in 5 children and youth have a diagnosable emotional, behavioral or mental health disorder and 1 in 10 young people have a mental health challenge that is severe enough to impair how they function at home, school or in the community.

There have been at least 43 incidents of gunfire on school grounds in 2018. When it comes to how American children are exposed to gun violence, gunfire at schools is just the tip of the iceberg–every year, over 2,700 children and teens are shot and killed and nearly 14,500 more are shot and injured. An estimated 3 million American children are exposed to shootings per year. Witnessing shootings — whether in their schools, their communities or their homes– can have a devastating impact. Children exposed to violence, crime, and abuse are more likely to abuse drugs and alcohol; suffer from depression, anxiety, and posttraumatic stress disorder; fail or have difficulties in school; and engage in criminal activity.

Suicide According to the Centers for Disease Control and Prevention, from 1999 through 2015, 1,309 children ages 5 to 12 took their own lives in the United States.

Gov. Kay Ivey’s Securing Alabama’s Facilities of Education SAFE Council The SAFE Council makes 10 recommendations in three areas: physical security, threat assessments and mental health, and coordinated training and planning by state agencies. Physical Security  Funding for School Resource Officers (SROs) and District Safety Coordinators (DSCs) Bond Issue for Enhancing School Building Security Surveillance Systems Linked to Law Enforcement Threat Assessments and Mental Health  School-Based Mental Health Identifying Warning Signs Reporting Threats Tracking School Violence Coordinated Training and Planning  Empowered and Accountable District Safety Coordinators Building a Culture of Safety School Safety Training and Compliance Teams

School Based Mental Health Services in Alabama Early Collaboration between ADMH and ALSDE – State Level Development and funding for first 10 Day Treatments in State of Alabama Policy Development – i.e. educational programs within RTC

School Based Mental Health Services in Alabama Early Collaboration – Local Level Limited Co-location of mental health services in school systems Limited Co-location of mental health services in Alternative Schools Limited access provided to mental health to come into the school – i.e. IHI and CM Summer Programs

School Based Mental Health Services in Alabama Modern Day System of Care State mental health agencies are being mandated by Federal arms to move to modern day systems of care. ALSDE and ADMH met and discussed how to move to a modern day system of care that will focus on: Evidenced-based Practices Data Driven and Performance Based Youth Directed and Family Guided

School Based Mental Health (SBMH) Collaboration ADMH and ALSDE have identified the need for a deliberate strategy aimed at improving service quality within and continuity between the two departments. The AIM: To achieve greater integration of MH services between the community mental health centers and the public schools To increase the utilization of evidence-based practices. The integration of these services will foster continuity of care and ensure sustained gains in academic and developmental domains for children, youth, and their families.

Goal of SBMH Collaboration The GOAL of the SBMH collaboration between ADMH and its providers and the ALSDE and Alabama’s local education agencies is to: Ensure that children and adolescents, both general and special education, enrolled in local school systems have access to high quality mental health prevention, early intervention, and treatment services. To be effective, comprehensive mental health services in schools must be provided by an on-site master’s level mental health professional in collaboration with teachers, administrators, and families.

School Based Mental Health Services in Alabama SBMH Partnership benefits: Mental Health Prevention – training for a population Improved awareness, collaboration and integration between Mental Health and Education resources at the State and Community levels Significant improvements in access to care for children and adolescents who are experiencing social/emotional problems that negatively affect academic success. Addresses common barriers to seeking services: - Transportation Issues - Stigma - “No-Shows” at MH Appts. - “No-Shows” at School! Access to the full array of MH services available through the Community Mental Health Center More consumers receiving needed services, with cost savings for many school systems

SBMH Collaboration Provides: High quality services that build on existing school programs, services, and strategies; A Continuum of care in a school setting-mental health education and promotion through intensive intervention; Authentic parent/ family engagement; Meaningful children and youth involvement Culturally and linguistically competent service provision; and Data-driven planning, evaluation, and quality improvement.

School Based Mental Health (SBMH) Collaboration MODEL “Nuts and Bolts” Initial Orientation Formalized Agreement between MH and LEA Data Collection & Reporting Standardized Referral Process “Gatekeeper” Bridges MH & ED Functions

School Based Mental Health (SBMH) Collaboration MODEL “Nuts and Bolts” Regular Accountability Meetings School provide space, MH provides Therapist Separation of School Records & MH Records Annual Review of SBMH Commitment

SBMH Expected Outcomes and Performance Indicators Provided by Alabama Department of Education: Number of students with unexcused absences > than 7 days reduced Number of unexcused absences > than 7 days reduced Rates of school attendance improved Number of students with out-of-control suspension > than 10 days reduced Number of out-of-school suspensions > than 10 days reduced School behavior improved Number of students receiving the Alabama High School Diploma increases Student graduation rate improved

SBMH Expected Outcomes and Performance Indicators Provided by local Mental Health Authorities: Number of students receiving mental health services increased Number of services provided/hours of services provided increased Student/Family engagement improved Provided by Alabama State Mental Health Department based on Child and Adolescent Needs and Strengths (CANS): Number of students whose level of life domain functioning improve Total level of life domain functioning improved Number of students with arrests decreases Delinquent behavior improved Number of students/families whose perception of care improves Family/Youth perception of care improved Number of students/families whose social connectedness improves. Social Connectedness

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