Enhancing Mental Health Services in CMS The School-Based Mental Health Program Cotrane Penn, Ph.D Student Services Department

2 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 school s Social Workers – 44 assigned to high needs schools Substance Abuse Counselors- 3 in CMS Mental Health Therapists – 2 agencies serving 30 schools 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

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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 long- term individual counseling Mental health agencies: Psychological evaluations, intensive outpatient therapy, family therapy, intensive in-home services, medication management 8

9 School-Based Service Provider Primary Referral Need Individual SupportGroup SupportFamily Support Community- Based Support CMS Student Services Consultation with school staff and/or student* Classroom guidance Parent conference Referral to or utilization of community resources+ Mentorship opportunities Short-term group counseling Home visit Short-term counseling (6 or < sessions) Family assessment Community agency coordination Long-term counseling (6 or < sessions) Long-term group counseling Parent consultation Behavior intervention plans Parent training Check-n-Connect School-Based Mental Health Agency Services Individual therapy Group therapy Family therapy Referral to day treatment or inpatient behavioral health facility Medication evaluation/Medication monitoring Intensive in- home services

Access Instruction Formal monitoring of overall student attendance pre- and post- therapy Formal monitoring of out-of-school suspensions and in-school suspensions pre- and 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 12 Short-Term ProgressLong-Term Progress ElementaryMAPEOG Reading 3D benchmarks MiddleMAPEOG High SchoolCredit Accrual/Semester Credit Accrual/School Year

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? One agency per school model Based on a number of factors, none school- specific Goal is to develop consistent practice and quality of care across agencies and school 14

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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

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20 Requesting SBMH Services Google Forms will be used to make requests Google Forms 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

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. 22 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

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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 26 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

27 Agency NameAgency Contact Information Family First Community ServicesJohn Waller, Clinical Director Mélange Health SolutionsBrenda Kendrick Carolinas Healthcare SystemCandice Whiteside Thompson Child and Family FocusDebra Shuler, Clinical Supervisor Agency Contact Information

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