School Mental Health ASSIST Équipe d’appui en santé mentale pour les écoles Mental Health Leaders’ Meeting October 2, 2012

2 Welcome!

3 Key Messages to Take Away 1. This work is important. 2. You are critical to its’ success. 3. We are here to support you. Together, we will shape the future of school mental health in Ontario.

4 This Work is Important 1 in 5 students – the need is great Educators feel ill-prepared to deal with the magnitude of the problem (Taking Mental Health to School, 2009) Schools are an optimal place to promote student well-being, and to identify and support students who struggle with mental health and addictions - but resources and supports are required The province is committed to working collaboratively across Ministries to support child and youth mental health in Ontario

5 Our priorities for the next three years Close Critical Service Gaps Increase availability of culturally appropriate services and serve more children and youth in Aboriginal, remote and underserved communities With complex mental health needs At the key transition point from secondary to post-secondary education Identify & Intervene Early Provide tools and support to those in contact with children and youth so they can identify mental health issues sooner Provide resources for effective responses to mental health issues Build mental health literacy and local leadership Fast Access to High Quality Services Build capacity in the community-based sector Reduce wait times Meet community needs Link education, child and youth mental health, youth justice, health care, and the community Support System Change Support development of an effective and accountable service system for all Ontarians Build on efforts that promote evidence-informed practice, collaboration, and efficiencies Develop standards and tools to better measure outcomes for children and youth

6 6 Starting with Child and Youth Mental Health Our Vision: An Ontario in which children and youth mental health is recognized as a key determinant of overall health and well-being, and where children and youth reach their full potential. Provide fast access to high quality service Kids and families will know where to go to get what they need and services will be available to respond in a timely way. Identify and intervene in kids’ mental health needs early Professionals in community-based child and youth mental health agencies and teachers will learn how to identify and respond to the mental health needs of kids. Close critical service gaps for vulnerable kids, kids in key transitions, and those in remote communities Kids will receive the type of specialized service they need and it will be culturally appropriate THEMES INDICATORS Reduced child and youth suicides/suicide attempts Educational progress (EQAO) Fewer school suspensions and/or expulsions Decrease in severity of mental health issues through treatment Decrease in inpatient admission rates for child and youth mental health Higher graduation rates More professionals trained to identify kids’ mental health needs Higher parent satisfaction in services received Fewer hospital (ER) admissions and readmissions for child and youth mental health Reduced Wait Times OVERVIEW OF THE MENTAL HEALTH AND ADDICTIONS STRATEGY FIRST 3 YEARS INITIATIVES Provide designated mental health workers in schools Implement Working Together for Kids’ Mental Health Hire Nurse Practitioners for eating disorders program Improve service coordination for high needs kids, youth and families Implement standardized tools for outcomes and needs assessment Amend education curriculum to cover mental health promotion and address stigma Develop K-12 resource guide for educators Implement school mental health ASSIST program &mental health literacy provincially Enhance and expand Telepsychiatry model and services Provide support at key transition points Hire new Aboriginal workers Implement Aboriginal Mental Health Worker Training Program Create 18 service collaboratives Expand inpatient/outpatient services for child and youth eating disorders Reduce wait times for service, revise service contracting, standards, and reporting Funding to increase supply of child and youth mental health professionals Improve public access to service information Pilot Family Support Navigator model Y1 pilot Increase Youth Mental Health Court Workers Provide nurses in schools to support mental health services Implement Mental Health Leaders in selected School Boards Outcomes, indicators and development of scorecard Strategy Evaluation

7 Ministry of Education Commitments Enhance the education curriculum Develop a K-12 Resource Guide/Website Provide support for professional learning in mental health for all Ontario educators Implement School Mental Health ASSIST Fund and support Mental Health Leaders in school boards Support Working Together for Kids’ Mental Health

8 You are Critical to Success of the MHA Strategy Research highlights the importance of leadership in effective school mental health This leadership relies on key system mobilizers who create and sustain organizational conditions necessary for effective school mental health The Ministry of Education has invested in you to serve this critical role

9 We are here to support you Leadership Modules ◦Focus on implementation science and creating conditions for effective school mental health Mental Health Awareness & Literacy materials ◦For system leaders ◦For schools Communication tools for use in your board Ongoing implementation and coaching support via School Mental Health ASSIST

10 Together, we will shape the future of school mental health in Ontario. We will be consulting with you, questioning with you, struggling with you, walking with you… to find the best ways to help all of Ontario students.

11 Introductions Your Name, Board/Organization, Role ◦MH Leaders and Superintendents, Cohort #1 What has been the best thing about the MH Leader Role? The Mental Health and Addictions Strategy? ◦MH Leaders and Superintendents, Cohort #2 What are you looking forward to the most? What are your hopes for the Mental Health and Addictions Strategy? ◦Other Guests How do you fit? Best thing about the Strategy?

12 AgendaOrdre du jour Welcome and GreetingsMot de bienvenue Introductions and OverviewPrésentations et aperçu de la session School Mental Health ASSIST and the MH Leader Role Aperçu de l’Équipe d’appui pour la santé mentale dans les écoles ASSIST Challenges and Helpful HintsDéfis et conseils pratiques LunchDéjeuner Leadership Modules Cohort 1 – Strategy Execution Cohort 2 – Implementation Science Modules de leadership 1 ère cohorte – l’exécution de votre stratégie en santé mentale 2 ème cohorte – la science de la mise en œuvre et le leadership MH Capacity Building ResourcesRessources Closing and Next StepsProchaines étapes et mot de la fin

School Mental Health ASSIST Awareness, Strategy Selection & Implementation Support Team Équipe d’appui en santé mentale pour les écoles Interactive Overview Interrupt! Ask Questions! Jot down questions for the parking lot

14 Mental Health is… “A state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity” World Health Organization

15 Mental Health Continuum

What is Positive Mental Health? It has something to do with relationships … 16

17 For many children, it is not that simple… Roughly one in five students in Canadian schools struggle with a mental health problem that interferes with their day to day functioning.

18 In their words… Change the View 2012

19 Schools are an optimal setting in which to:  Reduce stigma  Promote positive mental health  Build student social- emotional learning skills  Prevent mental health problems in high risk groups  Identify students in need  Build pathways to care Schools Have a Unique Opportunity

20 In Partnership with Community/Health Universal Evidence-Based Mental Health Promotion, Social-Emotional Learning Targeted Evidence- Based Prevention E-B Clinical Intervention Evidence-Based Clinical Intervention Targeted Evidence-Based Prevention Universal E-B Mental Health Promotion Community/Health School Districts

21 Background Reading on SMH Key Papers ◦Out of the Shadows at Last, 2006 ◦Kutash et al on School Based Mental Health, 2006 ◦Taking Mental Health to School, 2009 ◦IOM report on prevention/promotion, 2009 ◦SBMHSA Consortium Synthesis, Scan, Survey ◦Intercamhs International Survey of Principals Key Journals ◦Advances in School Mental Health (Editor, Weist) ◦School Mental Health (Editor, Evans) ◦School Psychology Quarterly Key Sites ◦SMHP UCLA ◦SMH Maryland ◦CASEL ◦SAMHSA ◦MindMatters

22 School Mental Health ASSIST is a provincial implementation support team designed to help Ontario school boards to promote student mental health and well-being, through leadership, practical resources and systematic research-based approaches to school mental health.

23 Leadership Structure Ontario Ministry of Education Lead ◦ Special Education Policy & Programs Branch School Board Lead ◦ Hamilton-Wentworth District School Board SMH ASSIST Core Team ◦ Director, and 4+ P/T Implementation Coaches (3 Senior School Mental Health Professionals, 1 Superintendent),.5 Research Associate Cross-Sector Partners ◦ Interministerial Staff Team ◦ Hospital for Sick Children, Ontario Centre of Excellence for Child & Youth MH ◦ Provincial Stakeholder Organizations Evaluation and Implementation Consultation Team ◦ Drs. Michael Boyle, Bruce Ferguson, Tom Kratochwill, Robert Lucio, Ian Manion, Doris McWhorter, Karen Milligan, Caroline Parkin, Joyce Sebian, Mark Weist

24 Priorities 1. Organizational Conditions for Effective School Mental Health 2. Mental Health Capacity- Building for Educators 3. Implementation of Evidence-Based Mental Health Promotion and Prevention Programming

25 Support to ALL Boards Resources Webinar series, other staff development materials Decision support tools Templates School Administrators’ Toolkit Consultation Workshops Representation on provincial reference groups & committees

26 Focus Boards 15 boards were Focus Boards in , another 15 announced for Boards receive 1 FTE Mental Health Leader and SMH ASSIST support Reciprocal relationship with SMH ASSIST ◦ASSIST provides leadership & implementation support ◦Focus Boards help with piloting resources that will be rolled out to all boards in time

27 Focus Boards Algoma DSB Algonquin and Lakeshore Catholic DSB CSD Catholiques Centre-Sud CSD des écoles catholiques du Sud- Ouest CSD du Nord-Est de l'Ontario District School Board of Niagara Hamilton-Wentworth DSB Hastings and Prince Edward DSB Huron-Superior Catholic DSB Keewatin-Patricia DSB Kenora Catholic District School Board Peel DSB Simcoe-Muskoka Catholic DSB Toronto Catholic DSB Trillium Lakelands DSB Selected for geographic, language, Catholic/Public representation, along a continuum of School Mental Health capacity CSD catholique des Grandes Rivières CSD du Grand Nord de l'Ontario Grand Erie DSB Halton DSB Lakehead DSB Lambton Kent DSB London District Catholic DSB Northeastern Catholic DSB Ontario North East DSB Ottawa Catholic DSB Simcoe County DSB Thunder Bay Catholic DSB Toronto DSB Upper Grand DSB York Catholic DSB

Introducing…Mental Health Leaders 28 What is Ontario Mental Health and Addictions Strategy? Open Minds, Healthy Minds is a ten-year Strategy designed to enhance the mental health and well-being of citizens of Ontario. It includes contributions from ten government Ministries and offers a systematic and comprehensive approach to service delivery along the continuum of mental health promotion, prevention, and intervention / ongoing care. The first three years of the Strategy are devoted to children and youth mental health and addictions under the leadership of the Ministry of Children and Youth Services. What are the Ministry of Education Commitments to the Strategy? Amend the education curriculum Develop a K-12 Resource Guide/Website Provide support for professional learning in mental health and addictions for all Ontario educators Fund and support Mental Health Leaders in publicly funded school boards Support Working Together for Kids’ Mental Health Implement School Mental Health ASSIST For more information, contact: Sandy Palinski, Manager Special Education Policy & Programs Branch Ministry of Education Telephone: What is the Role of the Mental Health Leader? Mental Health Leaders are full-time senior mental health professionals with dedicated responsibility for : conducting/updating board and school level resource mapping to determine areas of strength and need providing leadership for the board mental health team working with senior administration to develop and implement the board mental health & addictions strategy collaborating with board and community professionals to promote clear and integrated access to services coordinating systematic mental health literacy initiatives in the board selecting and supporting evidence-based approaches to mental health promotion and prevention How are the Mental Health Leaders positioned in School Boards? In most boards, Mental Health Leaders report to, or work closely with, Supervisory Officers with responsibility for student mental health and well-being. They also work alongside senior psychologists and social workers as part of a board mental health leadership team. Mental Health Leaders are a key point of contact for new professionals hired to support boards as part of the Ontario Mental Health and Addictions Strategy.

29 The Journey Ahead Understand the Big Picture Understand your Role Understand Alignment Understand your District and Community ◦Board Scan, Resource Mapping Assess Needs, Strengths, Priorities Create a Board MH Strategy ◦Organizational Conditions ◦Professional Learning ◦Mental Health Promotion/Prevention Programming Implement your Strategy

30 Understanding the Big Picture Provincial Level (e.g., interministry coordination, SMH ASSIST) Board Level (e.g., MH Strategy, coordinated mental health literacy training, menu of evidence-based strategies) School Level (e.g., enhanced staff understanding of students with behavioral problems and helpful strategies, more accurate identification and referral, more caring adults) Student Level (e.g., enhanced sense of belonging, more help-seeking, stronger coping skills) Better mental health and academic outcomes

Working Impact Model Focused Mental Health Leadership, Capacity, & Implementation Support Enhanced Student Perceptions about School Climate (presence of caring adults, sense of belonging, safety) Enhanced Staff Sense of Competence and Well- Being (knowledge re: mental health & sources of help, use of effective strategies, coping skills) Enhanced Student Mental Health and Well-Being System Coordination + Mental Health Awareness Enhanced District Conditions Enhanced MH Capacity Enhanced MH Implementation

32 Understanding Your Role Mental Health Leaders are senior mental health professionals with full-time dedicated responsibility: ◦ providing leadership for the board mental health team ◦ conducting/updating board and school level resource mapping to determine areas of strength and need ◦ working with senior administration to develop, execute and monitor the board mental health & addictions strategy ◦ collaborating with board/community professionals to consolidate processes to promote clear and integrated access to services ◦ coordinating systematic mental health literacy initiatives ◦ selecting and supporting evidence-based approaches to mental health promotion and prevention

33 Understanding Role Alignment Mental Health Leader complements: ◦Supervisory Officer responsible for SMH ◦Chief Social Worker, Chief Psychologist ◦Social Work, Psychology Staff ◦Other professionals who provide support (e.g., CYWs, Student Success, Guidance) ◦Community Mental Health Professionals Mental Health Leader also needs to define role relative to new professionals that are part of the MHA Strategy (MCYS workers in schools, MOHLTC nurses)

LNS SS_Lto18 Positive School Climate Learning for All Leadership Strategy Growing Success Student Voice Parent Engagement Accepting and Safe Schools Strategies Aboriginal Education Strategy Equity and Inclusive Education Strategy Equity and Inclusive Education Strategy BIP for Student Achievement K-12 School Effectiveness Framework Healthy Schools Mental Health & Addictions Strategy Connections Amend the education curriculum Implement School Mental Health ASSIST Develop a K- 12 Resource Guide /Website Fund and support Mental Health Leaders in school boards Provide support for professional learning in mental health for educators Initiative Alignment

35 Understanding your District and Community Board Scan ◦On-line surface scan that provides current status with respect to organizational conditions, professional learning, & MH programming ◦Fall and Spring each year Resource Mapping ◦Deeper exploration of the existing strengths, needs and resources in your board and community ◦System and School Level ◦Survey, interviews, meeting

36 Strategy Development Assess Needs, Strengths, Priorities ◦What are we doing well? ◦What is missing? ◦What are our priorities for the coming year? Create a Board MH Strategy ◦Organizational Conditions (leadership team, protocols, etc.) ◦Professional Learning (cascaded PD) ◦Mental Health Promotion/Prevention Programming (select, enhance, sustain) Implement!

37 Support for Mental Health Leaders Leadership Modules ◦Insiders’ Guide to School Boards ◦Implementation Science ◦Leadership and Change (on-line PACE modules) ◦Facilitation Skills ◦Collaboration Skills ◦Resource Mapping and Building a MH Strategy ◦Evidence-Based Practice in School MH Implementation Coach On-Line Community of Practice Resources/Templates for Recommended Protocols e-SMH Library

38 Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M. & Wallace, F. (2005). Implementation Research: A Synthesis of the Literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network (FMHI Publication #231). Download all or part of the monograph at: Implementation Research: A Synthesis of the Literature Implementation Science

39 Key Messages to Take Away School Mental Health ASSIST… 1. Is here to support you.

40 Learning Together Discussion Group Resources e-SMH Library

41 List 1-3 areas in which you have developed some particular knowledge / expertise related to school mental health When might we turn to YOU? List 1-3 areas in which you have developed some particular knowledge / expertise related to school mental health Like, Developing district infrastructure or protocols Working with community partners Supporting families in rural/remote communities Working with immigrant and refugee children Helping students with behavioral disorders Implementing evidence-based programs Working with FNMI communities Mental Health Literacy for Educators Suicide prevention…. Include your name!

42 Contact ASSIST Kathy Short, Ph.D., C.Psych. Director, School Mental Health ASSIST , x2634

Challenges and Helpful Hints Cohort # 1 Mental Health Leaders For Bringing a Mental Health and Addictions Strategy to Life in your Board

44 Key Themes positioning the role, working within school boards, creating/enhancing a leadership team, resource mapping, communicating about ASSIST, working with the community, managing distractions coordinating professional learning, dealing with existing programs and products, selecting evidence-based programming, developing a MH Strategy, managing crises.

Coordinating Professional Learning Cohort # 1 Mental Health Leaders Resources to Support Mental Health Awareness, Literacy, and Expertise

The Mental Health Capacity- Building Continuum Mental Health Awareness Mental Health Literacy Mental Health Expertise Basic mental health information, tailored for different school board audiences Deeper working knowledge for those who have a direct role in supporting student mental health (creating mentally healthy schools & classrooms, recognizing early signs of difficulty) Skills and knowledge for SMH professionals to effectively provide evidence-based promotion, prevention, and intervention ALLSOME FEW Capacity Building is not an event! It is an iterative deepening of knowledge that is embedded in school board life. It takes time. Resources should be tailored for different education audiences

47 Mental Health Awareness For All (MH Awareness Webinar) For Senior Leaders (MH District Conditions Webinar) For School Leaders (MH School Conditions Webinar) For Educators (MH Classroom Conditions Webinar) ◦Ontario Centre of Excellence for Child and Youth Mental Health - MH Awareness Workshop For Special Services (e.g., Student Success, Guidance, Special Education) For Parents For Youth

48 Mental Health Literacy For School Leaders (School Leaders’ Guide) For Educators (Educator Guide) Special Modules Ontario Centre of Excellence for Child and Youth Mental Health – Bullying, Suicide, Engagement, Stigma, Anxiety, Cross-Cultural Caring - Ontario Centre of Excellence for Child and Youth Mental Health – Bullying, Suicide, Engagement, Stigma, Anxiety, Cross-Cultural Caring - SMH ASSIST will create school versions of these SMH ASSIST modules (e.g., Creating a Mentally Healthy Classroom (HWDSB), Social Emotional Learning in the Classroom, Supporting the Disruptive/Impulsive/Sad Student) Other Resources (e.g., Suicide Postvention Protocol)

49 Mental Health Expertise For Mental Health Professionals Partnering with experts in the field ◦Substance Use (Canadian Centre on Substance Abuse) ◦Non-Suicidal Self-Harm (McGill) Other topics??

Closing and Next Steps And Thank You!

Next Steps – Cohort #2 Connect with ASSIST Implementation Team to schedule an individual meeting and begin the needs assessment process (SO and MH Leader) Visit the SMH website Complete the on-line implementation modules and other key readings Review the Board Scan and Resource Mapping materials 51

A visit to the Parking Lot Burning Questions and Comments… Please complete the evaluation form Thank you! 52