Presented for: The Leadership Summit on Mental Health By:Don Martin, Superintendent Winston-Salem/Forsyth County Schools October 17, 2005 October 17, 2005

WINSTON-SALEM/FORSYTH COUNTY SCHOOLS Student Enrollment—49,782 Student Enrollment—49, Schools 73 Schools -40 Elementary -14 Middle -13 High Schools (includes four small Gates high schools) - 6 Special Schools

WINSTON-SALEM/FORSYTH COUNTY SCHOOLS District Staffing to Improve Student Mental Health District Staffing to Improve Student Mental Health Ratio# Positions -Counselors1: 375 (134) -Social Workers1:1,476 ( 34) -Psychologists1:2,008 ( 25) School Health Alliance School Health Alliance Anti-Bullying Initiative Anti-Bullying Initiative

SCHOOL HEALTH ALLIANCE FOR FORSYTH COUNTY Non-profit 501(c)(3) – funded by Wake Forest University Baptist Medical Center, Forsyth Medical Center, various, grants, WS/FC Schools Non-profit 501(c)(3) – funded by Wake Forest University Baptist Medical Center, Forsyth Medical Center, various, grants, WS/FC Schools Founded 1999 Founded 1999 Mission: to improve the ability of students to learn by Mission: to improve the ability of students to learn by Improving their health and safety Improving their health and safety Coordinating and targeting resources of community health providers Coordinating and targeting resources of community health providers

SCHOOL HEALTH ALLIANCE FOR FORSYTH COUNTY OBJECTIVES To develop and evaluate models of school- based health care promoting preventive strategies and improving access to health care and mental health services To develop and evaluate models of school- based health care promoting preventive strategies and improving access to health care and mental health services To replicate and fund effective models To replicate and fund effective models

SCHOOL HEALTH ALLIANCE FOR FORSYTH COUNTY OBJECTIVES To develop and fund programs that address those conditions most closely associated with school performance (initially behavior problems and asthma) To develop and fund programs that address those conditions most closely associated with school performance (initially behavior problems and asthma) To focus on a preventive program for cardiovascular disease, a major cause of morbidity and mortality in Winston-Salem To focus on a preventive program for cardiovascular disease, a major cause of morbidity and mortality in Winston-Salem To serve as School Health Advisory Council for WS/FCS To serve as School Health Advisory Council for WS/FCS

SCHOOL HEALTH ALLIANCE BOARD OF DIRECTORS SCHOOL HEALTH ALLIANCE BOARD OF DIRECTORS Wake Forest University Health Sciences Forsyth Early Childhood Development Forsyth County Department of Social Services The North Carolina Baptist Hospitals, Inc. Forsyth County Department of Public Health Winston-Salem/Forsyth County Schools Winston-Salem State University CenterPoint Human Services Forsyth Pediatric Associates Forsyth County Council of PTAs Medical Park Hospital Forsyth Medical Center Forsyth-Stokes-Davie County Medical Society

SCHOOL HEALTH ALLIANCE SCHOOL-BASED MENTAL HEALTH SERVICES Licensed Clinical Social Workers (LCSW) Licensed Clinical Social Workers (LCSW) Three models Three models 1.5 FTE LCSW in comprehensive health center (Mineral Springs Elementary and Middle Schools)—parental consent required 1.5 FTE LCSW in comprehensive health center (Mineral Springs Elementary and Middle Schools)—parental consent required 0.5 FTE (Ashley) and 1.0 FTE (Atkins) LCSW partnered with registered nurse—students all eligible unless parent declines 0.5 FTE (Ashley) and 1.0 FTE (Atkins) LCSW partnered with registered nurse—students all eligible unless parent declines 1.0 FTE LCSW solo in high school (North Forsyth) for alternative and high risk students— offered to targeted students, voluntary 1.0 FTE LCSW solo in high school (North Forsyth) for alternative and high risk students— offered to targeted students, voluntary

SCHOOL HEALTH ALLIANCE SCHOOL-BASED MENTAL HEALTH SERVICES Social workers accept referrals from teachers and administrative staff; collaborate with other disciplines on SHA staff Social workers accept referrals from teachers and administrative staff; collaborate with other disciplines on SHA staff With parents’/students’ consent, social workers work closely with teachers, monitoring effects of therapy, assisting teachers with behavioral management With parents’/students’ consent, social workers work closely with teachers, monitoring effects of therapy, assisting teachers with behavioral management

SCHOOL HEALTH ALLIANCE SCHOOL-BASED MENTAL HEALTH SERVICES STRUCTURE Contract between SHA and WS/FCS Contract between SHA and WS/FCS  Medical direction by pediatrician  Coordination with other SHA services by nurse practitioner/coordinator  Consultation with psychiatrist (on-site in two models; periodic case review in all models)  Billing arrangements in transition

SCHOOL HEALTH ALLIANCE SCHOOL-BASED MENTAL HEALTH SERVICES EVALUATION MEASURES Comparison of initial vs. latest…  Child and Adolescent Functional Assessment Scale (CAFAS)  Reading and math grades

SCHOOL HEALTH ALLIANCE SCHOOL-BASED MENTAL HEALTH SERVICES EVALUATION OUTCOMES For students with mental health conditions  Statistical improvement in CAFAS scores  Statistical improvement in math grades  Trend toward improvement in reading grades (did not reach statistical significance)

SCHOOL HEALTH ALLIANCE SCHOOL-BASED MENTAL HEALTH SERVICES OTHER ACTIVITIES Community protocol for collecting and exchanging information between physicians and elementary schools Community protocol for collecting and exchanging information between physicians and elementary schools Common entry point for concerns: SAT at school Common entry point for concerns: SAT at school Schools collect Vanderbilt Scales (parent and teacher), achievement test results, cognitive screening test, current placement Schools collect Vanderbilt Scales (parent and teacher), achievement test results, cognitive screening test, current placement Form for physician to complete and return to school Form for physician to complete and return to school

SCHOOL HEALTH ALLIANCE SCHOOL-BASED MENTAL HEALTH SERVICES OTHER ACTIVITIES Liaison with Child and Family Advisory Committee of the Local Management Entity (LME) Liaison with Child and Family Advisory Committee of the Local Management Entity (LME) Liaison with Forsyth Council for Children and Families Liaison with Forsyth Council for Children and Families Contract with LME for administrative support of school-based services Contract with LME for administrative support of school-based services LME Director serves on Board of SHA LME Director serves on Board of SHA

THE DISCIPLINE TASK FORCE Formed and met during the school year. Formed and met during the school year. Consisted of parents, teachers, counselors and administrators. Consisted of parents, teachers, counselors and administrators.

THE DISCIPLINE TASK FORCE Purpose Purpose -To study areas of needed improvement based on the 2003 Safety Survey results. -To identify effective discipline models and programs that would address areas of concern.

THE DISCIPLINE TASK FORCE Concentrated on two areas: Concentrated on two areas: -Bullying -School Climate

THE DISCIPLINE TASK FORCE DEFINITION OF BULLYING The term “bully” means the repeated and deliberate verbal and physical abuse of a student by one or more students. This aggressive behavior is unwelcome, unprovoked and intended to do emotional harm. It generally occurs in a context where there is a real or perceived imbalance of power, physical or social, between the bully and the victim.

THE DISCIPLINE TASK FORCE TYPES OF PROHIBITED BULLYING BEHAVIORS a. Physical bullying includes the repeated and deliberate making of obscene gestures, pushing, shoving, hair pulling, and any other unwelcomed physical contact intended to create an intimidating and hostile environment.

THE DISCIPLINE TASK FORCE TYPES OF PROHIBITED BULLYING BEHAVIORS b. Verbal bullying includes such acts as: (1) hurtful name-calling, teasing, or intimidating; (2) defaming or spreading false rumors about another person to cause them to be disliked, humiliated or disrespected by their peers; (3) persuading, encouraging or leading other students to exclude or socially isolate the victim in order to cause emotional harm;

THE DISCIPLINE TASK FORCE TYPES OF PROHIBITED BULLYING BEHAVIORS b. (4) extorting money, property or services from another student; and/or (5) making derogatory, demeaning or hostile comments about another student’s race, disability, ethnicity, or gender.

THE DISCIPLINE TASK FORCE RECOMMENDATIONS DISTRICT 1. At the beginning of each school year, increase efforts to inform parents and students of policy and administrative regulation related to bullying.

THE DISCIPLINE TASK FORCE RECOMMENDATIONS DISTRICT 2. Provide information about bullying to use with parents and community groups - to increase awareness -to share prevention strategies. -to ask for support and involvement.

THE DISCIPLINE TASK FORCE RECOMMENDATIONS DISTRICT 3. Provide professional development related to bullying for all employees.

THE DISCIPLINE TASK FORCE RECOMMENDATIONS DISTRICT 4. Complete cultural competency training for all employees by the end of the school year.

THE DISCIPLINE TASK FORCE RECOMMENDATIONS DISTRICT 5. Improve the monitoring of student behavior on school buses by purchasing a camera per school for school administrators to place rotationally on buses as needed.

THE DISCIPLINE TASK FORCE RECOMMENDATIONS DISTRICT 6. Involve students in bullying prevention efforts: -a district-wide poster contest -an essay contest

THE DISCIPLINE TASK FORCE RECOMMENDATIONS School-Level 1. Ask that each school staff have a school wide discipline plan that includes rules and consequences that address bullying.

THE DISCIPLINE TASK FORCE RECOMMENDATIONS School-Level 2. Communicate the school-wide discipline plan in multiple ways.

THE DISCIPLINE TASK FORCE RECOMMENDATIONS School-Level 3. Encourage student clubs, such as Students Against Violence Everywhere (SAVE), Student Council, and other organizations to emphasize bullying prevention.

THE DISCIPLINE TASK FORCE RECOMMENDATIONS School-Level 4. Analyze and share school data Utilize the data to make revisions in the school ’ s safety plan as needed. Involve students at the upper elementary, middle and high school levels in this process.

THE DISCIPLINE TASK FORCE RECOMMENDATIONS School-Level 5. Emphasize and model the need to build strong relationships -staff -students and staff -staff and parents -staff and the school community.

THE DISCIPLINE TASK FORCE RECOMMENDATIONS School-Level 6. Integrate character education into content areas by using the WS/FCS Character Development Plan and the WS/FCS Character Education Supplement.

THE DISCIPLINE TASK FORCE RECOMMENDATIONS School-Level 7. Review the Life Management Skills course at the high school level for possible revision to include bullying prevention and intervention strategies.

THE DISCIPLINE TASK FORCE RECOMMENDATIONS Community 1. Share information about the district ’ s character education program with the faith-based community

THE DISCIPLINE TASK FORCE RECOMMENDATIONS Community 2. Develop a list of speakers from the district who will do presentations on bullying to businesses and community groups.

THE DISCIPLINE TASK FORCE STUDENT SURVEY RESPONSE Has a student bullied you this year at school? Percent Answering Yes Percent Answering Yes AllGradeGradeGrade Students Students %21.8%14.8% 8.6% %16.0%13.2% 5.8%

THE DISCIPLINE TASK FORCE STUDENT SURVEY RESPONSE When a student bullied you this year at school, did you tell an adult at the school? Percent Answering Yes Percent Answering Yes AllGradeGradeGrade Students Students %69.1%47.7%46.4% %63.2%49.6%45.6%

THE DISCIPLINE TASK FORCE STUDENT SURVEY RESPONSE When you reported bullying to an adult, did the adult do something about it? Percent Answering Yes Percent Answering Yes AllGradeGradeGrade Students Students %53.7%39.7%40.2% %60.6%49.2%43.5%

THE DISCIPLINE TASK FORCE STUDENT SURVEY RESPONSE Has one or more of your teachers discussed bullying with your class this year? Percent Answering Yes Percent Answering Yes AllGradeGradeGrade Students Students %83.6%41.4%11.4% %91.0%75.6%27.6%

THE DISCIPLINE TASK FORCE PARENT SURVEY RESPONSE Has a student bullied your child this year at school? Percent Answering Yes Percent Answering Yes AllGradeGradeGrade Parents Parents %15.2%15.3% 7.1% %15.1%17.1% 6.8%

THE DISCIPLINE TASK FORCE PARENT SURVEY RESPONSE When a student bullied your child this year at school, did you report the incident to the school? Percent Answering Yes Percent Answering Yes AllGradeGradeGrade Parents Parents %61.7%63.1%44.6% %67.8%63.7%58.3%

THE DISCIPLINE TASK FORCE PARENT SURVEY RESPONSE When you reported bullying, did the school do something about it? Percent Answering Yes Percent Answering Yes AllGradeGradeGrade Parents Parents %52.2%48.8%30.4% %54.5%45.6%28.6%

THE DISCIPLINE TASK FORCE PARENT SURVEY RESPONSE Rules are applied the same for everyone at this school. Percent Agreeing/Strongly Agreeing Percent Agreeing/Strongly Agreeing AllGradeGradeGrade Parents Parents %86.3%70.0%65.5% %81.0%63.4%64.0% %81.0%66.2%67.2% %82.5%66.7%56.4%

THE DISCIPLINE TASK FORCE PARENT SURVEY RESPONSE The principal at this school is available to parents when needed. Percent Agreeing/Strongly Agreeing Percent Agreeing/Strongly Agreeing AllGradeGradeGrade Parents Parents %87.8%73.6%69.7% %83.3%72.4%67.0% %86.8%73.8%69.4% %87.2%74.3%63.9%

THE DISCIPLINE TASK FORCE PARENT SURVEY RESPONSE My child is safe at this school. Percent Agreeing/Strongly Agreeing Percent Agreeing/Strongly Agreeing AllGradeGradeGrade Parents Parents %96.4%87.7%88.5% %94.8%88.4%84.6% %96.7%88.0%90.9% %97.0%88.0%88.8%

THE DISCIPLINE TASK FORCE PARENT SURVEY RESPONSE It is easy to communicate with teachers at this school. Percent Agreeing/Strongly Agreeing Percent Agreeing/Strongly Agreeing AllGradeGradeGrade Parents Parents %91.3%74.0%67.9% %88.4%75.6%62.8% %90.6%77.5%76.1% %92.2%79.5%75.3%

QUESTIONS