Organizational Conditions for Effective School Mental Health So, leadership is a critical component in effective school mental health. In the following section, organizational conditions that leaders can work to reinforce are described in detail. The Top Ten List

Self-Reflection How Concerning? How Important? Top 3 Concerns…

Research in Organizational Conditions Implementation Science (e.g., Fixsen et al.) Getting to Outcomes (e.g., Wandersman et al.) School-Wide Positive Behavior Support (e.g., Sugai et al.) Expanded School Mental Health (e.g., Weist et al.) REACh Framework (e.g., Kratochwill et al.) Knowledge Translation and Exchange (e.g., Barwick et al.) There is a growing evidence base on key conditions for supporting school mental health. The School Mental Health ASSIST team reviewed this literature, and consulted with several key leaders in the field, to arrive at a research-based Top 10 List of organizational conditions that support effective school mental health.

Navigating system change Is like behavior change with individuals – it occurs with persistent nudges

Top 10 List of Conditions Commitment School Mental Health Leadership Team Clear & Focused Vision Shared Language Assessment of Initial Capacity Standard Processes PD Protocols School Mental Health Strategy / Action Plan Broad Collaboration Ongoing Quality Improvement Each of these ten conditions will be described in detail next.

Self Reflection Where is your board currently, TODAY, along each of the conditions… Feel free to discuss, leave blank… Not handed in…

Commitment Condition ONE Board leaders view child and youth mental health as a priority, and communicate this through action Board leaders commit to Tiered Support Model Help board staff to understand the rationale for the model, emphasizing the focus in schools on mental health promotion and prevention and the need to work with community partners for help with students with significant mental health concerns Board leaders consistently attend community liaison meetings and internal MH team meetings Board leaders provide visible, strategic and tangible support for needed infrastructure, resources, staffing Condition #1. Effective school mental health requires commitment. Visible commitment on the part of senior staff – in the form of things like messaging about the Tiered Support Model, regular attendance at meetings, and tangible support towards needed infrastructure and resources.

Tiered Support in Systems of Care Organizational Conditions Universal Evidence-Based Mental Health Promotion, Social-Emotional Learning Targeted Evidence-Based Prevention E-B Clinical Intervention Evidence-Based Clinical Intervention Universal E-B Mental Health Promotion Community Mental Health Capacity Engagement Implementation Focus School Districts Continuous Quality Improvement

School Mental Health Leadership Team Condition TWO Board has a multidisciplinary, multi-layered mental health leadership team All of the right people are at the table (in terms of expertise, influence, relationships, representation) Parent and youth voice are critical Team has meaningful liaison with community partners Team is focused on vision-setting, leadership, collaboration, strategy/program selection, problem- solving Condition #2. A systematic and coordinated approach to school mental health is aided greatly by the presence of a multidisciplinary mental health leadership team. The composition of this team will vary, but representation is important for shared and distributed leadership. In best cases, this team has responsibility for setting direction, coordinating professional development, implementing the tiered service delivery model, leading mental health programming, and securing accountability.

Clear and Focused Vision Condition THREE Board has shared, realistic goals Vision is aligned with AOP, BIPSA, Strategic Directions Vision is aligned with key principles in school mental health (e.g., preventive, linked with instruction, evidence-based, connected with partners at home and school, strong use of data) Vision and goals are created collaboratively Vision is the basis for decision-making Condition #3. A clear and focused vision, that is created collaboratively and is aligned with board priorities and initiatives, is a key organizational element in school mental health. Most importantly, in districts that have been successful with implementation, this vision is used as a foundation on which to base decisions and actions.

Shared Language Condition FOUR The Board Vision for school mental health is communicated clearly across the organization Foundational knowledge about student mental health is conveyed Terms are defined consistently Where differences in language occur (e.g., across sectors), there is translation Use of early identification tools can be helpful for finding common ways to speak of problem areas Condition #4. Effective school mental health requires the involvement of many stakeholders, with varied professional backgrounds, often working across sectors and disciplines. At times, differences in language and understandings can interfere with an integrated system of care. Effective communities work towards shared meanings across partner organizations. There are many examples of communities in Ontario coming together under SSLI or Working Together for Kids’ Mental Health to develop this type of shared understanding.

Assessment of Initial Capacity Condition FIVE Assessment data informs the development of the board mental health strategy Before setting priorities, an assessment of organizational strengths, needs, and resources (resource mapping) can be very helpful This assessment includes a scan of resources, in the form of people, processes, and programs Staff and student voice data can deepen understanding of needs Condition #5. Too often, school mental health is managed in a fragmented manner. This occurs, in part, when new initiatives are introduced without appreciation for existing resources. School boards benefit from a period of “taking stock” - of the people, process, and program resources currently available - before embarking on new approaches in this area. Note that part of this taking stock can include gathering the perceptions of staff and students, with respect to priority areas of need.

Standard Processes Condition SIX Board has standard processes for school mental health: Who does what (role clarification) Selection of school and classroom evidence-based programs Delivery of training and coaching on programs and strategies Standards and tools for monitoring progress Partnerships with community Pathways to service Condition #6. In order to make school mental health more seamless, certain protocols and procedures can be helpful. Key processes to attend to include: articulating who does what within the board (e.g., What do social workers do? What do psychological consultants do? What do public health nurses do? What do mental health workers in schools do?), identifying how mental health programs are selected, and defining the pathway to service in your board (the route from when a teacher identifies a problem, to the child accessing school / board / community resources). The clarity that such protocols afford can assist with the smooth delivery of services in a tiered support model.

Protocols for Professional Development Condition SEVEN Board has a systematic approach to capacity building in mental health and well-being that includes: Mental Health Awareness for all Mental Health Literacy for those most closely involved with students Mental Health Expertise for those delivering specialized assessment & intervention services High quality training protocols, delivered by an engaging expert Job-embedded, with ongoing coaching Condition #7. Being systematic about professional development is very important, in order to avoid the trap of one time or fragmented workshops. System leaders need to consider which audiences, need which types of knowledge, delivered in which formats…. Who needs mental health awareness? Who is ready and needing mental health literacy? Are all of our key mental health professionals fluent or do they require training to deepen their expertise in particular areas? When selecting a speaker, it is important to think about who would be in the best position to deliver sustainable and relevant professional development (an outside expert? a school district leader? a combination?) Most critically, how can the professional development deepen iteratively over time so that educator knowledge is enhanced at a manageable and useful pace? School Mental Health ASSIST has worked with a national roundtable to create a Decision Support Tool to help with the selection of professional development strategies in this area. This tool is available to all Ontario school boards. Tools + Training + Technical Assistance + Quality Assurance

Mental Health Strategy / Action Plan Condition EIGHT The Board Mental Health Strategy is aligned with system goals The Strategy is founded on evidence-based practices in school mental health The Strategy is tailored to local context and data with respect to board needs and strengths The Strategy is focused on measureable outcomes An implementation support plan is clearly articulated Condition #8. A mental health strategy is a very important condition for effective service delivery within a tiered support model. Aligned with system priorities, and manageable in scope, this Strategy can capitalize on board strengths while addressing (a small number of) gap areas over a short period of time. A clear implementation support plan with key measurables is essential for ensuring full execution of the strategy.

Broad Collaboration Condition NINE The Board has several established platforms for dialogue and collaboration: Across departments and schools in the organization With community and health agencies With universities and other research organizations With parents With students With other boards With government Condition #9. This work is complex and is best done together! When boards create spaces for co-learning and collaboration, innovation emerges and commitment grows. There are many potential and willing partners. This is an area of passion for many, and tapping into this can lead to rich possibilities.

Ongoing Quality Improvement Condition TEN The board has a system of ongoing quality improvement, that includes measurement: Of program / strategy implementation Of teacher perceptions and knowledge Of student perceptions and knowledge Of student outcomes Condition #10. Continuous quality improvement is a key feature of successful school mental health systems. Measurement of process variables, like program implementation fidelity, of perceptions, and of outcomes, can assist with decisions about future actions. School Mental Health ASSIST is working with a team of leaders in this area to prepare tools to help in the area of future measurement.

Support THANK YOU! Your Superintendent / Director Your Board MH Team, MH Professionals SMH ASSIST team, and especially your coach, are here to help you to establish these conditions in your board over time THANK YOU!