School Mental Health Three Years After the New Freedom Commission Report:Ohio’s Experience and Lessons Learned Carl E. Paternite Center for School-Based Mental Health Programs Department of Psychology Miami University (Ohio) NAMI 2006 Annual Conference Washington, DC June 30, 2006

Key Current and Past Mental Health-Schools-Families Shared Agenda Partners in Ohio Ellen Abraham, Lakewood City Schools (Lakewood) Mike Armstrong, Ohio Department of Education (Columbus) Dawn Anderson Butcher, College of Social Work (Ohio State U., Columbus) Noelle Duvall, Children’s Resource Center (Bowling Green) Stephanie Falor, Ohio Department of Education (Columbus) Paul Flaspohler, Center for School-Based Mental Health Programs (Miami U., Oxford) Terre Garner, Ohio Federation for Children’s Mental Health (Cincinnati) Diana Leigh, Center for Learning Excellence (Ohio State U., Columbus) Paul Lilley, Alcohol, Drug Addiction, and MH Services Board of Hancock Co. (Findlay) Linda Maxwell, Children’s Hospital (Columbus) Sue Mikolic, National Alliance for the Mentally Ill of Ohio (Eastlake) Jennifer Miller, Ohio Department of Education (Columbus) Kathy Oberlin, Heartland Behavioral Health (Cuyahoga Falls) Julie Owens, Department of Psychology (Ohio U., Athens) Kay Rietz, Ohio Department of Mental Health (Columbus) Mary Lou Rush, Ohio Department of Education (Columbus) Dave Tener, Woodland Centers (Gallipolis) Jennifer Vargo, Center for Learning Excellence (Ohio State U., Columbus) Amy Wilms, Center for School-Based Mental Health Programs (Miami U., Oxford) Joe Zins, CASEL and University of Cincinnati (Cincinnati) AND MANY OTHERS

Accountability to…

Being Accountable to Students (Families) and Teachers By Ensuring Effective School Mental Health (SMH) Services Experiences of three students: Kristin, Tova, and Rachel

Accountability Questions What are the strengths of how Tova was “served” by her school? What are the weaknesses of how Tova was “served” by her school? In an ideal world, and in a school that is committed to getting the conditions right, how should students like Tova be served? What are the barriers (obstacles) to more effectively serving students like Tova? How would Tova be served in your school?

Accountability Questions What are the strengths of how Kristin’s brother George was “served” by his school? What are the weaknesses of how George was “served” by his school? In an ideal world, and in a school that is committed to getting the conditions right, how should George have been served? What are the barriers (obstacles) to more effectively serving students like George? How would George have been served in your school?

Accountability Questions What are the strengths of how Rachel was “served” by her school? What are the weaknesses of how Rachel was “served” by her school? In an ideal world, and in a school that is committed to getting the conditions right, how should students like Rachel be served? What are the barriers (obstacles) to more effectively serving students like Rachel? How would Rachel be served in your school?

Mission To help Ohio’s school districts, community-based agencies, and families work together to achieve improved educational and developmental outcomes for all children — especially those at emotional or behavioral risk and those with mental health problems.  Since 2001  Ohio Department of Mental Health  Ohio Department of Education  Center for School-Based Mental Health Programs at Miami University ( Ohio Mental Health Network for School Success

Ohio Mental Health Network for School Success Key Supplementary Funding  Shared Agenda seed grants (2002, 2005) from IDEA Partnership  Numerous additional State/regional organizations

Guiding Principles for a Mental Health, Schools, Families Shared Agenda  Mental health is crucial to school success  There are shared opportunities for mental health, schools, students and families to work together more effectively

The Ohio Mental Health Network for School Success Overarching Agenda  Build and sustain a “community of practice” to create and foster demand for expanded, effective school mental health programs and services  Create/foster demand at all levels—local, regional, state, and national

Ohio Mental Health Network for School Success The Ohio Mental Health Network for School Success Specific Action Agenda Create awareness of needs and gaps in resources; address stigma Gather data on needs, resources,and promising practices Partner with six action networks for regional and statewide efforts (e.g., training institutes, workshops, action research, etc.) Train and provide technical assistance to support adoption of evidence-based and promising practices Promote education—mental health—family collaboration Identify financial resources for school mental health initiatives Promote inter-professional strategies and practices in university-based professional preparation programs (education, psychology, counseling, social work, public health, child psychiatry, nursing…)

Integrated Systems to Support the Development of All Children Systems of Prevention and Promotion All Students (universal) Systems of Early Intervention Students At-Risk (selected) Systems of Treatment Students with Problems (indicated) School, Family, and Community Partnerships From work of Joe Zins

Ohio’s Mental Health, Schools, and Families Shared Agenda Initiative Phase 1 Statewide forum for leaders of mental health, education, and family policymaking organizations and child-serving systems (March 3, 2003) Phase 2 Six regional forums for policy implementers and consumer stakeholders (April-May, 2003) Phase 3 Legislative forum involving key leadership of relevant house and senate committees (October 9, 2003) Phase 4 Development and release of Shared Agenda report Phase 5 Ongoing policy/funding advocacy and technical assistance to promote attention to the crucial links between mental health and school success

Legislative Forum On Mental Health and School Success Creating A Shared Agenda In Ohio October 9, 2003

Phase 4 of Ohio’s Shared Agenda Initiative ODMH/ODE-sponsored ad hoc workgroup to develop Shared Agenda report addressing: Public Awareness and Advocacy Professional Development/Training and Service Delivery Policy and Funding Workgroup met three times between 11/03-3/04; Final report released August 2004 ( )

Ohio’s Mental Health, Schools, and Families Shared Agenda Initiative Phase 5 Ongoing policy/funding advocacy and technical assistance to promote attention to the crucial links between mental health and school success and to effective SMH practices.

Phase 5: An Immediate Legislative Outcome Senate Bill 2 Section (E) (effective June 9, 2004) “The standards for educator professional development developed under division (A) (3) of this section shall include standards that address the crucial link between academic achievement and mental health issues.”

Follow-up Advocacy and Technical Assistance Efforts with  Educator Standards Board  Numerous additional State/regional organizations and initiatives

Mental Health Issues and the No Child Left Behind Mandate: Two Important Interrelated Goals— Achievement and Wellbeing  1) Achievement promotes wellbeing  2) Wellbeing promotes achievement School philosophy often acknowledges 1 but fails to sufficiently acknowledge 2

Ohio Mental Health Network for School Success In Addition to Parents, Teachers are On the Mental Health “Front Line” Yet, teachers/educators are very poorly trained in problem recognition and mental health promotion Significant need to enhance teacher/educator training based on analysis of issues confronted in the classroom/school

Ohio Mental Health Network for School Success What Teachers/Educators Need Basic Current Knowledge About: Role of stress in students’ lives and impacts on learning Signs and symptoms of mental illness diagnoses (e.g., depression, ADHD, anxiety disorders, conduct disorders…) Risk factors and warning signs for suicide Protective factors that promote resilience in students Effective, culturally-informed treatments and supports for students with mental health problems Medications and effects (intended and side effects) on learning and behavior How to access community support and referral Impacts of stigma

Ohio Mental Health Network for School Success What Teachers/Educators Need Effective Strategies and Skills for: Promoting mental health (well-being) and academic achievement through instructional techniques and curriculum Creating a positive classroom climate that offers a healthy learning environment and promotes academic, social, and emotional development for all students Creating a positive, inclusive and safe school culture and climate Working with students displaying typical emotional and behavior problems Interacting with parents in empowering and affirming ways Listening to students

Phase 5 Mental Health and School Success: Ongoing Efforts in Ohio Linkage and consultation related to work of: Mental Health—Education Integration Consortium (MHEDIC) Bringing to together national experts and Ohio-based university faculty and practitioners in education and mental health fields to address: pre-service workforce preparation issues development of effective in-service training curricula and strategies

Phase 5 Getting the Conditions Right to Promote Student Well-being and Academic Success Collaboration with Ohio Department of Education, Ohio State University, and Miami University to develop and pilot test the: Ohio Community Collaboration Model for School Improvement

ODE’s new and expanded conceptualization of school improvement... Getting the Conditions Right!!!! Academic Outcomes

Phase 5 Network’s New SAMHSA-funded Initiative School Mental Health Effective Practice Integration Council (EPIC)

Ohio Mental Health Network for School Success Bridging the Gap between Research and Practice: Community Science (Wandersman, 2003) explicit attention is to the mechanisms/processes needed to develop, support, and sustain effective practices in real world settings An interdisciplinary framework for strengthening communities by improving the quality of practice in treatment, prevention, health promotion, and education

Ohio Mental Health Network for School Success From Research to Best Practices: Bridging the Gap (Green, Wandersman, Flaspohler, and others) “Best Practice” as Process rather than magic bullet programs Attention to local needs Control by practitioner, client, or community Local evaluation and self-monitoring Research in the “tailoring process” and new technology Consumer driven Synthesis and Translation

Effective Practice Expert (EPE) Actions in University-Community (U-C) Partnerships

EPIC Products Synthesized and Translated –Content –Tools –Processes

The Ten EPEs Miami University Ohio University Case Western Reserve University Ohio State University Kent State University Their Disciplines Clinical Psychology Community Psychology Criminal Justice Public Health Social Work Teacher Education

EPIC Values and Principles 1.EPIC is focused on strengthening the application of existing knowledge. 2.The overall aim of EPIC is to support high quality, interdisciplinary, collaborative synthesis and translation within and across all fields related to expanded school mental health. 3.EPIC must have an interdisciplinary perspective. 4.EPIC must have an agenda that prioritizes process over program. 5.EPIC is about supporting the common good. 6.The tools and products of EPIC will be produced for the public domain. 7.EPIC should be self-sustaining.

Ohio Mental Health Network for School Success Hopes for EPIC Initiative  EPIC tools and content papers will provide information useful in producing beneficial outcomes for youth and families.  Tools and processes will be accessible and useful to the range of stakeholders engaged in the process of planning, implementing, evaluating, sustaining, and continuously improving services related to SMH.  EPEs will increase readiness and capacity to implement services promoting SMH at the county, district, and/or building level.  University-Community partnerships will contribute to the sustainable promotion of services in SMH.

Phase 5 Connecting the Dots “We need ongoing advocacy and vigilance to gain and keep seats at the table, to overcome the power of silos and to promote and sustain state and local commitment to positive change” - CEP

Ohio Mental Health Network for School Success As Yogi Berra supposedly said, "In theory there is no difference between theory and practice, but in practice there is."

Connecting the Dots  Access to Better Care (ABC) School-Community Partnership Initiative (state, MH/ED)  Effective Practice Integration Council (federal, MH)  Eliminating Barriers Initiative (federal, MH)  Integration of Schools and Mental Health Systems (federal/state, ED)  Ohio Integrated Systems Model for Academic & Behavior Supports [PBIS] (federal/state, ED)  Ohio’s Community Collaboration Model for School Improvement (state, ED)  Shared Agenda Initiative (state/federal, ED/MH  Transformation State Incentive Grant (federal, MH)  21st Century Community Learning Centers (federal/state, ED)

Ohio Mental Health Network for School Success This PowerPoint presentation is available upon request