© 2010 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Expanded School Mental Health Services (ESMH) in Baltimore City Past (SY ‘88-’89): 4 schools/2 provider agencies Present (SY 10-11): 87 schools/9 provider agencies K-8 schools - 72 Transformation schools (grades 6-12) - 1 High schools-14 Future: Every school

© 2010 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY ESMH Model Augments school resources in addressing barriers to learning attributed to mental health concerns Partnerships with community mental health agencies and professionals that provide the full continuum of prevention, early identification and treatment services Students enrolled in general education programs Staffing levels are 0.5 FTE or 1.0 FTE Braided Funding: Baltimore City Public Schools, Baltimore Mental Health Systems, Baltimore Substance Abuse Systems, Family League of Baltimore, and the Department of Labor

© 2010 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY ESMH Model Standards Category 1: School-wide Supportive Activities – 20% clinician’s time Category 2: Treatment Activities/Services – 50% clinician’s time Category 3: Group Prevention Activities – 20% clinician’s time Category 4: Clinician professional Development – 10% clinician’s time

© 2010 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Collaborative Partnerships What is collaboration? Collaboration is a process of participation through which groups and organizations work together to achieve desired results.

© 2010 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Components of Effective Collaboration Interdependence Newly created activities Flexibility Collective Ownership of Goals Reflection of the process

© 2010 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Partnerships and Common Language Effective collaborative partnerships among key stakeholders are vital Schools Families Youth Mental health agencies Universities Local mental health, public health and substance abuse authorities

© 2010 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Advancing a Shared Agenda “Themes” Crafting a common language Beginning with the End in Mind: Navigating a Sustainability Plan Goal(s)selected as collectively agreed upon by all key stakeholders

© 2010 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Crafting a Common Language Effective collaborative partnerships among key stakeholders are vital Schools Families Youth Community mental health agencies Universities Local mental health, public health and substance abuse authorities

© 2010 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Developing Collaborative Partnerships Advancing a shared agenda o Learn and better understand each others system o Build the system together o Transparency and trust o Direct and open communication o Commitment to not shifting cost How do I help you meet your organizational goals? o How do you do business? Do you understand how my organization does business? o What are opportunities and barriers? o Identify shared goals and needs

© 2010 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY

Collaborative Tool Exercise Index - Collaborative Assessment Tool developed by Mellin, E.A., Bronstein, L., Anderson- Butcher, D., Ambrose, A., Ball, A. & Green, J.H. (2009)

© 2010 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY

Navigating a Sustainability Plan Beginning with the end in mind Build in a systematic way that has a systemic vision Partners design the system together Collaborative planning – goals, outcomes, budgets Align efforts – small shifts can make a big difference Shared leadership - which organization is in the strongest position to take the lead in accomplishing a goal

© 2010 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Moving Towards Growth and Enhanced Quality Goal: To implement a standardized protocol for data collection and reporting across the network of ESMH providers.

© 2010 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Moving Towards Growth and Enhanced Quality Four Purposes of Evaluation: 1. Assessment of merit and worth 2. Program and organizational improvement 3. Oversight and compliance 4. Knowledge development

© 2010 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Moving Towards Growth and Enhanced Quality 1. Assessment of merit and worth – Should the programs and services be expanded? What are the effects of the programs and services? Are the programs and services yielding the desired outcomes?

© 2010 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Moving Towards Growth and Enhanced Quality 2. Program and organizational improvement – What are the strengths and weaknesses of the programs and services? Are there barriers that can be removed? Does implementation follow best practice standards? What additional information is needed to facilitate the work of clinicians and their supervisors?

© 2010 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Moving Towards Growth and Enhanced Quality 3. Oversight and compliance – Is there compliance with statues, rules, regulations, contract deliverables, and other mandates for effective implementation and service delivery?

© 2010 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Moving Towards Growth and Enhanced Quality 4. Knowledge development – What training information is necessary to contribute to a broader understanding of effective school mental health? What opportunities exist that can offer better ways to think about the application of best practice on the local level?

© 2010 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Expanded School Mental Health Refers to programs that build on the core services typically provided by a school Augments services in schools by emphasizing shared responsibility Involves community mental health agencies Addresses full continuum of MH services

© 2010 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Evaluation in Expanded School Mental Health ESMH practitioners are increasingly asked to demonstrate the value of their job by producing results through data. Reflects overall trend in education & mental health toward increased accountability ESMH practitioners come from a variety of disciplinary backgrounds, some which do not emphasize evaluation/data use or have limited experience with data collection and evaluation of that data.

© 2010 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Evaluation in School Mental Health Why collect data and evaluate services? 1. To determine the effectiveness of programs, treatments and interventions 2. To determine the impact of ESMH on: * school climate * academic achievement * school attendance * behavior (as evidenced by suspension rates) 3. To support advocacy efforts for sustainability

© 2010 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Evaluation in School Mental Health What are the issues in terms of collecting data? # 1 Expectations of School Sites, needs of students and families #2 Expectations of Agency, documentation of services, data collection The Balancing Act: ESMH clinicians wear many hats and are expected to not only do their job as a clinician; but are also expected to collect effective and true data that demonstrate the value of their jobs.

© 2010 NATIONAL TECHNICAL ASSISTANCE CENTER FOR CHILDREN’S MENTAL HEALTH, GEORGETOWN UNIVERSITY Evaluation in School Mental Health *Guide for Decision-Making*