1. School-Based Mental Health Services in Alabama
Gayla Caddell – Coordinator, Child & Adolescent Mental Illness Services
ADMH Contact Information
Tina Sanders – Education Specialist, Special Education Services
ALSDE Contact Information

2. Overview of Mental Health Services in Alabama
MENTAL HEALTH OVERVIEW
Commissioner (Governor’s Cabinet)
Three Areas of Services (MI/SA/ID)
Adult Pre-occupied
Less than 10% of DMH dedicated dollars spent on C&A services
Why?
MI Division serves 100,000+ consumers.
Of this 25,000+ are C&A
C&A has partners for blended funding with DOE, DHR, DYS, etc.

3. Overview of Mental Health Services in Alabama
Started in the 1980s through a Federal Planning Grant.
Mandated other State Agencies participate with planning and this planning body still exists today – Child and Adolescent Task Force.
Multiple Needs Child Legislation developed and continues to be a strong relationship
Children Services

4. Mental Health Continuum of Care – SED Services
Early Childhood
MH (0-5)
Mental Health Prevention
Outpatient
Individual
Group
Family
Psychiatric/Nursing
Telepsychiatry
Consultation
Crisis
Outreach
Respite
Case Management
In-Home Intervention
Meaningful Day
Day Treatment
School-Based Mental Health (SBMH) Collaboration

5. Mental Health Continuum of Care – SED Services
Housing/Residential
Short-term Evaluation Treatment STTEP (6-12 years)
Group Home/Unlocked Residential
Transitional Age Group Home
Locked Residential
Psychiatric Stabilization
Private Inpatient Acute
DMH Unit at EAMC

6. Why Does Mental Health Matter in Schools?
Addressing mental health needs in school is critically important because 1 in 5 children and youth have a diagnosable emotional, behavioral or mental health disorder and 1 in 10 young people have a mental health challenge that is severe enough to impair how they function at home, school or in the community.

7. There have been at least 43 incidents of gunfire on school grounds in 2018.
When it comes to how American children are exposed to gun violence, gunfire at schools is just the tip of the iceberg–every year, over 2,700 children and teens are shot and killed and nearly 14,500 more are shot and injured.
An estimated 3 million American children are exposed to shootings per year. Witnessing shootings — whether in their schools, their communities or their homes– can have a devastating impact.
Children exposed to violence, crime, and abuse are more likely to abuse drugs and alcohol; suffer from depression, anxiety, and posttraumatic stress disorder; fail or have difficulties in school; and engage in criminal activity.

8. Suicide
According to the Centers for Disease Control and Prevention, from 1999 through 2015, 1,309 children ages 5 to 12 took their own lives in the United States.

9. Gov. Kay Ivey’s Securing Alabama’s Facilities of Education SAFE Council
The SAFE Council makes 10 recommendations in three areas: physical security, threat assessments and mental health, and coordinated training and planning by state agencies.
Physical Security 
Funding for School Resource Officers (SROs) and District Safety Coordinators (DSCs)
Bond Issue for Enhancing School Building Security
Surveillance Systems Linked to Law Enforcement
Threat Assessments and Mental Health 
School-Based Mental Health
Identifying Warning Signs
Reporting Threats
Tracking School Violence
Coordinated Training and Planning 
Empowered and Accountable District Safety Coordinators
Building a Culture of Safety
School Safety Training and Compliance Teams

10. School Based Mental Health Services in Alabama
Early Collaboration between ADMH and ALSDE – State Level
Development and funding for first 10 Day Treatments in State of Alabama
Policy Development – i.e. educational programs within RTC

11. School Based Mental Health Services in Alabama
Early Collaboration – Local Level
Limited Co-location of mental health services in school systems
Limited Co-location of mental health services in Alternative Schools
Limited access provided to mental health to come into the school – i.e. IHI and CM
Summer Programs

12. School Based Mental Health Services in Alabama
Modern Day System of Care
State mental health agencies are being mandated by Federal arms to move to modern day systems of care.
ALSDE and ADMH met and discussed how to move to a modern day system of care that will focus on:
Evidenced-based Practices
Data Driven and Performance Based
Youth Directed and Family Guided

13. School Based Mental Health (SBMH) Collaboration
ADMH and ALSDE have identified the need for a deliberate strategy aimed at improving service quality within and continuity between the two departments.
The AIM:
To achieve greater integration of MH services between the community mental health centers and the public schools
To increase the utilization of evidence-based practices.
The integration of these services will foster continuity of care and ensure sustained gains in academic and developmental domains for children, youth, and their families.

14. Goal of SBMH Collaboration
The GOAL of the SBMH collaboration between ADMH and its providers and the ALSDE and Alabama’s local education agencies is to:
Ensure that children and adolescents, both general and special education, enrolled in local school systems have access to high quality mental health prevention, early intervention, and treatment services.
To be effective, comprehensive mental health services in schools must be provided by an on-site master’s level mental health professional in collaboration with teachers, administrators, and families.

15. School Based Mental Health Services in Alabama
SBMH Partnership benefits:
Mental Health Prevention – training for a population
Improved awareness, collaboration and integration between Mental Health and Education resources at the State and Community levels
Significant improvements in access to care for children and adolescents who are experiencing social/emotional problems that negatively affect academic success.
Addresses common barriers to seeking services: Transportation Issues - Stigma “No-Shows” at MH Appts. - “No-Shows” at School!
Access to the full array of MH services available through the Community Mental Health Center
More consumers receiving needed services, with cost savings for many school systems

16. SBMH Collaboration Provides:
High quality services that build on existing school programs, services, and strategies; A
Continuum of care in a school setting-mental health education and promotion through intensive intervention;
Authentic parent/
family engagement;
Meaningful children and youth involvement
Culturally and linguistically competent service provision; and
Data-driven planning, evaluation, and quality improvement.

17. School Based Mental Health (SBMH) Collaboration MODEL “Nuts and Bolts”
Initial Orientation
Formalized Agreement between MH and LEA
Data Collection & Reporting
Standardized Referral Process
“Gatekeeper” Bridges MH & ED Functions

18. School Based Mental Health (SBMH) Collaboration MODEL “Nuts and Bolts”
Regular Accountability Meetings
School provide space, MH provides Therapist
Separation of School Records & MH Records
Annual Review of SBMH Commitment

19. SBMH Expected Outcomes and Performance Indicators
Provided by Alabama Department of Education:
Number of students with unexcused absences > than 7 days reduced
Number of unexcused absences > than 7 days reduced
Rates of school attendance improved
Number of students with out-of-control suspension > than 10 days reduced
Number of out-of-school suspensions > than 10 days reduced
School behavior improved
Number of students receiving the Alabama High School Diploma increases
Student graduation rate improved

20. SBMH Expected Outcomes and Performance Indicators
Provided by local Mental Health Authorities:
Number of students receiving mental health services increased
Number of services provided/hours of services provided increased
Student/Family engagement improved
Provided by Alabama State Mental Health Department based on Child and Adolescent Needs and Strengths (CANS):
Number of students whose level of life domain functioning improve
Total level of life domain functioning improved
Number of students with arrests decreases
Delinquent behavior improved
Number of students/families whose perception of care improves
Family/Youth perception of care improved
Number of students/families whose social connectedness improves.
Social Connectedness

21. Questions & Answers