1. Northern CA PBIS Symposium
Advancing Education Effectiveness: The Interconnected Systems Framework (ISF) for PBIS and School Mental Health
Northern CA PBIS Symposium
November 18, 2013

2. Content:
Describe the features of an Interconnected Systems Framework (ISF) for Integrating Mental Health in Schools
Describe efforts and resources from blended efforts of National Centers to promote a broader continuum of evidence-based practices to support the mental health of all students
Describe emerging examples of ISF

3. Acknowledgements Susan Barrett & Mark Weist-
Joanne Cashman- NASDSE(IDEA Partnership)
Rob Horner & George Sugai – National PBIS TA Center
SharonStephens & Nancy Lever-National Center for SMH
Jill Johnson-IL
Kelly Perales- PA
All the ISF Authors and participants

4. Some ‘Ah Ha’ moments…
Why expect teachers/principals to switch to proactive strength-based approach with the students deemed “the worst” when practices not being used for others?
Why ask them to build highly individualized plans from scratch one student at a time?
Was difficult because evidence-based behavioral approaches were not being used…

5. Need for Change? Special Education Sea of Ineligibility
General Education

6. Needed to Solve Problem
Bridging the Gap
General + Intensive Resources
General + Supplemental Resources
Needed to Solve Problem
Amount of Resources
General Resources
Intensity of Problem

7. Some “Big Picture” Challenges
Low intensity, low fidelity interventions for behavior/emotional needs
Habitual use of restrictive settings (and poor outcomes) for youth with disabilities
High rate of undiagnosed MH problems (stigma, lack of knowledge, etc)
Changing the routines of ineffective practices (systems) that are “familiar” to systems

8. Why Partnership Are Needed
One in 5 youth have a MH “condition”
About 70% of those get no treatment
School is “defacto” MH provider
JJ system is next level of system default
Suicide is 4th leading cause of death among young adults
Factors that impact mental health occur ‘round the clock’
It is challenging for educators to address the factors beyond school
It is challenging for community providers to address the factors in school
Potential partners must come together in a comprehensive system

9. BIG Idea… SMH +MTSS=ISF
How Multi-tiered Systems of Support (MTSS) can enhance mental health in schools
Installing SMH through MTSS in Schools
The Interconnected Systems Framework (ISF)
SMH +MTSS=ISF

10. Systems for Students with High-Risk Behavior SCHOOL-WIDE
Tertiary Prevention:
Specialized
Individualized
Systems for Students with High-Risk Behavior
SCHOOL-WIDE
POSITIVE BEHAVIOR INTERVENTIONS and
SUPPORT 5%
Secondary Prevention:
Specialized Group
Systems for Students with At-Risk Behavior
15%
Primary Prevention:
School-/Classroom-
Wide Systems for
All Students,
Staff, & Settings
Focus on layering of S on U and T on S
80% of Students 10

11. ISF Monograph Development June 2012 – September 2013
Define the common goals of SMH and PBIS
Discuss the advantages of interconnection
Identify successful local efforts to implement collaborative strategies and cross-initiative efforts
Define the research, policy, and implementation agendas to take us to the next action level

12. Positive Behavior Intervention and Support (www.pbis.org)
Decision making framework to guide selection and implementation of best practices for improving academic and behavioral functioning
Data based decision making
Measurable outcomes
Evidence-based practices
Systems to support effective implementation

13. SMH and PBIS Common Purpose
Schools supporting/promoting MH of ALL students
Prevention, early access, interventions commensurate with level of need (versus labeling with no or poor follow-up)
School personnel feel confident and competent in identifying and intervening with accuracy and effectiveness

14. Key Rationale PBIS and SMH systems are operating separately
Results in ad hoc, disorganized delivery of SMH and contributes to lack of depth in programs at Tiers 2 and 3 for PBIS
By joining together synergies are unleashed and the likelihood of achieving depth and quality in programs at all three tiers is greatly enhanced

15. Logic
Enhanced resources, staff and coordination of ISF help to build systems at all tiers Youth with challenging emotional/behavioral problems are generally treated very poorly by schools and other community agencies, and the “usual” approaches do not work

16. Logic, cont.
Effective academic performance promotes student mental health and effective mental health promotes student academic performance. The same integration is required in our systems

17. Development of ISF
: Site Development with PBIS Expansion (informal and independent)
2004: CoP focus on integration of PBIS and SMH
2009: First ISF White Paper
: Monthly calls with implementation sites, national presentations (from sessions to strands)
: Grant Submissions
June, September, 2013: ISF Monograph

18. Connections and Partnerships
OSEP National PBIS Technical Assistance Center (pbis.org)
Center for School Mental Health (csmh.umaryland.edu)
NASDSE (ideapartnership.org)
National COP for SBH (sharedwork.org)

19. Core Features of a Response to Intervention (RtI) Approach
Investment in prevention, screening and early intervention for students not at “benchmark”
Multi-tiered intervention approach
Use of progress monitoring and problem- solving process at all 3-tiers

20. Core Features of a Response to Intervention (RtI) Approach
Research-based practices and active use of data for decision-making at all 3-tiers
Use of progress monitoring and problem- solving process at all 3-tiers

21. ISF Defined
ISF provides structure and process for education and mental health systems to interact in most effective and efficient way.
ISF is guided by key stakeholders in education and mental health system who have the authority to reallocate resources, change role and function of staff, and change policy.
ISF applies strong interdisciplinary, cross-system collaboration.

22. ISF Defined
ISF uses the tiered prevention logic as the overall organizer to develop an action plan.
ISF involves cross system problem solving teams that use data to decide which evidence based practices to implement.
ISF involves ongoing progress monitoring for both fidelity and impact.
ISF emphasizes active involvement by youth, families, and other school and community stakeholders.

23. Traditional  Preferred
Each school works out their own plan with Mental Health (MH) agency;
District has a plan for integrating MH at all buildings (based on community data as well as school data);

24. Traditional  Preferred
A MH counselor is housed in a school building 1 day a week to “see” students;
MH person participates in teams at all 3 tiers;

25. Traditional  Preferred
No data to decide on or monitor interventions;
MH person leads group or individual interventions based on data;

26. Structure for Developing an ISF:
A District/Community leadership that includes families, develops, supports and monitors a plan that includes:
Community partners participating in all three levels of systems teaming in schools: Universal, Secondary, and Tertiary
Team of SFC partners review data and design interventions that are evidence-based and can be progress monitored
MH providers from both school and community develop, facilitate, coordinate and monitor all interventions through one structure

27. CICO SAIG Universal Team Secondary Systems Team Problem Solving Team
3-Tiered System of Support Necessary Conversations
Family and community
Family and community
Family and community
Community
Universal Team
Secondary Systems Team
Problem Solving Team
Tertiary Systems Team
Uses Process data; determines overall intervention effectiveness
Uses Process data; determines overall intervention effectiveness
Plans SW & Class-wide supports
Standing team with family; uses FBA/BIP process for one youth at a time
CICO
Universal Support
Brief
FBA/BIP
SAIG
Complex
FBA/BIP
WRAP
Group w. individual
feature
Brief FBA/BIP
Sept. 1, 2009 27 27

28. Interconnected Systems Framework Tier I: Universal/Prevention for All
Coordinated Systems, Data, Practices for Promoting Healthy Social and Emotional Development for ALL Students
School Improvement team gives priority to social and emotional health
Mental Health skill development for students, staff/, families and communities
Social Emotional Learning curricula for all
Safe & caring learning environments
Partnerships : school, home & community
Decision making framework guides use of and best practices that consider unique strengths and challenges of each school community

29. Interconnected Systems Framework Tier 2: Early Intervention for Some
Coordinated Systems for Early Detection, Identification, and Response to Mental Health Concerns
Systems Planning Team coordinates referral process, decision rules and progress monitors
Array of services available
Communication system: staff, families and community
Early identification of students at risk for mental health concerns due to specific risk factors
Skill-building at the individual and groups level as well as support groups
Staff and Family training to support skill development across settings

30. Interconnected Systems Framework
Tier 3: Intensive Interventions for Few
Individual Student and Family Supports
Systems Planning team coordinates decision rules/referrals and progress monitors
Individual team developed to support each student
Individual plans have array of interventions/services
Plans can range from one to multiple life domains
System in place for each team to monitor student progress

31. MH/PBIS: An Expanded Tier One
Broader range of Data
Opportunity to review community data and expand Tier 1 intervention options based on data
Universal screening
for social, emotional, and behavioral at-risk indicators
for families who may request assistance for their children
Teaching
social skills with evidence-based curricula to all students
appropriate emotional regulation and expression to all students
behavioral expectations to all students

32. School Data  Community Data Student and system level
Academic (Benchmark, GPA, Credit accrual etc)
Discipline
Attendance
Climate/Perception
Visits to Nurse, Social Worker, Counselor, etc
Screening from one view
Community Demographics
Food Pantry Visits
Protective and Risk Factors
Calls to crisis centers, hospital visits
Screening at multiple views

33. MH/PBIS: An Expanded Tier Two
Mapping of all existing interventions to ensure key resources are aligned to ensure both efficiency and effectiveness (“bully prevention”, “discipline”, “character education”, “RtI behavior”, etc.)
Groups co-facilitated by school staff and community partner (example – guidance counselor and community provider clinician)
Opportunity to expand the continuum of interventions based on data (i.e. trauma informed interventions)
Out-reach to families for support/interventions

34. MH/PBIS: An Expanded Tier Three
Quicker access to a richer continuum ofcommunity-based supports for students and families
FBA/BIP and/or person-centered wraparound plans completed together with school staff and mental health provider for one concise plan, rather than each ‘completing paperwork to be filed’

35. A District Example

36. IL District U-46 at a Glance: 2012-2013
Enrollment:
Total school enrollment 40,570
54.8% Low Income
97 languages spoken in U-46 homes
Facilities:
40 Elementary Schools (PreK-6)
8 Middle Schools (7-8) + 1 Alternative Middle School
5 High Schools + 2 Alternative High Schools
2 Early Childhood Centers
Communities Served:
11 communities
3 counties (Cook, DuPage, Kane)

37. 20 Community Partners 57 providers trained in PBIS/SAIG
Boys and Girls Club of Elgin*Centro de Informacion* Community Crisis Center*Crossroads Kids Club* Easter Seals*Elgin Police Department* Family Service Association of Greater Elgin Area*Fox Valley Pregnancy Center*Fox Valley Volunteer Hospice*Girl Scouts of Northern Illinois*Hanover Township Youth and Family Services*Kenneth Young*Renz Center*Streamwood Behavioral Healthcare System*Taylor Family YMCA*The Y*WAYS*West Ridge Community Church*Youth Leadership Academy

38. U-46 School and Community Alliance Work Groups 2009-2012
Operations
Tier 2/3
High School Violence Prevention

39. Tier 2/3 Work Group Outcomes
Creation of Guidelines for Schools and Agencies Working Together
Agency Partners are active members of Secondary Systems Teams (9)
Trained Agency Partners in Social Academic Instructional Groups/DPR Data
25 partners are sitting on teams and/or providing SAIG in schools
Use of the DPR (Daily Progress Report) for progress-monitoring

40. G. Elementary Major ODRs per 100 Students

41. G. Elementary Students with 6+ ODRs
This one went down over four years, good!

42. CO Elementary OSS Events and OSS Days

43. C-O Elementary Students with 6+ ODRs
This one went down over four years, good!

44. PBIS + Positive Youth Development
Key elements to the Youth Development
approach are the following:
Youth are viewed as a valued and respected asset to society;
Policies and programs focus on the evolving developmental needs and tasks of adolescents, and involve youth as partners rather than clients;
Families, schools and communities are engaged in developing environments that support youth;
Adolescents are involved in activities that enhance their competence, connections, character, confidence and contribution to society;
Adolescents are provided an opportunity to experiment in a safe environment and to develop positive social values and norms; and
Adolescents are engaged in activities that promote self-understanding, self-worth, and a sense of belonging and resiliency.

45. E. High School Example Social Academic Instruction Groups (SAIG)
Coordinated by EHS Counselor
Facilitated by Community Partner
Data: Feedback from Teachers and Students
Groups 6-8 weeks
Students grouped based on teacher feedback and lack of response to CICO
Agency partner is active member of secondary systems team

46. Weekly Progress Report: Earn and Give Respect (student will not talk back to staff) Hold Yourself Responsible (Student will be on time to class) Safety First (Student will wear ID around neck)

47. I feel connected to my school

48. I feel respected and important while at school

49. Next Steps for Alliance…
Increase Trauma focus at all three tiers
Directory of partners/agencies
Blend initiatives/coordinate across the district
Alternative to suspension expansion
Utilize exemplars in district as examples for other schools
Increase communication/visibility of Alliance

50. Closing thoughts………

51. Problem
Innovative practices do not fare well in old organizational structures and systems
Organizational and system changes are essential to successful use of innovations
Expect it
Plan for it
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008 52

52. The Need to Be Plan-ful:
Implementation occurs in stages:
Exploration-Adoption
Installation
Initial Implementation
Full Implementation
Innovation
Sustainability
2 – 4 Years
Fixsen, Naoom, Blase, Friedman, & Wallace, 2005

53. Problem
Students cannot benefit from interventions they do not experience
© Dean Fixsen, Karen Blase, Robert Horner, George Sugai, 2008

54. Ensuring Systems are Ready

55. Positive Behavior Support
Social Competence &
Academic Achievement
SYSTEMS
PRACTICES
DATA
OUTCOMES
Supporting
Decision
Making
Supporting
Staff Behavior
Adapted from “What is a systems Approach in school-wide PBS?”OSEP Technical Assistance on Positive Behavioral Interventions and Supports. Accessed at
Supporting
Student Behavior 56