1. 1 Sandy Keenan TA Partnership for Child and Family Mental Health(SOC) National Center for Mental Health Promotion and Youth Violence Prevention(SSHS/PL) November 5, 2009

2. 2  4.5 to 6.3 million children have mental health needs in this country, approximately 20%.  2/3 of them do not receive the services they need.

3. 3  Evidence that mental, emotional and behavioral disorders are common and begin early in life(20% of school age).  Evidence of multi-year effects of multiple preventive interventions on reducing substance abuse, conduct disorder, behavior, aggression and child mistreatment.  Evidence that school-based violence prevention can reduce the rate of aggressive problems by 25% to 33%.  Evidence that school-based preventive interventions for SEL can also improve academic outcomes.  Advances in implementation science, including its complexity and the importance of relevance to the community www.nap.eduwww.nap.edu 2009

4. 4  Safe Schools Healthy Students  PBIS  Systems of Care

5. 5  Department of Health and Human Services ◦ Substance Abuse & Mental Health Services Administration, ( SAMHSA)  Department of Education ◦ Office of Safe and Drug Free Schools (OSDFS)  Department of Justice ◦ Office of Juvenile Justice & Delinquency Prevention (OJJDP)

6. 6  Element 1: Safe School Environments and Violence Prevention  Element 2: Alcohol, Tobacco and Other Drug Prevention Activities  Element 3: Student Behavioral, Social and Emotional Supports  Element 4: Mental Health Services  Element 5: Early Childhood SEL Programs

7. 7  Community based promotion and prevention initiative  Partnership with Education, Law Enforcement, Juvenile Justice, Mental Health and other community agencies  Implementation of evidence based practices at the school, classroom and individual level  Core management team (community)  Data driven decision making

8. 8  A framework for intervention  3- tiered model of promotion, prevention and intervention(all, some and few)  Implemented at the individual, classroom, school, or district level  Team approach  Data driven decision making

9. 9  Community based initiative  Multi agency partnerships between mental health and other major system partners  Population of Focus: MH diagnosis and at risk for out of home or out of school placement  Family and youth driven  Individual community based planning and interventions(through a local, county, tribal or statewide project)

10. 10  Family Driven  Youth Guided  Cultural competence  Evidence Based Practice  Interagency collaboration  Home, community, and school-based  Individualized strength-based care  Continuous Quality Improvement (CQI)

11. 11  Behavioral and emotional problems decreased ( 35% improved at 6 months, 48% at 18 months)  Youth involvement with juvenile justice decreased (e.g., arrests fell by 60% at 18 months)  Youth became less depressed and less anxious  Youth suicide attempts were reduced by half in 6 months

12. 12  Community based collaborative efforts involving multiple agency partners  Variety of models/share a value of shared responsibility for meeting the emotional and behavioral needs of children and youth  Interagency training and professional development activities  Implementation of evidence based interventions

13. 13  Time  Limited resources  Change  Blending of multiple cultures  Trained workforce  Integration into existing initiatives  Sustainability

14. 14 Focus of Change System level Organizational level Direct Service Focus of Systems Reform Focus of Evidence Based Services

15. 15 Focus of Change System level Organizational level Direct Service Systems Integration and Strategic Planning

16. 16  These 3 initiatives have a large federal investment that usually can not be met by communities alone.  Assumption that communities “want” to change these systems and achieve better outcomes (just by applying).  Administrative support at multiple levels(just by applying).  Policies developed/resources appropriated to support system change.

17. 17  Regular School Attendance (> 80% of the time) increased from 74% to 81% in 6 months  Absences due to behavioral and emotional problems were reduced by 1/5 in 18 months  31% more youth achieved passing grades after 18 months

18. 18  Behavioral and emotional problems decreased ( 35% improved at 6 months, 48% at 18 months)  Youth involvement with juvenile justice decreased (e.g., arrests fell by 60% at 18 months)  Youth became less depressed and less anxious  Youth suicide attempts were reduced by half in 6 months

19. 19  improved school attendance  Fewer discipline problems  Fewer arrests  More passing grades  Improved academic performance  Less depression and anxiety  Less suicide attempts  Improved social and emotional health  Improved environments which promote better outcomes

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