Interconnected Systems Framework (ISF)Replication

November 21, 2014

Agenda

• ISF overview

• Readiness steps (2014-15)

• Implementation steps (2015-16)

• Questions

Pennsylvania State Community of Practice on School Based Behavioral Health

“tertiary demonstration sites”:ScrantonMontrose

Advancing Education Effectiveness:

Interconnecting School Mental Health

and School-Wide Positive

Behavior SupportEditors: Susan Barrett,

Lucille Eber and Mark Weist

Development of an Interconnected Systems Framework for School Mental Health

Access on the Center for School Mental Health or National PBIS websites:

• http://csmh.umaryland.edu/Resources/ Reports/SMHPBISFramework.pdf

• http://www.pbis.org/school/school_mental_health/interconnected_systems.aspx

Edited by: Susan Barrett and Lucille Eber, National PBIS Center Partners; and Mark Weist, University of South Carolina (and Senior Advisor to the University of Maryland, Center for School Mental Health)

BIG Idea…

• 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

Logic

Youth with challenging emotional/behavioral problems are generally treated very poorly by schools and other community agencies, and the “usual” approaches do not work

Enhanced resources, staff and coordination of ISF helps to build and enhance systems at all tiers

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

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.

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.

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);

Primary Prevention:School-/Classroom-Wide Systems for

All Students,Staff, & Settings

Secondary Prevention:Specialized Group

Systems for Students with At-Risk Behavior

Tertiary Prevention:Specialized

IndividualizedSystems for Students

with High-Risk Behavior

~80% of Students

~15%

~5%

SCHOOL-WIDE POSITIVE BEHAVIOR

SUPPORT

Implementation Science

• Exploration and Adoption• Installation Phase• Initial Implementation• Full Implementation• Innovation and Sustainability

Fixsen, 2010

STUDENTSin one school

RtI

SpecialEducation

SEL

Fragmented Structures Fragmented Practices

StudentAssistance

Teams

StudentAssistance

Teams

SocialWork

Services

FamilyCoordinators

Pre-referralInterventions

After SchoolPrograms

School-basedMental Health

Services

StudentSupportLeaders

How does a school decide how to support different students?

SCHOOL

Violence & Crime

Prevention

Drug Services

Juvenile Court

Services

Social Services

Child Protection Services

Special Education

Pupil Services Health

Services

Mental Health

Services

Drug Prevention

Community Based

Organizations

Clinic

After-School

Programs

Adapted from: Health is Academic: A guide to Coordinated School Health Programs (1998). Edited by E. Marx & S.F. Wooley with D. Northrop. New York: Teachers College Press.

Fragmented Policy Fragmented Practices

Compelling FactorsDetention/ RTF

t h

Intake

Intake

CW Sys

Intake

Referral

Referral

Referral

Referral

Referral

Referral

MH Sys

D&A Sys

JJ Sys

Ed. Sys

Intake

MCO Sys

MR Sys

Intake

Referral

Partial

Psych

Detox

AAA

Intake

Court

Probation

Residential

Eligibility

Counseling

Special Ed

Truancy

Mentor

APS

Partial

Residential

Mobile T

Case Mgmt.

TSS/BSC

Inpatient

Case Mgmt..

Care Mgmt.Primary Care

Case Work

Foster Care

Health Sys

ER

Intake

Hospital.

Therapist. Psychiatrist

SupervisorSW/Psych

BuildingPrincipal

Rep.

Service Providers

Local Area Network

Co-Convenor

Homeless Coordinator Mental

Health/708 Board

Curriculum/Prof. Dev

RtI Coordinator

FamilyGroups

PoliceJuvenile Justice

Special EducationDirector

Supt/Asst. Supt

Core District and Community Leadership

Team

Building Level Model

Community/Family

Mental Health Rep.

SW, School Psych

Guidance

Principal

Special Education Teachers

Grade Level

Teachers

Building Leadership

Team

Tier 3/Tertiary Interventions 1-5%•_____________________•_____________________•_____________________

1-5% Tier 3/Tertiary Interventions• ___________________________• ___________________________• ___________________________

Tier 2/Secondary Interventions 5-15%•___________________________•___________________________•___________________________•___________________________•___________________________•___________________________

5-15% Tier 2/Secondary Interventions• ____________________________• ____________________________• ____________________________• ____________________________• ____________________________• ____________________________

Tier 1/Universal Interventions80-90%•________________________•________________________•________________________•________________________•________________________•________________________

80-90% Tier 1/Universal Interventions• ____________________________• ____________________________• ____________________________• ____________________________• ____________________________

School-Wide Systems for Student Success:A Response to Intervention (RtI) Model: SUPPORTS

Academic Systems Behavioral Systems

Illinois PBIS Network, Revised May 15, 2008. Adapted from “What is school-wide PBS?” OSEP Technical Assistance Center on Positive Behavioral Interventions and Supports. Accessed at http://pbis.org/school-wide.htm

Building Level Action Plan

Problem Solving Team (individual student)

Tertiary Systems Team

Secondary Systems Team

Universal Systems Team

PRACTICES PRACTICES PRACTICES PRACTICES

Data Decision Rule Data Decision Rule Data Decision Rule Data Decision Rule

UNIVERSAL SYSTEM SECONDARY SYSTEM TERTIARY SYSTEM

20

Tier 1/Universal School-Wide Assessment

School-Wide Prevention Systems

SIMEO Tools: HSC-T, RD-T, EI-T

Check-in/ Check-out (CICO)

Group Intervention with Individualized Feature (e.g., Check and Connect -CnC and Mentoring)

Brief Functional Behavior Assessment/Behavior Intervention Planning (FBA/BIP)

Complex or Multiple-domain FBA/BIP

Wraparound

ODRs, Attendance, Tardies, Grades, DIBELS, etc.

Daily Progress Report (DPR) (Behavior and Academic Goals)

Competing Behavior Pathway, Functional Assessment Interview, Scatter Plots, etc.

Social/Academic Instructional Groups (SAIG)

Positive Behavior Interventions & Supports:A Response to Intervention (RtI) Model

Illinois PBIS Network, Revised October 2009Adapted from T. Scott, 2004

Tier 2/Secondary

Tier 3/Tertiary

Inte

rven

tio

nAssessm

en

t

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

Other DatasetsPositive Assets• Parks & Playgrounds• Hospitals• Community Centers• Recreation Centers• Vacant housing• Community• Core service agencies

Disadvantage• Census (income, familystructure, population

Potential Risk Factors• Alcohol Outlets• Crime• Libraries• Religious Buildings• Fast food outlets• Lottery outlets

Show outcomes leading to Social and financial Benefit

• Show outcomes for PBIS and SMH– Social competence– Emotional functioning – Improved GPA, test scores, attendance, teacher retention– Organizational Health– Climate

• Demonstrate financial impact• Show link between fidelity and outcomes

Greenberg et al., 2005; Greenberg et al., 2003; Welsh et al., 2001; Zins et al., 2004; Bruns et al., 2004; Lehr et al., 2004; Jennings, Pearson, & Harris, 2000; see Hoagwood, Olin, Kerker, Kratochwill, Crowe, & Saka, 2007 and Wilson & Lipsey, 2007)

WSHS

WSHS

WSHS

WSHS

• Tier One Problem Solving Team

• Student Team

• Faculty input

• Administrative support

Annual Fidelity CheckAction Planning

• Benchmarks of Advanced Tiers– Do we have more than one strategy available to

support students who need more?– Do we use data to make decisions?– Are we selecting Evidence-Based Practices?– Do we have the staff and resources to implement

with fidelity?– Are we progress monitoring?

Revisit Resource Map

• Do we have a continuum of interventions and supports?

• Does our systems team include representatives from our community partners?

• Are their gaps that we need filled?• Can we present needs to our district and

community leadership team?

Innovation and Sustainability

• Community level dialogue– Data– Practices– Systems

• Collaboration and Communication

District level dialogue

• Physical Health/Behavioral Health Collaboration

• Wellness and access to care

• Wright Center – Commonwealth Medical College

• Data point of children entering Kindergarten – not “ready” – social/emotional/behavioral

Example School One

Example School Two

Example School Three

Community Partners

• Head Start

• Early Childhood Mental Health Community Providers– Scranton Counseling Center– Friendship House– NEIU 19

• United Way

Intervention strategies

• Program Wide PBIS– NEIU– PaTTAN

• Prevent Teach Reinforce – Young Children– Typically “tier three”– Pre-school and kindergarten teachers attend– Use for classroom management strategies

• Parent Child Interactive Therapy – PCIT– Evidence based practice– Home/school/community connection

Intervention strategies continued:

• “summer camp” for all enrolled kindergarteners who had no prior “school” experience

• Funded through Title One dollars with support from United Way

• 4 week program that included food, parent connection, and pro-social skills for children

Example One 2014

Example Two 2014

Next steps:

• Facilitators– identify potential replications sites– Complete readiness activities Spring 2015

Questions?