School-Linked Mental Health

Kristin Lofgren| School Mental Health Consultant| Behavioral Health

2/15/2021 Minnesota Department of Human Services | mn.gov/dhs 1

2008 Systems Alignment: School-Linked Mental Health

• School-based mental health (SLMH) services reach children in typical, every-day environments. The natural, non-stigmatizing location offers an early and effective environment for intervention.

• These school-connected clinical behavioral health treatments include interventions that:

Improve identification of behavioral health issues for children and youth.

Increase and improve accessibility for children and youth.

Improve clinical and functional outcomes for children and youth with behavioral health issues.

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Why Mental Health Treatment in Schools?

• Youth are 6x more likely to complete mental health treatment in schools than in community settings (Jaycox et al., 2010)

• Mental health treatment has large effects on decreasing mental health symptoms (Sanchez et al., 2018)

• Mental health services are most effective when they are integrated into students’ academic instruction (Sanchez et al., 2018)

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School-Linked Mental Health: State Appropriations

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$-

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000

$14,000

$16,000

$18,000

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023

School-Linked Mental Health Grant Appropriations

School-Linked Mental Health: School Sites

2/15/2021 5Minnesota Department of Human Services | mn.gov/dhs

SLMH School Districts and School Programs

675

872921

953

1014

11161150

224273 276 288 288

328 317

200

300

400

500

600

700

800

900

1000

1100

1200

2013/2014 2014/2015 2015/2016 2016/2017 2017/2018 2018/2019 2019/2020

School programs

School districts

SLMH: Student and School Numbers

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Of the 1150 school program sites:

• 54% are in Elementary Schools

• 14% are in Middle Schools

• 28% are in High Schools or Alternative Learning Centers

SLMH Treatment and Supports

Common Diagnosis of students receiving SLMH services:

• F41.1 Generalized anxiety disorder

• F90.2 Attention-deficit hyperactivity disorder, combined type

• F43.25 Adjustment disorder with mixed disturbance of emotions and conduct

• F43.8 Post-traumatic stress disorder, unspecified

Common Clinical Services:

• Diagnostic Assessments

• Psychotherapy, child and family

• Psychoeducation

• Skills Training and Development

• Outcome Measures

• Treatment planning

Common Ancillary Supports:

• Consultation, parent and teacher

• School-wide training on mental health

• Transportation

• Build partnerships at local level; Multi-Tiered System of Support (MTSS) teams

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SLMH Outcomes

• Improve clinical and functional outcomes for students.

• Improve clinical service quality through evidence-based treatments.

• Increase in the number of mental health clinicians who are trained in and providing Evidence-Based Practices (EBP).

• Improve capacity and infrastructure development to support the expansion and sustainability of services.

• Develop and strengthen partnerships between mental health providers and host school districts.

2/15/2021 Minnesota Department of Human Services | mn.gov/dhs 9

COVID Impact: State-Level Responses

• DHS SLMH waiver receives approval; allows increased flexibility for mental health staff to connect with students and families.

• DHS SLMH contract amendments allow flexibility in duties, expenses, and data during pandemic.

• DHS & MDE: Bi-weekly WebEx meetings with SLMH providers and related service providers.

• Review local level collaboration of “School District Distance Learning Plans” and share ideas with other providers/schools.

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COVID Impact: Student, Family, Teacher Engagement strategies

• School district IT department ensures that each Chromebook had the right app so students could connect for Telemedicine sessions.

• “Relentless spirit" motivating providers and schools to stay connected to families and students to maintain support with minimal interruption.

• School-based therapists called their clients and immediately began scheduling online telemedicine sessions.

• Utilize “check and connect” at all levels (e.g. students, families, and teachers).

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COVID Impact: Students receiving mental health supports

13384 13167

9636

12425

13581

10342

8642

9930

0

2000

4000

6000

8000

10000

12000

14000

16000

Jan-Mar Apr-Jun Jul-Sept Oct-Dec

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Quarter

2019

2020

Next Steps

• FY 2022-23 Human Services Governor’s Budget Recommendations include SLMH.

• APBS (Association of Positive Behavior Supports) International conference in March 2021 will highlight Minnesota’s DHS SLMH & MDE PBIS partnership initiatives to support students.

• Inclusion of Integrated Care within SLMH framework.

• Telemedicine; Infrastructure development.

• Federal SAMHSA grants awarded to enhance school mental health framework.

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Thank you!

Kristin Lofgren

Behavioral Health Division

kristin.lofgren@state.mn.us

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