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Leading for Effective School Mental Health
School Mental Health ASSIST
Summit on Children and Youth Mental Health 2012
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Session AgendaActivity Time FrameOverview Presentation – SMH ASSIST 10:00-10:45
Top 10 Carousel Rotation #1 – MH Leaders 10:50-11:20
Top 10 Carousel Rotation #2 – MH Leaders 11:25-11:55
Lunch 12:00-12:55
Top 10 Carousel Rotation #3 – MH Leaders 1:00-1:30
Top 10 Carousel Rotation #4 – MH Leaders 1:35-2:05
Closing Keynote - Dr. John Malloy 2:15-3:002
With an elbow partner, or two…
What does effective leadership look like at a School or Board level?
LEADERSHIP
Paint a Picture… 3
Ontario Leadership Framework
Leadership is a lever to support large scale system
improvement to enhance achievement and well-being.
The Ontario Leadership Framework is relevant to our
work with student mental health and well-being.
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Ontario Leadership Framework
5 Domains:
1. Setting Directions
2. Building Relationships and Developing People
3. Developing the Organization
4. Leading the Instructional Program
5. Securing Accountability
5 Core Leadership Capacities:
1. Promoting Collaborative Learning Cultures
2. Aligning Resources with Priorities
3. Using Data
4. Setting Goals
5. Engaging in Courageous Conversations 5
Jot down a few ideas….
What are some of the qualities of an effective leader?
Which of these do you possess, and value most strongly?
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Overview The Promise of School Mental Health Provincial, National and International Initiatives Acknowledging Past (and present) Challenges Ontario’s Mental Health & Addictions Strategy School Mental Health ASSIST Top 10 Conditions for Effective School Mental Health
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The Promise of School Mental Health
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Mental Health is…
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“A state of complete physical, mental, and social well-being, and not merely the absence of disease or
infirmity”
World Health Organization
Mental Health Exists on a Continuum
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Mental Health Problems are Common
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Roughly one in five students in Canadian
schools struggle with a mental health problem that interferes with their day to day functioning.
What are Mental Health Problems?Mental health problems are emotional, behavioural and brain-related disturbances that interfere with development, personal
relationships, and functioning
Disturbances that are severe and persistent enough to cause significant symptoms, distress, and impairment in one or more areas of daily life are termed mental health disorders/mental
illness.14
Mental Health Problems include a Range of Difficulties
Mental health problems are characterized by many different signs and symptoms,
and present in various forms
Some mental health problems manifest outwardly (externalizing) Students appear aggressive, impulsive, non-compliant
Some mental health problems manifest inwardly (internalizing) Students appear withdrawn, lonely, anxious, depressed
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The Good News
Proven strategies and supports Psychosocial and pharmacological treatments are most
common, and are often used together While many mental disorders are chronic, we can help with
coping Early identification and intervention improves prognosis
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But Most Do Not Receive the Help They Need
Up to 80% of children and youth who experience a mental health problem will not receive treatment
Major barriers include: Lack of, difficulty accessing, or long
waitlists for local servicesStigmaMisidentification or lack of identification of symptoms
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Schools Have a Unique OpportunitySchools are an optimal setting in which to:
Reduce stigma Promote positive mental health Build student social-emotional
learning skills Prevent mental health
problems in high risk groups Identify students in need Build pathways to care
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School Mental Health is Not New…
Schools and communities in Canada and elsewhere have been dealing with these issues for decades
Inconsistent, fragmented approaches, with pockets of excellence…
What’s new is the galvanizing of research, policy and practice to reach an integrated solution to a complex problem
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National, International, & provincial initiativesMoving Forward on the Promise of School Mental Health
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OUT OF THE SHADOWS AT LAST
The Standing Senate Committee on Social Affairs, Science and Technology
The Honourable Michael J. L. Kirby, Chair
May 2006
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Making the school a site for the effective delivery of mental health services involves several key steps. First, its potential must be recognized.
National Initiatives Related to School Mental Health
School-Based Mental Health & Substance Abuse Consortium
Canada’s Mental Health Strategy (MHCC)EvergreenNational Infant Child & Youth Mental Health ConsortiumOpening Minds
Joint Consortium for School HealthPublic Health Agency of CanadaCanadian Association for School HealthHealth CanadaCanadian Centre for Substance Abuse
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SBMHSA Consortium40 member team of researchers, education professionals, school mental
health professionals, etc.3 year projectLed by Ontario Centre of Excellence for Child & Youth Mental Health
Synthesis of ResearchScan of Nominated PracticesNational Survey
Findings:Research gives us clear directionProgramming does not consistently reflect researchOrganizational and systemic barriers impede
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International Initiatives in School Mental Health
International Alliance for Child and Adolescent Mental Health in Schools (Intercamhs) http://www.intercamhs.net/
US – Canada Alliance for School Mental Health
SBMHSA webinar - international initiatives (Aus, Germany, US)
Advances in School Mental Health Promotion
Key international conferences featuring School Mental Health17th Annual Conference on Advancing School Mental Health, October 25-
27, Salt Lake City, Utah --- see Mark Weist at CMHO!26th Annual Children’s Mental Health Research and Policy Conference,
March 3-6, Tampa, Florida24
Provincial Initiatives in School Mental Health
Emergence of government strategies (e.g., BC, MN, NS, ON)
Development of provincial coalitions (e.g., BC, ON)
Funded provincial initiatives related to mental health capacity building (e.g., AB, QB, NS, ON)
Cross-sectoral initiatives, infrastructure, protocols (e.g., BC, NB, ON)
Student mental health in provincial curriculum
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Acknowledging challengesLearning from past and present
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Taking Mental Health to SchoolDifferent models of mental health service delivery across Ontario
boards (Taking Mental Health to School, 2009)
Variable leadership structures, levels/types of professional support, relationship with community, range of services
Acknowledgement of promising supports (e.g., Student Support Leadership Initiative)
Need for leadership, coordination, access to evidence-based approaches, implementation support, evaluation 27
Past (present) Systemic ChallengesSchool boards are complex systems
Infrastructure, processes and protocols lackingLack of clarity re: roles and responsibilitiesSpecial services are…special
Inconsistencies across Boards with respect to: LeadershipProgrammingFundingAccess to servicesCollaboration
28Structural Challenges
Past (present) Systemic ChallengesMental Health is not well understood
Not traditionally part of educator trainingPD as a “one time event”Links to high pressure achievement agenda unclear
Stigma, Attitudinal BiasesDiscomfort and fearSometimes seen as outside of educator roleWorry about making a mistake, getting too close
29Knowledge Challenges
Mental Health Literacy
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0
10
20
30
40
50
60
70
80
90
100
not at all a little somewhat very extremely
Concern about Mental Health…
Educator Preparedness…
Past (present) Systemic ChallengesInconsistent access to high-quality programming
Evidence-based programs are expensiveRegional differences (in services, access, needs)Funding shortfalls
Competing demandsAcademic achievement agenda, with inherent pressures and
supports, occupy most of timePlates are full and increasing
Fragmented systems Service pathways and protocols are not well-defined
31Implementation Challenges
Commitments to the Mental Health & Addictions Strategy
Ontario Ministry of Education
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Strategy Priorities for the Next 3 Years Close Critical Service Gaps
• Increase availability of culturally appropriate services and serve more children and youth• in Aboriginal, remote and
underserved communities
• With complex mental health needs
• At the key transition point from secondary to post-secondary education
Identify & Intervene Early
• Provide tools and support to those in contact with children and youth so they can identify mental health issues sooner
• Provide resources for effective responses to mental health issues
• Build mental health literacy and local leadership
Fast Access to High Quality Services
• Build capacity in the community-based sector
• Reduce wait times• Meet community needs• Link education, child and
youth mental health, youth justice, health care, and the community
Support System Change• Support development of an effective and accountable service system for all Ontarians• Build on efforts that promote evidence-informed practice, collaboration, and efficiencies • Develop standards and tools to better measure outcomes for children and youth
Starting with Child and Youth Mental Health Our Vision:
An Ontario in which children and youth mental health is recognized as a key determinant of overall health and well-being, and where children and youth reach their full potential.
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Provide fast access to high quality service
Kids and families will know where to go to get what they need and services will be available to respond
in a timely way.
Identify and intervene in kids’ mental health needs early
Professionals in community-based child and youth mental health agencies and teachers will learn how to
identify and respond to the mental health needs of kids.
Close critical service gaps for vulnerable kids, kids in key transitions, and those in
remote communitiesKids will receive the type of specialized service they need
and it will be culturally appropriate
TH
EM
ES
IND
ICA
TO
RS • Reduced child and youth suicides/suicide
attempts
• Educational progress (EQAO)
• Fewer school suspensions and/or expulsions
• Decrease in severity of mental health issues through treatment
• Decrease in inpatient admission rates for child and youth mental health
• Higher graduation rates
• More professionals trained to identify kids’ mental health needs
• Higher parent satisfaction in services received
• Fewer hospital (ER) admissions and readmissions for child and youth mental health
• Reduced Wait Times
OVERVIEW OF THE MENTAL HEALTH & ADDICTIONS STRATEGY - FIRST 3 YEARS
INIT
IAT
IVE
S
Provide designated mental health
workers in schools
Implement Working Together for Kids’ Mental
Health
Hire Nurse Practitioners for eating disorders program
Improve service coordination for high needs
kids, youth and families
Implement standardized tools for outcomes and needs
assessment
Amend education curriculum to cover
mental health promotion and address stigma
Develop K-12 resource guide for educators
Implement School Mental Health ASSIST
program &mental health literacy provincially
Enhance and expand Telepsychiatry model
and services
Provide support at key transition points
Hire new Aboriginal workers Implement Aboriginal Mental
Health Worker Training Program
Create 18 service collaboratives
Expand inpatient/outpatient services for child and youth
eating disorders
Reduce wait times for service, revise service contracting, standards, and reporting
Funding to increase supply of child and youth mental
health professionals
Improve public access to service information
Pilot Family Support Navigator model
Y1 pilot
Increase Youth Mental Health Court Workers
Provide nurses in schools to support mental health
services
Implement Mental Health Leaders in
selected School Boards
Outcomes, indicators and development of scorecard
Strategy Evaluation
Interconnected Initiatives
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School Boards
Health Care
Settings
Community
Settings
MOHLTCNurse LeadersMHA Nurses in DSB programService CollaborativesSSLI
MCYSMH Workers with SchoolsWorking Together Student Support Leadership Initiative (SSLI)
EDUSMH ASSIST SSLI
EDU Strategy Commitments Amend the education curriculum Develop a K-12 Resource Guide/Website Provide support for professional learning in mental
health for all Ontario educators Fund and support Mental Health Leaders Implement School Mental Health ASSIST
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Leadership Structure Ontario Ministry of Education Lead
Special Education Policy & Programs Branch
School Board Lead Hamilton-Wentworth District School Board
SMH ASSIST Core Team Director, and 4+ P/T Implementation Coaches (3 Senior School Mental Health
Professionals, 1 Superintendent),.5 Research Associate (new!)
Cross-Sector Partners Interministerial Staff Team Hospital for Sick Children, Ontario Centre of Excellence for Child & Youth MH Provincial Stakeholder Organizations
Evaluation and Implementation Consultation Team Drs. Michael Boyle, Bruce Ferguson, Tom Kratochwill, Robert Lucio, Ian Manion,
Doris McWhorter, Karen Milligan, Caroline Parkin, Joyce Sebian, Mark Weist38
Support to ALL Ontario BoardsResources• Webinar series, other staff
development materials• Decision support tools• Templates• School Administrators’ Toolkit
Consultation
Workshops
Representation on provincial reference groups & committees
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Focus Boards15 Focus Boards in 2011-2012 Another 15 announced for 2012-2013Boards receive 1 FTE Mental Health Leader and SMH ASSIST
supportReciprocal relationship with SMH ASSIST
ASSIST provides leadership & implementation supportFocus Boards help with piloting resources that will be rolled out
to all boards in time
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First Priorities1. Organizational Conditions for
Effective School Mental Health (addressing structural challenges)
2. Mental Health Capacity-Building(addressing knowledge challenges)
3. Implementation of Evidence-Based Mental Health Promotion and Prevention Programming(addressing implementation challenges)
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Organizational Conditions for Effective School Mental Health
Organizational Conditions1. Commitment
2. School Mental Health
Leadership Team
3. Clear & Focused Vision
4. Shared Language
5. Assessment of Initial
Capacity
6. Standard Processes
7. PD Protocols
8. School Mental Health
Strategy / Action Plan
9. Broad Collaboration
10. Ongoing Quality
Improvement43
Self ReflectionWhere is your board currently, TODAY, along
each of the conditions…Feel free to discuss, leave blank…For your records…
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Commitment
Condition #1
Board leaders view child and youth mental health as a priority, and communicate this through action
Board leaders commit to Tiered Support Model Help board staff to understand the rationale for the model,
emphasizing the focus in schools on mental health promotion and prevention and the need to work with community partners for help with students with significant mental health concerns
Board leaders consistently attend community liaison meetings and internal MH team meetings
Board leaders provide visible, strategic and tangible support for needed infrastructure, resources, staffing
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Tiered Support in Systems of Care
Universal Evidence-BasedMental Health Promotion, Social-Emotional Learning
Targeted Evidence-
Based Prevention
E-B ClinicalIntervention
Evidence-Based Clinical Intervention
Targeted Evidence-Based
Prevention
Universal E-B Mental Health
Promotion
Community
School DistrictsIm
plem
entation
Focus
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School Mental Health Leadership Team
Condition #2
Board has a multidisciplinary, multi-layered mental health leadership team
All of the right people are at the table (in terms of expertise, influence, relationships, representation)
Parent and youth voice are critical
Team has meaningful liaison with community partners
Team is focused on vision-setting, leadership, collaboration, strategy/program selection, problem-solving
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Clear and Focused Vision
Condition #3
Board has shared, realistic goals Vision is aligned with AOP, BIPSA, Strategic
Directions Vision is aligned with key principles in school
mental health (e.g., preventive, linked with instruction, evidence-based, connected with partners at home and school, strong use of data)
Vision and goals are created collaboratively Vision is the basis for decision-making
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Shared Language
Conditio
n #4
The Board Vision for school mental health is communicated clearly across the organization
Foundational knowledge about student mental health is conveyed
Terms are defined consistently Where differences in language occur (e.g.,
across sectors), there is translation Use of early identification tools can be helpful
for finding common ways to speak of problem areas
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Assessment of Initial Capacity
Condition #5
Assessment data informs the development of the board mental health strategy
Before setting priorities, an assessment of organizational strengths, needs, and resources (resource mapping) can be very helpful
This assessment includes a scan of resources, in the form of people, processes, and programs
Staff and student voice data can deepen understanding of needs
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Standard Processes
Condition
#6
Board has standard processes for school mental health: Who does what (role clarification) Selection of school and classroom evidence-
based programs Delivery of training and coaching on programs
and strategies Standards and tools for monitoring progress Partnerships with community Pathways to service
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Protocols for Professional Development
Condition #7
Board has a systematic approach to capacity building in mental health that includes: Mental Health Awareness for all Mental Health Literacy for those with students Mental Health Expertise for those delivering specialized assessment
& intervention services
High quality training protocols, delivered by an engaging expert
Job-embedded, with ongoing coaching
Tools + Training + Technical Assistance + Quality Assurance 52
Mental Health Strategy / Action Plan
Con
diti
on
#8
The Board Mental Health Strategy is aligned with system goals
The Strategy is founded on evidence-based practices in school mental health
The Strategy is tailored to local context and data with respect to board needs and strengths
The Strategy is focused on measureable outcomes An implementation support plan is clearly
articulated 53
Broad Collaboration
Condition #9
The Board has several established platforms for dialogue and collaboration: Across departments and schools With community and health agencies With universities and other research
organizations With parents With students With other boards With government 54
Ongoing Quality Improvement
Condition #10
The board has a system of ongoing quality improvement, that includes measurement:
Of program / strategy implementation Of teacher perceptions and knowledge Of student perceptions and knowledge Of student outcomes
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Visit SMH ASSIST
http://smh-assist.ca/
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Contact School Mental Health ASSISTKathy Short, Ph.D., C.Psych.
Director, School Mental Health [email protected], x2634
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Questions???
School Mental Health
ASSIST
Équipe d’appui en santé mentale pour les écoles
