Scranton Highand

LourdesmontHelping Students Succeed Through an Interconnected

Systems Framework

ConnectionsWho We Are:O Kelly Perales –

Community Care Behavioral Health

O Mike Baldi – Lourdesmont

Interconnected Systems Frameworkpaper

(Barrett, Eber and Weist , revised 2009)

Developed through a collaboration of theNational SMH and National PBIS Centers

www.pbis.orgwww.csmh.umaryland.edu

Why Schools Need MH/Community Partnerships

OOne in 5 youth have a MH “condition”OAbout 70% of those get no treatmentOSchool is “defacto” MH providerO JJ system is next level of system defaultO1-2% identified by schools as EBDOThose identified have poor outcomesOSuicide is 4th leading cause of death

among young adults

Interconnected Systems Framework for School Mental Health

Tier I: Universal/Prevention for AllCoordinated 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 students· Safe & caring learning environments · Partnerships between school, home and the

community· Decision making framework used to guide and

implement best practices that consider unique strengths and challenges of each school community

Interconnected Systems Framework for School Mental Health

Tier 2: Early Intervention for Some

Coordinated Systems for Early Detection, Identification, and Response to Mental Health Concerns

· Systems Planning Team identified to coordinate referral process, decision rules and progress monitor impact of intervention

· Array of services available· Communication system for staff, families and

community · Early identification of students who may be 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

Interconnected Systems Framework for School Mental HealthTier 3: Intensive Interventions for Few

Individual Student and Family Supports

· Systems Planning team coordinates decision rules/referrals for this level of service and progress monitors

· Individual team developed to support each student

· Individual plans may have array of interventions/services

· Plans can range from one to multiple life domains

· System in place for each team to monitor student progress

Structure for Developing an ISF:Community Partners Roles in TeamsO A District/Community leadership that includes families,

develops, supports and monitors a plan that includes:

O Community partners participate in all three levels of systems teaming: Universal, Secondary, and Tertiary

O Team of SFC partners review data and design interventions that are evidence-based and can be progress monitored

O MH providers form both school and community develop, facilitate, coordinate and monitor all interventions through one structure

Old Approach New ApproachO Each school works out

their own plan with Mental Health (MH) agency;

O A MH counselor is housed in a school building 1 day a week to “see” students;

O No data to decide on or monitor interventions;

O “Hoping” that interventions are working; but not sure.

O District has a plan for integrating MH at all buildings (based on community data as well as school data);

O MH person participates in teams at all 3 tiers;

O MH person leads group or individual interventions based on data;

O For example, MH person leads or co-facilitates small groups, FBA/BIPs or wrap teams for students.

Old Approach New Approach

O District/school receive prevention and intervention services based on available grant or budget dollars.

O District and community leadership team used data to provide prevention and intervention based on pooled resources and need.

Community Partners Roles in Teams

O Participate in all three levels of systems teaming: Universal, Secondary, and Tertiary

O Facilitate or co-facilitate tertiary teams around individual students

O Facilitate or co-facilitate small groups with youth who have been identified in need of additional supports

3-Tiered System of Support Necessary Conversations (Teams)

CICO

SAIG

Group w. individualfeature

ComplexFBA/BIP

Universal Support

Problem Solving Team

Tertiary Systems Team

Brief FBA/BIP

Brief FBA/BIP

UniversalTeam

WRAP

Secondary Systems Team

Plans SW & Class-wide supports

Uses Process data; determines overall

intervention effectiveness

Standing team; uses FBA/BIP process for one youth at a time

Uses Process data; determines overall

intervention effectiveness

Time LineSchool Year Activity2008-09 •Community Care engaged district regarding SBBH

Team2009-10 •SBBH Team begins work within district –

September 2009•District and Community Leadership Team is established, district commitment signed, tertiary demonstration project begins – spring 2010

2010-11 •Tier One SWPBIS is fully implemented with kickoff at the start of the school year•Tier Two training begins in the spring of 2011 with some implementation – in some buildings (framework/building fit)

2011-12 •All three tiers are being implemented in some capacity. •Unique features of High School implementation•Changes within building/district

School Based Behavioral Health (SBBH) an Accountable Clinical Home

O Accountable TO the family and FOR the careO Accessible, coordinated, and integrated careO Comprehensive service approach O Increased accountability and communicationO Single point of contact for behavioral healthO School is “launching pad” for services delivered

in all settingsO Youth continue on the team with varying

intensity of service

SBBH Team Components

LICENSED MASTER’S

PREP CLINICIANS

(MHP)

EXPERIENCED

BACHELOR’S PREP

WORKERS (BHW)

ADMIN AGENCY SUPPORT

CONSULTATION TO

MHPS PRN

SBBH Service Components

CLINICAL INTERVENTI

ONS

CASE MANAGEME

NT

CRISIS INTERVENTI

ON

CASE CONSULTATI

ON AND TRAININGfor educational

staff

A High School Clinical Home

O SuccessesO ChallengesO Collaboration and communication

with the school

Raymond’s Story:A Successful Transition

O Reason for referral – history prior to SBBH

O Diagnosis – FSIQ medicationsO Treatment goals – modalities

employedO Current status – GED and electrical

tradeO Reason for success – clinical home

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

•SBBH Team•Outpatient therapy•SB Partial•Guidance – individual support•SAVES/school aged mothers

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

•SAP•Guidance – groups•Community Partners – groups•Resource Officer

Tier 1/Universal Interventions80-90%80-90% Tier 1/Universal Interventions

•SWPBIS•Drug and Alcohol Prevention

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

Resources

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

Needs

SYST

EMS

PRACTICES

DATASupportingStaff Behavior

SupportingDecisionMaking

SupportingStudent Behavior

STUDENT OUTCOMES

Social Competence &Academic Achievement

OutcomesChange in Family Functioning

0.0

0.2

0.4

0.6

0.8

1.0

1.2

1.4

1.6

1.8

Change at 3 mos Change at 6 mos Change at 9 mos

Not Implementing Low Fidelity High Fidelity

Impr

ovin

g

OutcomesChange in Child Functioning

0.0

0.2

0.4

0.6

0.8

1.0

1.2

1.4

1.6

1.8

Change at 3 mos Change at 6 mos Change at 9 mosNot Implementing Low Fidelity High Fidelity

Impr

ovin

g

Outcomes – SDQ-PChange in Difficulties Score

-3.5

-3.0

-2.5

-2.0

-1.5

-1.0

-0.5

0.0

0.5

1.0

Change Q1 Change Q2

Not Implementing Low Fidelity High Fidelity

Impr

ovin

g

Outcomes – SDQ-TChange in Difficulties Score

-4.0

-3.5

-3.0

-2.5

-2.0

-1.5

-1.0

-0.5

0.0

0.5

1.0

Change Q1 Change Q2

Impr

ovin

g

Not Implementing Low Fidelity High Fidelity

Sustainability and Scaling(next steps and expansion)

O At Tier One – O continued systems,

data, and practices and staff buy-in

O At Tier Two – O “formal” PBIS

training and teaming

O Further clarification of continuum of resources and gaps in interventions

Any Questions?

Thank you!GO

KNIGHTS!!!!!!