COMPREHENSIVE BEHAVIORAL HEALTH SERVICES: USING DATA FOR - PowerPoint PPT Presentation

COMPREHENSIVE BEHAVIORAL HEALTH SERVICES: USING DATA FOR IDENTIFICATION, Annual Conference of PARTNERSHIP DEVELOPMENT, Advancing AND RESEARCH School Mental Health, Sept 19, 2014 Pittsburgh PA ANDRIA AMADOR, CAGS, NCSP & MARY COHEN, PH.D., BOSTON PUBLIC SCHOOLS MELISSA PEARROW, PH.D. & VICTORIA SHEPPARD, M.S. UNIVERSITY OF MASSACHUSETTS BOSTON

CONFERENCE OBJECTIVES ¡ Background of project and introduce how needs were identified and addressed through a Comprehensive Behavioral Health Model (CBHM) ¡ Using data to secure support from internal and external stakeholders ¡ Using data to systematically identify needs ¡ Using data for research and partnership development

IMPACT OF MH ISSUES ON ACADEMIC SUCCESS — Preschool children with social emotional needs, expulsion rate 3x higher than children in k-12 — Children with mental health issues: — Miss up to 22 days in an academic year — Suspension/expulsion rate 3 times higher than those without mental health needs — Up to 14 % receive mostly Ds and Fs for grades (in comparison to 7% for all children with disabilities) — Mental health disorders contributes to over 10% of high school dropouts — Students with behavioral health issues à less school success — (Sources: Blackorby et al., 2003; Blackorby, & Cameto, 2004;Breslau et al., 2008; Doll, 1996; Gilliam, W.S, 2005; Hanchon & Allen, 2013; Wagner et al, 2005)

Andria Amador, USING DATA TO SECURE CAGS Director of SUPPORT Behavioral Health Services

BOSTON PUBLIC SCHOOLS ¡ City with diverse neighborhoods and communities § Three school zones § Ten distinct neighborhoods § More than 100 languages spoken by families ¡ More than 120 schools § 84 elementary § 18 middle/ junior high school § 34 secondary - 3 exams schools and 1 performing arts schools ¡ Staffing § Over 8000 professional staff § 54 School Psychologists, 6 Pupil Adjustment Counselor (SW) & 3 Behavior Specialists

STUDENTS IN BPS

LOCAL NEED ¡ Local need § 1 in 5 children in Boston have experienced at least 1 adverse childhood experience § Marathon Bombing § 60 critical incidents each year ¡ National and State Initiatives (policy, legislation) § Safe and Supportive School Legislation § Department of Justice Forum City ¡ Role change of School Psychologist: Change agents § CBHM from the ground up § NASP Practice Model

NEEDS OF STUDENTS AND SCHOOLS ¡ A 2012 report identified the need for mental health services rated as a high priority in the majority of Boston Public Schools ¡ 94% of all respondents reported that on-site mental health support was needed at their school ¡ 66% of schools reported that providing mental health services was a high or highest priority of need for their school Schools at the Hub, Weiss & Siddall, 2012

COMPREHENSIVE BEHAVIORAL HEALTH MODEL (CBHM) ¡ Impetus to create and design this model § Expand the role of school psychologists for all domains of practice (NASP Practice Model) § Expanded partnership with Boston Children’s Hospital § Address the needs of the students in Boston § Address inequities in access to services § Respond to state and national initiatives

USING DATA TO GARNER SUPPORT ¡ Support from internal stakeholders § Administrators § School psychologists § Teachers ¡ Support from external stakeholders § Parents § Hospitals § Community mental health agencies § Local officials § University partners

KEY STAKEHOLDER INTERVIEWS (N=76) ¡ What behavioral health issues have the greatest impact on the students in your school? Ag Agreement Issue Social skills/self-regulation 75% Family stress 50% Trauma 47% Bullying 21% Depression 17% Acculturation 14%

INTERNAL SUPPORT ¡ Benefits of buy-in articulated to administrators through shared agreements ¡ Principal buy-in: breakfasts, contracts, scheduling… ¡ “Creative resourcing of staff” ¡ Parents and families ¡ Support and capacity building of school psychologists § Professional Learning Communities (PLC) § Purchasing new curriculum and training § Efforts to balance proactive and preventive strategies with their responsibilities regarding special education mandates

COMMUNITY PARTNERSHIPS ¡ Historically, partnerships lacked consistent representation and oversight by district ¡ Inequities in partnerships with schools § More than 120 schools in BPS, and only 90 have partnerships with community mental health agencies § Composition of services varies by school and by agency § Vast inequities in services across the district ¡ Need for consistency in identification and treatment outcomes § No systematic monitoring of progress by agencies § No monitoring of outcomes by district

OUTCOMES ¡ University Partnerships § Aligned university field work with CBHM needs and supports § Increased number of students § Increased number of hours of service provided by students ¡ Community Partnerships § Formed Partnership with Boston Children’s Hospital § Aligned work with Defending Childhood Initiative § Work closely with other city agencies § Received federal and state grants

OUTCOMES ¡ Mental Health Partners: § District-level staff involvement with the School-Based Mental Health Collaborative § Mandatory training for all mental health providers (over 250) § Created guidelines to clarify roles and expectations of the partnership § Standards of Practice, based on best practices § Memorandum of Agreement (MOA) to create greater equity in access to services for all students

Mary Cohen, USING DATA TO IDENTIFY PhD School NEEDS THROUGH Psychologist Extraordinair UNIVERSAL SCREENING e

UNIVERSAL SCREENING DEFINED “Universal screening is the systematic assessment of all children within a given class, grade, school building, or school district, on academic and/or social-emotional indicators that the school personnel and community have agreed are important” (Ikeda, Neessen, & Witt, 2009)

UNIVERSAL SCREENING RATIONALE ¡ Universal screening to identify students at-risk of developing behavior problems offers several advantages: § Cost-efficient (less expensive than special education evaluations) § Proactive (identify students who can benefit from extra supports) § Reach students who typically “fly under the radar” (shy, withdrawn students can also experience poor outcomes: academic failure, social ostracism, heightened risk of suicide) § Objective (help address disproportionality issues)

SPECIAL EDUCATION ¡ 20% of students in BPS receive Special Education services ¡ Massachusetts has the 2 nd highest rate of identification of special needs (12%) in the United States

SPECIAL EDUCATION CATEGORIES

UNIVERSAL SCREENING RATIONALE ¡ President’s Commission on Excellence in Special Education (2001) and No Child Left Behind (2001) recommend acade academic ic AND be beha havioral ioral screening ¡ Greater likelihood of alt altering ring ne negat ativ ive lif life tr trajec ectory y associated with early intervention (Patterson, Reid, & Dishion, 1992) ¡ Massachusetts Safe & Supportive Schools le legis islat lation ion requires that schools address the mental health needs of students (passed this summer)

COMPO CO MPONE NENT NTS O S OF THE F THE CO COMPR MPREHE HENSI NSIVE BE BEHA HAVIORAL AL HE HEAL ALTH TH MODEL ( MODEL (CB CBHM) HM) – – S SCHOOL LEVEL CHOOL LEVEL Universal Screening Coaching & Teams Consulting Data Comprehensive Collection Professional Behavioral & Progress Development Health Model Monitoring Tiered Levels of Intervention Social- Emotional Collaboration with Learning Mental Health Curriculum Partners

PILOT PROJECT ¡ To select universal screening tool ( Spring 2012) § Six demographically-diverse schools § Samples and examined multiple tools and rated using criteria § Screening team comprised of district administration, school psychologists and interns, and two consultants ¡ Schools selected for Cohort 1 (2012-2013) § 10 schools chosen to participate § Represent elementary, middle, and high school § Mental health partnership

SELECTION OF BIMAS ¡ BIMAS

SUMMARY OF BIMAS ¡ BIMAS: empirically-based; sensitive to change (excellent for RtI) ¡ Standard and Flex ¡ Big Norm Samples and Good Psychometric Properties ¡ Powerful Web-based Interface ¡ Easy paper and online administration and scoring options ¡ Wide Selection of Informative Web-based Reports

TRAIN THE TEACHERS BIMAS I - Introduction and Administration BIMAS II - Interpretation and Data-Based Decision Making BIMAS III - Group Formation and Progress Monitoring

HOW THE BIMAS IS USED 1. Sc 1. Screen eening- g- as a brief screening device to detect students in need of further assessment and to identify their respective areas of strengths and needs 2. 2. St Student Progress Monitoring- To provide feedback about the progress of individual students or clients 3. Pr 3. Progr ogram E m Evaluati tion on - - To gather evidence that intervention services are effective.