Interconnected Systems Framework ISF Replication November 21 2014

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”: Scranton Montrose

Advancing Education Effectiveness: Interconnecting School Mental Health and School-Wide Positive Behavior Support Editors: 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_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 • Each school works out their own plan with Mental Health (MH) agency; Preferred • District has a plan for integrating MH at all buildings (based on community data as well as school data);

SCHOOL-WIDE POSITIVE BEHAVIOR SUPPORT ~5% ~15% Primary Prevention: School-/Classroom. Wide Systems for All Students, Staff, & Settings ~80% of Students Tertiary Prevention: Specialized Individualized Systems for Students with High-Risk Behavior Secondary Prevention: Specialized Group Systems for Students with At-Risk Behavior

Implementation Science • • • Exploration and Adoption Installation Phase Initial Implementation Full Implementation Innovation and Sustainability Fixsen, 2010

Fragmented Structures Student Assistance Teams Fragmented Practices Student Support Leaders Rt. I School-based Mental Health Services SEL STUDENTS in one school Special Education Student Assistance Teams Social Work Services Family Coordinators Pre-referral Interventions After School Programs How does a school decide how to support different students?

Fragmented Policy Fragmented Practices After. School Programs Special Education Clinic Violence & Crime Prevention Juvenile Court Services Mental Health Services Pupil Services Community Based Organizations Social Services Health Services SCHOOL Drug Prevention Child Protection Services Drug Services 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.

Compelling Factors Detention/ RTF AAA APS Probation Partial Detox Court Mentor Truancy Psych Residential Special Ed Counseling Referral Intake Referral Eligibility Intake Ed. Sys JJ Sys rral Residential Case Work Intake CW Sys Intake Foster Care Referral MH Sys MR Sys Intake Psychiatrist th D&A Sys Refe Therapist. MCO Sys Partial Health Sys Referral Case Mgmt. . ER Hospital. Intake TSS/BSC Mobile T Intake Primary Care Mgmt. Case Mgmt. Inpatient

Supt/ Asst. Supt Supervisor SW/Psych Special Education Director Police Juvenile Justice Building Principal Rep. Core District and Community Leadership Team Service Providers Family Groups Local Area Network Co-Convenor Rt. I Coordinator Homeless Coordinator Mental Health/ 708 Board Curriculum/ Prof. Dev

Building Level Model Grade Level Teachers Special Education Teachers Community/ Family Building Leadership Team Mental Health Rep. Principal SW, School Psych Guidance

School-Wide Systems for Student Success: A Response to Intervention (Rt. I) Model: SUPPORTS Academic Systems Tier 3/Tertiary Interventions • _____________________ • ___________ Tier 2/Secondary Interventions 5 -15% • ___________________________ • ___________________________ Behavioral Systems 1 -5% Interventions 5 -15% Interventions Tier 1/Universal Interventions 8080 -90% Interventions • ________________________ • ____________ Illinois PBIS Network, Revised May 15, 2008. from “What is school-wide PBS? ” OSEP • ____________ Adapted Technical Assistance Center on Positive Interventions and Supports. • ____________ Behavioral Accessed at http: //pbis. org/school-wide. htm • ____________ Tier 3/Tertiary • ____________ • ____________ Tier 2/Secondary ____ • _________________________ ___ • _______________ ___ Tier 1/Universal • _____________ ___ • • _________________________ _____ ___ • _______________________

Building Level Action Plan UNIVERSAL SYSTEM SECONDARY SYSTEM TERTIARY SYSTEM Universal Systems Team Secondary Systems Team Problem Solving Team (individual student) Tertiary Systems Team PRACTICES Data Decision Rule 20

Positive Behavior Interventions & Supports: A Response to Intervention (Rt. I) Model Tier 1/Universal School-Wide Assessment School-Wide Prevention Systems n me t (Behavior and Academic Goals) Competing Behavior Pathway, Functional Assessment Interview, Scatter Plots, etc. Illinois PBIS Network, Revised October 2009 Adapted from T. Scott, 2004 Int er ve ss se Daily Progress Report (DPR) nt ion Tier 2/ Secondary As ODRs, Attendance, Tardies, Grades, DIBELS, etc. Tier 3/ Tertiary SIMEO Tools: HSC-T, RD-T, EI-T Check-in/ Check -out (CICO) Social/Academic Instructional Groups (SAIG) Group Intervention with Individualized Feature (e. g. , Check and Connect -Cn. C and Mentoring) Brief Functional Behavior Assessment/ Behavior Intervention Planning (FBA/BIP) Complex or Multiple-domain FBA/BIP Wraparound

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 Datasets Positive Assets • Parks & Playgrounds • Hospitals • Community Centers • Recreation Centers • Vacant housing • Community • Core service agencies Disadvantage • Census (income, family structure, 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 Check Action 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 – Pa. TTAN • 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?