School Mental Health ASSIST

1. School Mental Health ASSIST Équipe d’appui en santé mentale pour les écoles Mental Health Leaders’ Meeting October 2, 2012

2. Welcome!

3. Key Messages to Take Away • This work is important. • You are critical to its’ success. • We are here to support you. Together, we will shape the future of school mental health in Ontario.

4. This Work is Important • 1 in 5 students – the need is great • Educators feel ill-prepared to deal with the magnitude of the problem (Taking Mental Health to School, 2009) • Schools are an optimal place to promote student well-being, and to identify and support students who struggle with mental health and addictions - but resources and supports are required • The province is committed to working collaboratively across Ministries to support child and youth mental health in Ontario

5. 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 • 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 • 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 • 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 Our priorities for the next three years

6. 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. 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 communities Kids will receive the type of specialized service they need and it will be culturally appropriate 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. THEMES • Fewer hospital (ER) admissions and readmissions for child and youth mental health • Reduced Wait Times • Reduced child and youth suicides/suicide attempts • Educational progress (EQAO) • Fewer school suspensions and/or expulsions • Higher graduation rates • More professionals trained to identify kids’ mental health needs • Higher parent satisfaction in services received • Decrease in severity of mental health issues through treatment • Decrease in inpatient admission rates for child and youth mental health INDICATORS Implement Working Together for Kids’ Mental Health Implement standardized tools for outcomes and needs assessment Enhance and expand Telepsychiatry model and services Provide support at key transition points Pilot Family Support Navigator model Y1 pilot Improve public access to service information Develop K-12 resource guide for educators Improve service coordination for high needs kids, youth and families Amend education curriculum to cover mental health promotion and address stigma Funding to increase supply of child and youth mental health professionals Increase Youth Mental Health Court Workers Hire new Aboriginal workers Implement Aboriginal Mental Health Worker Training Program Outcomes, indicators and development of scorecard Expand inpatient/outpatient services for child and youth eating disorders Hire Nurse Practitioners for eating disorders program Implement school mental health ASSIST program &mental health literacy provincially Provide designated mental health workers in schools Reduce wait times for service, revise service contracting, standards, and reporting Strategy Evaluation Implement Mental Health Leaders in selected School Boards Create 18 service collaboratives Provide nurses in schools to support mental health services OVERVIEW OF THE MENTAL HEALTH AND ADDICTIONS STRATEGYFIRST 3YEARS INITIATIVES 6

7. Ministry of Education Commitments • Enhance the education curriculum • Develop a K-12 Resource Guide/Website • Provide support for professional learning in mental health for all Ontario educators • Implement School Mental Health ASSIST • Fund and support Mental Health Leaders in school boards • Support Working Together for Kids’ Mental Health

8. You are Critical to Success of the MHA Strategy • Research highlights the importance of leadership in effective school mental health • This leadership relies on key system mobilizers who create and sustain organizational conditions necessary for effective school mental health • The Ministry of Education has invested in you to serve this critical role

9. We are here to support you • Leadership Modules • Focus on implementation science and creating conditions for effective school mental health • Mental Health Awareness & Literacy materials • For system leaders • For schools • Communication tools for use in your board • Ongoing implementation and coaching support via School Mental Health ASSIST

10. Together, we will shape the future of school mental health in Ontario.We will be consulting with you, questioning with you, struggling with you, walking with you…to find the best ways to help all of Ontario students.

11. Introductions • Your Name, Board/Organization, Role • MH Leaders and Superintendents, Cohort #1 What has been the best thing about the MH Leader Role? The Mental Health and Addictions Strategy? • MH Leaders and Superintendents, Cohort #2 What are you looking forward to the most? What are your hopes for the Mental Health and Addictions Strategy? • Other Guests How do you fit? Best thing about the Strategy?

13. School Mental Health ASSIST Équipe d’appui en santé mentale pour les écoles Awareness, Strategy Selection & Implementation Support Team Interactive Overview Interrupt! Ask Questions! Jot down questions for the parking lot

14. Mental Health is… “A state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity” World Health Organization

15. Mental Health Continuum

16. It has something to do with relationships… What is Positive Mental Health?

17. For many children, it is not that simple… Roughly one in five students in Canadian schools struggle with a mental health problem that interferes with their day to day functioning.

18. In their words… Change the View 2012

19. Schools 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 Schools Have a Unique Opportunity

20. In Partnership with Community/Health Organizational Conditions Community/Health E-B Clinical Intervention Universal E-B Mental Health Promotion Mental Health Capacity Engagement Targeted Evidence-Based Prevention Implementation Focus Targeted Evidence-Based Prevention Universal Evidence-Based Mental Health Promotion, Social-Emotional Learning School Districts Continuous Quality Improvement Evidence-Based Clinical Intervention

21. Background Reading on SMH • Key Papers • Out of the Shadows at Last, 2006 • Kutash et al on School Based Mental Health, 2006 • Taking Mental Health to School, 2009 • IOM report on prevention/promotion, 2009 • SBMHSA Consortium Synthesis, Scan, Survey • Intercamhs International Survey of Principals • Key Journals • Advances in School Mental Health (Editor, Weist) • School Mental Health (Editor, Evans) • School Psychology Quarterly • Key Sites • SMHP UCLA • SMH Maryland • CASEL • SAMHSA • MindMatters

22. School Mental Health ASSIST is a provincial implementation support team designed to help Ontario school boards to promote student mental health and well-being, through leadership, practical resources and systematic research-based approaches to school mental health.

23. 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 • 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 Weist

24. Priorities • Organizational Conditions for Effective School Mental Health • Mental Health Capacity-Building for Educators • Implementation of Evidence-Based Mental Health Promotion and Prevention Programming

25. Resources Webinar series, other staff development materials Decision support tools Templates School Administrators’ Toolkit Consultation Workshops Representation on provincial reference groups & committees Support to ALL Boards

26. Focus Boards • 15 boards were Focus Boards in 2011-2012, another 15 announced for 2012-2013 • Boards receive 1 FTE Mental Health Leader and SMH ASSIST support • Reciprocal relationship with SMH ASSIST • ASSIST provides leadership & implementation support • Focus Boards help with piloting resources that will be rolled out to all boards in time

27. Focus Boards Algoma DSB Algonquin and Lakeshore Catholic DSB CSD Catholiques Centre-Sud CSD des écoles catholiques du Sud-Ouest CSD du Nord-Est de l'Ontario District School Board of Niagara Hamilton-Wentworth DSB Hastings and Prince Edward DSB Huron-Superior Catholic DSB Keewatin-Patricia DSB Kenora Catholic District School Board Peel DSB Simcoe-Muskoka Catholic DSB Toronto Catholic DSB Trillium Lakelands DSB CSD catholique des Grandes Rivières CSD du Grand Nord de l'Ontario Grand Erie DSB Halton DSB Lakehead DSB Lambton Kent DSB London District Catholic DSB Northeastern Catholic DSB Ontario North East DSB Ottawa Catholic DSB Simcoe County DSB Thunder Bay Catholic DSB Toronto DSB Upper Grand DSB York Catholic DSB Selected for geographic, language, Catholic/Public representation, along a continuum of School Mental Health capacity

28. Introducing…Mental Health Leaders • What is Ontario Mental Health and Addictions Strategy? • Open Minds, Healthy Mindsis a ten-year Strategy designed to enhance the mental health and well-being of citizens of Ontario. It includes contributions from ten government Ministries and offers a systematic and comprehensive approach to service delivery along the continuum of mental health promotion, prevention, and intervention / ongoing care. The first three years of the Strategy are devoted to children and youth mental health and addictions under the leadership of the Ministry of Children and Youth Services. • What are the Ministry of Education Commitments to the Strategy? • Amend the education curriculum • Develop a K-12 Resource Guide/Website • Provide support for professional learning in mental health and addictions for all Ontario educators • Fund and support Mental Health Leaders in publicly funded school boards • Support Working Together for Kids’ Mental Health • Implement School Mental Health ASSIST • What is the Role of the Mental Health Leader? • Mental Health Leaders are full-time senior mental health professionals with dedicated responsibility for : • conducting/updatingboard and school level resource mapping to determine areas of strength and need • providing leadership for the board mental health team • working with senior administration to develop and implement the board mental health & addictions strategy • collaborating with board and community professionals to promote clear and integrated access to services • coordinating systematic mental health literacy initiatives in the board • selecting and supporting evidence-based approaches to mental health promotion and prevention • How are the Mental Health Leaders positioned in School Boards? • In most boards, Mental Health Leaders report to, or work closely with, Supervisory Officers with responsibility for student mental health and well-being. They also work alongside senior psychologists and social workers as part of a board mental health leadership team. Mental Health Leaders are a key point of contact for new professionals hired to support boards as part of the Ontario Mental Health and Addictions Strategy. • For more information, contact: • Sandy Palinski, Manager • Special Education Policy & Programs Branch • Ministry of Education • Telephone: 416-327-8208 • E-Mail: Sandy.Palinski@ontario.ca

29. The Journey Ahead • Understand the Big Picture • Understand your Role • Understand Alignment • Understand your District and Community • Board Scan, Resource Mapping • Assess Needs, Strengths, Priorities • Create a Board MH Strategy • Organizational Conditions • Professional Learning • Mental Health Promotion/Prevention Programming • Implement your Strategy

30. Understanding the Big Picture

31. Working Impact Model Enhanced Student Mental Health and Well-Being Enhanced District Conditions Enhanced Student Perceptions about School Climate (presence of caring adults, sense of belonging, safety) System Coordination + Mental Health Awareness Focused Mental Health Leadership, Capacity, & Implementation Support Enhanced MH Capacity Enhanced Staff Sense of Competence and Well-Being (knowledge re: mental health & sources of help, use of effective strategies, coping skills) Enhanced MH Implementation

32. Understanding Your Role • Mental Health Leaders are senior mental health professionals with full-time dedicated responsibility: • providing leadership for the board mental health team • conducting/updating board and school level resource mapping to determine areas of strength and need • working with senior administration to develop, execute and monitor the board mental health & addictions strategy • collaborating with board/community professionals to consolidate processes to promote clear and integrated access to services • coordinating systematic mental health literacy initiatives • selecting and supporting evidence-based approaches to mental health promotion and prevention

33. Understanding Role Alignment • Mental Health Leader complements: • Supervisory Officer responsible for SMH • Chief Social Worker, Chief Psychologist • Social Work, Psychology Staff • Other professionals who provide support (e.g., CYWs, Student Success, Guidance) • Community Mental Health Professionals • Mental Health Leader also needs to define role relative to new professionals that are part of the MHA Strategy (MCYS workers in schools, MOHLTC nurses)

34. LNS SS_Lto18 Healthy Schools Positive School Climate K-12 School Effectiveness Framework Learning for All Leadership Strategy BIP for Student Achievement Growing Success Equity and Inclusive Education Strategy Aboriginal Education Strategy Student Voice Accepting and Safe Schools Strategies Parent Engagement Provide support for professional learning in mental health for educators Fund and support Mental Health Leaders in school boards Implement School Mental Health ASSIST Mental Health & Addictions Strategy Connections Amend the education curriculum Develop a K-12 Resource Guide /Website Initiative Alignment

35. Understanding your District and Community • Board Scan • On-line surface scan that provides current status with respect to organizational conditions, professional learning, & MH programming • Fall and Spring each year • Resource Mapping • Deeper exploration of the existing strengths, needs and resources in your board and community • System and School Level • Survey, interviews, meeting

36. Strategy Development • Assess Needs, Strengths, Priorities • What are we doing well? • What is missing? • What are our priorities for the coming year? • Create a Board MH Strategy • Organizational Conditions (leadership team, protocols, etc.) • Professional Learning (cascaded PD) • Mental Health Promotion/Prevention Programming (select, enhance, sustain) • Implement!

37. Support for Mental Health Leaders • Leadership Modules • Insiders’ Guide to School Boards • Implementation Science • Leadership and Change (on-line PACE modules) • Facilitation Skills • Collaboration Skills • Resource Mapping and Building a MH Strategy • Evidence-Based Practice in School MH • Implementation Coach • On-Line Community of Practice • Resources/Templates for Recommended Protocols • e-SMH Library

38. Implementation Science Implementation Research: A Synthesis of the Literature Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M. & Wallace, F. (2005). Implementation Research: A Synthesis of the Literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network (FMHI Publication #231). Download all or part of the monograph at: http://www.fpg.unc.edu/~nirn/resources/detail.cfm?resourceID=31

39. Key Messages to Take Away School Mental Health ASSIST… • Is here to support you.

40. Learning Together • Discussion Group • Resources • e-SMH Library

41. When might we turn to YOU?List 1-3 areas in which you have developed some particular knowledge / expertise related to school mental health • Like, • Developing district infrastructure or protocols • Working with community partners • Supporting families in rural/remote communities • Working with immigrant and refugee children • Helping students with behavioral disorders • Implementing evidence-based programs • Working with FNMI communities • Mental Health Literacy for Educators • Suicide prevention…. Include your name!

42. Contact ASSIST • Kathy Short, Ph.D., C.Psych. Director, School Mental Health ASSIST Kathy.Short@hwdsb.on.ca 905-527-5092, x2634

43. Challenges and Helpful Hints For Bringing a Mental Health and Addictions Strategy to Life in your Board Cohort # 1 Mental Health Leaders

44. Key Themes • positioning the role, • working within school boards, • creating/enhancing a leadership team, • resource mapping, • communicating about ASSIST, • working with the community, • managing distractions • coordinating professional learning, • dealing with existing programs and products, • selecting evidence-based programming, • developing a MH Strategy, • managing crises.

45. Coordinating Professional Learning Resources to Support Mental Health Awareness, Literacy, and Expertise Cohort # 1 Mental Health Leaders

46. The Mental Health Capacity-Building Continuum Capacity Building is not an event! It is an iterative deepening of knowledge that is embedded in school board life. It takes time. Resources should be tailored for different education audiences

47. Mental Health Awareness • For All (MH Awareness Webinar) • For Senior Leaders (MH District Conditions Webinar) • For School Leaders (MH School Conditions Webinar) • For Educators (MH Classroom Conditions Webinar) • Ontario Centre of Excellence for Child and Youth Mental Health - MH Awareness Workshop • For Special Services (e.g., Student Success, Guidance, Special Education) • For Parents • For Youth

48. Mental Health Literacy • For School Leaders (School Leaders’ Guide) • For Educators (Educator Guide) • Special Modules • Ontario Centre of Excellence for Child and Youth Mental Health – Bullying, Suicide, Engagement, Stigma, Anxiety, Cross-Cultural Caring -SMH ASSIST will create school versions of these • SMH ASSIST modules (e.g., Creating a Mentally Healthy Classroom (HWDSB), Social Emotional Learning in the Classroom, Supporting the Disruptive/Impulsive/Sad Student) • Other Resources (e.g., Suicide Postvention Protocol)

49. Mental Health Expertise • For Mental Health Professionals • Partnering with experts in the field • Substance Use (Canadian Centre on Substance Abuse) • Non-Suicidal Self-Harm (McGill) • Other topics??

50. Closing and Next Steps And Thank You!