Enhancing Mental Health Services in CMS

The School-Based Mental Health ProgramCotrane Penn, Ph.D

Student Services Department

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• School Counselors • 1 per elementary school• 2 – 3 per middle school• 1 for approximately 400 high school students

• School Psychologists – one for 2 to 3 schools• Social Workers – 44 assigned to high needs schools• Substance Abuse Counselors- 3 in CMS• Mental Health Therapists – 2 agencies serving 30

schools

Current State of Mental Health Services in CMS

Current State of Mental Health Services in CMS

• Mental Health Agency Services• Concentrated in Title I Schools• Primarily serve Medicaid-eligible

students• Primarily serve elementary schools

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The Future State of Mental Health Services in CMS

• CMS holds consistent expectations across agencies• Agency work in CMS is contingency-based• Students served based on need, not ability to pay • True collaborative relationship between district,

schools, and agencies• Expanded continuum of care available in all CMS

schools

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The CMS Vision for School-Based Mental Health Services

To increase the availability of evidence-based mental health services for the purpose of improving student’s emotional well-being and enhancing their ability to access and benefit from instruction.

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Mental Health Goal Strands6

Increase the Availability of Services• Increase the number of agencies serving CMS

schools• Increase the number of schools receiving

agency services• Eliminate barriers that prevent students from

accessing agency services

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Mental Health Services Available

• District mental health staff: Short-term individual and group counseling, limited long-term individual counseling

• Mental health agencies: Psychological evaluations, intensive outpatient therapy, family therapy, intensive in-home services, medication management

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School-Based Service Provider

Primary Referral Need

Individual Support Group Support Family Support Community-Based Support

CMS Student Services

Consultation with school staff and/or student*

Classroom guidance

Parent conference

Referral to or utilization of community resources+Mentorship

opportunities Short-term group

counseling

Home visit

Short-term counseling (6 or < sessions)

Family assessment

Community agency

coordination

Long-term counseling (6 or < sessions)

Long-term group counseling

Parent consultation

Behavior intervention plans Parent training

Check-n-Connect

School-Based Mental Health

Agency Services

Individual therapy

Group therapy

Family therapyReferral to day treatment or

inpatient behavioral health

facility

Medication evaluation/Medication

monitoring

Intensive in-home services

Access Instruction• Formal monitoring of overall student

attendance pre- and post- therapy• Formal monitoring of out-of-school

suspensions and in-school suspensions pre- and post- therapy

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Improved Well-Being• All agencies use the same assessment of

student behavior pre- and post- services • BASC-2 Online

• Streamlines therapy goal development• Allows for teacher rating of student

internalizing and externalizing behaviors• Allows CMS to see typical improvement rates

and better understand agency efficacy

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Benefit from Instruction• Formal monitoring of short-term & long-term

achievement growth pre- and post- therapy

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Short-Term Progress Long-Term Progress

Elementary MAP EOG

Reading 3D benchmarks

Middle MAP EOG

High School Credit Accrual/Semester

Credit Accrual/School Year

Authorized School-Based Agencies• The New Providers• Family First Community Services• Mélange Health Solutions

• The Continuing Providers• Carolinas Healthcare System• Thompson Child and Family Focus

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Agency Assignments• Posted on SBMH program website• Questions? cotrane.penn@cms.k12.nc.us

• One agency per school model• Based on a number of factors, none school-

specific• Goal is to develop consistent practice and quality

of care across agencies and school

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Program Element Highlights

Agency Responsibilities• Provide master’s level clinicians• Regular, schedule-based presence at schools• Work collaboratively with teachers and staff• Attend individual student meetings• Maintain contact with student and school when

student placed in a facility• Provide consultation and education to school

staff

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School Responsibilities• Support and promote provision of agency services• Work collaboratively with agency staff• Invite agency staff to pertinent planning and

intervention meetings• Obtain parent permission for agency presence at

student meetings• Conduct regular review meetings to get status and

progress updates on agency students• Designate a point person to manage agency

protocol within the school17

Collaborative Responsibilities• Ensure access to services for all students in need• Use a “warm hand-off” for parent permission• Crisis intervention for agency clients• Bi-directional sharing of information• Shared school behavior goals

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The SBMH “Soft Start”

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Requesting SBMH Services• Google Forms will be used to make requests• It is a secured site

• Any student who will be referred for agency services needs a request submitted

• Only the designated CMS staff can make requests

• Authorization is needed for service oversight and budget management

• The Soft Start Referral process steps

Orienting the Agency Therapist• Introduce therapist to critical staff• Administrators• Secretaries• Student Services Staff & EC staff

• Share school-specific norms• Sign-in/sign-out expectations• Classroom visit norms• Staff arrival/departure times

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Orienting the Agency Therapist cont.

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• Special tips• Staff dress code

• Tour of school & provide school map• Help therapist understand various schedules• Elementary grade level/classroom • Middle & High school S1/S2 & A-day/B-day

schedules• Testing calendars and related restrictions

• How to schedule meeting space

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The SBMH Fall 2014 “Hard Start”

What will be done before the “hard start” in the fall?

• Comprehensive training of agency staff on:School staff roles and responsibilities School-based team processesReferral to services processAgency responsibilities in the school settingInteracting with clients in the school setting

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Preparing for the “hard start” cont.Working in educational settings (general

overview of school practices, procedures, and the day-to-day work of schools, importance of the master schedule)*

Agency effectiveness review processAgency entry plan development*- present

entry plan concept to agencies• Acquire and train on BASC-2 usage• Meet with all school leaders to address Q & As

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School-Based Mental Health Therapy as an RtI Intervention

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• All students receiving school-based mental health services are considered to be in tier 2 or 3 of the district’s RtI model• Placing a student at tier 2 or 3 denotes that

he or she is at-risk and requires additional school-based behavioral supports

• Starting in the Fall of 2014, the regular education intervention process guidelines will apply to SBMH Program services

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Agency Name Agency Contact Information

Family First Community Services John Waller, Clinical Directorjwaller@fam1stcom.com

Mélange Health Solutions Brenda Kendrickbkendrick@melangehs.com

Carolinas Healthcare System Candice WhitesideCandice.Whiteside@carolinashealthcare.org

Thompson Child and Family Focus Debra Shuler, Clinical Supervisordshuler@thompsoncff.org

Agency Contact Information

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