Reducing Barriers toReducing Barriers toLearning in Urban Schools throughLearning in Urban Schools through

Expanded School Mental HealthExpanded School Mental Health

Mark D.Mark D. WeistWeist

University of MarylandUniversity of Maryland

School of MedicineSchool of Medicine

Two Important Goals:Two Important Goals:Achievement and WellbeingAchievement and Wellbeing

1) Achievement promotes wellbeing1) Achievement promotes wellbeing

2) Wellbeing promotes achievement2) Wellbeing promotes achievement

School philosophy often acknowledges 1 butSchool philosophy often acknowledges 1 butfails to acknowledge 2fails to acknowledge 2

Schools Increasingly Focus on ReducingSchools Increasingly Focus on ReducingAcademic Barriers to LearningAcademic Barriers to Learning

Example: Reading First InitiativeExample: Reading First Initiative–– Early intervention on emergent literacy to promoteEarly intervention on emergent literacy to promote

achievement of grade level competency by theachievement of grade level competency by thethird gradethird grade

But Schools Often Fail to Focus onBut Schools Often Fail to Focus onNon-Academic Barriers to LearningNon-Academic Barriers to Learning

And Non-Academic Barriers to LearningAnd Non-Academic Barriers to LearningExert a Powerful Negative InfluenceExert a Powerful Negative Influence

EnvironmentalEnvironmental–– Poor nutritionPoor nutrition

–– Family stressFamily stress

–– Family conflictFamily conflict

–– Peer influencesPeer influences

–– Exposure to violenceExposure to violence

–– Abuse, NeglectAbuse, Neglect

–– Poor school environmentPoor school environment

PersonalPersonal–– AttentionalAttentional difficultiesdifficulties

–– Behavioral problemsBehavioral problems

–– DepressionDepression

–– AnxietyAnxiety

–– Social problemsSocial problems

–– Trauma reactionsTrauma reactions

A ParadoxA Paradox

Pressures related to achieving satisfactoryPressures related to achieving satisfactoryAnnual Yearly Progress (AYP) have led manyAnnual Yearly Progress (AYP) have led manyschools to increase focus on reducingschools to increase focus on reducingacademic barriers to learning AT THEacademic barriers to learning AT THEEXPENSEEXPENSE of programs that focus on non-of programs that focus on non-academic barriers to learningacademic barriers to learning

School Effectiveness in PromotingSchool Effectiveness in PromotingAchievementAchievement

Least effective: Limited focus on academicLeast effective: Limited focus on academicand nonacademic barriersand nonacademic barriers

More effective: Focus on academic barriersMore effective: Focus on academic barriers

Most effective: Integrated Focus on academicMost effective: Integrated Focus on academicandand nonacademic barriersnonacademic barriers

Positive Behavior InterventionsPositive Behavior Interventionsand Supports (PBIS)and Supports (PBIS)

A school wide approach to promoting positive andA school wide approach to promoting positive andreducing problem school behaviorreducing problem school behavior

Evidence of strong effectiveness in improving schoolEvidence of strong effectiveness in improving schoolclimate, reducing office referrals and suspensions forclimate, reducing office referrals and suspensions forbehavioral concerns, and freeing education andbehavioral concerns, and freeing education andadministrative staff to focus on academicsadministrative staff to focus on academics

Schools with PBIS may not focus on more seriousSchools with PBIS may not focus on more seriousemotional/behavioral barriers to learning (seeemotional/behavioral barriers to learning (seewww.pbis.orgwww.pbis.org))

Expanded School Mental Health (ESMH)Expanded School Mental Health (ESMH)

ESMH programs join families, schools, mentalESMH programs join families, schools, mentalhealth and other community systemshealth and other community systemsTo develop a full array of effective programsTo develop a full array of effective programsand services that improve the schooland services that improve the schoolenvironment, reduce barriers to learning, andenvironment, reduce barriers to learning, andprovide prevention, early intervention andprovide prevention, early intervention andtreatmenttreatmentfor youth in general and special educationfor youth in general and special education

Outcomes of Effective ESMHOutcomes of Effective ESMH

Student:Student:–– Improved attendance, behavior and academic performanceImproved attendance, behavior and academic performance

School:School:–– Improved environment, reduced violence, reducedImproved environment, reduced violence, reduced

inappropriate special education referralsinappropriate special education referrals

System:System:–– Enhanced collaboration between child serving agencies,Enhanced collaboration between child serving agencies,

increased and more efficient use of resourcesincreased and more efficient use of resources

TheThe ““Shared AgendaShared Agenda”” InitiativeInitiative

Collaboration between families, otherCollaboration between families, otherstakeholders, the National Association of Statestakeholders, the National Association of StateDirectors of Special Education, NationalDirectors of Special Education, NationalAssociation of State Mental Health ProgramAssociation of State Mental Health ProgramDirectors, and many other organizationsDirectors, and many other organizationsBroadly disseminated concept paper (seeBroadly disseminated concept paper (seewww.nasdse.org/sharedagenda.pdfwww.nasdse.org/sharedagenda.pdf))Seed grants to statesSeed grants to statesNational and state training programsNational and state training programs

Shared AgendaShared Agenda ImpactsImpacts

Increasing buy-in among education systems ofIncreasing buy-in among education systems ofintegrated approaches that address academic and non-integrated approaches that address academic and non-academic barriers to learningacademic barriers to learningProviding support for the growth, improvement andProviding support for the growth, improvement andintegration of school mental health approaches (e.g.,integration of school mental health approaches (e.g.,PBIS, ESMH)PBIS, ESMH)Promoting state-level progress and national to state toPromoting state-level progress and national to state tolocal linkageslocal linkagesAdvancing collaborative approaches and theAdvancing collaborative approaches and thedevelopment of communities of practicedevelopment of communities of practice

University of MarylandUniversity of MarylandSchool Mental Health Program (SMHP)School Mental Health Program (SMHP)

Established in 1989 in 4 schoolsEstablished in 1989 in 4 schools

Currently operating in 21 schools:Currently operating in 21 schools:–– 9 elementary9 elementary

–– 2 elementary-middle2 elementary-middle

–– 6 middle6 middle

–– 4 high4 high

Annual budget of around $1 million ($800,000Annual budget of around $1 million ($800,000contracts; $200,000 fee-for-service)contracts; $200,000 fee-for-service)

SMHP Mission ThemesSMHP Mission Themes

Committed, energetic, resilient staff from multipleCommitted, energetic, resilient staff from multipledisciplinesdisciplines

Strong collaborative approach with youth, familiesStrong collaborative approach with youth, familiesand all school staffand all school staff

Emphasis on productivity, continuous qualityEmphasis on productivity, continuous qualityimprovement and evidence-based practiceimprovement and evidence-based practice

SMHP Statistics 2002-2003SMHP Statistics 2002-2003

Total FTE for 21 schools = 19.3Total FTE for 21 schools = 19.3

2208 Students seen (M per school = 105)2208 Students seen (M per school = 105)

11436 Individual sessions (M = 544)11436 Individual sessions (M = 544)

14780 Group contacts (2405 sessions) (M =14780 Group contacts (2405 sessions) (M =703)703)

551 Family sessions (M = 26)551 Family sessions (M = 26)

4490 Contacts with educators (M = 213)4490 Contacts with educators (M = 213)

SMHP 2003-2004 (cont.)SMHP 2003-2004 (cont.)

Sample of new cases seen 4 or more timesSample of new cases seen 4 or more times(n = 963):(n = 963):–– 63% had 90% or better attendance rate63% had 90% or better attendance rate

–– 97% had no school suspensions97% had no school suspensions

–– 4% referred for special education assessment4% referred for special education assessment

The Baltimore Experience:The Baltimore Experience:Key IngredientsKey Ingredients

Strong leadershipStrong leadership

A commitment to childrenA commitment to children

VigorousVigorous nonacceptancenonacceptance ofof Same Old Same OldSame Old Same Old

History in school healthHistory in school health

Funding experience and perseveranceFunding experience and perseverance

Interdisciplinary networksInterdisciplinary networks

Political will and activismPolitical will and activism

Center for School Mental Health AssistanceCenter for School Mental Health Assistance

CSMHACSMHAEstablished in 1995 with a grant from theEstablished in 1995 with a grant from theMaternal and Child Health Bureau of theMaternal and Child Health Bureau of theHealth Resources and Services AdministrationHealth Resources and Services Administration(HRSA)(HRSA)

Renewed 5-year funding in 2000 from HRSA,Renewed 5-year funding in 2000 from HRSA,with co-funding from the Substance Abuse andwith co-funding from the Substance Abuse andMental Service AdministrationMental Service Administration

CSMHA GoalsCSMHA Goals

Increase public support for expanded schoolIncrease public support for expanded schoolmental healthmental health

Improve the quality of mental healthImprove the quality of mental healthpromotion and intervention in schoolspromotion and intervention in schools

Facilitate the integration of youth servingFacilitate the integration of youth servingsystems in the advancement of ESMHsystems in the advancement of ESMH

CSMHA ObjectivesCSMHA Objectives

Provide technical assistance and consultationProvide technical assistance and consultation

Provide national training and educationProvide national training and education

Disseminate and develop knowledgeDisseminate and develop knowledge

Promote communication and networkingPromote communication and networking–– phone: 410-706-0980 (888-706-0980 toll free)phone: 410-706-0980 (888-706-0980 toll free)

–– email:email: csmha@psych.umaryland.educsmha@psych.umaryland.edu

–– web: http://web: http://csmha.umaryland.educsmha.umaryland.edu

Dimensions of Progress in ESMHDimensions of Progress in ESMH

Advocacy, coalition building, policy change,Advocacy, coalition building, policy change,resource enhancementresource enhancement

Stakeholder involvement, needs assessments,Stakeholder involvement, needs assessments,resource mapping, strategic developmentresource mapping, strategic development

Staff training and supervision, evidence-basedStaff training and supervision, evidence-basedpracticepractice

Quality improvement and evaluationQuality improvement and evaluation

Dimensions of Progress (cont.)Dimensions of Progress (cont.)

Moving toward a full mental health promotion-Moving toward a full mental health promotion-intervention continuumintervention continuum

Coordinating programs and services andCoordinating programs and services andcontributing to system of care developmentcontributing to system of care development

Addressing areas of special needAddressing areas of special need

Three Critical Areas forThree Critical Areas forESMH to AdvanceESMH to Advance

Advocacy and Infrastructure DevelopmentAdvocacy and Infrastructure Development

Doing and Coordinating the Work in SchoolsDoing and Coordinating the Work in Schools

Quality and AccountabilityQuality and Accountability

Doing and Coordinating the WorkDoing and Coordinating the Work

Continuum of Programs and ServicesContinuum of Programs and Servicesin School Mental Healthin School Mental Health

More Intensive Intervention

Prevention and Early Intervention

Enhance Environment, Broad Mental Health Promotion

Factors Necessary for theFactors Necessary for theDevelopment of the ContinuumDevelopment of the Continuum

Desired Outcomes Effective mental health promotion and intervention

Outstanding staff and program qualities Ongoing training, technical assistance & support

School and community buy-in and investment

Resources Awareness raising, advocacy, policy improvement

Youth Mental Health ServicesYouth Mental Health Servicesin Most Communitiesin Most Communities

Primary Secondary Tertiary

Education - - - - - - - -

M. Health - - - - - - - -

Pub. Health

The VisionThe Vision

Primary Secondary Tertiary

Education -------------- -------------- --------------

M. Health --- -------------- --------------

Pub. Health --------------

Deciding on Roles in a SchoolDeciding on Roles in a School(no stereotyping intended)(no stereotyping intended)

Primary Secondary Tertiary

Sch. Psy. XOXOXO XXXXXX XX

Sch. SW. XOXOXO XXXXXX

Sch. Co. XOX0 OOO

Com. St. XO OOOOOO OOOOOO REG.ED=O SPEC.ED=X

Two Keys to PreventionTwo Keys to Prevention

Catalano et al. (2002) reviewed 161 YouthCatalano et al. (2002) reviewed 161 YouthDevelopment Programs.Development Programs.

Two strategies in all effective programs were:Two strategies in all effective programs were:–– Skill buildingSkill building

–– Environmental, organizational changeEnvironmental, organizational change

Quality and AccountabilityQuality and Accountability

Dimensions of QualityDimensions of Quality

You are where you should beYou are where you should be

Stakeholders are involvedStakeholders are involved

Strong collaborative processesStrong collaborative processes

Access is a priorityAccess is a priority

Productive, efficient staffProductive, efficient staff

Full range of empirically supported approachesFull range of empirically supported approaches

Developmental/cultural sensitivityDevelopmental/cultural sensitivity

Cultural CompetenceCultural Competence

Knowledge dimension (e.g., understanding theKnowledge dimension (e.g., understanding theculture)culture)

Skill dimension (e.g., altering interpersonalSkill dimension (e.g., altering interpersonalspace)space)

Interest in listening/connecting dimension (e.g.,Interest in listening/connecting dimension (e.g.,ensuring diverse community stakeholders areensuring diverse community stakeholders areinvolved in all aspects of the program).involved in all aspects of the program).

Importance of Family InvolvementImportance of Family Involvement

SEARCH Institute study:SEARCH Institute study:–– As parental involvement in schools increased,As parental involvement in schools increased,

problem behaviors in students (alcohol use,problem behaviors in students (alcohol use,violence, antisocial problems) decreasedviolence, antisocial problems) decreased

–– RoehlkepartainRoehlkepartain & Benson, 1994& Benson, 1994

Barriers to Family InvolvementBarriers to Family Involvement

Service availabilityService availability

StigmaStigma

Fear of being blamedFear of being blamed

Feeling unwelcome in the schoolFeeling unwelcome in the school

Fear of violated confidentialityFear of violated confidentiality

Perceived lack of mutualityPerceived lack of mutuality

Traditional ApproachTraditional Approach

““In the past, families were seen primarily asIn the past, families were seen primarily ascontributing to the mental health problems ofcontributing to the mental health problems oftheir children, and their ONLY ROLE was intheir children, and their ONLY ROLE was intreatment to alter their structure and/ortreatment to alter their structure and/orfunctioningfunctioning”” ((OsherOsher, 2001), 2001)

Best ApproachBest Approach

““The model of therapist as expert is replacedThe model of therapist as expert is replacedby a shared-learner framework in which bothby a shared-learner framework in which bothparties (family member and clinician)parties (family member and clinician)contribute knowledge and insightcontribute knowledge and insight”” ((AxelrodAxelrod etetal., 2003)al., 2003)

Dallas Youth and Family CentersDallas Youth and Family Centers

Family greeter welcomes all new families, helps themFamily greeter welcomes all new families, helps themwith forms, and provides general supportwith forms, and provides general support

Flexible hours, centers open at least two nights aFlexible hours, centers open at least two nights aweekweek

Having fun with food!Having fun with food!

Special programs:Special programs:–– Adult Basic Education (ABE)Adult Basic Education (ABE)

–– Power of Parenting (POP)Power of Parenting (POP)

–– Family Youth Interaction (FYI)Family Youth Interaction (FYI)

A Four-Pronged Approach to Evidence-A Four-Pronged Approach to Evidence-Based Practice in School Mental HealthBased Practice in School Mental Health

Decrease stress/risk factorsDecrease stress/risk factors

Increase protective factorsIncrease protective factors

Train in validated skillsTrain in validated skills

ImplementImplement manualizedmanualized interventionsinterventions–– (see Schaeffer, 2002;(see Schaeffer, 2002; WeistWeist, 2003), 2003)

Examples of ModifiableExamples of ModifiableStress/Risk FactorsStress/Risk Factors

IndividualIndividual–– low commitment to school, early school failure,low commitment to school, early school failure,

association with acting out peersassociation with acting out peers

FamilyFamily–– marital discord, poor family managementmarital discord, poor family management

CommunityCommunity–– poor housing, community disorganizationpoor housing, community disorganization

(Hawkins et al., 1992;(Hawkins et al., 1992; MrazekMrazek & Haggerty, 1994)& Haggerty, 1994)

Examples of Modifiable Protective FactorsExamples of Modifiable Protective Factors

IndividualIndividual–– social competence, internal locus of control,social competence, internal locus of control,

reading for pleasurereading for pleasure

FamilyFamily–– routines and rituals, parenting skills, parentalroutines and rituals, parenting skills, parental

responsivenessresponsiveness

CommunityCommunity–– good schools, positive relationships with othergood schools, positive relationships with other

adultsadults (Hawkins et al., 1992;(Hawkins et al., 1992; MrazekMrazek & Haggerty, 1994)& Haggerty, 1994)

AssetsAssets

Receive SupportReceive Support

Neighbors EncourageNeighbors Encourage

Feel SafeFeel Safe

Adult Positive ModelsAdult Positive Models

Feel ValuedFeel Valued

Family has StandardsFamily has Standards

Parents feel that theParents feel that theschool helpsschool helps

Want to do wellWant to do well

Read for PleasureRead for Pleasure

Stand up for BeliefsStand up for Beliefs

Accept ResponsibilityAccept Responsibility

Resist Peer PressureResist Peer Pressure

OptimisticOptimistic

Life has PurposeLife has Purpose

AssetsAssets –– Protective FunctionsProtective FunctionsSource: The Asset Approach: Giving Kids What They Need to SucceedSource: The Asset Approach: Giving Kids What They Need to Succeed

(Search Institute, 1997)(Search Institute, 1997)

0

10

20

30

40

50

60

70

P e r c e n t a g e s

Problem Alcohol Use

Illicit Drug Use

Sexual Activity

Violence

10 or less 30 or more

Critical Parenting ProcessesCritical Parenting Processes

Consistent, fair disciplineConsistent, fair discipline

Careful monitoring and supervision ofCareful monitoring and supervision ofchildrenchildren’’s activities, peer associates, ands activities, peer associates, andwhereaboutswhereabouts

Positive family managementPositive family management

Involvement in the childInvolvement in the child’’s daily lifes daily life

Training in problem-solving (Patterson, Reid,Training in problem-solving (Patterson, Reid,&& DishionDishion, 1992), 1992)

Validated SkillsValidated Skills

Relaxation trainingRelaxation training

Problem solvingProblem solving

Cognitive restructuringCognitive restructuring

Self-control trainingSelf-control training

Anger management trainingAnger management training

Social competence and resistance trainingSocial competence and resistance training–– (see(see ChristophersenChristophersen && MortweetMortweet, 2001), 2001)

EBP should be viewed as a key component of aEBP should be viewed as a key component of alarger agenda focused on Qualitylarger agenda focused on Quality

But:But:–– The research literature on quality in childrenThe research literature on quality in children’’ss

mental health is very limited (and boring), andmental health is very limited (and boring), and

–– Quality assessment and improvement efforts inQuality assessment and improvement efforts inschool mental health practice are patchy andschool mental health practice are patchy andhighly variablehighly variable

Enhancing Quality in ExpandedEnhancing Quality in ExpandedSchool Mental HealthSchool Mental Health

Randomized controlled study to assess impactsRandomized controlled study to assess impactsof systematic quality improvement on clinicianof systematic quality improvement on clinicianbehavior, satisfaction with services, andbehavior, satisfaction with services, andstudent outcomesstudent outcomes

First experimental study of qualityFirst experimental study of qualityimprovement in school mental healthimprovement in school mental health

Will provide guidelines for best practice andWill provide guidelines for best practice andwill help to standardize practicewill help to standardize practice

Example Quality Principle andExample Quality Principle andIndicatorsIndicators

Principle # 3Principle # 3

–– Programs are implemented to address needs andPrograms are implemented to address needs andstrengthen assets for students, families, schools andstrengthen assets for students, families, schools andcommunitiescommunities

Example IndicatorsExample Indicators

–– Have you conducted assessments on common risk andHave you conducted assessments on common risk andstress factors faced by students?stress factors faced by students?

–– Are you developing programs to help students contend withAre you developing programs to help students contend withcommon risk/stress factors?common risk/stress factors?

Outcomes Evaluation:Outcomes Evaluation:Continuum of ApproachesContinuum of Approaches

Stories, perceptionsStories, perceptions

Satisfaction ratingsSatisfaction ratings

Changes in individual studentsChanges in individual students

Changes in groups of studentsChanges in groups of students

Changes in groups compared to other groupsChanges in groups compared to other groups

Controlled, system-wide, multidimensionalControlled, system-wide, multidimensional

School Mental Health OutcomesSchool Mental Health OutcomesGroup (SMHOG)Group (SMHOG)

Interdisciplinary group (psychology, socialInterdisciplinary group (psychology, socialwork, public health; education, mental health,work, public health; education, mental health,research)research)

Tracking and making recommendations toTracking and making recommendations toimprove ESMH programs in Baltimoreimprove ESMH programs in Baltimore

Special Education Placement RatesSpecial Education Placement RatesSchools that initiated SBMH services in 1992-93 (N=6)Schools that initiated SBMH services in 1992-93 (N=6)

Source: Maryland Department of Education (MSDE)Source: Maryland Department of Education (MSDE)

10

11

12

13

14

15

16

1991 1992 1993 1994 1995 1996 1997Per

cent

of

tota

l enr

ollm

ent

in S

peci

al E

duca

tion

SBMH All BCPSS

Program Inception

Advocacy and InfrastructureAdvocacy and InfrastructureDevelopmentDevelopment

Barriers to Support of ESMHBarriers to Support of ESMH

Concerns about:Concerns about:–– confidentiality/ privacyconfidentiality/ privacy

–– competition for resourcescompetition for resources

–– effectivenesseffectiveness

–– appropriatenessappropriateness

Myths about School Mental HealthMyths about School Mental Health

““Manipulating childrenManipulating children’’s mindss minds””

TeachingTeaching ““new agenew age”” conceptsconcepts

Compromising family valuesCompromising family values

Providing services without parental approval andProviding services without parental approval andparental consentparental consent

Stigma is HugeStigma is Huge

Being calledBeing called ““crazycrazy”” is about the worst thingis about the worst thingyou could be calledyou could be called

Stigma accounts for significant utilizationStigma accounts for significant utilizationproblemsproblems

Knowledge removes stigmaKnowledge removes stigma

Media AdvocacyMedia Advocacy

Strategic use of media to support a communityStrategic use of media to support a communityorganization and/or to advance a social ororganization and/or to advance a social orpublic policy initiativepublic policy initiative

Boards of EducationBoards of Education

Are often highly politicalAre often highly political

Generally are not focused on mental healthGenerally are not focused on mental health

The Two-Edged Sword of SystematicThe Two-Edged Sword of SystematicMental Health Screening in SchoolsMental Health Screening in SchoolsNeed will no doubt overwhelm existingNeed will no doubt overwhelm existingresourcesresources

But, without screening we are turning ourBut, without screening we are turning ourheads away from youth in need, and failing toheads away from youth in need, and failing todevelop data that will help infuse advocacydevelop data that will help infuse advocacyefforts with a sense of urgencyefforts with a sense of urgency

The Need for Advocacy TrainingThe Need for Advocacy Training

Most people in most child serving systemsMost people in most child serving systemshave little or no training in effective advocacyhave little or no training in effective advocacy

Advocacy Involves:Advocacy Involves:

Bringing diverse people together around aBringing diverse people together around acommon themecommon themeUnderstanding the lay of the land in terms ofUnderstanding the lay of the land in terms ofthe problem and existing efforts to address itthe problem and existing efforts to address itDeveloping an idea that works betterDeveloping an idea that works betterIncreasing support for the idea and refining itIncreasing support for the idea and refining itFacilitating the translation of the idea intoFacilitating the translation of the idea intopolicy and practice change with necessarypolicy and practice change with necessaryresource/system enhancementsresource/system enhancements

Toward Funding for a Full Continuum ofToward Funding for a Full Continuum ofPrograms and ServicesPrograms and Services

Maximizing all potential sources of revenue:Maximizing all potential sources of revenue:–– allocations from schools and departments ofallocations from schools and departments of

educationeducation

–– state and local grants and contractsstate and local grants and contracts

–– federal and foundation grants and contractsfederal and foundation grants and contracts

–– ““line itemline item”” supportsupport

–– innovative prevention fundinginnovative prevention funding

–– fee-for-servicefee-for-service

The Significant Impacts of FederalismThe Significant Impacts of Federalism

State of residence determines whether youth useState of residence determines whether youth usemental health more than race/ethnicity or incomemental health more than race/ethnicity or income

Differences in mental health use by children acrossDifferences in mental health use by children acrossstates are generally not related to differences in levelsstates are generally not related to differences in levelsof need (e.g. AL and TX present higher rates of needof need (e.g. AL and TX present higher rates of needbut lower rates of use)but lower rates of use)–– Sturm,Sturm, RingelRingel && AndreyevaAndreyeva, 2003 (, 2003 (www.pediatrics.orgwww.pediatrics.org))

Ohio Mental Health Network forOhio Mental Health Network forSchool SuccessSchool Success

Regional action networks for mental health in schoolsRegional action networks for mental health in schools

Networks raise awareness, develop resources, offerNetworks raise awareness, develop resources, offerTA, do training within and across sitesTA, do training within and across sites

Annual publication on progressAnnual publication on progress

Genuine cost sharing across major systemsGenuine cost sharing across major systems

Strong partnerships with universities andStrong partnerships with universities anddevelopment of centers of excellencedevelopment of centers of excellence

New Mexico School Behavioral HealthNew Mexico School Behavioral HealthInitiativeInitiative

Strong regional networks, monitoring thatStrong regional networks, monitoring thatleads to action on where every jurisdictionleads to action on where every jurisdictionstandsstands

Strong training emphasis for MH and primaryStrong training emphasis for MH and primarycare providers, train the trainers approachcare providers, train the trainers approach

Growing legislative advocacyGrowing legislative advocacy

““Childhood RevealedChildhood Revealed”” –– Youth Mental HealthYouth Mental HealthAwareness InitiativeAwareness Initiative

MarylandMaryland’’s Blueprint for Childrens Blueprint for Children’’ssMental HealthMental Health

Three pillars:Three pillars:–– Quality and System ImprovementQuality and System Improvement

–– Service Delivery Support and TreatmentService Delivery Support and Treatment

–– Mental Health Promotion: Early Childhood (EC),Mental Health Promotion: Early Childhood (EC),Expanded School Mental Health (ESMH)Expanded School Mental Health (ESMH)

Centers for Mental Health inCenters for Mental Health inSchoolsSchools

Supported by the Office of Adolescent Health,Supported by the Office of Adolescent Health,Maternal and Child Health Bureau, Health ResourcesMaternal and Child Health Bureau, Health Resourcesand Services Administration;and Services Administration;

With co-funding from the Center for Mental HealthWith co-funding from the Center for Mental HealthServices, Substance Abuse and Mental HealthServices, Substance Abuse and Mental HealthServices Administration, U.S. Department of HealthServices Administration, U.S. Department of Healthand Human Services.and Human Services.

UCLA Center for MentalUCLA Center for MentalHealth in SchoolsHealth in Schools

Directed by HowardDirected by Howard AdelmanAdelman and Lindaand LindaTaylorTaylor

Phone: 310-825-3634Phone: 310-825-3634

EnewsEnews:: listserv@listserv.ucla.edulistserv@listserv.ucla.edu

web: http://web: http://smhp.psych.ucla.edusmhp.psych.ucla.edu