Workgroup Participants: Wyndee Davis Antoinette Gurden Deb Kennedy Deborah Magee Harry Marmorstein
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New Jersey Department of Children and Families Division of Child Behavioral Health Services Meeting Students’ Behavioral Health Needs Workgroup Participants: Wyndee Davis Antoinette Gurden Deb Kennedy Deborah Magee Harry Marmorstein Dr. Nadezhda Robinson Presentation by Antoinette Gurden
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Workgroup Participants: Wyndee Davis Antoinette Gurden Deb Kennedy Deborah Magee Harry Marmorstein Dr. Nadezhda Robinson Presentation by Antoinette Gurden. Department of Children and Families Table of Organization (Three Major Divisions). DCF. - PowerPoint PPT Presentation
Transcript of Workgroup Participants: Wyndee Davis Antoinette Gurden Deb Kennedy Deborah Magee Harry Marmorstein
New Jersey Department of Children and FamiliesDivision of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
Workgroup Participants:Wyndee DavisAntoinette GurdenDeb KennedyDeborah MageeHarry MarmorsteinDr. Nadezhda Robinson
Presentation by Antoinette Gurden
Slide 2
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
Department of Children and Families
Table of Organization
(Three Major Divisions)
DCF
Division of Child Behavioral
Health Services
Division of Youth and
Family Services
Division of Prevention and
Community Partnerships
DCBHS Overview
Slide 3
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
At Home
In School
Out of Trouble
(with their families and not in out-of-home treatment settings)
(in district)
(not involved with the Juvenile Justice Systemand at risk of detention or incarceration)
System of Care Guiding Principles
DCBHS Overview
Slide 4
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
Division of Child Behavioral Health Services
Contracted EntitiesContracted
Systems Administrato
r Training and Technical
Assistance
Care Management
Agency
Family Support
OrganizationMobile
Response & Stabilization
Services
Youth Case Management
DCBHS Overview
Slide 5
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
New Jersey Division of Child Behavioral Health Report reflects data as of 9/22/08Services (DCBHS) Summary Report Excerpts Quarterly Report
Statewide (See Report NJ0184.3):
•The total number of children enrolled is 38,731.
•The total number of children who are active in a CMO is 3,067.
•The total number of children who are active in a YCM is 4,177.
•The total number of children who are active in MRSS is 851.
•The average number of families actively receiving peer support from an FSO is 1,182.
•The largest age group served by the DCBHS is children ages 14 through 17.
This age group comprises 45% of all children served.
•There are 41% females, 59% males served by the DCBHS.
DCBHS Overview
Slide 6
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
Utilization Management
AssessmentServices
Outpatient Services
IIC ServicesMRSS Services
Case Management Services
Out of Home Treatment Services
Acute Care Services
Assessment Services
Outpatient and Addictions Treatment(Not yet integrated into the DCBHS System of Care)
Intensive In-Community & Behavioral Assistance Services
Mobile Response & Stabilization Services
Inpatient TreatmentIntensive Residential Treatment
Out of Home Treatment
Case Management Services
Access and Utilization Management (CSA)
DCBHS Overview
Slide 7
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
Youth presents with behavior
Current System of Screening Students
Youth screened at Psychiatric Emergency Service (PES)
PES are not kid-friendly
Current screening laws designed for adults
Medical model is not useful for most youth
Designed to determine if youth meets admission standard rather than what services youth may need
Current System of Screening Students
Slide 8
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
Benefits:
Drawbacks:
Current System of Screening StudentsYouth presents with behavior
threats
danger to self
danger to others
Benefits:
Drawbacks:
Screened for safetyReferral to services
Long waitInappropriate environment
High costIntense reaction to situation
Screened for safetyReferral to services
Lost time in schoolScreened long after event
Punishes youth for BH issues
Youth screened immediately at PES
Youth suspended until screened at
PES
Changes youth’s school experienceUndue burden on family Undue burden on family
Current System of Screening Students
Slide 9
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
Current System of Screening StudentsYouth presents with behavior
threats
danger to self
danger to others
Current System of Screening Students
mood change
change in functioning
There is currently no standard response for youth who exhibit:
Slide 10
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
Proposed Model to Screen Youth in SchoolsYouth presents with
behaviorthreat to self or others
mood change
change in functioning
Response determined by age and risk factors
Regardless of age, youth at high risk for
harming self or others referred to PES
Proposed Model to Screen Students
Slide 11
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
Step 1Identify Concern
Slide 12
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
and
Scenario AYouth needs immediate attention
and/or
suggest that youth may be at risk of significant emotional distress or of causing harm to self or others
Youth’s behavior within the last 5 or fewer days
Youth’s disclosure of information
the disruption in youth’s behavior impedes youth’s ability to learn and affect youth’s relationships with peers and/or staff
Step 1: Identify Concern
Slide 13
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
Risk factors are perceived within the context of the youth’s individual cognitive and
intellectual capacity
Step 1: Identify Concern
Youth has a viable plan to carry out
threat as indicated
Youth has immediate access
to the means to carry out threat as
indicatedYouth has a
sincere intention to do harm
There is a realistic concern for the safety of the youth or others
based on the youth’sindividual risk
factors
Scenario AYouth needs immediate attention
Slide 14
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
Step 1: Identify Concern
Consider suicide risk factors when youth threatens to harm self:
Significant change in eating, sleeping habits
Frequent complaints about physical symptoms
Neglect of personal hygiene and friendships
Boredom or loss of interest in previously pleasurable activities
Giving hints of not being around for long, such as verbal statements or giving away possessions
Sudden cheerfulness after a period of depression
Scenario AYouth needs immediate attention
Slide 15
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
Scenario AYouth needs immediate attention
Step 1: Identify Concern
Service Pathways Appropriate for Youth in Scenario A
PES Psychiatrist
Slide 16
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
Scenario BYouth presents with threatening behavior
Response to behavior should be shaped by the youth’s ability to:
and his or her subsequent:de-escalate him/herself by venting
amenability toward negotiating an alternate plan
Step 1: Identify Concern
De-escalateAbide by negotiated plan Utilize existing resources
Youth who is able to
and ormay be appropriate for Scenario C
De-escalateAbide by negotiated plan Utilize existing resourcesand ormay be appropriate for services other than PES
Youth who is NOT able to
Slide 17
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
Scenario B
Step 1: Identify Concern
Service Pathways Appropriate for Youth in Scenario B
Pediatrician Psychiatrist
Private BH
ProviderCSA MRSS
Slide 18
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
Scenario CYouth needs services
and
and/or
suggest that youth may be at risk of significant emotional distress or of causing harm to self or others
Youth’s behavior within the last 3 months or less
Youth’s disclosure of information
The disruption in youth’s behavior has consistently interfered with
Step 1: Identify Concern
Youth’s ability to learn and has affected
Youth’s relationships with peers and/or staff
Slide 19
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
Scenario C
Step 1: Identify Concern
Service Pathways Appropriate for Youth in Scenario C
Pediatrician
Private BH Provider
CSAMRSS
Information and
Referral
Assessment
Slide 20
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
Step 2Discuss Concern
With Family
Slide 21
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
Step 2: Discuss Concern With Family
After a concern is identified at any level, the family and school personnel collaborate on an action plan
Many high school aged youth can participate in this discussion
1.Sit down with the family
2.Develop an action plan
3.Develop a plan for follow up
Slide 22
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
Step 3Family Chooses
Response Option
Slide 23
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
Step 3: Choose Response Option
Available Options
PES
Psychiatrist
CommunityAssessment
Pediatrician
Mobile Response & Stabilization
Services
CSA
Informationand
Referral
Private BH Provider
Slide 24
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
Step 3: Choose Response Option
Service OptionResponse
Time Frame Outcome
PES
Psychiatrist
Pediatrician
CSA
Information and Referral
Community Assessment
Mobile Response and Stabilization Services
Same day
Same day
Same day
Immediate
7-10 days
1 hour
Determination of inpatient admissibility
Determination of current risk to self/others, diagnosis, referrals
Referrals to services covered by private insurance if appropriate
Information about services available locally
Comprehensive biopsychosocial assessment and referral for services
72 hour intense intervention and up to 8 weeks of stabilization services
Indicates confidence in the ability of this option to effect meaningful and lasting change for this youth and family and minimize disruption of school attendance and school relationships
Private Behavioral Health Provider 1-3 months Assessment, family/individual therapy,
diagnosis
Slide 25
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
Step 4Follow Up
Slide 26
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
Step 3: Follow Up
Follow Up Responsibilities
Ensure that family’s needs have been met through the requested service
Be available to work with providerat family’s request
Slide 27
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
Benefits of New Screening ModelReduces lost education time
Components Necessary for Successful ImplementationWorking relationship between school and screening and service providers
Ensures youth is linked to appropriate services
Eliminates unintended effect of punishing youth for BH needs
Working relationship with families
Acceptance of new model to satisfy “zero tolerance” policies
Slide 28
New Jersey Department of Children and Families ▪ Division of Child Behavioral Health Services
Meeting Students’ Behavioral Health Needs
Please feel free to contact the
Division of Child Behavioral Health Services
Contact Person:(609) 292-4741
E-mail Address:Phone Number:
Dr. Nadezhda Robinson
We look forward to partnering with you to meet the
behavioral health needs of your students
