Dufferin-Peel Catholic District School Board
Mississauga, Ontario, Canada
CASH Community of Practice on
School Mental Health Webinar
December 8, 2011
Dec. 8, 2011 © Lean & Colucci 1
Dec. 8, 2011 © Lean & Colucci 2
Education Reform
Recommends closing the achievement gap through
◦ Improved leadership & accountability
◦ Improved pedagogy (e.g., Blankstein, 2004; Fullan, Hill &
Crevola, 2006)
Acknowledges the existence of mental health problems in
students and the need to address them
Suggests mental health interventions generally be carried
out by community services in or out of schools
Where student support service professionals are employed
by a school district, they are often are not considered to be
first choice providers of mental health intervention
Dec. 8, 2011 © Lean & Colucci 3
Child/Youth Mental Health Reform
Includes schools, but limited context, narrow focus
Suggests community organizations have large role to
play in intervention, both in and out of schools
Suggests teachers take on 2 additional roles
◦ Early identifiers of student mental health problems
◦ Providers of mental health promotion and prevention
(Kirby & Keon, 2006, U.S. Department of Health and
Human Services, 1999)
Dec. 8, 2011 © Lean & Colucci 4
A Commonly Utilized Approach
to Address Barriers to Learning
Many school systems address mental health barriers to
learning through referrals and/or partnerships with
community organizations
In the next figure, we see that this model does not
address all barriers to learning, represented by:
Randomly placed ovals – fragmented, disjointed services
White space in lower circle – unaddressed barriers to
learning
Dec. 8, 2011 © Lean & Colucci 5
School System Approach to Address Barriers to Learning: Referrals
Formal & Informal Partnerships with Community Organizations
Dec. 8, 2011 © Lean & Colucci 6
Limitations of Formal & Informal Partnerships
with Community Organizations
Inherent fragmentation and duplication of service
Different outcome measures than schools
Schools are not their only clients
Selective client base
Exclusionary criteria
Catchment areas
Can be project based and time-limited
“What program can I fit this client into?”
Do not always utilize population-based approach
Dec. 8, 2011 © Lean & Colucci 7
System Approach to Address Barriers to Learning:
School-based Student Support Services Teams and
Community Organizations
Utilized by many school systems in large urban areas
School-based board-employed support services are
represented in the large oval in the lower circle
Fragmentation of interventions shown by small ovals
scattered and haphazardly distributed in bottom circle
Community organizations not sufficiently integrated
with school-based support services
This represents that not all barriers to learning are
addressed, despite formal and informal partnerships
with community organizations and school support
services
Dec. 8, 2011 © Lean & Colucci 8
System Approach to Address Barriers to Learning: School-based
Student Support Services Teams and Community Organizations
Dec. 8, 2011 © Lean & Colucci 9
SBMH Issues
Although research clearly states the advantages of
using school-based student support services
professionals to provide SBMH services (Crisp et al.,
2006; Massey et al., 2005), this is not a common
practice
Education system mandating multi-disciplinary
school-based student support services is not universal
Although these professionals are trained and capable
of addressing mental health issues in students, their
role is often limited to providing interventions to
special education students and/or crisis intervention
Dec. 8, 2011 © Lean & Colucci 10
SBMH Issues
School-based support service effectiveness measured
by clearing all referrals – “head counts”
One student/small group/deficit-based intensive
service delivery
Few prevention programs
Insufficient parental involvement
Lack of a sound structure to jointly plan and facilitate
interventions
Dec. 8, 2011 © Lean & Colucci 11
Addressing the Issues in SBMH
Barriers to Learning makes a case for integrating
mental health services in schools and provides a
practice-based evidence model for achieving this goal
Barriers to Learning also supports the implementation
of a population-based approach to addressing the
mental health of all students
Dec. 8, 2011 © Lean & Colucci 12
Dec. 8, 2011 © Lean & Colucci 13
SISSM
In the School-based Integrated Support Services
Model (SISSM) framework, school-based support
services professionals (e.g, psychology, social work)
play a coordinating role integrating additional mental
health professionals and others from community
organizations
School-based student support services professionals
can be instrumental in providing a seamless delivery of
services to ensure the best outcome for all children and
youth facing mental health and academic issues
Dec. 8, 2011 © Lean & Colucci 14
SISSM
CORE GROUP of school-based (preferably district-
employed) support services professionals assigned to
each school
CORE GROUP facilitates integration and
collaboration of school-based support services
professionals and school-linked community
organizations to provide mental health services in
schools
This avoids fragmentation of services & duplication of
interventions
Dec. 8, 2011 © Lean & Colucci 15
Proposed School System Approach to Address Barriers to Learning: The
School-based Integrated Support Services Model (SISSM) (Lean & Colucci ©)
Dec. 8, 2011 © Lean & Colucci 16
SISSM Process
Establish Local Area Service Collaboration Group
(identify & recruit leadership and membership)
Map existing local resources and services
Determine school(s) needs (3 tiers)
Establish broad and specific focus/goals/outcome
measures
Reallocate/redeploy community-based services to
address school needs in collaboration with school-
based services
Evaluate program(s)
Dec. 8, 2011 © Lean & Colucci 17
SISSM Flow Chart
Dec. 8, 2011 © Lean & Colucci 18
Dec. 8, 2011 © Lean & Colucci 19
Dec. 8, 2011 © Lean & Colucci 20
Re-allocation and re-deployment of
community-based professionals into schools
• Reduces fragmentation and duplication of services
• Integration of outcome measures (academic and
mental health)
• No exclusionary criteria, catchment areas and selective
client bases
• Interventions based on school-identified needs
• Able to span continuum of services (universal,
targeted, intense)
• Less stigma and easier access for students and parents
Dec. 8, 2011 © Lean & Colucci 21
School-based Support Services
Intervention and Roles: SBMH
Dec. 8, 2011 © Lean & Colucci 22
Flexibility of SISSM
SISSM was developed to function in any jurisdiction and
within any structure and funding model
School-based district-employed support services personnel
within SISSM are part of school’s culture enabling them to
integrate community professionals into schools
coordinate interventions within a population-based approach
For school districts that do not employ mental health
professionals, SISSM offers a framework whereby
community professionals with training in school-based
services, including school culture and climate, can
successfully practice in the school system
Dec. 8, 2011 © Lean & Colucci 23
Funding Models for SBMH
SBMH funding
Totally government funded
School-based District-employed (e.g, through education funding)
School-linked other government department employed (through
health or mental health funding)
Insurance-based funding
Private insurance (e.g., HMO’s)
Government needs-based funding (e.g., Medicaid)
Government, university, NGO and private grants
Combination of any of the above
SISSM would be most successful with sustained funding
Dec. 8, 2011 © Lean & Colucci 24
Dec. 8, 2011 © Lean & Colucci 25
In the Works – Book 2
Broad and Specific School Board Mental Health
Strategy Planners
Tool for Developing Intervention Menus for School-
based Mental Health Supports
Training Syllabus for School-based Support Services in
SISSM Framework
Training Syllabus for School-linked Professionals in
SISSM Framework
Needs Assessment Tool
Mapping Local Resources Tool
Dec. 8, 2011 © Lean & Colucci 26
DRAFT Mapping Local Resources Tool
Organization Disciplines/ Programs Tiers
Titles
School Board ---------- Psychology, Social CBT for Anxiety 3
Work
Community Local Hospital Psychologist on Section 23 Class 3
Mental Health Eating Disorder for Inpatients
Team
Social Services Child Social Workers Prevention 1
Protection Activity
Health & Child Mental Psychology, Social Parenting Aggressive 2
Children Group
Allied Health Health Clinic Work, CYW
Youth Justice NPU, Probation & Youth Anti-bullying class 3
presentations
Probation Officers
Community Recreation Youth Leaders Basketball 2
Organizations Centre
Universities & Local Psychology, SW, Intervention for 3
Colleges University & CYW, SLP students: aggressive
College research & interns students
Dec. 8, 2011 © Lean & Colucci 27
References
Crisp, H.L., Gudmundsen, G.R., & Shirk, S.R. (2006).
Transporting evidence-based therapy for adolescent
depression to the school setting. Education and
Treatment of Children, 29(2), 287-309.
Kirby, M.J.L., & Keon, W.J. (2006). Out of the Shadows
at Last: Transforming Mental Health, Mental Illness
and Addiction Services in Canada. Ottawa, Senate of
Canada Standing Senate Committee on Social Affairs,
Science and Technology.
Dec. 8, 2011 © Lean & Colucci 28
References
Massey, O.T., Armstrong, K., Boroughs, M., Henson, K., &
McCash, L. (2005). Mental health services in schools: A
qualitative analysis of challenges to implementation,
operation and sustainability. Psychology in the Schools.
(42(4), 361-372.
U.S. Department of Health and Human Services. (1999)
Mental Health: A Report of the Surgeon General. Rockville,
MD: U.S. Department of Health and Human Services,
Substance Abuse and Mental Health Services
Administration, Center for Mental Health Services,
National Institutes of Health, National Institute of Mental
Health.
Dec. 8, 2011 © Lean & Colucci 29
Dec. 8, 2011 © Lean & Colucci 30