PA SS/HS State ProgramKick-off MeetingHarrisburg, PA

December 11, 2013

Safe Schools/Healthy Students State Program

Objectives

• About SAMHSA and it’s Mission• Overview of SS/HS History• Lessons learned • SS/HS State Program• National perspectives• Expectations• Resources Available

SS/HS Federal Team for Pennsylvania

Joyce Sebian- Lead Federal Project Officer240-270-1846Joyce.sebian@samhsa.hhs.gov

Margie Weiser- Federal Project Officer240-276-2243Margaret.Weiser@samhsa.hhs.gov

SAMHSA, Division of Prevention, Traumatic Stress, and Special ProgramsMental Health Promotion Branch1 Choke Cherry RoadRockville, Maryland 20857

Frank Rider; Resource Specialistfrider@air.org

Resource Center- American InstitutesFor Research (AIR)

Mental Health Promotion Branch Overview

• Grant Programs:• Safe Schools / Healthy

Students Initiative • Project LAUNCH• Prevention Practices in

Schools• Community Resilience and

Recovery Initiative• Other initiatives:

• National Forum on Youth Violence

• Strong Cities Strong Communities

• State Prevention Policy Academy

• Stopbullying.gov

• Contracts/Cooperative Agreements:• National Center for Mental Health

Promotion and Youth Violence Prevention

• TA for SSHS• TA for Project LAUNCH• TA for PPS

• National Evaluations• Cross-site evaluation of SSHS• Cross-site evaluation of Project

LAUNCH with six special studies• Consolidated State TA Contract –

collaboration among CMHS,CSAT,CSAP

• Safe and Supportive Schools TA contract – IAA w ED

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SAMHSA’S MISSION

To reduce the impact of substance abuse and mental illness on America’s communities.

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SAMHSA’s Strategic Initiatives

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Daily Disaster of Unprevented and Untreated Mental Illness and Substance

Abuse Disorders

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Adverse Childhood Experience Study (ACE)

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An Ounce of Prevention

If we are able to: Savings

Prevent a child from becoming dependent on alcohol we can save approximately:

$ 700,000

Help a child graduate from high school who would otherwise have dropped out, we can save as much as:

$ 388,000

Identify and prevent child abuse and neglect we can save about:

$ 250,000 to $ 285,000

Help a high-risk youth avoid substance abuse and prevent them from becoming a “career criminal” we can save between:

$ 2.6 to $ 4.4 million

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• Well-designed prevention interventions REALLY WORK!

• Prevention and wellness interventions can have multiple benefits that extend beyond a single disorder.

• Key is to identify risks that may increase a child’s risk of Mental, Emotional and Behavioral Health (MEB) disorders. —biological, psychological, and

social factors—

Key Message: Focus on Prevention and Wellness

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Core Concepts of Prevention

1. Prevention requires a paradigm shift

2. Mental health and physical health are inseparable

3. Successful prevention is inherently interdisciplinary

4. Mental, emotional, and behavioral (MEB) disorders are developmental

5. Coordinated community level systems are needed to support young people

6. Developmental perspective is key

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Prevention Window (2009 IOM)

http://www.iom.edu/Reports/2009/Preventing-Mental-Emotional-and-Behavioral-Disorders-Among-Young-People-Progress-and-Possibilities.aspx

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Preventive Intervention OpportunitiesSubstance Abuse and Mental Illness

Project LaunchGBGSafe Schools/Healthy Students

Garrett Lee Smith

The 2009 Institute of Medicine report, “Preventing Mental, Emotional and Behavioral Health Disorders Among Young People,” emphasized the need for a public health approach and the need for development of prevention infrastructure in states and communities.

•State and local communities should become familiar with, adopt, and implement a framework that will guide their work. •In most widely recognized public health models, a series of action steps are necessary 

Institute of Medicine Report

http://www.iom.edu/Reports/2009/Preventing-Mental-Emotional-and-Behavioral-Disorders-Among-Young-People-Progress-and-Possibilities.aspx

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Behavioral Health Outcome Logic Model

Adapted from IOM Report: Toward Quality Measures for Population Health and the Leading Health Indicators, Released: July 9, 2013

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A Paradigm Shift

• Beyond the “One child at a time” Approach

• Population approach

• Informed by the growing body of prevention science

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Behavioral Health Outcome Logic Model

It’s not just about the goldfish… it’s also about the water.

From Assistant Secretary Howard Koh MD, US DHHS.

What is the SS/HS State Program?

PURPOSE

• To create safe and supportive schools and communities by bringing the SS/HS model to scale at the state/tribe level by building partnerships among educational, behavioral health and criminal/juvenile justice systems.

EXPECTATIONS

• Increase the number of children and youth who have access to behavioral health services;

• Decrease the number of students who abuse substances;

• Increase supports for early childhood development

• Improve school climate

• Reduce the number of students who are exposed to violence.

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SS/HS Core Concepts

Core Concepts of Prevention

Core Concepts in SS/HS

Prevention requires a paradigm shift

Approaches youth violence prevention through a theory of change that requires stakeholders to take ownership of the change process from conceptualization through sustainability

Mental and physical health are inseparable

Connects the prevention of youth violence and substance abuse to the promotion of good mental, emotional and behavioral health from early childhood through high school

Inherently interdisciplinary

Addresses school climate; mental, emotional and behavioral health; alcohol, tobacco and substance abuse prevention; and early childhood development through universal and selective evidence base practices

Coordinated community-level systems

Collaboration between school districts, law enforcement, juvenile justice and mental health and substance abuse services at the local level

Developmental perspective

Delivers effective evidence based interventions from early childhood though adolescence

History of SS/HS

• Since 1999, the U.S. Departments of Education, Health and Human Services, and Justice have collaborated on the Safe Schools/Healthy Students (SS/HS) Initiative.

• The SS/HS Initiative provides students, schools, and communities with federal funding to implement an enhanced, coordinated, comprehensive plan of activities, programs, and services that focus on while promoting healthy childhood development while minimizing• the risk of school violence • the use of alcohol, tobacco, and other drugs

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Reach of Safe Schools/Healthy Students

Over 365 Grantees Since 1999

Element 1: Safe school environments and violence prevention activities.

Element 2: Alcohol, tobacco, and other drug prevention activities.

Element 3: Student behavioral, social, and emotional supports.

Element 4: Mental health services.

Element 5: Early childhood social and emotional learning programs.

SS/HS Five Elements

Problem in Brief

• Bullying: More than one in Three students ages 12 to 18 were bullied at school in 2007

• Physical fights: Nearly one in three high school students took part in a physical fight in 2009

• Underage drinking: Nearly one in three adolescents ages 12 to 17 drank alcohol in 2008

• Serious in-school crime: Students today are more likely to experience crimes such as theft, assault, and rape in school than outside school.

• A students mental health is seriously impacted when exposed to disruptive behaviors, aggression, and violence in schools

c

c

Selected Findings

cThere was a dramatic 263 percent increase in the number of students who received school-based mental health services, and an astounding 519 percent increase in those receiving community-based services.

More than 98 percent of grantees established processes to identify and link students to needed services.

The partnership formed for this project was deeper and more meaningful than anything that has come before it in our county --- school district representative

As a Result of This Initiative, Schools and Communities

• Became safer, and fewer students were exposed to violence.

• Fewer students reported that they had experienced violence (7 percent decrease since grant award).

• Fewer students reported that they had witnessed violence (4 percent decrease).

• Fully 96 percent of school staff said Safe Schools/Healthy Students had improved school safety.

• More than 90 percent of school staff said Safe Schools/Healthy Students resulted in less violence on their campus.

• Nearly 80 percent of school staff said Safe Schools/Healthy Students had reduced violence in their community.

c

Features of SS/HS that Make a Difference

• Partnerships between School Districts, Mental Health and Juvenile Justice, and law enforcement

• Enhanced through the development/implementation of comprehensive plan and by implementing evidence based programs that make a positive difference

• Enhanced by engagement of other strategic partnerships- examples-faith organizations, out of school time (YMCA, Boys/Girls Clubs, Universities, Cooperative Extension, Parks, Foundations, Business and employers, City/County Governments, Health care/hospitals etc.

SS/HS Framework

Guiding Principles 5 SS/HS Elements Strategic Approaches

Cultural and Linguistic Competency

Promoting Early Childhood Social Emotional Learning and Development

Policy Change and Development

Serving Vulnerable and At-Risk Populations

Promoting Mental, Emotional and Behavioral Health

Capacity Building

Developmentally Appropriate

Connecting Families, Schools and Communities

Systemic Change and Integration

Sustainability Preventing and Reducing Alcohol, Tobacco and Other Drug Use

Collaboration and Partnership

Evidence Based Interventions

Creating Safe and Violence Free Schools

Technology

Resource Leveraging

What’s the Difference?

SS/HS 1999-2012

• Local level leadership through Core Management Team (CMT)

• Funds went to local school district

• Focused on systems change and direct services provision

• Collaboration with key partners at the local level

• Administered through the U.S. Department of Education as a grant.

SS/HS 2013• State/tribe & local level leadership • Funds go to State Education or

Mental Health Agency• State will select three local

education agencies within three communities.

• Focus on infrastructure development, systems change and local level direct services provision

• Administered through SAMHSA as a cooperative agreement.

SS/HS State Program Grantees

• CT – Department of Mental Health and Addiction Services

• MO – Department of Education• WI – Department of Public Instruction• MV – Mental Health and Developmental

Services Agency• NH – Department of Education• OH – Department of Mental Health• PA – Office of Mental Health

Program Overview

State Activities

• Leadership and oversight

• Infrastructure development; needs assessment, environmental scan

• Collaboration with State Education, Behavioral health and Criminal/Juvenile Justice Agencies = State Management Team

• Selection of 3 local education agencies

• Develop comprehensive plan

• Project evaluation

Program Overview

Local Education/Local Community Activities

• Infrastructure development• Leadership and coordination• Collaboration with mental health, law enforcement and

juvenile justice• Core Management Team• Implementation of direct services (evidence based

practices) • Support development of comprehensive plan

Safe Schools/Healthy Students State Grant Phase 1

Phase 2: SS/HS Framework

The SS/HS framework assists states in developing a comprehensive plan that reflects their application, environmental scan, and needs assessment and provides for a process of continuous quality improvement that leads to sustainability and wide spread adoption of the SS/HS model.

Phase 3: Development of the Comprehensive Plan

State and community partners will work with their local evaluators to develop a comprehensive plan and an evaluation plan that align.

Phase 4: Implementation

State and community partners will continue to focus on building a strong partnership and using data-informed decision making to guide implementation years 2-4 of the grant.

Phase 5: State Expansion and Sustainability

State and community partners will collaboratively decide which strategies, policies, EBPs, and best practices should be adopted widely across the state and identify mechanisms to ensure sustainability.

TimelineTask Due Date

Identify members of the State Management Team

December 1, 2013

Identify members of the LEA/Community Core Management Team

January 1, 2014

Identify two state Project Coordinators - one full time and other part-time. Together, both must represent state Mental Health and Education

January 1, 2014

Identify a Project Manager for each of the three LEAs

January 1, 2014

Complete the environmental scan and needs assessment process

March 1, 2014

Complete development of a Memorandum of Agreement between the required project partners and other agencies

April 1, 2014

Timeline

Task Due Date

Complete development of a process for selecting evidence-based programs

May 1, 2014

Complete development of the SS/HS State Program comprehensive plan

June 1, 2014

Complete development of a project evaluation planJune 1, 2014

Begin implementation of the SS/HS State Program comprehensive plan

September 1, 2014

Collect and report all baseline data for all performance measures

September 1, 2014

Public Health Wheel

http://www.health.gov/phfunctions/public.htm

3 CORE Functions

And10 Essential Elements

A Conceptual Framework for a

Public Health Approach to Children’s Mental Health

Also applies to Behavioral health

http://gucchdtacenter.georgetown.edu/public_health.html

Considering Contextual Factors for the SS/HS State Program

http://www.uvm.edu/extension/community/nnco/collab/framework.html#contextual”

Six contextual factors identified as important to successful and sustained collaborations

• Connectedness

• History of Working Together/Customs

• Political Climate

• Policies/Laws/Regulations

• Resources

• Catalysts

Behavioral Health Disparities and the Enhanced National CLAS Standard

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National CLAS Standards

Affordable Care Act & Prevention

Preventing diseases and promoting wellness is major theme in the ACA

Targeted prevention activities funded through commercial insurance, Medicare, and Medicaid

Community prevention activities funded through a variety of grant programs:• Prevention and Public Health Trust Fund *• Community Transformation Grants• Others

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NATIONAL PREVENTION STRATEGY

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National Prevention Strategy = working together to improve the health and quality of life for individuals, families, and communities by moving the nation from a focus on sickness and disease to one based on prevention and wellness. One of the seven priorities is mental and emotional well-being.

National Prevention Strategy- links to grant opportunities and info

http://www.surgeongeneral.gov/initiatives/prevention/strategy/report.pdf http://www.surgeongeneral.gov/initiatives/prevention/strategy/index.html

www.Mentalhealth.gov

http://store.samhsa.gov/product/Community-Conversations-About-Mental-Health-Information-Brief/SMA13-4763

Now is the Time

White House initiative following the Sandy Hook Elementary School tragedy and other recent violent incidents:

Includes: •Making schools safer; and •Increasing access to mental health services

Bullying Prevention

• StopBullying.gov provides information from various government agencies on• what bullying is, • what cyberbullying is, • who is at risk, and • how you can prevent and respond to bullying 

http://www.stopbullying.gov

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“The potential for lasting, positive impact on this generation of children is phenomenal”

Law enforcement partner (SS/HS)