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Sandy Keenan
TA Partnership for Child and Family Mental Health(SOC)
National Center for Mental Health Promotion and Youth Violence Prevention(SSHS/PL)
November 5, 2009
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4.5 to 6.3 million
children have mental
health needs in this
country,
approximately 20%.
2/3 of them do not
receive the services
they need.
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Evidence that mental, emotional and behavioral disorders are
common and begin early in life(20% of school age).
Evidence of multi-year effects of multiple preventive
interventions on reducing substance abuse, conduct disorder,
behavior, aggression and child mistreatment.
Evidence that school-based violence prevention can reduce
the rate of aggressive problems by 25% to 33%.
Evidence that school-based preventive interventions for SEL
can also improve academic outcomes.
Advances in implementation science, including its complexity
and the importance of relevance to the community
www.nap.edu 2009
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Safe Schools Healthy Students
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PBIS
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Systems of Care
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Department of Health and Human Services
◦ Substance Abuse & Mental Health Services Administration, (
SAMHSA)
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Department of Education
◦ Office of Safe and Drug Free Schools (OSDFS)
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Department of Justice
◦ Office of Juvenile Justice & Delinquency Prevention (OJJDP)
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Element 1: Safe School Environments and
Violence Prevention
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 SEL Programs
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Community based promotion and prevention
initiative
Partnership with Education, Law Enforcement,
Juvenile Justice, Mental Health and other
community agencies
Implementation of evidence based practices
at the school, classroom and individual level
Core management team (community)
Data driven decision making
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A framework for intervention
3- tiered model of promotion, prevention and
intervention(all, some and few)
Implemented at the individual, classroom,
school, or district level
Team approach
Data driven decision making
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Community based initiative
Multi agency partnerships between mental
health and other major system partners
Population of Focus: MH diagnosis and at risk
for out of home or out of school placement
Family and youth driven
Individual community based planning and
interventions(through a local, county, tribal or
statewide project)
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Family Driven
Youth Guided
Cultural competence
Evidence Based Practice
Interagency collaboration
Home, community, and school-based
Individualized strength-based care
Continuous Quality Improvement (CQI)
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Behavioral and emotional problems decreased
(35% improved at 6 months, 48% at 18
months)
Youth involvement with juvenile justice
decreased (e.g., arrests fell by 60% at 18
months)
Youth became less depressed and less
anxious
Youth suicide attempts were reduced by half
in 6 months
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Community based collaborative efforts
involving multiple agency partners
Variety of models/share a value of shared
responsibility for meeting the emotional and
behavioral needs of children and youth
Interagency training and professional
development activities
Implementation of evidence based
interventions
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Time
Limited resources
Change
Blending of multiple cultures
Trained workforce
Integration into existing initiatives
Sustainability
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Focus of Change
System level
Focus of
Systems
Reform
Organizational
level
Direct Service
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Focus of
Evidence
Based
Services
Focus of Change
System level
Organizational
level
Direct Service
Systems Integration
and Strategic Planning
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These 3 initiatives have a large federal
investment that usually can not be met by
communities alone.
Assumption that communities “want” to
change these systems and achieve better
outcomes (just by applying).
Administrative support at multiple levels(just
by applying).
Policies developed/resources appropriated to
support system change.
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Regular School
Attendance (> 80% of
the time) increased
from 74% to 81% in 6
months
Absences due to
behavioral and
emotional problems
were reduced by 1/5 in
18 months
31% more youth
achieved passing
grades after 18 months
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
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Behavioral and emotional problems decreased
(35% improved at 6 months, 48% at 18
months)
Youth involvement with juvenile justice
decreased (e.g., arrests fell by 60% at 18
months)
Youth became less depressed and less
anxious
Youth suicide attempts were reduced by half
in 6 months
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
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improved school attendance
Fewer discipline problems
Fewer arrests
More passing grades
Improved academic performance
Less depression and anxiety
Less suicide attempts
Improved social and emotional health
Improved environments which promote better
outcomes
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