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School-Linked Mental Health
Kristin Lofgren| School Mental Health Consultant| Behavioral Health
2/15/2021 Minnesota Department of Human Services | mn.gov/dhs 1
2008 Systems Alignment: School-Linked Mental Health
• School-based mental health (SLMH) services reach children in typical, every-day environments. The natural, non-stigmatizing location offers an early and effective environment for intervention.
• These school-connected clinical behavioral health treatments include interventions that:
Improve identification of behavioral health issues for children and youth.
Increase and improve accessibility for children and youth.
Improve clinical and functional outcomes for children and youth with behavioral health issues.
2
Why Mental Health Treatment in Schools?
• Youth are 6x more likely to complete mental health treatment in schools than in community settings (Jaycox et al., 2010)
• Mental health treatment has large effects on decreasing mental health symptoms (Sanchez et al., 2018)
• Mental health services are most effective when they are integrated into students’ academic instruction (Sanchez et al., 2018)
2/15/2021 Minnesota Department of Human Services | mn.gov/dhs 3
School-Linked Mental Health: State Appropriations
2/15/2021 Minnesota Department of Human Services | mn.gov/dhs 4
$-
$2,000
$4,000
$6,000
$8,000
$10,000
$12,000
$14,000
$16,000
$18,000
2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023
School-Linked Mental Health Grant Appropriations
School-Linked Mental Health: School Sites
2/15/2021 5Minnesota Department of Human Services | mn.gov/dhs
SLMH School Districts and School Programs
675
872921
953
1014
11161150
224273 276 288 288
328 317
200
300
400
500
600
700
800
900
1000
1100
1200
2013/2014 2014/2015 2015/2016 2016/2017 2017/2018 2018/2019 2019/2020
School programs
School districts
SLMH: Student and School Numbers
2/15/2021 Minnesota Department of Human Services | mn.gov/dhs 7
Of the 1150 school program sites:
• 54% are in Elementary Schools
• 14% are in Middle Schools
• 28% are in High Schools or Alternative Learning Centers
SLMH Treatment and Supports
Common Diagnosis of students receiving SLMH services:
• F41.1 Generalized anxiety disorder
• F90.2 Attention-deficit hyperactivity disorder, combined type
• F43.25 Adjustment disorder with mixed disturbance of emotions and conduct
• F43.8 Post-traumatic stress disorder, unspecified
Common Clinical Services:
• Diagnostic Assessments
• Psychotherapy, child and family
• Psychoeducation
• Skills Training and Development
• Outcome Measures
• Treatment planning
Common Ancillary Supports:
• Consultation, parent and teacher
• School-wide training on mental health
• Transportation
• Build partnerships at local level; Multi-Tiered System of Support (MTSS) teams
2/15/2021 Minnesota Department of Human Services | mn.gov/dhs 8
SLMH Outcomes
• Improve clinical and functional outcomes for students.
• Improve clinical service quality through evidence-based treatments.
• Increase in the number of mental health clinicians who are trained in and providing Evidence-Based Practices (EBP).
• Improve capacity and infrastructure development to support the expansion and sustainability of services.
• Develop and strengthen partnerships between mental health providers and host school districts.
2/15/2021 Minnesota Department of Human Services | mn.gov/dhs 9
COVID Impact: State-Level Responses
• DHS SLMH waiver receives approval; allows increased flexibility for mental health staff to connect with students and families.
• DHS SLMH contract amendments allow flexibility in duties, expenses, and data during pandemic.
• DHS & MDE: Bi-weekly WebEx meetings with SLMH providers and related service providers.
• Review local level collaboration of “School District Distance Learning Plans” and share ideas with other providers/schools.
2/15/2021 Minnesota Department of Human Services | mn.gov/dhs 10
COVID Impact: Student, Family, Teacher Engagement strategies
• School district IT department ensures that each Chromebook had the right app so students could connect for Telemedicine sessions.
• “Relentless spirit" motivating providers and schools to stay connected to families and students to maintain support with minimal interruption.
• School-based therapists called their clients and immediately began scheduling online telemedicine sessions.
• Utilize “check and connect” at all levels (e.g. students, families, and teachers).
2/15/2021 Minnesota Department of Human Services | mn.gov/dhs 11
COVID Impact: Students receiving mental health supports
13384 13167
9636
12425
13581
10342
8642
9930
0
2000
4000
6000
8000
10000
12000
14000
16000
Jan-Mar Apr-Jun Jul-Sept Oct-Dec
Nu
mb
er
of
Stu
de
nts
Se
rve
d
Quarter
2019
2020
Next Steps
• FY 2022-23 Human Services Governor’s Budget Recommendations include SLMH.
• APBS (Association of Positive Behavior Supports) International conference in March 2021 will highlight Minnesota’s DHS SLMH & MDE PBIS partnership initiatives to support students.
• Inclusion of Integrated Care within SLMH framework.
• Telemedicine; Infrastructure development.
• Federal SAMHSA grants awarded to enhance school mental health framework.
2/15/2021 Minnesota Department of Human Services | mn.gov/dhs 13
Thank you!
Kristin Lofgren
Behavioral Health Division
2/15/2021 Minnesota Department of Human Services | mn.gov/dhs 14