Sarah Miles, School Mental Health Training Coordinator

School Mental Health Consultant STH Team

School Mental Health Services for Students in Temporary Housing

Discuss services are in schools through School Mental Health

Presentation Objectives

Understand the background and relevance of School Mental Health

Apply these themes specifically to the STH population

See the scope and impact of mental health issues in NYC

Take away resources for students, families, and staff

School Mental Health Mission

Improve academic outcomes by helping schools address

emotional well-being and support healthy social,

emotional and behavioral development.

Build capacity of educators to understand and address

mental health needs and encourage help-seeking.

Connect schools, students and families to mental health

information, services, resources and support.

Create positive school environments that foster students

social and emotional development.

School Mental Health Vision

The SMH program envisions a system where mental health is integrated into the academic landscape through a variety of strategies, programs, or innovations that support the emotional well- being of children and families and build supportive environments in the schools. We do this in ways that promote excellence, equity, and equal access for all.

Office of School HealthOrganizational Chart

Oral Health

VisionSchool Health

NursingMental Health

School Wellness

MedicalAdolescent

Health

Office of School Health

Roger Platt, MD Assistant Commissioner

Department of Health and

Mental Hygiene

Department of Education

New York City Youth Mental Health Data

From the NYC Youth Risk Behavior Survey 2017

Did students attempt suicide one or more times during the past 12 months?

Year % Yes Answers Number of Students

2013 8.1 18,000

2015 8.3 19,000

2017 11.0 24,000

15

Representing 83,000 students Representing 47,000 students

The Scale of Homelessness Among NYC Students

• Show symptoms of anxiety, depression and suicidality

Mental Health in the STH CommunityNYC Data

• Have adverse childhood experiences

• Display symptoms of trauma

The STH population is at higher risk to…

• Feeling unsafe at school• Hygiene• Hunger• Sleeping in school

Higher risk for early substance use or substance abuse

More Risks for the STH Population

Universal

School-wide supports

that promote mental

health awareness

3

Selective

Supports aimed to intervene early for at risk

students

2

Targeted

Intensive supports for

students with identified

concerns

1

Three-Tiered School Mental Health Framework

School Mental Health Services are not a cookie-cutter approach. There is a wide range of services for all

programs, and program models differ on each campus in order to address the unique needs of the students

and the community.

• Logical point of entry

• Frontline identification

• More natural setting for students

• Increased access and follow-up

• Closes treatment gaps for students of color

• Important role in public health campaigns

• Sole provider for many children

Schools Are On the Frontlines of Communities

• Increases resiliency and help-seeking behavior

• Improvement in…• Student decision-making • School culture and commitment to school• Student social emotional skills• Positive interactions with others

• Increased knowledge about mental health

• Decreased mental health stigma

Students Benefit From Having More Mental Health Information

• Fewer… • Referrals based on challenging behavior• Referrals for special education services• Students in restrictive environments

• Decreased disruption from class time and school activities

• Improved academic achievement

• Increased teacher confidence around mental health

Mental Health Affects Student Achievement

School-Based Mental Health

Clinics (SBMHC)

School-Based Health Centers

(SBHC)

School Response Teams (SRT)

School Mental Health Consultant

Program

Renewal and AIDP Community

School Program

School Mental Health Prevention and

Intervention Program (PIP)

The 100 Schools Project

Existing ProgramsThrive NYC-Funded

Programs

(In addition to existing programs)

Mental Health Services in NYC Schools

School-Based Mental Health Clinic Services

Treatment with a Mental Health Provider using one or more of the following

modalities:

- Individual Treatment

- Group Treatment

- Family Treatment

- Psychiatric Evaluation

- Medication Monitoring

- Crisis Intervention

Mental Health Assessment &

Evaluation

Office of School Health: Mental Health supports School Based Health CentersOffice of School Health: Adolescent Health oversees SBHCs

• Primary Care and Preventive Health including screening, immunizations, physicals, care for chronic illnesses

• First Aid to any student registered in the building• Vaccinations• Emergency Care to anyone in the building• Reproductive Health for High School Students

School-Based Health Centers (SBHC)

There is… Mental Health at most SBHCsHealth Education at some SBHCsDental services at some SBHCs

In collaboration with designated school staff referrals, SRT conducts assessments and recommends treatment

for mental health and social services as needed.

The team spends one day a week in each school.

The team can be immediately available to travel to any of the schools in the cluster to assist with crises.

The team offers training, consultations and conducts school-wide assessments.

If needed, treatment for students would be provided at the team’s community location (i.e., mental health clinic).

SRT

School B

School A

School ESchool D

School C

School Response Team (SRT)

The SRT serves a cluster of 5 middle schools to meet the mental health needs of their students.

School Mental Health Programs Funded

through Thrive NYC

School Mental Health Consultant Program

Renewal and AIDP Community School Program

School Mental Health Prevention and Intervention Program

The 100 Schools Project

Promote

Assess

Map

Train

Link

Consult

School Mental Health Consultant Program

About the Consultant Role

• Assess short- and long-term MH service needs on the 3 tiers

• Provide school-based mental health consultation tailored school needs

• Train school staff about mental health and connect them to community-based resources

• Provide referral services for students with additional needs

• Offer Universal trainings for the school community

• Strengthen the school’s approach to utilizing appropriate community alternatives to the ER

• Build on existing DOE, DOHMH, and other NYC systems and resources to address emotional needs of students

STH Consultant Program:Schools with a high STH population have consultants who also work with Shelter Liaisons that support the school community.

Mental Health programming is aligned to Community School’s program expectations.

School Mental Health Managers:

• Assist schools and Lead CBOs in assessing the need for mental health services and

related interventions using a tiered approach: Universal, Selective, Targeted.

• Provide ongoing technical assistance to schools and Lead CBOs on development

and use of mental health needs, program development and priorities.

• Assist CBOs in sub-contracting with qualified mental health providers.

• When appropriate, work with schools, Lead CBOs, and providers to obtain licensing

approval when creating a School-based Mental Health Clinic (SBMH).

Mental health services and providers are managed through the Lead CBO

Community Schools Services Overview

• Assist schools in assessing the need for mental health services and related interventions using a tiered approach: Universal, Selective, Targeted.

• Work with schools (non community schools) , and providers to obtain licensing approval when creating a School-based Mental Health Clinic (SBMH).

• Assist schools in partnering with qualified mental health providers.

• Provide on-going technical assistance to schools on development and use of mental health needs, program development and priorities.

• Oversee the quality of the clinical programs and develop and use standards, EBT, and program improvement tools to measure program quality and effectiveness, and to tailor interventions when indicated.

School Mental Health Managers oversee mental health services and providers in the school.

PIP Services

Mental health programming is aligned to 44 High Needs Schools

School Staff

Coaching and supporting school staff on effective crisis responses and de-escalation

techniques

Assisting school staff in early identification and brief intervention

of behavioral health issues

Assisting with referrals for students with behavioral health

needs

Parents & Community

Parent education

Establishing community linkages

Assisting families with referrals and follow-up

Teachers

Trainings for teachers on educating students about mental health and

substance use with a focus on prevention strategies

Professional development, support, and self-care strategies

Classroom observations and teacher conferences

What are the Challenges to

Providing Services in Schools?

What are some additional challenges in working with STH population in schools?

• Attendance and lateness• Inconsistent busing • Parent engagement• Need for specialized staff that is not available to all schools• Expectations of shelters

Professional Development for DOE Staff

Professional Development for DOE Staff

Kognito At-Risk SuiteYouth Mental Health First Aid

Making Educators Partners (MEP)Creating Suicide Safety in Schools

An online training module for full-time staff of elementary, middle, and high schools. The module uses interactive online roleplay to educate teaches on how to recognize early signs and symptoms of psychological distress and connect students to resources within the school setting. Visit the Kognitowebsite to sign in and start using the program.

Kognito’s At-Risk Suite

nyc.kognito.com

A full day (8-hour) training through Thrive NYC that gives participants the basic knowledge and skills to respond to a young person in emotional distress.

Youth Mental Health First Aid

For educators and any member of the public who interacts with young people regularly.

To find a training contact David Rivera at drivera3@health.nyc.gov

Designed to increase awareness and understanding of youth suicide, increase recognition of warning signs, and improve confidence in the initial response to mental health crisis to conduct an appropriate referral.

To sign up or schedule a training schools should contact the Counseling Managers at their Borough Field Support Center.

A 45 to 90-minute classroom-based professional development program from Thrive NYC

Making Educators Partners (MEP)

CSSS is a 6-hour workshop offered through collaboration between the Suicide Prevention Center of New York State and the NYC Office of School Health. The workshop aims to help educators:

Develop comprehensive suicide prevention and response plan Learn about resources to enhance safety and health of school environmentsReview existing suicide prevention and intervention readinessReceive evidence-based and best practice guidance

Administrators, social workers, school counselors, psychologists, teachers, school-based mental health providers, and those engaged in prevention planning in the school.

An implementation team of 4 to 5 staff per school is ideal.

Prevention and Intervention for NYC Schools

Creating Suicide Safety in Schools

Mental Health Resources for New Yorkers

Text WELL to 65173

1-888-NYC-WELL (1-888-692-9355)

nycwell.cityofnewyork.us

This is not an appropriate resource for individuals who:

• Are at imminent risk for danger to self or others – CALL 911!• Live on the street or his/her whereabouts are unknown• Have an ACT team or receive AOT services• Do not have the consent of a parent/caregiver (children)

• Goal: Assess the child’s and family’s needs, assist in managing a situation, and connect the child to services in the community. (NOT for psychological assessments)

• Multi-disciplinary team• When a call is made

• CMCTs call the parent/caregiver to assess the situation and obtain consent (if needed)• The CMCT responds in-person within 48 – depending on the urgency of the call• The call can be made by any concerned person – including parents!

Children’s Mobile Crisis Teams (CMCT)

Provide support and resources to families who are raising children with mental health needs. They aim to reduce the isolation and stress of parenting a child with emotional and behavioral difficulties.

Family Resource Centers through Vibrant (formerly Mental Health Association of NYC)

Manhattan North: 212-410-1820

Manhattan South: 212-964-5253

Bronx North: 718-220-0456

Bronx South: 718-220-3868

Queens West: 718-651-1960

Queens East: 347-644-5711

Brooklyn North: 877-425-8133

Brooklyn South: 347-394-5186

Staten Island: 718-698-5307

HiteSite

www.hitesite.org

More Resources

STH Content Experts

School Mental Health Campaign

Elementary School

High SchoolMiddle School

Campaign Posters for all Ages

Thank you!

Sarah Miles, School Mental Health Training Coordinator, smiles1@health.nyc.gov Monica Gavilanes, STH Field Supervisor School Mental Health Consultants, mgavilanes@health.nyc.gov (12/5)Lana Ritterman-McAndrew, School Mental Health Consultant, lrittermanmcandrew@health.nyc.gov (12/12)Ani Nunez, STH School Mental Health Consultant, anunez4@health.nyc.gov (12/19)

References

Photos from Unsplash and Pexels

1. Breux, P., Boccio, D., & Brodsky, B. (2017). Creating Suicide Safety in Schools: A public health suicide prevention program in New York

State. Suicidologi, 22(2). doi: 10.5617/suicidologi.5438

2. Center for School Mental Health. (2018). Community-Partnered School Behavioral Health State of the Field in Maryland. University of Maryland

School of Medicine. Retrieved from https://mdbehavioralhealth.com/SBH/implementation/resourcecenter

3. Center for School Mental Health. (2013). The Impact of School Mental Health: Educational, Social, Emotional, and Behavioral Outcomes.

University of Maryland School of Medicine. Retrieved from

http://mdbehavioralhealth.com/downloads/3716/CSMH+SMH+Impact+Summary+July+2013+.pdf?1496239910

4. Coalition for the Homeless. (2018). State of the Homeless 2018. Retrieved from http://www.coalitionforthehomeless.org/wp-

content/uploads/2018/03/CFHStateoftheHomeless2018.pdf

5. Institute for Children, Poverty & Homelessness. (2018). More Than a Place to Sleep: Understanding the Health and Well-Being of Homeless High School

Students. New York City. Retrieved from https://www.icphusa.org/reports/homelessstudenthealth/#executive-summary

6. NYC Youth Risk Behavior Survey. Retrieved from https://a816-healthpsi.nyc.gov/epiquery/YRBS/yrbsIndex.html

7. NYS TEACH-S. (2018). INFO-BRIEF: Trauma-Sensitivity and School Success. Retrieved from https://nysteachs.org/wp-content/uploads/2018/09/INF_SS_InfoBrief.TraumaSensitivityandSchoolSuccess_091018.pdf

8. NYS-TEACHS. (2018). SIRS Data on Student Homelessness. Retrieved from https://nysteachs.org/resources/sirs-data-on-student-homelessness/