Previous Research and Initiatives
The CSMH has been involved in school mental health research and evaluation related to several projects and initiatives. Previous research and evaluation components are highlighted below.
Calverton Elementary/Middle School Mental Health Initiative (Funded by the Open Society Institute, Baltimore)
This project sought to reduce suspension and expulsions in Baltimore City Schools designated as “Persistently Dangerous.” In addition to providing a full continuum of mental health services (including individual, group, and family therapy, consultation, and prevention programming), the project focused on improving school climate, particularly as it relates to safety, connectedness, and warmth. The project, locally called 1100 Peace, included a mediation program and a restorative justice component for students who have been suspended. Data collected included: school climate summary data, social-emotional-behavioral survey data for students seen four or more times, grades, attendance, academic promotion, and satisfaction and impact data related to the mediation and restorative justice programs.
Excellence in School Mental Health Initiative (Funded by the Association of Baltimore Area Grantmakers)
This project sought to improve and implement evidence-based positive learning strategies and school cohesion within two Baltimore City elementary/middle schools, Patapsco (#163) and Bay-Brook (#124). The child intervention components were the 1) Paths to PAX curriculum, a school-based intervention aimed at enhancing school climate through the use of positive language and positive coping strategies; 2) Coping Power, a multi-session group that educates students on: short and long term goals, organizational and study skills, social skills, problem solving skills, the ability to resist peer pressure and gaining successful entry into positive peer groups; and 3) Incredible Years, a prevention program aimed at increasing student emotional intelligence through education on identifying feelings, social competence, anger management, and problem solving. The school staff and clinicians held regular social events for parents to encourage positive social interaction and school connectedness. Program success was evaluated through end-of-the-year aggregate data on student office referrals, student suspensions for behavioral problems, attendance data, student lateness, grades in core academic subjects, reports of student behavior, and student Psychosocial Environment Profile, reports of student behavior, school adjustment and academic performance will be evaluated through the annual end-of-year recording of aggregate data on student office referrals and school suspensions for behavioral problems, student attendance, student lateness, and grades in core academic subjects. The duration of this project was two and one-half years beginning January 2007 and ending June 2009. Excellence in School Mental Health Initiative.
Maryland Statewide School Mental Health Survey
In April 2008, an online survey was distributed to Directors of Student Services and were completed in collaboration with Directors of Special Education and Core Service Agency Directors in each of the 24 jurisdictions in Maryland. Content areas addressed include: evidence-based programs implemented, staffing of mental health personnel (school-hired, school-based community providers, community providers), family involvement, formal collaboration guidelines with child welfare and juvenile services, and funding sources. Maryland Statewide School Mental Health Survey.
Mental Health Promotion for Children and Adolescents in Foster Care in Schools
The goal of this grant was to assist the State of Maryland’s Transformation Grant in its support of the Department of Health and Mental Hygiene, Mental Hygiene Administration (MHA), Department of Human Resources (DHR), and local Departments of Social Services, in collaboration with the Maryland State Department of Education (MSDE), the Maryland Department of Juvenile Services, and other state and local agencies and initiatives in integrating services and improving outcomes for children, adolescents, and graduates of Maryland’s foster care system. The CSMH developed an issue brief on Foster Care and School Mental Health. In addition, the CSMH developed a training curriculum for education, mental health, child welfare, and juvenile services staff, and families and youth on issues related to effective school-based outreach, support, mental health promotion and intervention for youth in foster care in Maryland Schools. The training curriculum is available at the School of Mental Health. Lastly, in conjunction with a National Community of Practice on School Mental Health, sponsored by the CSMH and the IDEA Partnership formed a practice group emphasizing school mental health and child welfare connections using Maryland as a national example.
Quality and Evidence-Based Practice
The CSMH has a long history of advancing quality assessment and improvement in school mental health, including a focus on evidence-based practice. Through a research project (R01-MH71015-01A1) led by Mark Weist, Ph.D. the CSMH worked in three states (Maryland, Delaware, and Texas) on a formative evaluation assessing proximal impacts on quality of clinician services and implementation of EBPs, as well as distal impacts on student level outcomes. The results were published in August 2009 in School Mental Health (Weist, Lever, Stephan, Youngstrom, Moore, Harrison, Anthony, Rogers, Hoagwood, Ghunney, Lewis, & Stiegler, 2009). Based on this work, the CSMH developed a set of 10 principles (listed below) and corresponding quality indicators reflecting the vision of best practice for the expanded school mental health field.
- Principle 1: All youth and families are able to access appropriate care regardless of their ability to pay.
- Principle 2: Programs are implemented to address needs and strengthen assets for students, families, schools, and communities.
- Principle 3: Programs and services focus on reducing barriers to development and learning, are student and family friendly, and are based on evidence of positive impact.
- Principle 4: Students, families, teachers and other important groups are actively involved in the program's development, oversight, evaluation, and continuous improvement.
- Principle 5: Quality assessment and improvement activities continually guide and provide feedback to the program.
- Principle 6: A continuum of care is provided, including school-wide mental health promotion, early intervention, and treatment.
- Principle 7: Staff hold to high ethical standards, are committed to children, adolescents, and families, and display an energetic, flexible, responsive, and proactive style in delivering services.
- Principle 8: Staff are respectful of and competently address developmental, cultural, and personal differences among students, families, and staff.
- Principle 9: Staff build and maintain strong relationships with other mental health and health providers and educators in the school, and a theme of interdisciplinary collaboration characterizes all efforts.
- Principle 10: Mental health programs in the school are coordinated with related programs in other community settings.
School-Based Primary Care-Mental Health Collaborative Care: The Mental Health and Education Training (MHET) Initiative
The MHET Initiative was developed in partnership with the National Assembly on School-based Health Care, a national in technical assistance, training and advocacy on the delivery of comprehensive health care for students in school-based health centers (SBHCs). The purpose of MHET was to increase knowledge and implementation of mental health screening, diagnosis, referral, coding, and empirically-supported short-term interventions among SBHC primary care and mental health providers. This interdisciplinary initiative reached 19 SBHCs in six states between 2004-2006 and was designed based on a four- pronged approached to evidenced-based practice in school mental health: 1) decrease stress/risk factors; 2) increase protective factors; 3) increase knowledge in core mental health skills, and 4) implement evidence-based manualized interventions. The MHET Final Report presents the methodology, results and lessons learned from the two-year MHET initiative, and provides direction for future initiatives designed to enhance school-based primary care and mental health providers’ mental health service quality.
School Mental Health Capacity Building Partnership (SMHCBP)
The CSMH partnered with the National Assembly on School-Based Health Care (NASBHC), the Center for School-Based Mental Health Programs at Miami University in Ohio, the Center for Advancement of Mental Health Practices in Schools at the University of Missouri-Columbia, and the Federation of Families of Palm Beach County, Inc. In May of 2006, NASBHC received a five-year cooperative agreement with the Center for Disease Control's (CDC) Division of Adolescent Health (DASH) to build capacity of state and local education agencies to provide effective and sustainable school mental health services to young people. The aim of this initiative was to disseminate model mental health policies, programs, and services to education agencies in order to improve access to high quality, school-based mental health services. The CSMH has partnered with NASBHC on all areas of this project, including steering committee and management team leadership, product development, technical assistance, dissemination and evaluation. SMHCBP Resources.
Center for Adolescent Research in Schools (CARS)
As the successful recipient of a $9 million, five-year (2008-2013) grant from the Institute of Educational Sciences, the Center for Adolescent Research in Schools (CARS) offers an exciting and unique opportunity to advance scientific and practical knowledge in a way that will guide the field towards a cohesive and effective approach for resolving the challenges experienced by this group of students.
The primary goal of this project is to develop and evaluate an intervention package to reduce the fundamental challenges experienced by secondary students with serious behavioral disorders (SBD). Given the paucity of research with this age group, the group will use a multi-stage process of development, refinement, and valuation. A secondary goal is to conduct supplemental studies leading to improved outcomes for secondary students with SBD. The scope of the work is described below:
- Finalize a preliminary intervention package based on synthesis of available
- information/data on student need and interventions with preliminary efficacy
- Refine the preliminary intervention package to determined key components that a) will be efficacious, b) will have a pervasive and generalized impact, and c) can be readily learned and implemented by typical school personnel
- Evaluate the efficacy of intervention package across diverse educational settings
- Conduct supplementary studies on key issues pertinent to understanding and improving outcomes for secondary students with SBD
Key staff attached to the project include: Lee Kern, PhD (PI, Lehigh University), Steven W. Evans, PhD (co-PI, James Madison University), Tim Lewis, PhD (co- PI, University of Missouri), and Mark Weist, PhD (University of Maryland). The Center for School Mental Health (CSMH), under the supervision of Dr. Mark Weist, is presently involved in several sub-projects of the grant, including an examination of federal and state-level classification of students with emotional and behavioral disorders, an assessment of school characteristics, and an analysis of the impact of educator stress on student outcomes. The CSMH will assist with the development and refinement of the intervention packages from Fall 2008 – Summer 2010, and, in the Fall of 2010 – Spring 2013, engage in the intervention administration and data collection process in the schools.
Intervention packages will be delivered to secondary schools in Pennsylvania (Allentown School District), Virginia (Rockingham County Public Schools), Missouri (Special School District, North Kansas City Schools), Maryland (Anne Arundel County Public Schools, Baltimore City Public Schools, Harford County Public Schools, Prince George’s County Public Schools), and Kentucky (Jefferson County Public Schools). Potential interventions fall into three categories: enhancing school and teacher capacity, building youth competence, and increasing family and community supports. The intervention foci, student challenges, and strategies are listed below.
Core Student Challenge
Enhancing School and Teacher Capacity
Building Youth Competence
Increasing Family and Community Supports
The Center for School Mental Health is excited to be a part of this ground-breaking initiative. Interested persons can learn more about the CARS initiative.
Thought Leader Dialogue
Advancing Integrated Mental Health and Education Research
The Center for School Mental Health, in collaboration with the Center for Health and Health Care in Schools, co-hosted a meeting in Charleston, South Carolina (September 21, 2011) with participation from mental health and education researchers, education leaders, and federal and private foundation funders. The purpose of the meeting was to identify action steps to promote a coordinated research agenda that a) encourages collaboration between education and child emotional/behavioral health stakeholders, and b) supports the application of emotional/behavioral health and education research findings to educational practice.
Capacity Building Partnership Resources
The School Mental Health Capacity Building Partnership (SMHCBP) was a 5--year cooperative agreement between the Centers for Disease Control's (CDC) Division for Adolescent Health and the National Assembly on School-Based Health Care (NASBHC), with the CSMH serving as the primary national partner to the initiative. The overall charge of the SMHCBP was to build capacity of state and local education agencies to provide effective and sustainable school mental health services to young people.
- SMHCBP overview page at NASBHC for further detail and all initiative products.
- Organization Matrix: A matrix of organizations that provide school mental health capacity building assistance.
- Assessment Tools: A list of capacity building assessment tools that builds capacities in five key areas: planning, collaboration cultural competence, quality improvement, and surveillance.
- "Top Ten Critical Factors to School Mental Health: What Early Adopters SayTop Ten Critical Factors to School Mental Health: What Early Adopters SayTop Ten Critical Factors to School Mental Health: What Early Adopters Say": A document summarizing common themes and strategies that emerged in the four site visits. (One page edition)
- "What Students Have to Say about Mental HealthWhat Students Have to Say about Mental HealthWhat Students Have to Say about Mental Health": A document that communicates the most pressing concerns directly from the perspective of youth from Maryland, Missouri, Ohio, and Oregen.