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SCHOOL BASED MENTAL HEALTH SERVICE Canterbury’s Strategic Response Harith Swadi CDHB CAF Mental Health Service

SCHOOL BASED MENTAL HEALTH SERVICE · 2016-08-25 · bouncebackability – coping Enhance prevention and early intervention mental health services Deliver specific targeted tailored

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Page 1: SCHOOL BASED MENTAL HEALTH SERVICE · 2016-08-25 · bouncebackability – coping Enhance prevention and early intervention mental health services Deliver specific targeted tailored

SCHOOL BASED MENTAL HEALTH SERVICE

Canterbury’s Strategic Response

Harith SwadiCDHB CAF Mental Health Service

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Child & Youth Community Mental Health Service New Case Starts

Case Starts Mean SD2+ SD2- SD3+ SD3-

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Child & Youth Community Mental Health Service Contacts

Contacts Mean SD2+ SD2- SD3+ SD3-

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Adopt a leaner more focused model of service delivery Choice and Partnership Approach Same Day Response (CAF Emergency) Care Pathways – Carve-outs

Take a systems approach and focus on collaborative work across the system e.g. NGO, School Counsellors

Promote and develop a focus on mental ‘health’- Investment Positive Parenting School Based Mental Health Service

What we did to adapt

Page 9: SCHOOL BASED MENTAL HEALTH SERVICE · 2016-08-25 · bouncebackability – coping Enhance prevention and early intervention mental health services Deliver specific targeted tailored

Positive Parenting is the immunity jab against mental illness

Page 10: SCHOOL BASED MENTAL HEALTH SERVICE · 2016-08-25 · bouncebackability – coping Enhance prevention and early intervention mental health services Deliver specific targeted tailored

Mental health refers to the maintenance of successful mental activity.

This includes maintaining productive daily activitiesand maintaining fulfilling relationships with others.

It also includes maintaining the abilities to adapt to change and to cope with stresses.

While responding to ‘disorders’ we promote health

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A Night out in Christchurch

Page 12: SCHOOL BASED MENTAL HEALTH SERVICE · 2016-08-25 · bouncebackability – coping Enhance prevention and early intervention mental health services Deliver specific targeted tailored

Adopt a leaner more focused model of service delivery

Choice and Partnership Approach

Same Day Response (CAF Emergency)

Care Pathways – Carve-outs

Take a systems approach and focus on collaborative work across the system

NGOs

Primary Care

Promote and develop a focus on mental ‘health’- Investment

Positive Parenting

School Based Mental Health Service

What we did to adapt

Page 13: SCHOOL BASED MENTAL HEALTH SERVICE · 2016-08-25 · bouncebackability – coping Enhance prevention and early intervention mental health services Deliver specific targeted tailored

Why A School Based Service?

Why not? 15,000 hours Early Intervention Cross Agency Work Enhancing capability Health Promotion and Prevention Convenience Captive Population Representative population Respond to specific needs in specific community Clusters approach Optimal real life environment for assessment and intervention Addresses specific school MH issues

Page 14: SCHOOL BASED MENTAL HEALTH SERVICE · 2016-08-25 · bouncebackability – coping Enhance prevention and early intervention mental health services Deliver specific targeted tailored

Stand downs/suspension/exclusion Non-attendance – truancy, refusal Contagions – self harm School-based incidents – violence Education specific issues – anxiety, transitions, exam stress Classroom issues – ADHD, disruptive behaviour, ODD, CPS Community based incidents School staff mental wellbeing

Addresses specific school MH issuesExamples:

Page 15: SCHOOL BASED MENTAL HEALTH SERVICE · 2016-08-25 · bouncebackability – coping Enhance prevention and early intervention mental health services Deliver specific targeted tailored

For the schools to be mental health proficient, self sufficient at a basic level, and be part of young people’s mental health system

Develop and promote public health approach to young people’s mental health in schools.

Help school become a place where young people benefit from every experience, good or adverse’ because every experience counts

Promote mental health resilience in the face of adversity– resistance, bouncebackability – coping

Enhance prevention and early intervention mental health services

Deliver specific targeted tailored services

Deliver primary and some secondary level services

What we intended to achieve

Page 16: SCHOOL BASED MENTAL HEALTH SERVICE · 2016-08-25 · bouncebackability – coping Enhance prevention and early intervention mental health services Deliver specific targeted tailored

We took a developmental approach

1. Be accepted as part of the school health system2. Establish the foundation for developing a spirit of collaboration –

relationships at governance level3. Build Trusting relationships and networks of support at field level4. Establish Credibility – be there, listen and deliver, 5. Build acceptance of MH in school settings - consistency6. Deliver MH prevention activities and interventions7. Deliver primary level brief assessments and interventions8. Deliver school-setting specific services9. Deliver secondary level assessments and interventions

Page 17: SCHOOL BASED MENTAL HEALTH SERVICE · 2016-08-25 · bouncebackability – coping Enhance prevention and early intervention mental health services Deliver specific targeted tailored

Small team, started June 2013 – 3FTE Has since expanded to 8.7FTE Work collaboratively with Education, MSD and Others in Schools Work with all level schools Provides a Service – Not roll out a programme Our primary customer is the school Engage every interested school and assign a key liaison clinician Tell us what you need. If we can’t do it, we know someone who can. Our work must be culturally informed and safe

The SBMH team

Page 18: SCHOOL BASED MENTAL HEALTH SERVICE · 2016-08-25 · bouncebackability – coping Enhance prevention and early intervention mental health services Deliver specific targeted tailored

Governance Communications Handling information Reporting Activity Review Recruit the right people Send invitation letter Set up engagement meeting Focus on high needs

How we started

Page 19: SCHOOL BASED MENTAL HEALTH SERVICE · 2016-08-25 · bouncebackability – coping Enhance prevention and early intervention mental health services Deliver specific targeted tailored

Pastoral Care meetings

School Counsellors support

Navigating the MH system

Managing incidents

Mental Health workshops e.g. ASD

Parent Mental Health Education

Managing Challenging Behaviour

Anxiety Management

Parent-School engagement facilitation

Supporting kids who self harm workshops

Mindfullness workshops

Suicide postvention support

Helping kids with mood management

Stress management for adults

Where to find help resource book

Health Mind Platter

Cultural MH orientation for teachers

Staff well-being survey

Some menu examples(or make your own Pizza)

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Number of schools engaged

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By practising mindfulness, we allow ourselves to stop worrying about past problems and future fears, and focus more fully on the here and now.

Page 25: SCHOOL BASED MENTAL HEALTH SERVICE · 2016-08-25 · bouncebackability – coping Enhance prevention and early intervention mental health services Deliver specific targeted tailored

Child public mental health

Healthy parenting is the key to child mental health

https://www.sparx.org.nz/

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An increase in mental health problems especially fear and anxiety Delays in developmental maturity Persistence of difficulties in some groups Children were more likely to be affected than youth The grown ups in their lives were too stressed to maintain support

levels

What we learned (5 things) aboutYoung people in school:

Page 30: SCHOOL BASED MENTAL HEALTH SERVICE · 2016-08-25 · bouncebackability – coping Enhance prevention and early intervention mental health services Deliver specific targeted tailored

What we learned (5 things) aboutFamilies, parents and caregivers:

Families went through sustained long periods of stress There was a significant rise in mental health problems It was difficult for many families to engage with schools Uncertainty was their biggest stressor They were great at supporting each other

Page 31: SCHOOL BASED MENTAL HEALTH SERVICE · 2016-08-25 · bouncebackability – coping Enhance prevention and early intervention mental health services Deliver specific targeted tailored

What we learned (5 things) aboutSchools:

They knew exactly what they needed and were very keen on receiving support

Huge variability in preparedness to deal with difficulties An incredible level of professionalism and wanting to get on with it School leadership engagement with SBMH is vital for success Teachers were not just teachers; much more and they suffered too

Page 32: SCHOOL BASED MENTAL HEALTH SERVICE · 2016-08-25 · bouncebackability – coping Enhance prevention and early intervention mental health services Deliver specific targeted tailored

What we learned (5 things) aboutCommunities:

Desperate to get back to the new normal/routine Different needs in different communities Some communities found it harder to adapt Eastern suburbs and rural communities suffered more Stressed communities found it hard to engage with schools

Page 33: SCHOOL BASED MENTAL HEALTH SERVICE · 2016-08-25 · bouncebackability – coping Enhance prevention and early intervention mental health services Deliver specific targeted tailored

What we are planning to do

Add the next ingredient of direct mental health support to young people in school setting

3 New FTEs Utilise a Brief Intervention Model Emphasis on Early Intervention Enhance our capability to engage with more schools using a

cluster-of-schools approach

Page 34: SCHOOL BASED MENTAL HEALTH SERVICE · 2016-08-25 · bouncebackability – coping Enhance prevention and early intervention mental health services Deliver specific targeted tailored

The young people of Canterbury were hit hard by the earthquakes

The indirect impact of the earthquakes will not disappear any time soon

With the extra resource, we can support those who have been affected

Resilience is the name of the game. We need to build the resilience of Canterbury’s young people, their families and their communities

Working with schools and their communities is a viable and effective model towards achieving that

5 Take Home Messages

Page 35: SCHOOL BASED MENTAL HEALTH SERVICE · 2016-08-25 · bouncebackability – coping Enhance prevention and early intervention mental health services Deliver specific targeted tailored

10 Lessons (aka Headache Saving Tips)

Be prepared for Internal scepticism Be aware of others’ anxiety Be aware of MoE anxiety Engage, engage, engage – key person Know who else is there and what their role is Help schools be focused “What are the needs – name the top one” Be always available (Key contact on our side) Be clear about what your core business Ditch the one-size-fits-all idea Take a Can-do attitude and think of the unthinkable

Page 36: SCHOOL BASED MENTAL HEALTH SERVICE · 2016-08-25 · bouncebackability – coping Enhance prevention and early intervention mental health services Deliver specific targeted tailored

No Health Without Mental Health

And one more

Page 37: SCHOOL BASED MENTAL HEALTH SERVICE · 2016-08-25 · bouncebackability – coping Enhance prevention and early intervention mental health services Deliver specific targeted tailored

Mental Health is the product of the collective impact:

GenesEnvironmentExperiences

There is relatively little we can do for kids about genes

There is plenty we can do about their environment and experiences

And that is everyone's responsibility