Office of the Superintendent of Schools MONTGOMERY COUNTY PUBLIC SCHOOLS Rockville, Maryland. May 10, 2005

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Office of the Superintendent of Schools MONTGOMERY COUNTY PUBLIC SCHOOLS Rockville, Maryland DISCUSSION 9.0 May 10, 2005 MEMORANDUM To: From: Subject: Members of the Board of Education Jerry D. Weast, Superintendent of Schools Mental Health Task Force Report Executive Summary The purpose of this memorandum is to present the report and recommendations of the Mental Health Task Force (MHTF) and discuss how the Montgomery County Public Schools (MCPS), in collaboration with our community partners, will promote the mental wellness of our children. Research clearly indicates that when students are mentally healthy their academic productivity accelerates. The goal of the MHTF is to recommend strategies that will create an environment that supports healthy child development within a safe and caring community that provides the maximum opportunity for all children to learn. The work of this task force is in alignment with, and specifically supports, the MCPS Strategic Plan, Our Call to Action: Pursuit of Excellence. The recommendations of the MHTF build on strategies that MCPS already has in place and expand existing mental health programs and services through enhanced collaborative efforts with our partners in the community. The MHTF report is attached. Background The MHTF represents an unprecedented level of collaboration among MCPS, county agencies, and private organizations. It was created in February 2004 and co-chaired by Mr. Matthew Kamins, supervisor of psychological services, Office of Special Education and Student Services; and Ms. Ronnie Biemans, special projects manager, Behavioral Health and Crisis Services, Montgomery County Department of Health and Human Services (DHHS). In order to ensure multiple perspectives, effective coordination, and cross-agency resource utilization, 55 stakeholders, representing the organizations and agencies in Montgomery County that provide mental health services to children, participated. Participants also included selected MCPS staff, family members, community leaders, and advocacy groups.

Members of the Board -2- May 10, 2005 of Education Recommendations In the MHTF report there are five recommendations that specifically focus on raising community awareness of the critical link between mental health and academic success. The recommendations strengthen our understanding of the connections between academic achievement and mental wellness for all students and are supported and documented by research in the safe schools and mental health literature. Timely school and community intervention will help remove barriers to achievement, prevent mental health problems, and support social and emotional development. I commend the members of the MHTF for their dedication to this very worthwhile endeavor. The next step in the process is to provide the report to the MCPS staff members and community partners who will be responsible for considering these recommendations. At the table today to present the MHTF report are Dr. Carey M. Wright, associate superintendent, Office of Special Education and Student Services; Ms. Ronnie Biemans, special projects manager, Behavioral Health and Crisis Services, Montgomery County Department of Health and Human Services; Mr. Matthew Kamins, supervisor, Psychological Services; and Ms. Lisa Warren, parent of a student at Gaithersburg Middle School. JDW:mk Attachment

MONTGOMERY COUNTY PUBLIC SCHOOLS Rockville, Maryland Report of the Mental Health Task Force March 2005 EXECUTIVE SUMMARY In February 2004, Dr. Jerry D. Weast, superintendent of schools, requested the formation of a task force to consider what additional strategies the Montgomery County Public Schools (MCPS) must employ to assimilate mental health programming into the academic day successfully. The task force focus was to recommend strategies to create an environment that supports healthy child development within a safe and caring community that provides the maximum opportunity for all children to learn. The task force was co-chaired by Mr. Matthew Kamins, supervisor of psychological services, Office of Special Education and Student Services, and Ms. Ronnie Biemans, special projects manager, Behavioral Health and Crisis Services, Montgomery County Department of Health and Human Services (DHHS). The task force determined that while much already is being done to address our children s mental health needs, gaps still exist between the current level of service provision and the desired state of mental health services and supports. The following issues highlight the disparities that exist between where we are now and where we want to be: Awareness and Education There is a need to educate all stakeholders regarding the link between mental health and academic achievement. In addition, school staff and parents need to become more familiar with the signs of mental illness so that they can recognize when interventions are necessary. Identification of Need A comprehensive needs analysis would greatly enhance our effectiveness in addressing the mental health needs of our students. Although national data allows us to approximate the need, a countywide assessment would pinpoint specific areas where the need is the greatest. This would facilitate the development of a focused plan that prioritizes the delivery of services to those children most in need. Evaluation and Coordination of Programs and Services Although many programs and services are currently being provided, we do not know if these services are necessarily the most appropriate ones or if those services are achieving the desired results. It is important to develop a system for monitoring the results of the programs and to ensure that there is a match between what is needed and what is provided.

Mental Health Task Force Report 2 March 2005 Delivery of Service Because funding is limited, it is imperative that services are not duplicated among agencies. If it is discovered that several agencies are providing the same service, we need to identify the most effective delivery model and eliminate the duplication. This will allow those funds to be applied to programs and services that are needed but that are not currently being delivered. Access In many cases, the community does not know what mental health programs and services are available or how to access them. This is especially true in those communities where English is not the primary language and with high incidences of poverty. There is a critical need for mental health services that are linguistically and culturally competent in order to serve our diverse community effectively. The following recommendations will help close the gap and move us closer to the desired state of addressing the mental health needs of our students: 1. Raise awareness, educate all stakeholder groups, and update relevant MCPS policies and regulations to reflect the critical link between mental health and academic success. 2. Ensure that a full continuum of school/community mental health programs and services that is aligned with the national successful schools model is available to all students (from preschool through high school). Specifically, a. Continue support for successful mental health initiatives, including the Collaborative Action Process; Kids First Alliance, the MCPS Safe Schools/Healthy Students grant initiative; and Linkages to Learning. b. Implement countywide anti-bullying approaches that provide school communities with the tools necessary to 1) determine if bullying is a problem; 2) educate students, staff, and the community about bullying; and 3) apply effective prevention and intervention models that minimize the effects and risks associated with bullying. c. Provide adequate staffing of school-based mental health professionals. When new schools open, align staffing with population growth and other known factors that positively influence mental wellness and academic achievement; include school psychologists, pupil personnel workers, school social workers, and school counselors in base staffing. 3. Maintain and expand critical public and private partnerships (e.g., DHHS, Juvenile Justice Services, Child Welfare Services, Collaboration Council, and the Mental Health Association) to maximize resource sharing and utilization of funding from outside sources to support school-based mental health services. 4. Participate in a cooperative community-wide assessment of the mental health needs of the children of Montgomery County and update this assessment periodically. 5. Participate in the design and development of a multiagency resource locator. Create mechanisms to share key need-to-know data regarding the mental health of children in Montgomery County.

MONTGOMERY COUNTY PUBLIC SCHOOLS Rockville, Maryland Report of the Mental Health Task Force March 2005 I. BACKGROUND: MENTAL HEALTH AND THE ACHIEVEMENT CONNECTION Students need rigorous and developmentally appropriate curricula and high-quality instruction in order to be successful in school. Much time, attention, and the greater part of a school system s budget are devoted to ensuring these elements are in place. However, a key component of academic success that is often overlooked is student mental health and well-being. Mr. Robert Chase, immediate past president of the National Education Association, stated, A child who does not get the mental health support he needs will not be successful in school. Unfortunately, mental health issues often do not get enough emphasis to make a difference for students. The mission of public schools is to educate all students. However, children with serious emotional disturbances have the highest rates of school failure. Fifty percent of these students drop out of high school, compared to 30 percent of all students with disabilities. 1 Schools are where children spend most of each day. While schools are primarily concerned with education, mental health is essential to learning as well as to social and emotional development. Because of this important interplay between emotional health and school success, schools must be partners in the mental health care of our children. Schools are in a key position to identify mental health problems early and to provide a link to appropriate services. 1 School mental health programs have proven to be effective in helping students manage emotional stress, support positive behavior, and help ensure academic achievement. MENTAL HEALTH DEFINED The Surgeon General (from the National Action Agenda for Children s Mental Health) defines mental health as the successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and the ability to cope with adversity; from early childhood until late life, mental health is the springboard of thinking and communication skills, learning, emotional growth, resilience, and self-esteem. The National Mental Health Center defines mental health as how a person thinks, feels, and acts when faced with life s situations. Mental health is how people look at themselves, their lives, and the other people in their lives; evaluate their challenges and problems; and explore choices. This includes handling stress, relating to other people, and making decisions. Research from the National Institute of Mental Health (NIMH) and the Substance Abuse and Mental Health Services Administration (SAMHSA) indicates that, at some time during a student s schooling, as many as 21 percent of 1 President's New Freedom Commission on Mental Health, 2002.

the school-age population will have a mental health condition that will block their learning and adjustment in school. School violence, bullying, gang activity, terrorism, and challenging family dynamics all affect the mental health of our students. About half of the students with mental health issues will have a persistent mental illness that, left untreated, will continue to affect school performance. It is very important that parents and school staff understand the correlation between mental health and academic success, and that school systems and local communities work collaboratively to ensure that mental health issues are addressed proactively. II. CHARGE TO THE TASK FORCE Recognizing the connection between mental health and academic productivity and the need to develop comprehensive, integrated programming, as recommended by the Blue Ribbon Task Force on Mental Health in Montgomery County, Dr. Jerry D. Weast, superintendent of schools, requested the formation of a task force to consider what additional strategies the Montgomery County Public Schools (MCPS) might employ to successfully assimilate mental health programming into the academic day. The task force focus was to recommend strategies to create an environment that supports healthy child development within a safe and caring community that provides the maximum opportunity for all children to learn. The Mental Health Task Force (MHTF) was created in February 2004 and co-chaired by Mr. Matthew Kamins, supervisor of psychological services, Office of Special Education and Student Services, and Ms. Ronnie Biemans, special projects manager, Behavioral Health and Crisis Services, Montgomery County Department of Health and Human Services (DHHS). In order to ensure multiple perspectives, effective coordination, and cross-agency resource utilization, 55 stakeholders, representing the organizations and agencies in Montgomery County that provide mental health services to children, participated. Selected MCPS staff, family members, community leaders, and advocacy groups also participated (Appendix A). The goal of the MHTF is to recommend strategies that will create an environment that supports healthy child development within a safe and caring community that provides the maximum opportunity for all children to learn. The work of this task force is in alignment with and specifically supports the MCPS strategic plan, Our Call to Action: Pursuit of Excellence. The recommendations of the MHTF build on strategies that MCPS already has in place and expand existing mental health programs and services through enhanced collaborative efforts with our partners in the community. III. PROCESS Because of the size of the task force and enormity of the task, it was determined that the most efficient way to approach the issue was to identify several smaller, more manageable subtasks. The task force reached consensus on forming the following five subgroups: Needs Analysis Subgroup: Identify the steps required to conduct an analysis of the mental health needs of all MCPS students. Bullying Subgroup: Provide an analysis of bullying nationwide and in MCPS and make recommendations regarding the most effective approach to bullying abatement. Benchmarking Subgroup: Benchmark with other school systems and communities to identify best practices and research-based proven techniques that have proven effective in 2

the delivery of mental health services and the staffing required to implement such services. Current Services Subgroup: Document Montgomery County s mental health resources, including MCPS, community resources, and private partners. Identify redundancies, inconsistencies, and gaps in provision of service. Commercial Programs Subgroup: Identify commercial programs that address social and emotional learning (SEL) and make recommendations for the preferred/recommended program, including the rationale/criteria for selecting one program over another. Each group worked on its assigned task and reported findings on a regular basis to the task force as a whole. Because of the interrelatedness of the topics/issues, the findings of the subgroups are presented in the composite in the next section of this report. IV. CURRENT STATE: THE NEED FOR M ENTAL HEALTH SERVICES Most of the data that is available regarding the need for mental health services comes from national studies such as the reports published by UCLA s Department of Psychology, Youngsters Mental Health and Psychosocial Problems: What are the Data? 2000, and the President's New Freedom Commission on Mental Health, 2002. Both reports draw from a growing body of evidence showing that school mental health programs improve educational outcomes by decreasing absences, and discipline referrals and improving test scores. The reports underscore that the key to improving academic achievement for children with mental health issues is to identify mental health problems early and, when needed, provide appropriate services or links to services. The reports reveal the following compelling statistics: An estimated 12 to 22 percent of all youngsters under the age of 18 are in need of services for mental, emotional, or behavioral problems. Approximately 21 percent, or one in five children and adolescents, experience the signs and symptoms of a mental health disorder during the course of a year. Of these, 11 percent experience significant impairment and about 5 percent experience extreme functional impairment. Of the 5 percent with extreme problems, estimates suggest that 13 percent have anxiety disorders, 10 percent have disruptive disorders, 6 percent have mood disorders, and 2 percent have substance abuse disorders. Most sources suggest that diagnosis of Attention Deficit-Hyperactivity Disorder (ADHD) is on the rise. Between 3 5 percent of school-age children are diagnosed with ADHD. This translates into an estimated 1.5 to 2.5 million children, with boys four to nine times more likely to be diagnosed. In 2000, approximately 3 million youths were considered at risk for suicide during the preceding year. It is reported that 70 percent of children and adolescents who need treatment do not receive mental health services. 3

Because Montgomery County has not yet conducted a comprehensive survey on the mental health needs of its students, it is necessary to rely on national mental health research and data, as well as surveys used by other communities/school districts, to estimate the mental health needs of MCPS students. Based on these national statistics, the following projections for Montgomery County are not unreasonable: Between 17,000 and 31,000 children in MCPS have mental health needs. Between 12,000 and 22,000 children in Montgomery County who need services are not receiving them. Approximately 5,600 children in Montgomery County are at risk for suicide. Even if the assumption is made that these figures are elevated, they still indicate that a significant problem exists that must be addressed. V. CURRENT STATE: M ENTAL HEALTH PROGRAMS AND SERVICES IN THE COUNTY Within the school environment, the mental wellness of students is closely correlated to how welcoming the school environment is; how engaging the curriculum is; and how effective the teaching staff is in connecting to the learning, social, and behavioral needs of their students. MCPS has worked diligently to create a safe, secure, and effective learning environment for all students. The system has focused directly on improving and maintaining high-quality instruction, effective teaching, and reducing class size so that student needs can be addressed appropriately. Montgomery County has specific staff, services, and programs that directly support and nurture student wellness. In the Schools School-Based Mental Health Providers: Because MCPS recognizes the link between mental health and academic achievement; there already are many programs and services in place that address this critical connection. In each of our schools, Student Services staff provide prevention and early intervention programs designed to support the academic achievement and personal growth of students. These school counselors, school psychologists, pupil personnel workers, and social workers work in close partnership to teach foundational skills in the areas of personal, interpersonal, academic, career, and healthy development. In addition, they identify and address barriers to school success. National research suggests these school-based prevention and early intervention programs supporting social and emotional health meet the needs of approximately 80 90 percent of students. For the remaining students, additional school-based and community mental health services are necessary. In MCPS, several service options some that involve our community partners are currently in place. The Collaborative Action Process: The Collaborative Action Process (CAP) provides an evidence-based framework for systematic problem solving when students are not achieving school success. CAP emphasizes regular meetings of grade-level teams, in collaboration with school-based specialists, school counselors, school psychologists, and pupil personnel workers. The teams examine instructional, individual, developmental, peer, and family factors that affect behavior and achievement. Parents are active participants in the dialogue. CAP teams also meet 4

to discuss individual student cases and schoolwide issues that grade-level teams are unable to address successfully. Schools participating in CAP support mental health by developing schoolwide approaches to the development of social skills and discipline. The CAP model was identified as a positive practice by the Montgomery County Council Blue Ribbon Task Force on Mental Health. In FY 2005, 29 schools are utilizing the CAP model. Three school psychologists and one school counselor provide direct training for the staff and families in these schools. In FY 2006, the budget includes the addition of 3.0 school psychologists and 3.0 pupil personnel workers, at a cost of $511,985. This added staff will train an additional 30 schools to implement the CAP model. Schools are in the process of being identified through collaboration with the community superintendents and principals based on well-defined selection criteria. A four-year systemwide implementation plan has been developed through which CAP will be implemented in all schools by the end of 2009. In the initial implementation of CAP, data collection was informal, and this voluntary approach has limited a consistent analysis of the program s effectiveness. However, trends in the schools that have implemented the process reveal that the disproportional representation of African American students in special education programs has decreased. Teachers report that they have improved their ability to activate and utilize problem-solving strategies. They also have witnessed improvements in classroom and schoolwide discipline and an increase in student timeon-task. Plans are under way to formalize CAP data collection in all schools. Additionally, the Office of Special Education and Student Services is partnering with the Office of Strategic Technologies and Accountability to develop data warehousing and analysis processes. This partnership enables accurate assessment of the benefits of CAP, critical analysis of student instructional achievement and behavioral growth, and the monitoring of reductions in disproportionality in special education. Bullying Prevention and Intervention: According to the Center for Mental Health Services Safe Schools/Healthy Students initiative, bullying is a pervasive problem in schools that can have a significant shaping influence on an individual student s academic success, personal growth, and mental and physical well-being, as well as the overall school environment. Unchecked bullying behavior may escalate into episodes of school violence affecting individuals, groups of students, and, in the most extreme cases, entire school buildings. Nationally, 38 percent of all school-age children have had some experience with a bully (National School Safety Center, 1994). Eight percent of students miss one day of class per month for fear of bullies (Bureau of Justice Statistics School Crime), and those who are bullied daily are five times more likely to be depressed and far more likely to be suicidal (Fight Crime Invest in Kids, September 2003). MCPS regularly participates in the national anti-bullying campaign, Take a Stand, Lend a Hand: Stop Bullying Now. In 2004, MCPS served as a local site for the national interactive teleconference and webcast. 5

Many schools have developed bullying prevention programs tailored to the needs of their school communities and are implementing interventions designed to stop bullying behaviors and support those affected by it. Schools that identify that bullying is occurring also can use CAP to analyze the extent of bullying behavior, determine why the behavior is occurring, and develop effective interventions. Many schools have adopted the Stop and Think Social Skills Program or Second Step to address bullying behavior. The Comprehensive School Counseling Program also has recommended lessons that teach appropriate social skills and equip students to activate assistance when help is needed. Currently, MCPS is examining several exemplary commercial anti-bullying programs critically to determine cost and program effectiveness. The Kids First Alliance Initiative: The Kids First Alliance (KFA) is a three-year grant initiative funded through the federal government s Safe Schools/Healthy Students Initiative. The project serves the 10 Gaithersburg Cluster schools and provides schoolwide prevention and intervention initiatives, including CAP described above and the Stop and Think social skills curriculum. The grant has allowed MCPS to strategically hire and place student services staff (school psychologists, school counselors, and school social workers) as coaches for CAP and Stop and Think, increase access to mental health services, and reduce ratios of students to mental health service providers. Schools report that KFA provides effective easy-to-use strategies for teachers to deal with instructional difficulties and problem behavior. Evaluation procedures for KFA have been developed and baseline and comparison school data is currently being collected. Identified mental health indicators are linked with school performance data to determine the effectiveness of the KFA model. Support Services for Emotionally Disabled Students: MCPS students identified as having an emotional disability receive specialized support services throughout the school day from trained special educators, school psychologists, and social workers employed by the school system. In addition, in 1997 at Rolling Terrace Elementary School a pilot mental health therapy program was initiated to provide clinical supports to emotionally disabled students. Based on the success of that program, the Montgomery County Child and Adolescent Clinic increased its services and also now provides six hours per week of in-school mental health at Georgian Forest Elementary School, and Julius West, Eastern, and Shady Grove middle schools. Comprehensive Health Education: Mental health is a key component of the MCPS comprehensive health education curriculum. Health education instruction is mandated by the Maryland State Department of Education for students in Grades K 8, and there is a 0.5 credit high school graduation requirement. The Maryland Voluntary State Curriculum for Health Education includes seven standards. Standard number one is Mental and Emotional Health: Students will demonstrate the ability to use mental and emotional health knowledge, skills, and strategies to enhance one's self-concept and one's relationship with others. Beginning in the early elementary grades, students start to identify the importance of dealing with feelings and getting along with others. In the upper elementary grades, they learn about stress, stress management, and conflict resolution. In middle and high school, students learn the basic principles of mental/emotional wellness and personal and social responsibility, stress management, depression awareness, and suicide prevention. Health education teachers work collaboratively with Department of Student Services staff to develop strategies that specifically address the needs of students in school. 6

Red Flags Middle School Program: Red Flags is a middle school program offered through the MCPS health education curriculum in collaboration with the Department of Student Services and the Montgomery County Mental Health Association. Red Flags is presented to eighth graders, staff, and parents to increase awareness of teenage depression and the symptoms associated with this concern. The three-day unit defines depression and describes its connection to health, wellness, and academic achievement; provides suggestions to students, staff, and families about what to do to activate support when they suspect someone is depressed; and specifies sources for help in the school and the community. Red Flags is currently being offered in 27 schools. Social and Emotional Learning: Social and emotional learning (SEL) is defined as the process of developing fundamental social and emotional competencies in children. MCPS school psychologists and school counselors are implementing these programs (e.g., Stop and Think and Second Step) in several schools. In order to enhance the academic achievement of students, schools must move beyond academic reform initiatives and embrace SEL as a means of supporting healthy social and emotional development. Core social and emotional competencies have been identified as fundamental and are emphasized in all SEL programs. Because SEL programming has been linked to positive outcomes for students, when implemented appropriately, it is important that these types of programs are available in MCPS. In the Community The Child Mental Health Interagency Work Group was tasked in 2003 with implementing the county s Mental Health Plan for Children and Youth. The School Mental Health Initiative began as an effort by the Child Mental Health Interagency Work Group toward the goal of increasing service capacity within the system of care for children and their families. The expansion of mental health supports in county schools continues to be a top priority for DHHS, other agency partners, and family representatives serving on the Child Mental Health Interagency Work Group. Services provided by the Department of Health and Human Services and other community partners are as follows: Linkages to Learning: Linkages to Learning (LTL) is a comprehensive DHHS program. LTL is a school-based collaboration among DHHS, MCPS, and contracted nonprofit, communitybased service providers. In addition to an array of social and family support services, LTL offers mental health programming that incorporates prevention and early-intervention services, including acculturation groups; social skills groups; individual, group, and family counseling; and case management. Currently, there are 24 LTL sites in Montgomery County in the Montgomery Blair, Albert Einstein, Gaithersburg, John F. Kennedy, Seneca Valley, Wheaton, and Rockville clusters, and the Northeast Consortium. Every two years, LTL staff examines the Free and Reduced-price Meals System (FARMS) data to identify possible sites for expansion of the program. Funding has been requested in FY 2006 for new sites at Weller Road and Wheaton Woods elementary schools. Community Kids: Wraparound services are those services provided through multiple agency coordination, integration, and alignment. SAMHSA grant-funded intensive wraparound support services are provided to children and youth with serious emotional disabilities and multiple service needs. These services ensure the development of a coordinated individualized service plan developed by a team driven by the family s needs and preferences. This approach has been 7

nationally researched and is demonstrated to reduce costly residential placements and allow children and youth with significant challenges to remain in the community with demonstrated success at home, school, and in the community. Emotional Disabilities Classroom Support Service: In 1997, Montgomery County s Child and Adolescent Clinic began offering intensive on-site services to students in emotionally disabled classrooms. These services have expanded from one to four school sites. Four clinicians serve 25 children weekly. Children and youth receiving these services have been able to improve their behavior and increase productive time in the classroom. Contracted Intensive Therapy Services (GUIDE, Family Services, etc.): Intensive therapy services are provided at selected school sites and include individual, group, and family therapy services; psychiatric evaluation; medication management; CAP team consultation; and teacher consultation. These services are typically supported through Medicaid billing and by DHHS funds. VI. DESIRED STATE There are many effective approaches being implemented within the schools and through public and private partnerships. Access to services and service delivery would be enhanced if communication, integration, and sustainability of these programs were closely coordinated. MHTF found that a successful model (The Triangle of Care, below) exists and is based on a nationally recognized, evidence-based successful schools model. This model is endorsed by the federal government in Early Warning Timely Response, SAMSHA, and supported by the County Council Blue Ribbon Task Force on Mental Health and the Montgomery County Children s Mental Health Plan. INTENSIVE INTERVENTIONS FOR A FEW INTERVENE EARLY FOR SOME CHILDREN A SCHOOLWIDE FOUNDATION FOR ALL CHILDREN The Triangle of Care Mental health programs and services aligned along the successful schools continuum of services have proven evidence of success. When all three service levels are implemented and aligned, students are available for learning, families are supported, teachers and principals are focused on instruction, and school climate is positively enhanced. Schools implementing this model have 8

higher academic achievement, fewer special education referrals, reduced discipline problems, and greater parent and teacher satisfaction. Primary Prevention: The base of the Triangle of Care represents a schoolwide foundation for all children. All schools need to promote effective teaching and learning in a caring climate that supports social behavior. Focused, Early Intervention: The middle level of the model provides resources for those children who require interventions beyond those provided in the foundation. These services are available during the school day. When the intervention is successful, the child becomes more open to the foundational supports identified above. Intensive Intervention: The top of the triangle represents what must be done to help children with the greatest need. Activities such as community-embedded, wraparound services are made available for those children. These services are often coordinated through the school but may be provided by other public or private organizations in the community. VII. THE GAP Although much already is being done to address our children s mental health needs, gaps still exist between the desired state described above and the current level of service provision. The following issues highlight the disparities that exist between where we are now and where we want to be. Awareness and Education: There is a need to educate all stakeholders regarding the link between mental health and academic achievement. In addition, school staff and parents need to become more familiar with the signs of mental illness so that they can recognize when interventions are necessary. Identification of Need: A comprehensive needs analysis would greatly enhance our effectiveness in addressing the mental health needs of our students. Although national data allows us to approximate the need, a countywide assessment will pinpoint specific areas where the need is greatest. This would facilitate the development of a focused plan that prioritizes the delivery of services to those children that need it most. Evaluation and Coordination of Programs and Services: Although many programs and services are currently being provided, we do not know if these services are necessarily the most appropriate ones or if they are achieving the desired results. It is important to develop a system for monitoring the results of the programs and to ensure that there is a match between what is needed and what is provided. Delivery of Service: Because funding is limited, it is imperative that services are not duplicated among agencies. If it is discovered that several agencies are providing the same service, we need to identify the most effective delivery model and eliminate any duplication. This will allow those funds to be applied to programs and services that are needed, but are not being delivered currently. 9

Access: In many cases, the community does not know what mental health programs and services are available or how to access them. This is especially true in those communities where English is not the primary language and there is a high incidence of poverty. There is a critical need for mental health services that are linguistically and culturally competent in order to serve our diverse community effectively. VIII. RECOMMENDATIONS The following recommendations will help close the gap and move us closer to the desired state of addressing the mental health needs of our students: 1. Raise awareness, educate all stakeholder groups, and update relevant MCPS policies and regulations to reflect the critical link between mental health and academic success. 2. Ensure that a full continuum of school/community mental health programs and services that are aligned with the national successful schools model are available to all students (from preschool through high school). Specifically: a) Continue support for successful mental health initiatives, including CAP, Kids First Alliance, the MCPS Safe Schools/Healthy Students grant initiative, and Linkages to Learning. b) Implement countywide anti-bullying approaches that provide school communities with the tools necessary to 1) determine if bullying is a problem; 2) educate students, staff, and the community about bullying; and 3) apply effective prevention and intervention models that minimize the effects and risks associated with bullying. c) Provide adequate staffing of school-based mental health professionals. When new schools open, align staffing with population growth and other known factors that positively influence mental wellness and academic achievement; include school psychologists, PPWs, school social workers, and school counselors in base staffing. 3. Maintain and expand critical public and private partnerships (e.g., DHHS, Juvenile Justice Services, Child Welfare Services, Collaboration Council, and the Mental Health Association) to maximize resource sharing and utilization of funding from outside sources to support school-based mental health. 4. Participate in a cooperative communitywide assessment of the mental health needs of the children of Montgomery County and update this assessment periodically. 5. Participate in the design and development of a multi-agency resource locater. Create mechanisms to share key need-to-know data regarding the mental health of children in Montgomery County. 10

IX. NEXT STEPS AND CONCLUSION Recognizing the complexity of the recommendations, the task force suggests that MCPS staff develop an implementation plan for the recommendations. This plan should identify specific action steps, a timeline, and the office responsible for ensuring completion. Once action steps are developed for the recommendations, additional feedback should be sought from larger contingents of stakeholders. This step is critical to ensure buy-in and facilitate a smooth and successful implementation. Addressing the mental health needs of our children in comprehensive ways is not an easy task, but it is necessary. In doing so, we must be certain to weave together approaches for the school, community, and home. As stated in UCLA s Mental Health Project Overview, Advancing mental health in schools is about much more than expanding services and creating full-service schools. It is about establishing comprehensive, multifaceted approaches that help ensure schools are caring and supportive places that maximize learning and well-being and strengthen students, families, schools, and neighborhoods. The task force supports the work that already is under way in the county. The efforts of our mental health professionals, including school staff and public and private providers, make a tremendous difference in the lives of so many children every day. Implementation of the task force recommendations will serve to enhance and strengthen the programs and services being provided and will add what is needed to complete the full continuum of services available to our children and their families. 11