The document discusses building effective student mental health identification and response systems in schools, including improving early identification through universal screening, developing multi-source referral systems using multidisciplinary teams, and establishing information sharing agreements to monitor intervention access and effectiveness. Effective referral pathways clearly define roles and responsibilities, share information efficiently, and make intervention decisions collaboratively with the priority being student wellbeing. The presentation also provides an overview of the School Mental Health Referral Pathways toolkit for establishing comprehensive systems.

1. 1203 Preservation Park Way, Suite 302 Oakland, CA 94612 | Tel: 510-268-1260 | schoolhealthcenters.org
November 13, 2019
SCHOOL-BASED MENTAL
HEALTH
BEST PRACTICE SERIES:
Building Effective Student
Mental Health Identification
& Response Systems

2. The California School-
Based Health Alliance is
the statewide
non-profit organization
dedicated to improving
the health & academic
success of children &
youth by advancing health
services in schools.
Learn more:
schoolhealthcenters.org
Putting Health Care in Schools

3. • Conference
registration discount
• Tools & resources
• Technical assistance
Sign up today:
bit.ly/CSHAmembership
Become a
member, get
exclusive benefits

4. California School-Based Health Conference
May 14-15, 2020 | Sacramento

5. The views, opinions, and content
expressed in this presentation do not
necessarily reflect the views, opinions, or
policies of the Center for Mental Health
Services (CMHS), the Substance Abuse
and Mental Health Services
Administration (SAMHSA), or the U.S.
Department of Health and Human
Services (HHS).
DISCLAIMER

6. Building Effective Student Mental Health
Identification and Response Systems
School Mental Health Referral Pathways
Wednesday, November 13
California School-Based Health Alliance / Pacific Southwest MHTTC
School-Based Mental Health Best Practices Training Series
Meagan O’Malley, PhD, NCSP
Associate Professor,
CSU Sacramento
Meagan.omalley@csus.edu

7. Disclaimer 1
The views, opinions, and content expressed in
this presentation do not necessarily reflect the
views, opinions, or policies of the Center for
Mental Health Services (CMHS), the Substance
Abuse and Mental Health Services
Administration (SAMHSA), or the U.S.
Department of Health and Human Services
(HHS).

8. Pacific Southwest Mental Health Technology Transfer
Center (MHTTC)

9. Our Role
We offer a collaborative MHTTC model in order to provide training, technical assistance (TTA), and
resource dissemination that supports the mental health workforce to adopt and effectively
implement evidence-based practices (EBPs) across the mental health continuum of care.
Our Goal
To promote evidence-based, culturally appropriate mental health prevention, treatment, and
recovery strategies so that providers and practitioners can start, strengthen, and sustain them
effectively.
Pacific Southwest Mental Health
Technology Transfer Center (MHTTC)

10. Services Available
No-cost training, technical assistance, and resources
Pacific Southwest Mental Health
Technology Transfer Center (MHTTC)

11. Central Valley School-based Health
Coalition
• Part of the CA School-based Health Alliance:
schoolhealthcenters.org
• Quarterly Meetings
• Next meeting Friday, Dec 13th at Madera South High School
• Four Part Mental Health Training Series
• Next training Wednesday, Dec 4th at the Madden Library at Fresno State:
• Suicide Assessment & Intervention in School Settings
• Annual Statewide Conference and Central Valley Trauma/MH
Convenings
• Members in counties from San Joaquin to Kern (and beyond)
• CV has 35 SBHC’s of the 277 in CA

12. Experience…
• Working as a school psychologist in rural
and urban schools in the United States
• Designing school climate and school mental
health measurement and intervention
studies
• Overseeing school climate and mental
health-related technical assistance to
schools throughout the US
• Teaching school psychology graduate
students about prevention science

13. TODAY’SPLAN
What When
Welcome, Introduction, &
Orientation
1:00 -1:30 p.m.
Identify, Treat, and Monitor for
Social, Emotional, and
Behavioral Wellbeing: Key
Considerations and Tools
1:30 – 3:30 p.m.
Reflections, Take-aways & Close 3:30 – 4:00 p.m.

14. Disclaimer 2
Systems are complex and varied.
Today’s workshop provides an
overview of best practice
considerations for referral
practices.

15. What relationship to
you have to referral
pathways?
What information
do you need to feel
prepared for your
work?
What are
you
concerned
about?
Elbow partner
What’s your
name? Where
are you from?
What are
you curious
about?
Excited for
or about?

16. WHY we do what we do…
• We care about mental health
• We care about the wellbeing of
children and youth
• We believe in the value of
education and the necessity to
be mentally and emotionally
well in order to learn
• We are committed to service
• We are committed to
democratic access to care

17. We are committed for the
right reasons, and together
we face so many
challenges…

18. Many children are suffering…
• One in six school-aged youth
experiences impairments in life
functioning due to a mental illness (APA
2016)
• Half of mental illnesses emerge during
or before adolescence, and three-
quarters emerge before the age of 25
(Kessler et al, 2007)
• Among students in grades 9-12 in the
U.S. during 2013-2014, 17.0% of
students seriously considered
attempting suicide, and 8.0% of
students attempted suicide one or more
times in the previous 12 months. (Kann
et al., 2004)

19. And child-serving systems are
not meeting their needs…
• Fewer than half of young people with
mental illness receive adequate
treatment. (Kessler et al., 2004)
• Having a mental illness is associated with
being pushed out of school through
suspension, expulsion, and credit
deficiency (Kang-Yi, Maddell, Hadley,
2013)
• 50 to 75 percent of the 2 million youth
encountering the juvenile justice system
meet criteria for a mental health disorder
(Underwood & Washington, 2016)

20. Fortunately, we know that
prevention works.
• Early detection of mental health concerns leads to improved
academic achievement and reduced disruptions at school.
• The earlier mental health concerns are detected and
addressed, the more likely the young person is to avoid the
onset and/or progression of a mental illness.
(Baskin et al., 2010)

21. If we agree that
….we come to the work for the same reasons,
….many of the children we serve are suffering,
….and our current systems aren’t serving them
well
….yet there are signs that we could do it better
Then it’s time to rethink….

22. Rethink….how we see our
roles
From Arborist
To Forester

23. Rethink….the role of the
school
Intervention
Catalyst
• Schools can collect various forms of data to support the identification
of students requiring intervention.
Intervention
Provider
• Schools can also take a role in social-emotional and behavioral
service delivery and effectiveness monitoring by providing
interventions within the school setting.
Service
Coordinator
• Schools can support the coordination of services by systematically
communicating with outside providers (e.g., psychologists) regarding
their delivery and effectiveness of treatments within the community.
Slide modified from original by L Wolf-Prusan

24. Guiding our work
this afternoon:
NITT School
Mental Health
Referral Pathway
Toolkit (2015)
http://tinyurl.com/
SMHRPtoolkit

25. School
Mental
Health
Referral
Pathways
The series of actions or steps
taken for identifying and
treating a youth with a
potential mental health issue.
25
Formalized &
effective systems
that link youth to
mental health
service providers
and related
supports.

26. What are School Mental Health Referral
Pathways (SMHRPs)?
Effective referral pathways share similar characteristics:
 They define the roles and responsibilities of all partners in a system.
 They clearly articulate procedures for managing referrals within and
between partners.
 They share information across partners in an efficient manner.
 They monitor the effectiveness of evidence-based interventions
provided by and with all partners within a system.
 They make intervention decisions collaboratively with a priority on what
is best for and with young people and their families.
(p.11)

27. Orientation to the Toolkit
Chapter 1: Laying the foundation: Assessing your
current process provides tools and techniques for
establishing referral management systems; establishing a
problem-solving team; and mapping school- and community-
based mental health resources across MTSS tiers.
Chapter 2, Building Effective Partnerships, describes
strategies for collaborating with external partners to develop
robust prevention and intervention supports at all three MTSS
levels.
Chapter 3, School-Based Problem-Solving to Promote
the Mental Health of Young People, gives an in-depth
description of the problem-solving process that school-based
teams can use to create individualized intervention plans for
young people whose social, emotional, and behavioral needs
extend beyond the universal, Tier 1 supports provided in the
general classroom environment.
Chapter 4, Cultural and Linguistic Considerations,
provides an overview of cultural and linguistic considerations
for building effective referral pathways.

28. What
needs to
happen to
reduce all
types of
social,
emotional
, and
behaviora
l
problems
at school
• Multisource identification procedures
• Improving early identification through universal and targeted
screening for social and emotional wellbeing
IDENTIFY
• Improve multi-source referral systems using multidisciplinary
teams
• Improve school-based access to licensed and credentialed
mental health providers
TREAT
• Develop information sharing agreements across agencies to
monitor intervention access and effectiveness
MONITOR

29. What
needs to
happen to
reduce all
types of
social,
emotional
, and
behaviora
l
problems
at school
• Multisource identification procedures
• Improving early identification through universal and targeted screening
for social and emotional wellbeing
IDENTIFY
• Improve multi-source referral systems using multidisciplinary teams
• Improve school-based access to licensed and credentialed mental
health providers
TREAT
• Develop information sharing agreements across agencies to monitor
intervention access and effectiveness
MONITOR

30. Do All Paths Leads to Help?
X

31. How would these scenarios play out in your
school?
I am a 3rd grade teacher. A student in my class recently started having
difficulty managing his emotions in class. Without apparent provocation
he will begin to cry, put his head on the table, and refuse to respond to
me or other students. Where do I go for help?
I am the school’s bus driver. A student recently moved to the district
and started riding my bus. I notice students teasing her about her
clothes and she is often tearful. She also seems to miss school a lot; at
least once every couple of weeks she is not on my bus. Where do I go
for help?
I am in the 9th grade and my friend texted me this morning before
school that she wanted to kill herself. I don’t think she means it, but I
am not sure I if should tell an adult. Where do I go for help?

32. Improving our referral systems:
Key Guiding Questions
• Do we have an organized system for eliciting and channeling
referrals?
• Who needs to know about our system? Do they know about
our system?
• Is our system flexible and efficient enough to encourage
referrals from different sources?
• Do we have an organized way of collating and examining
referrals?
• Are we confident our system is capturing every child that has a
need?

33. Multiple Methods of Early Identification
• Teacher, parent, peer, and self
referral
• Pediatric setting referral
• Problem solving team data
• SARB Boards
• SST Teams
Student
needing
support
Teacher
Peer
Family
member
School
counselor
Nurse
Assistant
principal
PSW
Community-
Based
Mental
Health
Provider
School
Psychologist
Other?
What other multidisciplinary
teams examine student-
related information on your
campus? How networked is
the data they collect and
review?

34. Forms, Forms, Forms:
Characteristics of Effective
Identification Forms
• High quality identification forms (aka “consultation forms”, “referral
forms”:
• Are easily found and accessed
• Are uncoupled from specific referring problems
• Limit the reporting burden placed on the referee
• Do not ask referee to diagnose, only to describe
• Are easy and quick to complete
• Are written in plain language
• Are translated to primary languages used by the
referee
• Involve 360-degree communication with the referee

35. Referral Form Activity
• With your tablemates, review the
referral forms provided, note
their strengths and opportunities
for improvement.
• Consider:
• Do I know where to find my
agency’s referral forms? If not,
who would I ask first?
• What improvement suggestions do
I have for my agency’s referral
forms? To whom do I send my
recommendations?

36. Teacher Referral Strategies
alone lead to familiar
challenges…
• Refer-Test-Place models
• teachers differ in their ability to work with students
• perceptions of “teachability”
• teachers not trained to know how problematic
behavior must be prior to referral
• Children’s behavioral/emotional problems may
be under-referred and/or referral is delayed
(Lloyd, Kauffman, Landrum, & Roe, 1991; Severson et al., 2007; Tilly, 2008; Walker et al., 2000)
Slide Source: Katie Eklund, PhD

37. Teacher Referral Strategies
alone lead to familiar
challenges…
Some of problem behavior
may be linked to classroom
climate and behavior
management & may
represent a systemic
problem rather than an
individual one
More subtle aspects of
mental health problems may
go unidentified (i.e.,
“internalizing”)
Referral may
disproportionately select for
students who have
disruptive behavior (i.e.,
“externalizing”)
Referral may not occur until
the problem has reached a
point where it interferes with
learning, thereby reinforcing
a wait-to-fail model

38. Universal Screening
• For Today:
• What is the purpose of universal screening?
• What are characteristics of quality instruments for
universal screening?
• For Another Time:
• What are key universal screening procedures?
• How to manage consent procedures?
• How to assign to intervention based on screening
results?

39. Who can provide screening
information?
• School pragmatics suggest utilizing:
• Parent ratings for Pre-K and K entry
• Primary use with PK and K-12
• Teacher ratings for younger students
• Primary use in PreK -6; Secondary use with 7-12
• Self-reports with secondary school students
due to their increasing awareness of their own
psychological experiences
• Primary use with 3-12
Slide Source: Katie Eklund, PhD

40. When should we screen?
• School entry (Spielberger, Haywood, Schuerman, & Richman,
2004)
• Critical transitions (Stoep et al., 2005)
• Certain grades (Catron & Weiss, 1994)
• Differential developmental time periods (Najman et
al., 2007)
• Number of times per year
Slide Source: Katie Eklund, PhD

41. What is a good screener?
Good
Screener
Quick & Cheap
Key Variables
Strengths AND
Weaknesses
Psychometrically
sound
Slide Source: Katie Eklund, PhD

42. Universal Screening Tools
• Student Risk Screening Scale* (Drummond, 1994)
• Strengths & Difficulties Questionnaire (Goodman, 2001)
• BASC-3 Behavioral and Emotional Screening System*
(Kamphaus & Reynolds, 2015)
• Social, Academic, and Emotional Behavior Risk
Screener* (Kilgus & von der Embse, 2014)
• Social Emotional Health Survey-Secondary* (Furlong,
Dowdy, & Nylund-Gibson, 2019)
Slide Source: Katie Eklund, PhD

43. Source: SAMHSA (2015). School Mental Health Referral Pathways Toolkit.

44. ODR
Data

45. SWIS
Data
Example

46. Data Collation/Aggregation
• Social, emotional, behavioral
• Discipline data: Office Discipline Referrals
• Paper referrals, multi-source
• Electronic referrals, multi-source
• Universal screening data
• Attendance
• Academic
• Criterion referenced
• Formative and summative

47. Data Aggregating Tools

48. Student
Grade
Gender
Ethnicity
STEEP
Reading
(Winter)
STEEP
Reading
(Spring)
ReadingBM#1
ReadingBM#2
ReadingBM#3
STEEP
Math
(Winter)
STEEP
Math
(Spring)
MathBM#1
MathBM#2
MathBM#3
Attendance
(Fall)
Attendance
(Spring)
ODR(Fall)
ODR(Spring)
BehaviorRisk
John 8 1 5 27 37 83.3 76 66.7 45 45 40 20 46.7 7 3.5 0 0 1
Billy 8 1 1 35 35 86.7 88 86.7 143 142 84 80 90 4 2.5 0 0 0
Sarah 8 2 2 37 33 90 72 93.3 102 45 72 64 60 1 4 0 0 0
Eric 8 1 2 39 39 83.3 96 73.3 171 173 64 68 56.7 4 7 1 0 0
Dirk 8 1 1 18 25 85 89 99 107 114 82 83 99 0 1 1 0 1
Jennifer 8 2 1 25 29 80 80 66.7 110 107 76 84 76.7 1 9 0 0 0
Melissa 8 2 1 14 15 40 24 33.3 31 41 56 32 36.7 5 15 0 0 1
Frank 8 1 6 6 15 43.3 40 40 53 40 56 36 50 3 5 1 0 2
Joshua 8 1 1 14 20 90 100 100 50 53 64 84 93.3 0 3 0 0 0
Patrick 8 1 1 21 17 56.7 64 73.3 88 85 68 52 56.7 15 14.5 0 0 0
Justin 8 1 1 28 32 93.3 92 80 74 71 92 92 86.7 4 4 0 0 0
Moriah 8 2 5 23 23 56.7 88 46.7 90 99 68 40 80 19 12.5 0 0 0
Henry 8 1 5 23 22 76.7 76 86.7 125 136 68 60 73.3 8 1.5 0 0 0
Ellie 8 2 1 29 30 56.7 68 46.7 133 104 60 36 56.7 0 9 0 0 0
Kevin 8 1 1 26 26 100 84 73.3 119 95 72 52 73.3 2 5 0 0 0
Samson 8 1 1 30 34 80 80 66.7 138 122 84 88 80 4 9 0 0 0
Sergio 8 1 1 4 10 30 16 33.3 25 30 24 24 20 9 4.5 2 3 2
Tabitha 8 2 1 15 17 80 72 73.3 31 39 80 80 93.3 20 19 0 0 0
Rick 8 1 1 16 21 56.7 84 46.7 87 100 64 52 43.3 4 6.5 0 0 0
Marjorie 8 2 1 36 40 83.3 92 80 201 177 92 92 96.7 2 6 0 0 0
Samantha 8 2 5 23 18 50 60 60 44 57 44 28 40 2 15.5 1 1 0

49. What
needs to
happen to
reduce all
types of
social,
emotional
, and
behaviora
l
problems
at school
• Multisource identification procedures
• Improving early identification through universal and targeted screening
for social and emotional wellbeing
IDENTIFY
• Improve multi-source referral systems using multidisciplinary teams
• Improve school-based access to licensed and credentialed mental
health providers
TREAT
• Develop information sharing agreements across agencies to monitor
intervention access and effectiveness
MONITOR

50. 1.
2.
3.
4.
5.6.

51. Stage 1:
Establishing
a Referral
Network
 Are systems in place to manage
all types of referral concerns?
 Are all sources of identification
data integrated into a single
system?
 Are referral systems formalized?
 Does a collaborative structure
exist to manage referrals?
 Are all individuals who might
make a referral aware of the
referral process?
 Are referral systems sensitive to
developmental, cultural, and
linguistic diversity?

52. Stage 2:
Manage
Referral
Flow
 Does the problem-solving
team effectively collect initial
referrals from all sources?
 Does the problem-solving
team effectively expand on
initial referrals?
 Does the problem-solving
team have defined decision
rules?
 Does the problem-solving
team have a record-
management system?

53. DEFINING ROLES &
RESPONSIBILITIES
How can schools best build effective
partnerships with other organizations
to support the mental health of
school-aged young people?

54. Defining Roles
and
Responsibilities
Bring stakeholders together –
may include school personnel,
family members, youth,
evaluators, parks and
recreation, juvenile justice,
social service providers
Consider type of partnership
(next slide) and differences in
terminology, confidentiality and
information sharing, processes
in diagnosing mental health
needs and providing services,
licensure, and funding

56. Partnership Activity

57. Memoranda of
Understanding:
Common
Components
✓ Parties to the collaboration
✓ Purpose (goals and objectives)
✓ Collaborative functions (assessment, referral, direct service)
✓ Roles and responsibilities of mental health clinicians
✓ Supervision responsibility of community agency partner
✓ Roles and responsibilities of the school
 Miscellaneous procedures (leave, reporting of hours, sign-in)
 Legal considerations (confidentiality of records, disclosures)

58. Sharing of Information
Critical to share information, but must adhere to FERPA and HIPAA (as applicable)

59. Want more information on
data sharing?
11/19: HIPAA/FERPA Refresher + New
Resource!
Tuesday, November 19th, from 11am-12pm: Join us for a
refresher webinar to review the basics of HIPAA and FERPA
and see examples of how sharing student/patient information
can appropriately happen under each. This presentation will
focus on substance use case studies and the recently launched
web resource, A California Guide for Sharing Student Health
and Education Information - coming soon in early November.
Presenter: Rebecca Gudeman, JD, MPA; Senior Director,
Health; National Center for Youth Law
https://www.surveygizmo.com/s3/5273798/HIPAA-FERPA-
Refresher?mc_cid=22c5a6ba8c&mc_eid=739865543b

60. Tracking Referrals and Monitoring
Treatment Progress
• Develop systems for electronic data sharing and
tracking with appropriate security precautions
• Assess outcomes by deciding:
• What to measure
• How to measure intervention effectiveness
• Level of change expected
• How often to measure
• How to share effectiveness information
*Toolkit includes Resources for Identifying
Treatment Monitoring Systems and
Sample Software Systems for Monitoring Progress

61. Example of a Referral
Database
• Requires only student
initials and ID number
to decrease probability
of confidentiality
breaches
• Person making referral
makes
recommendation for
either school or
community-based
services
• Conditional branching
determines which
questions will then
follow
Source: Steve Kilgus. PhD

62. School-based Recommendations Community-based Recommendations
Source: Steve Kilgus. PhD

63. • All referrals are automatically logged in a
Google Sheet (which only those LEA or SEA
officials with permission can access)
Source: Steve Kilgus. PhD

64. • Tracking the number of referrals that actually
resulted in service provision
• Provider Response Form
• Google Form
• Link to form sent to service providers
• Providers respond with information regarding
service delivery
• Cross referencing these with Component 2 referrals
allows for calculation of service delivery
percentages
Source: Steve Kilgus. PhD

65. • LEA and SEA officials (with access) can
prepopulate form, resulting in a individualized
link that is then sent to the service provider
Source: Steve Kilgus. PhD

66. • Provider indicates:
• If services were
provided
• And if so, what services
were provided
• Form can be modified
to track additional
information
• Treatment frequency
• Treatment duration
• Progress toward goals

67. • All provider responses are automatically
logged in a Google Sheet (which only those
LEA or SEA officials with permission can
access)
• Separate tab within the same spreadsheet where
school referrals are logged
Source: Steve Kilgus. PhD

68. • LEA and SEA officials will receive email
notifications each time school referral or
provider response is received
Source: Steve Kilgus. PhD

69. • All referrals are automatically logged in a Google Sheet (which
only those LEA or SEA officials with permission can access)
Source: Steve Kilgus, PhD

70. Effective
Referral
Manage
ment
Systems
Coordinated supports provided through
multiple partner agencies
• Law enforcement, county/public mental health,
private mental health providers
Cross-agency management of crisis
lines, tip lines, social media aggregators,
and web-based monitoring software
• Safe to Tell, Colorado
• OK2SAY, Michigan
• GoGuardian
• Securely
• Gaggle

71. Stage 3:
Map
Resources
 Has the team identified all
school and community
resources available to them?
 Has the team examined the
breadth and quality of
interventions available at the
school?
 Has the team examined
issues related to access to
community-based resources?

73. Tier 1
Non-profit community-based agency or
university center consults with school on
implementation and evaluation of positive
behavioral interventions and supports
Tier 2
Private mental health clinician
contracted to provide
targeted skill training to small
groups
Tier 3
Multisystemic
therapy
RESOURCE
MAPPING
ACTIVITY

74. What
needs to
happen to
reduce all
types of
social,
emotional
, and
behaviora
l
problems
at school
• Multisource identification procedures
• Improving early identification through universal and targeted screening
for social and emotional wellbeing
IDENTIFY
• Improve multi-source referral systems using multidisciplinary teams
• Improve school-based access to licensed and credentialed mental
health providers
TREAT
• Develop information sharing agreements across agencies to monitor
intervention access and effectiveness
MONITOR

75. Evaluate
Intervention
Effectiveness
 What will it look like when this student no longer
experiences the problem for which they were
referred?
 Does the problem-solving team collect process
data?
 Does the problem-solving team collect outcome
data?
 Does the problem-solving team monitor
intervention progress?
 Does the problem-solving team request
intervention effectiveness information from
community partners?
 Does the problem-solving team request feedback
from the student or his or her family about the
intervention experience?
 Has the problem-solving team adopted systems
for tracking response to intervention?
 Does the problem-solving team report
intervention effectiveness information to
stakeholders?

76. A Note on Measuring
Treatment Effectiveness

77. SMHRPs
Key
Questions
Where are
we in the
work?
1. How can schools build effective
systems for matching
students referred for social,
emotional, or behavioral
concerns with high-quality
interventions that meet their
needs?
2. How can schools build effective
problem-solving teams?
3. How can problem-solving teams
self-assess their effectiveness
to continuously improve?

78. Asset mapping like
systems or connected
practices in place
• RTI
• PBIS/MTSS
• YMHFA
• Other
Stakeholder
experiences
• What do students
understand about
the referral
process?
• What do teachers
understand?
• Administration
understand?
• Community mental
health partners?
• State agency
partners?
• Family/guardians?
Consensus
• What push back
might we predict,
and why?
• What
interdependent pay
off might we
message, and how?
78

79. KEY
QUESTIONS
FOR US
What are strategies that might ensure school
leaderships’ excitement for these partnerships?
What is your role in establishing and then
maintaining these partnerships?
What push back do we foresee regarding: Defining
roles & responsibilities, Sharing information and
monitoring progress across systems, Planning for
transitions between levels of care

80. Integrating Our Work

81. Integrating our Work:
Reviewing this morning’s content
YODA QUESTIONS (3-5) C3-PO + R2D2 ANSWERS

82. Green, yellow,
red lights
• What are some of the challenges
we face? In our own practices and
belief systems? What needs to be
disrupted?
• Now after our learning, what might
we need to be more intentional
about when it comes to leading and
managing school mental health
referral pathways?
• What should we keep doing? Start
doing? What excites us?

83. Closing

84. Our Learning Reflections
Ideas (what do you think?)
Challenges (what concerns you?)
Commitments (what will you do?)

85. Connect with
Me!
Meagan O’Malley, PhD, NCSP
Meagan.omalley@csus.edu
530-574-0860

86. Join us for the rest of the
ISF West Coast Party!
Interconnected Systems Framework (ISF) 201:
When School Mental Health is Integrated
Within an MTSS - What's Different
Tuesday, December 10
6-7 p.m. ET / 3-4 p.m. PT / 12-1 p.m. HT
Register: https://tinyurl.com/MHTTC-ISF-201
Interconnected Systems Framework (ISF) 301:
Installing an Integrated Approach
Tuesday, January 21
6-7 p.m. ET / 3-4 p.m. PT / 12-1 p.m. HT
Register: https://tinyurl.com/MHTTC-ISF-301

87. Thank you for attending!
Please take a few minutes
to give us your feedback.

88. References & Resources
• Algozzine, B., Barrett, S., Eber, L., George, H., Horner, R., Lewis, T., Putnam, B., Swain-Bradway, J., McIntosh, K., & Sugai, G
(2014). School-wide PBIS Tiered Fidelity Inventory. OSEP Technical Assistance Center on Positive Behavioral Interventions and
Supports
• Algozzine, B., Barrett, S., Eber, L., George, H., Horner, R., Lewis, T., Putnam, B., Swain-Bradway, J., McIntosh, K., & Sugai, G
(2019). School-wide PBIS Tiered Fidelity Inventory. OSEP Technical Assistance Center on Positive Behavioral Interventions and
Supports. www.pbis.org.
• Arnault, D. S. (2009). Cultural determinants of help seeking: A model for research and practice. Research and Theory for Nursing
Practice: An International Journal, 23(4), 259-278.Hart, R. (1992). Children's participation. Florence, Italy: UNICEF International
Child Development Centre.
• Banks, T., & Obiakor, F. E. (2015). Culturally Responsive Positive Behavior Supports: Considerations for Practice. Journal of
Education and Training Studies, 3(2). doi: 10.11114/jets.v3i2.636
• Jackson, S., Walker, J. S., & Seibel, C. (2015). Youth & Young Adult Peer Support: What Research Tells Us About its
Effectiveness in Mental Health Services. Portland, OR: Research and Training Center for Pathways to Positive Futures, Portland
State University.
• de Jong, J. T. V. M. (2007). Traumascape: an ecological–cultural–historical model for extreme stress. In D. Bhugra & K. Bhui
(Eds.), Textbook of Cultural Psychiatry (pp. 347-363). Cambridge University Press.
• Harris, J., Davidson, L., Hayes, B., Humphreys, K., LaMarca, P., Berliner, B., Poynor, L., & Van Houten, L. (2014). Speak Out,
Listen Up! Tools for using student perspectives and local data for school improvement (REL 2014–035). Washington, DC: U.S.
Department of Education, Institute of Education Sciences, National Center for Education Evaluation and Regional Assistance,
Regional Educational Laboratory West. Retrieved from http://ies. ed.gov/ncee/edlabs.
• McPhee, Kathryn M. and Givhan, Kiarra, "PBIS teams perceived connections between culture and PBIS implementation" (2016).
Georgia Association for Positive Behavior Support Conference. 25.
https://digitalcommons.georgiasouthern.edu/gapbs/2016/2016/25
• NITT School Mental Health Referral Pathway Toolkit (2015): http://tinyurl.com/SMHRPtoolkit
• Stuart, J. (2007). The culture of trauma: A personal perspective. Teacher Education Journal of South Carolina, 13-17.
• Weist, M. D., Garbacz, S. A., Lane, K. L., & Kincaid, D. (2017). Aligning and integrating family engagement in Positive Behavioral
Interventions and Supports (PBIS): Concepts and strategies for families and schools in key contexts. Center for Positive
Behavioral Interventions and Supports (funded by the Office of Special Education Programs, U.S. Department of Education).
Eugene, Oregon: University of Oregon Press.

89. Pacific Southwest MHTTC
Contact Info
Email: pacificsouthwest@mhttcnetwork.org
Phone: (844) 856-1749
Website: https://mhttcnetwork.org/pacificsouthwest
Join the PacSW MHTTC Newsletter!
https://tinyurl.com/pacsw-mh-news
Let us know about your
TTA needs and topic interests.
www.surveymonkey.com/r/MHTTCneedsassessment

90. Thank you.
SAMHSA’s mission is to reduce
the impact of substance abuse and
mental illness on America’s communities.
www.samhsa.gov
1-877-SAMHSA-7 (1-877-726-4727) ● 1-800-487-4889 (TDD)

91. schoolhealthcenters.org
info@schoolhealthcenters.org
schoolhealthcenters
sbh4ca
sbh4ca
STAY CONNECTED
1203 Preservation Park Way, Suite 302 Oakland, CA 94612 | Tel: 510-268-1260 | schoolhealthcenters.org
Molly Baldridge
mbaldridge@schoolhealthcenters.org
Peter Le
ple@schoolhealthcenters.org
Tracy Mendez
tmendez@schoolhealthcenters.org