Cue the Zoom on Baltimore

Weist, M. D., Stiegler, K., Cox, J., Vaughan, C., Lindsey, M., & Ialongo, N. (2010). The Excellence in School Mental Health Initiative: Final Report (pp. 1–41).


Last week I looked at School Mental Health procedures in Australia. I was really jazzed to learn that the sort-of unformed ideas floating around in my head for the last year a) was already fleshed out and b) ACTUALLY EXISTED. And they have for over a decade! But I wanted to do more research about how we are addressing School Mental Health a little closer to home. Preliminary research suggested that Maryland is the place to be for this sort of thing, so that’s where I looked. If we were on YouTube, this is where we’d zoom out of Phoenix and pan over to the East Coast. Cue the Zoom on Baltimore:

In this report, completed by the University of Maryland, Center for School Mental Health, the authors reviewed data collected over two and a half years as two specific schools implemented the Excellence in School Mental Health Initiative (ESMHI). According to the report, “The overall goal of the project was to demonstrate the potential for a full continuum of environmental enhancement, stakeholder involvement and evidence-based mental health promotion and intervention integrated into two schools serving students in grades Kindergarten through 8th grade” (Weist et al., 2010).

I realize reading that might invoke a little of what I experienced earlier this week. Are you thinking, “Um, what? I think I know all of those words, but I when I read that sentence they just kind of glide right under me …” Here’s a picture that might help from (of course!) our friends over at MindMatters in Australia:

The Excellence in School Mental Health Initiative involved programs and staff to support all levels of the triangle:

  • They developed and ran parent groups to improve parent involvement and relationships with teachers
  • They implemented Paths to PAX, a universal/school-wide prevention program
  • They provided professional development to teachers to improve understanding of mental and behavioral health
  • They provided small group interventions for students struggling with behaviors, also known as “early intervention strategies”
  • And mental health clinicians held individual/group therapy sessions with students.

Many schools around the country have parts of this triangle in place, but it is rather rare to see the entire continuum fully supported. The purpose of the project was to find how well all these pieces fit together when they were all in place, including things like the parent involvement. The authors specifically noted that this study could not be used to make causal conclusions (i.e. saying that if your school does these things, it will get the same results), but could be used to make recommendations for the future or for other schools. The authors used descriptive, qualitative and quantitative data to both create and evaluate the initiative. This included a variety of demographic and school data, such as enrollment, attendance, discipline, etc.; surveys and interviews with students, staff, parents, and community members; treatment data collected by mental health providers; case studies; and focus groups.

The authors found that there were many gains, including better parent-school relationships, students receiving more mental health care, and improved teaching strategies in regards to behavior in the classrooms. They also found that while there are many reasons  to give mental health care within the school setting, there are a lot of things that can get in the way. Things like high teacher turnover rates, teachers being overwhelmed with everything else they are expected to do, and variable support from administration all impact the implementation and effectiveness of such programs. BUT!!! They did find that having significant supports – like great funding (described below), buy-in from higher levels, and University support – made it possible to face challenges head-on and overcome many barriers.

I was simultaneously disappointed and pleased with the results. This initiative had funding from a lot of different places, including the City of Baltimore, the University of Maryland, the Baltimore School District, and several public and private organizations. It seems like it would be a dream! But even with all that they ran into many of the same problems I have experienced in trying to carry out different layers of the triangle above. For example, I’ve been at a few schools that buy new programs to address the widest level of the triangle (Whole School Environment). Everyone is gung-ho for the first few weeks, but implementation falls off after a month or two. I would have thought that with so many resources and support staff promoting this initiative for 2.5 years, there would have been more buy-in and compliance from staff. But in reality, they dealt with the same problems I have seen, and for the same reasons: too many other things to focus on, too overwhelmed, high teacher mobility, lack of administrative support, and the program not meeting perceived expectations. While this was disappointing, it was also refreshing to know that simply implementing a new program or jumping on the next bandwagon of a particular intervention is not going to change the school culture. To really make a lasting impact on the school culture, it needs to happen slowly and over a long time.

I did have more criticisms of this report than I did last week’s. For the most part, the report was well-written and easy to follow. They used language that was easy for someone in the educational field to understand, and they gave so much data to support their conclusions. The difficulty was that there was So. Much. Data! And it was all in paragraph form, which meant it was nearly impossible to really get a good handle on it. They were using data from 2 schools and gave in-depth analysis of each type of data from each school. If it had been presented with visuals, like graphs and charts, it would have been so much easier to grasp. Throughout the report they did reference graphs and charts in the appendices… but there weren’t actually any appendices at the end. And the Appendices link provided in the Table of Contents was no longer active. I think I would have been better able to make connections to my own school if I could have seen the data differently.

As I am collecting these articles and reports, I am building this dream world in my head. I want these things in Phoenix, in Arizona. I want to be a part of building them, of making them actually happen. I want to see students in their classrooms more because they’re getting in trouble less. I want to see students that have a better quality of life because they understand what to do in the classroom or in social situations and they have the skills to do it. I want to see teachers who are less depressed and stressed out. I want to be in classrooms where teachers are able to focus on the things that made them want to be a teacher, not all the extraneous junk that keeps getting piled on their plates. (OK, mental health initiatives probably won’t actually affect that, but hey – it’s my dream world, I can make it look however I want!)

I really do want to see some of these initiatives in play, though, to see what they look like when they’re actually happening. Does it look, feel, and sound like any other school? Are culture changes only noticeable if you’re an insider, privy to all the inner-workings of a school? Or is it tangible? Noticeable to everyone who walks in? Do students and teachers enjoy being there because of the positive atmosphere? Or is it still a school, where kids complain about homework and teachers count down the days to summer break? I don’t have the answer yet, but I am doing what I can to find out!

Weist, M. D., Stiegler, K., Cox, J., Vaughan, C., Lindsey, M., & Ialongo, N. (2010). The Excellence in School Mental Health Initiative: Final Report (pp. 1–41).

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Lead School Psychologist at Peoria Unified School District

Janine Fischer is the lead school psychologist for the Peoria Unified School District. She is currently pursuing her Educational Doctorate degree in Educational Leadership and Innovation through Arizona State University. Her passions in life are kids, mental health, and changing the world by making kids’ lives better.

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