Mental Health Planning and Mental Health Planning and Evaluation Template -- Evaluation Template --
ONLINEONLINETJ Cosgrove, LICSWTJ Cosgrove, LICSW
Public Health – Seattle & King CountyPublic Health – Seattle & King County
Laura Hurwitz, LCSWLaura Hurwitz, LCSWDirector, School Mental Health ProgramsDirector, School Mental Health Programs
Objectives of WebinarObjectives of Webinar
Participant will be able to…assess whether the on-line Mental Health
Planning and Evaluation Template is an appropriate tool for your setting.
learn the steps for using the on-line Mental Health Planning and Evaluation Template.
learn how the on-line Mental Health Planning and Evaluation Template can be used in a quality improvement process.
MHPET PurposeMHPET Purpose
Enhance the evaluation of mental health services in the SBHC and/or in any school setting
Improve mental health practices in the SBHC and/or in any school setting
Collect data for school mental health advocacy and technical assistance efforts at NASBHC
SBHC Staffing ModelsSBHC Staffing Models(N=1235)(N=1235)
Unknown4%
Primary Care-Mental Health
34%
Primary Care Only31%
Primary Care Mental Health
Plus31%
Mental Health Services in SBHCs With (n=655) Mental Health Services in SBHCs With (n=655) and Without (n=277) Mental Health Providersand Without (n=277) Mental Health Providers
0 10 20 30 40 50 60 70 80 90 100
*Crisis Intervention
*Grief and Loss Therapy
*Psycho-education
*Assessment
*Screening
*Mental Health Diagnosis
*Brief Therapy
*Long Term Therapy
*Medication Management/Administration
*Case Management
*Skill-Building
*Referrals
*Substance Use Counseling
*Tobacco Use Counseling
*Conflict Resolution/Mediation
*Other
With Mental Health Provider Without Mental Health Provider
* P<.01
Mental Health Services in SBHCsMental Health Services in SBHCsFastest growing component of SBHC.In ten years, the percentage of SBHCs
with mental health staff went from 30% to over 65%.
Survey of SBHC providers in 2004/2005 found that expansion of mental health services was the first priority for program funding.
Need for Quality Improvement in Need for Quality Improvement in Mental Health in SBHCsMental Health in SBHCs
Increased recognition that objective measures were needed for SBHC quality of care, especially in mental health
Such a measure would need to recognize:– Many disciplines– Wide range of interventions– Limited translational research around best
practice in schools
Continuous Quality Continuous Quality Improvement (CQI) Improvement (CQI) at NASBHCat NASBHC
Seeks to improve all performance not just areas of unacceptable care.
Focuses on the processes of health care delivery and use of research-based approaches to reduce variations in those processes.
Need to understand and revise process in order to improve quality
2001 - NASBHC developed CQI tool to assess clinically based sentinel conditions, including MH
MHPET MHPET DevelopmentDevelopment
January 2004 NASBHC convened a workgroup to develop an evaluation tool
Based on School Mental Health Quality Assessment Questionnaire (MH-QAQ) developed by Mark Weist et al. at the Center for School Mental Health
Broadened questions from clinician to program level
Expanded questions to be more inclusive of school staff and non-mental health providers
Shortened, fewer dimensions and indicators
MH-QAQMH-QAQSchool Mental Health Quality Assessment
Questionnaire (MH-QAQ) Developed by Mark Weist et al. at the Center
for School Mental Health (CSMH)http://csmha.umaryland.edu/research.html/quality_assessment.html
Part of first ever systematic study “Enhancing quality in expanded school mental health” of school mental health quality assessment and improvement (QAI)
This study was supported by the National Institute of Mental Health
MHPET Beta-testMHPET Beta-test41 individuals completed the MHPET tool
– 20 mental health providers– 11 medical providers– 6 support staff members– 4 administrators
21 unique SBHC sites were represented (Talbot - 9, Illinois - 5, Seattle - 3, Montefiore - 4)
MHPET Beta-test MHPET Beta-test Responded to interview questionsRevised and finalized tool accordingly:
– generalized to school mental health– changed name (“program” to “planning”)– simplified dimensions and language– included substance abuse
Beta-test on-line MHPETBeta-test on-line MHPETBeta-test with 29 participants in 6 schools
(3 SBHCs) in Baltimore, Pittsburgh, Little Rock, and Worchester
Teams completed both sets of MHPET and were given follow-up interview questions
Team leads participated in conference callsBased on feedback, adjusted web links and
revised instructions (e.g. clarified role of participants and team leads)
MHPET web-based tool MHPET web-based tool
Now online www.nasbhc.org under “mental health” section
Set up to be completed by teamsTeams complete tool and go back 3-6
months later to complete a second timeComputer generates scores
Using the Web-Based Using the Web-Based MHPETMHPET
Principles for SBHCsPrinciples for SBHCs Supports the school Responds to the community Focuses on the student Delivers comprehensive care Advances health promotion activities Implements effective systems Provides leadership in adolescent and child
health
http://www.nasbhc.org/site/c.jsJPKWPFJrH/b.2743459/k.9519/NASBHC_Principles_and_Goals_for_SBHCs.htm
Laura Hurwitz
Laura Hurwitz
Laura Hurwitz
James A Davis Middle School 1224 Clarendon Ave.
Bessamer, AL
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3
Set Two Survey will be available after…
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James A Davis Middle School 1224 Clarendon Ave.
Bessamer, AL
Set Two Survey will be available after July 25, 2008
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0
Quality Quality Improvement/PlanningImprovement/Planning
Indicators with scores of 3 or less are automatically flagged as potential areas for improvement
Raters select targeted areas for improvement(dimensions and/or indicators with averages that are low relative to others)
Identify resources for improving target areas Develop and implement improvement plan Compare scores 3-6 months later and assess
progress
Using MHPET to identify Using MHPET to identify improvement targetsimprovement targets
Examine the lowest rated indicators first.– Which of these can you impact in the next 6
months?Parallel to goal setting with a student/client:
– What are the strengths?– What areas are in need of improvement?– Realistic?– Obtainable?
Using MHPET to identify Using MHPET to identify improvement targets (cont.)improvement targets (cont.)
“Halo effect”– By focusing on 2-3 indicators is there
potential to positively impact others?If “don’t know” is prevalent in your
responses, can you select targets that will result in informing these key people?
Place the MHPET results in the context of other data.
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Qualifiers and CaveatsQualifiers and CaveatsQuality Improvement for mental health
services in schools is new and unfamiliar territory
Consider where your program is developmentally
This is not about judgment i.e. good or bad, right or wrong
Should not be tied to staff performance appraisal or funding
MHPET Next StepsMHPET Next Steps
Develop compendium of quality improvement resources for each indicator
MHPET will have on-line link to resource for each indicator
Develop training module on quality improvement (School Mental Health Capacity Building Partnership)
Collect and analyze national data from MHPET
NASBHC Resources for Quality NASBHC Resources for Quality Improvement: www.nasbhc.orgImprovement: www.nasbhc.org
Paper version currently availablehttp://www.nasbhc.org/atf/cf/{CD9949F2-2761-42FB-BC7A-CEE165C701D9}/MHPET.pdf General mental health resourceshttp://www.nasbhc.org/site/c.jsJPKWPFJrH/b.2642293/k.85AC/mental_health.htm
Resource for Quality Improvement:Resource for Quality Improvement:The School Mental Health ConnectionThe School Mental Health Connection
www.schoolmentalhealth.orgIn association with University of Maryland
Center for School Mental Health (CSMH) www.csmh.umaryland.edu
40 indicators of quality in school mental health services
PowerPoints provide background information, a menu of suggested activities, helpful hints, web resources, and references
Other Resources for Quality Other Resources for Quality ImprovementImprovement
Center for Health & Health Care in Schools www.healthinschools.org
UCLA Center for Mental Health in Schools www.smhp.psych.ucla.edu
National Technical Assistance Center for Children's Mental Health at Georgetown University Center for Child and Human Development www.gucchd.georgetown.edu
IDEA Partnership www.sharedwork.org
Contact InformationContact InformationTJ Cosgrove, LICSW
Public Health – Seattle & King [email protected]
206.263.8352
Laura Hurwitz, LCSWDirector, School Mental Health
www.nasbhc.org202.638.5872 x205
