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Where We’ve Been
• Provide comprehensive school-based behavioral health services since 1997
• The first ESD in Washington State to be dually licensed
• Working with schools and community partners to innovate behavioral health models
Our Mission
•Guiding students
• Enriching our school districts
• Increasing knowledge of mental health
•Raising awareness of substance abuse
Our Why
All students who need treatment are identified, assessed, and provided evidence-based services and ongoing supports.
Significant Behavioral Health Issues
34%
41% 43%
54%
67% 69%
45%
57%61%
0%
10%
20%
30%
40%
50%
60%
70%
80%
8th Grade 10th Grade 12th Grade
Depression and Anxiety
Depressive Feelings Anxious Can't Control Worry
Healthy Youth Survey (2018) ESD 113
21%
26% 25%
16%
21% 20%
10%12% 11%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
8th Grade 10th Grade 12th Grade
Past Year Suicidal Feelings and Actions
Considered Suicide Made a Suicide Plan Attempted Suicide
Significant Behavioral Health Issues
Healthy Youth Survey (2018) ESD 113
Behavioral Health & Graduation
• The single greatest predictor of a person’s health and well-being across the lifespan is educational attainment.
• Youth with co-occurring needs were the least likely to graduate on time (12%) and most-likely to drop out (80%).
• If high school dropout rates were cut in half nationally, the US would save an estimated $7.3 billion annually in Medicaid spending
Where We AreLicensed Locations
• Grays Harbor CountyAberdeen
• Lewis County Chehalis
• Mason County Shelton
• Pacific CountyRaymond
• Thurston CountyTumwaterYelm
Current ClimateTotal Served (2018-2019)
Total Districts: 31
Substance Use Disorder
• Assessments Completed: 767
• Clients in Treatment: 673
Mental Health
• Assessments Completed: 179
• Clients in Treatment: 312
Grays Harbor County
• Aberdeen• Elma• Hoquiam• Montesano• North Beach• Ocosta• Wishkah Valley
Grays Harbor County
Treatment Numbers (2018–19)
155Substance Use Disorder Assessments Completed
152Substance Use Disorder
Clients in Treatment
Lewis County• Adna
• Centralia
• Chehalis
• Morton
• Napavine
• Pe Ell
• Toledo
• White Pass
• Winlock
Lewis County
143Substance Use Disorder Assessments Completed
119Substance Use Disorder
Clients in Treatment
Treatment Numbers (2018–19)
Pacific County
• Naselle• Ocean Beach• Raymond• South Bend• Willapa Valley
Pacific County
52Substance Use Disorder Assessments Completed
49Substance Use Disorder
Clients in Treatment
Treatment Numbers (2018–19)
Student Demographics
1%
6%
27%
64%
2%
Client Grade Level
Other
Grades 1-5
Grades 6-8
Grades 9-12
HS Diploma/ GED
Data gathered on 01-15-2020N=1147
Referral Sources
57%
23%
13%
3% 3%1%
School
Criminal Justice
Self/Family
Community Referral
Other Provider
Unknown
Data gathered on 01-15-2020N=1225
Entry Referral Source
Growth Under Change
15,320
13,56114,126
16,941
18,288
14,631
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
18,000
20,000
2014-2015 2015-2016 2016-2017 2017-2018 2018-2019 2019-2020 (Projected)
Ho
urs
of
Trea
tmen
t
Program Year
Funding Challenges
• The current behavioral health system is built on a clinic-based model that is best suited for adults.
• Infrastructure that is focused on funding only Tier 3 services (instead of early intervention and prevention).
• Fee-for-service models that do not reflect service delivery trends in a school setting.
Funding Sources
• Medicaid
• Private Insurance
• Grants
• Contracts
• State and Local Partners
• School Districts
Great Rivers Region
of assessment and treatment services in the Great Rivers region are to clients who are not Medicaid funded at all or who lose Medicaid coverage at some point during their treatment.25%
Coverage Challenges
• Time in juvenile detention
• Time in an IMD
• Barriers to (re)establishing Medicaid coverage
• Lack of insurance coverage
• Seeking services independently
• Undocumented status
• Custody issues
Multi-Tiered Systems of Support
Tier 3: Behavioral Health Service
Tier 2: Targeted Interventions
Tier 1: School-Wide Practices
Is Our Effort Working?
Substance Type Before Program After Program Percent Change
Alcohol (Any) 47.2% 33.3% 29.4% reduction
Binge Drinking (5+) 27.3% 16.7% 38.7% reduction
Marijuana (Any) 61.9% 41.8% 32.5% reduction
2018-2019 School-Based Behavioral Health Outcomes
Data based on 416 students completing both a pre/post-test
Is Our Effort Working?2018-2019 School-Based Behavioral Health OutcomesSSD Change in Mental Health Problem Severity
1
1.5
2
2.5
3
3.5
4
Risk/Threat to Others (n=8) Risk/Threat to Self (n=10) Impaired School Function (n=37) Emotional/Behavioral (n=81) Relationship Problems (n=54)
Pre-Service Counselor Risk/Severity Rating Post-Service Counselor Reisk/Severity Rating
Severe problem
No problem
The Future
• Advocate with key partners to find a funding model that allows all youth to access care
• Expand Behavioral Health Services in the region including more intensive level services
• Build a Threat Assessment/Safety Consortium that partners directly with our behavioral health work
• Explore capacity to provide crisis services throughout our region
• Provide behavioral health supports for GRAVITY and Olympic Academy
QUESTIONS?
