School Mental Health Project

Budget Cuts Threaten
Student/Learning Supports

With budget cuts looming, school owned staff and community providers working in schools are often fighting for their jobs and competing with each other to avoid being the ones laid off. The problem is reflected in the following communication recently sent to the Center:

"In our state there is an expanded initiative going on for the state to fund school mental health services provided by community mental health agency professionals. We (licensed mental health professionals/school social workers) are employees of the district and concerned that our positions may be eliminated unless we make the case to district administrators that there is benefit from integrating school-based staff services with school-owned MH staff, all MH staff. I strongly believe that there is a lot of justification for districts spending the additional money to fund positions like ours (in our state, school social workers are not yet certified and thus not required; most districts do not have them, school counselors are mandated by the state Department of Ed). Currently we work collaboratively with agency staff, there is some duplication but we provide services, being employees, that they cannot, for lots of different reasons."

The message ended with the question:

What case can be made to administrators about the value
of school-owned student support and MH professionals?

Here are some thoughts that have been offered so far in response to this matter. If you have something to add on this important matter, we look forward to hearing from you.

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Center Response

In our experience a strong cadre of school owned personnel is indispensable for maximizing the impact of school linked personnel. See the Center's brief information resource entitled Why School-owned Student Support Staff are So Important.
Online at: http://smhp.psych.ucla.edu/pdfdocs/school-ownedstudentsupportstaff.pdf

The gist of the document is included below for your convenience. (Online supporting documents are available by accessing the online version.) This is followed by comments we have already elicited from a broad range of colleagues. (And, we look forward to sharing your comments.)

"A major goal of school and community collaboration is to increase the resources available to meet the mission of schools. One arena for collaboration has been to bring community agency resources to schools. Given the sparse resources of both schools and community agencies the original intent was to increase services and enhance availability and access.

This positive intent is steadily being undermined as some policy makers have come to the mistaken view that community agency services can effectively meet the needs of schools in addressing barriers to learning and teaching. And, with budget tightening, school administrators and school boards are making the difficult decision about what to cut based on this erroneous conclusion. This set of circumstances has led to an increased trend toward reducing school-owned student support staff and contracting with community services for specific services. Unfortunately, this short-sighted budget slashing strategy not only reduces the amount of student support needed by teachers and schools, it also counters school improvement efforts designed to reframe support programs, services, and infrastructure into a potent and invaluable system of learning supports that is fully integrated with the school's educational mission.

By themselves, the type of clinical services community agencies can bring to schools are an insufficient strategy for dealing with the biggest problems confronting schools. Clinically oriented services are only one facet of any effort to develop a comprehensive system of learning supports. These are not criticisms of the services per se. It is simply the fact that such services do too little to address the range of factors that cause poor academic performance, dropouts, gang violence, teenage pregnancy, substance abuse, racial conflict, and so forth.

The trend to contract for specific support services ignores the following crucial reasons school-owned student support staff are so important:

The need is for school-community collaborations that can evolve comprehensive, integrated approaches by complementing and enhancing what each sector does best. Such approaches do more than can be accomplished by a few contracted community services. They address a wide array of the most prevalent barriers to learning –– the ones that parents and teachers know are the major factors interfering with the progress of the majority of students."


Some Responses from Colleagues Across the Country
  1. "This has caused quite a stir in our state, as you might imagine. In my experience, you get a different answer depending on who you talk to. The mental health agencies claim they can do a better job because they are more highly trained on mental health interventions, and because they are not school-owned, they don''t get assigned to bus duty and other irrelevant school tasks. The school-owned mental health worker claims that they can impact more kids, reach more families, and are more trusted by teachers.

    In the ideal world we would have both through a strong, collaborative partnership. Our state is definitely lagging behind in the school social work field, and I would like to see a mandate for this position. School counselors feel they do not have the mental health expertise to work with serious issues. School psychologists are scarce in our rural areas, and most of their expertise is underutilized as they are relegated to assessments for special education. But all of these school-owned positions play a role in supporting healthy emotional development and connecting to or providing services to those children with emotional problems.

    I have seen, however, cases in our state where community agencies have had a tremendous impact. This works best if the clinician is fully integrated into the school and spends a good part of their day in consultation with teachers and in building capacity for the school to work on promotion and prevention. To come in and "fix" a few kids and then leave is, as you know, not a very effective model and does little to assist with school improvement efforts. (But many agency folks don't get this.)

    The school mental health money in the state budget was axed, so we don't have to struggle with this right at the moment. But I think from a school capacity/school improvement position it is something we should probably tackle."

  2. "Our view has always been that a) this should be a shared school, family, community system agenda and that not involving the community systems (primarily mental health, but also child welfare, juvenile services, etc) can be an undue burden on schools and misses opportunities for cross systems partnerships. b) there should be clear policies in place that no new initiative involving community partners working in schools should in any way compromise the position of any school-employed staff."

  3. "As someone who worked for 15 years in the public schools and who now supports others doing the same, I see this as a fairly common situation that creates a lot of tension, distrust, and turf wars. Even when there are no plans to replace one type of worker with another, the introduction of partner agency staff doing similar work can create suspicion, unless handled really well. Unfortunately, in budget-tightening times, the reality is that schools often do reduce such positions to ‘keep the cuts away from the classroom!'"

  4. "The issue of contracting out staff has been an on-going discussion/fight etc. Our district has historically supported and funded school social work positions. We do work collaboratively with the local community health agencies and they support our efforts in some of the schools. This summer there was some suggestion that the District was going to sub-contract the department - but it was met with OVERWHELMING protests and the idea was quickly shoved. The staff is a part of the union which added to the support. Some of the issues that the staff raised was that our staff knows the families and the school staff/community and that we are 'vested' in the community. We are fortunate to offer our staff a great deal of staff development - so we were able to show that our staff is 'well trained' and 'highly knowledgeable about the 'issues.' We were also able to highlight the stability and continuity of care as often times there is a big change over in staff at the agencies. We have also mobilized a parents and community support that advocated for the retention of this department."

  5. "Like most school mental health service providers, I welcome help from other mental health professionals. School professionals recognize that we can't do this alone. Even though this sounds like a logical solution to the increasing demands being placed on our schools, here are just some of the concerns I would have for this type of arrangement:

    • How will infrastructure by changed (because it will need to change)? How will campus leadership teams and student intervention teams need to change? Will resources be shared or reallocated? If so, how? How will staff be impacted? How much training/professional development will staff need (most likely, training will need to involve school staff, as well as staff of community service providers). In what areas will staff/community members need training (i.e., training on school systems processes; identification of student needs; local, state and federal accountability issues, etc., etc.) Who will need training (all staff, some staff) and how much?

    • What is the framework for this service delivery model? Have mental health professionals (school & community) been involved in developing the framework for this model? If so, do they have a common definition of school mental health services, as well as a common language, common understanding, and common perspective regarding school mental health services?

    These are just some of the concerns I would have for this arrangement. As we discussed in our telephone conversation, there is groundwork that must be done before we even can begin to talk about the type of arrangement proposed. School mental health services and clinical mental health services are very different in terms of definition, eligibility, treatment plans, etc. Service providers may have conflicting perspectives with regards to these services and this may, in fact, put the child in the middle of the conflict, not to mention how it will impact the quality of services received. Much groundwork will need to be laid before this type of arrangement can be considered. Based on the information provided, I can see this creating more fragmentation and issues of ownership amongst mental health professionals in the schools and communities. Thus, I would be very hesitant to support this type of model without extensive preliminary planning."

  6. "In this day of dwindling resources, in order for schools to maintain their mental health staff, clear roles need to be defined and the ranges of services defined so that there is no duplication of services, but a sharing of responsibilities and a wrap around model."

  7. "School employed staff offer services/perspectives that are valuable. These perspectives are because they are school employed. At the same time, we in schools need to work with agency based MH practitioners. We can facilitate and develop very good systems of care with agency folks. There not only is room for everyone, there is a need to offer the best we can to students."

  8. "I don't know of a specific empirical research study that addresses this, but there is clearly a significant benefit to schools and communities working together to provide comprehensive school mental health services. Typically, school-employed people like school counselors, school psychologists, and school social workers (who are usually certified or licensed by state education agencies) are required to have specific training and supervised experience in education (curriculum, instruction, learning), child development and treatment methods, school based consultation and intervention models, school law, and school systems. It sounds like in the state of the person who wrote you that these standards might not be well articulated for school social workers, but in many states they have specific requirements (including course and training guidelines) that are needed to earn the state credential as a school social worker. The value of having this type of training is obvious as the professional is well versed in school systems and functioning, and shares the mission and commitment of schools as a priority ­student learning. However, school employed folks are also rarely in sufficient number to provide comprehensive services and it isn't really practical to deliver intensive therapeutic services during the school day. Subsequently, schools really benefit from having strong partnerships with community mental health so that these comprehensive services can be available and accessible to families in need before or after school. We have an informational flyer that describes the value of this relationship that might be helpful in clarifying these roles: See this link: http://www.nasponline.org/resources/handouts/sbmhservices.pdf

    So, in my opinion, the key here is that schools need to invest upfront in a sufficient number of school-employed MH professionals (SC, SP, SW) and then provide supplemental MH services offered in partnership with community mental health."

  9. "MH and school counseling staff usually have different training, and a different perspective. I think there is substantial overlap, but they bring different things to the table.

    Administrative Issues – When two agencies try to supervise operations on one setting, frequently there is conflict. Sometimes schools just decide to hire their own counselors, so the administrative conflicts are eliminated. MH people get angry when schools are able to pay more, "stealing" the MH employees. So, that level of difference is usually there.

    I've worked with our state MH department on some language to give MH and school staff some ways to differentiate. Here's some of that thinking:

    • Educational Counseling vs. Mental Health Therapy – Educational Counseling: Services provided for students to address personal/social skills, behavioral skills, and education, academic, and career development issues. Educational counseling may be delivered in individual or group settings.

    • Mental Health Therapy: Psychiatric therapeutic treatment of an acute or chronic issue, under medical supervision, to address mental health and emotional difficulties/disabilities. Mental health therapy may be delivered in individual, group, or family settings.

    The following is offered to further clarify the differences between counseling that might be delivered by education staff as opposed to therapy more likely to be delivered by mental health staff.

    Educational Counseling
    1. Personal/social skills development
    2. Behavior skills development
    3. Conflict resolution/anger management skills development
    4. Peer relationships
    5. Goal setting/decision making
    6. Career guidance & academic development
    7. Study skills development

    Mental Health Therapy

    1. DSM IV-R diagnoses
    2. Medical necessity & oversight based on psychiatric diagnosis
    3. Psychodynamic/insight oriented
    4. Brief therapy/solution focused
    5. Emotional disorder/behavioral disorder
    6. Individual/family/group systems psychotherapy
    7. Mental health difficulties

    MH counseling usually comes from a medical perspective, and is more often reimbursable via Medicaid funds.".

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If you have something to add to this important matter, go to http://smhp.psych.ucla.edu/netexch.htm and enter your comment or send them to ltaylor@ucla.edu


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