Attendees in this section focused on considering how a multi-sector and multi-disciplinary approach to behavioral health allows people to work together so that students can flourish. This is accomplished when we advance students’ social and emotional learning and provide necessary resources to those around the student so that they are better equipped to support learning.
Social and emotional learning (SEL) skills support students and adults in setting goals, showing empathy, establishing and maintaining relationships, and making responsible decisions.
Students who participated in evidence-based social and emotional learning programs showed gains in academic achievement, reduced rates of drop out, mental health problems, and risky behaviors. These skills are linked to school achievement, yet the social and emotional health of students is often not systematically assessed or addressed.
Barriers:
- Policies: Inconsistent or weak policy signals re: importance of SEL and approaches to adopt
- Practices: Interventions are not evaluated, or evaluated consistently, using common metrics of success
- Resource Flows: Funding is available for training, but training-based interventions are difficult to sustain and scale
- Relationships & Connections: Leaders are not on the ground and may miss what support, program, etc. is really needed
- Power Dynamics: Individual schools have a great deal of autonomy, can choose their preferred approach (or no approach)
- Mental Models: Students’ SEL is not seen as a whole community challenge – it is either a “schools problem” or a “parents/families problem”
Attendees prioritized the following action items:
· Cultural competency
· Statewide stakeholder
· Local heavy lifting
· Statewide and local common understanding of SEL/framing
· Statewide funding process: focus on SEL, staffing
Click here to see the actor map created in this session.
Attendees in this section discussed how in aIn a multi-sector and multi-disciplinary approach to behavioral health, schools serve as hubs for screening, facilitating access to, and support the completion of needed treatments and/or services. multi-sector and multi-disciplinary approach to behavioral health, schools serve as hubs for screening, facilitating access to, and support the completion of needed treatments and/or services.
High, and rising, rates of teen depression and suicide-related behaviors are a serious public health issue. According to the most recent national Youth Risk Behavior Survey (YRBS), between 1999-2017, high school students in grades 9-12 reported significant increases in feeling sad or hopeless (from 28.3% to 31.5%).
In Wisconsin, data from the 2017 YRBS show that nearly 40% of students reported high levels of anxiety, 27% reported experiencing depression, and more than 16%, or one in six students, reported that they had engaged in self-harm. The most recent report to the Wisconsin Legislature from the Office of Children’s Mental Health (OCMH) shows suicide rates increased more than national rates from 7.5 per 100,000 to 9.8 per 100,000. Additionally, the rate of youth mental health hospitalizations in Wisconsin (7 children per 1,000) continues to be high compared to the national rate (approximately 1.6 children per 1,000). There was also a decrease in parent-reported early childhood screenings during well-check visits for social, emotional, behavioral, or developmental disabilities and delays from 34% to 27%. Lastly, there was a slight increase in the percentage of young adults diagnosed with a mental illness (24%).
Barriers:
- Policies: Privacy laws are a perceived/real barrier to sharing information between schools/community providers
- Practices: Various models for screening, services, referrals exist, without strong consensus as to best fit
- Resource Flows: School personnel are stretched and this is a complex set of services to add; may be grant-funded
- Relationships & Connections: Community providers may not understand how schools operate, what their constraints are
- Power Dynamics: Early ID and treatment leads to better health and cost avoidance, but reimbursement can be difficult to get
- Mental Models: Schools, students, families experience and have internalized stigma – weak demand for/support for school based screening and services
Attendees prioritized the following action items:
- A shared community vision
- Demonstration of the need which leads to an increase of mental health providers
- Care coordination that addresses siloed thinking
- Development of policy support
- Mental health providers and school districts will need to create a shared vision for onsite MA services in schools which will eliminate monetary barriers to receiving services and benefit kids who need therapy
- Organizations will need to implement technology solutions to provide behavioral health appointments for rural locations
- Mechanisms for knowledge sharing (not recreate wheel)
- DPI: Connect communities to share ideas
- Increase behavioral health reimbursement rates (clinical)
- Equitable sustained funding
- Teacher universities/DPI will need to include "whole child curriculum" which will change perceptions of mental health as not part of my job
Click here to see the actor map created in this session.
Attendees in this section discussed how in a multi-sector and multi-disciplinary approach to behavioral health, community partners utilize technology, referral resources, care navigators, and warm handoffs to ensure connections to culturally and linguistically responsive services are made.
Better connecting individuals to available community resources improves the ability of individuals and families to address unmet needs for behavioral health, health care, and other supports and services including housing, food, transportation, and other social determinants of health. The Network of Care’s partnership with the United Way and its 2-1-1 program is an example of this strategy. The “MyConnection” website serves as a resource for individuals, families, agencies with mental health questions or concerns. It also provides information about mental health and substance use services in the Fox Cities and Brown County region.
Communities find that pairing people with technology leads to even better access and results. One strategy that is gaining in popularity is the use of community health workers (CHWs). CHWs serve a variety of functions including providing outreach, education, referral and follow-up, case management, advocacy, and home visiting services. There is some evidence that CHWs improve patient knowledge, access to health care, and healthy behaviors.
Barriers:
- Policies: Insurance plan design makes central hub/referral model difficult
- Practices: Information and referral systems/approaches are proliferating, creating confusion, redundancy
- Resource Flows: No obvious funding source for central I&R resources or staff. Organizations compete for the funding that exists
- Relationships & Connections: Partners may resist creating a central hub to protect perceived uniqueness in service offerings
- Power Dynamics: People who need this kind of support lack power to cause it to be created
- Mental Models: Consumer skepticism over whether help exists, and organizational skepticism over reliability of centralized I&R function, stifles innovation
Attendees prioritized the following action items:
- Address trust issues and share power "nothing for us without us"
- Holding ourselves accountable to providing quality and reliable service
- Stigma reduction
- Increased collaboration among multi-sector stakeholders and provide incentives for collaboration
- Community mental health navigators can recruit and train trusted community members
- Collaborative priority: funding 'the hub' (hub and spoke) and creating a one right door model
- Cross-community development of a shared narrative about mental health and wellness that can be shared and adaptable (stories)
- Better medical reimbursement options available to service providers
- Reduction in regulations around information sharing
- Statewide mental health information and referral system
- Statewide trauma-informed ready communities
- Increased funding: local, state, federal
Click here to see the actor map created in this session.
Attendees in this section discuss how in a multi-sector and multi-disciplinary approach to behavioral health, employers incorporate the behavioral health needs of employees and their families into workplace strategies and employers have the support they need to foster mentally healthy workplaces.
Investments by employers in behavioral health screening and treatment, and in mental health in the workplace, can offer significant returns. The costs of mental health conditions to employers is greater than diabetes, respiratory illnesses, and cancer combined. Approximately one in five adults experience some form of diagnosable mental illness in any year, and half of those adults with mental illness do not receive treatment. Over 80% of employees that do receive treatment report higher levels of work enjoyment and efficacy. Providing access to needed behavioral health services results in lower overall medical costs, increased productivity levels, reduced absenteeism, and decreased disability costs.
Barriers:
- Policies: Mental health parity adopting in plan design has been mixed
- Practices: Few models exist for employer support for employees’ behavioral health needs, or needs of employees’ family members
- Resource Flows: Employers lack obvious financial incentives to support employees’ behavioral health
- Relationships & Connections: Groups that connect employers (e.g. Chamber, Rotary) don’t focus on these issues, so employers can’t easily learn from one another
- Power Dynamics: Employees may not have the power or influence to get their employers to focus on mental health
- Mental Models: Employers may not understand or believe that people with behavioral health needs can be good employees with the right support
Attendees prioritized the following action items:
- Senior leaders need to consider the cost benefit of enhancing existing programs which will increase a culture of acceptance and increase empathy
- Employers and management need to get information flowing to the right people which will aid in the de-stigmatization of mental health
- Health plans and legislators need to submit, synthesize, and disseminate information which will make the problem real in dollars and cents and allow for a better understanding of the true costs of behavioral health issues
- Health departments, EAP providers, mental health organizations (local, county, county-led initiatives) will need to communicate compelling data which will convince employers of the ROI of positive mental health policies
- Insurance purchase groups/insurance regulators need to bring parity for mental health services which will increase the number of providers and decrease stigma
Click here to see the actor map created in this session.