renew.unh.edu

NH: RENEW: An Interconnected Systems Framework Pilot In

New Hampshire

Kathryn Francoeur, University of New Hampshire

Nicole Quinn, Seacoast Mental Health Center

Grace Laliberte & Carol Mastacouris , Exeter High School

Carol James, Exeter Alternative School

Justin Tilbe, RENEW Youth Mentor

5/30/2014

renew.unh.edu

Learning Objectives

• Overview of the RENEW model as a tertiary support

• Case Example:

– Using the RENEW model to blend the partnerships between schools and mental school agencies

• Lessons Learned, Future Direction

5/30/2014 2

renew.unh.edu

Why We Need MH Partnerships

• One in 5 youth have a MH “condition”

• About 70% of those get no treatment

• School is “defacto” MH provider

• JJ system is next level of system default

• 1-2% identified by schools as EBD

• Those identified have poor outcomes

• Suicide is 4th leading cause of death among young adults

renew.unh.edu

What is needed…

Wagner & Davis (2006) recommend that programs for youth with EBD emphasize:

• Relationships

• Rigor

• Relevance

• Address the needs of the whole child

• Involve students and families in transition planning

4

renew.unh.edu

RENEW History, Goals, & Principles

renew.unh.edu

• Developed in 1996: 3-year RSA-funded employment model demonstration project for youth with “SED

• 1998-2007:Developed a non-profit community based agency

• Provided high schools RENEW as the tertiary level intervention in a 3-tiered PBIS model (2002- present) : NH, Illinois, PA, WI, MA, MD

• Provided to youth as part of SOC projects in North Carolina

• Provided by community mental health providers in New Hampshire (2008- present)

• Focus is on community-based, self-determined services and supports

Rehabilitation, Empowerment, Natural Supports, Education and Work {RENEW }

RENEW Facilitator's Training Fall 2013, Copyright Institute on Disability, University of New Hampshire

renew.unh.edu

Universal: School-Wide Assessment

School-Wide Prevention Systems

Tier 2

Tier 3/Tertiary

RENEW and

Wraparound

Simple Individual

Interventions (Brief FBA/BIP, Schedule/

Curriculum Changes, etc)

Small Group

Interventions

(CICO, Social and

Academic support

groups, etc)

ODRs, Attendance,

Tardies, Grades,

Credits, Progress

Reports, etc.

Progress Monitoring (Behavior and Academic Goals)

Competing Behavior Pathway,

Functional Assessment Interview,

Student Progress Tracker;

Individual Futures Plan

The APEX High School Model: Positive Behavior Interventions & Supports & RENEW

Malloy, Agorastou & Drake, 2009 Adapted from Illinois PBIS Network, Revised Sept., 2008 & T. Scott, 2004

renew.unh.edu

2 Shorter-Term

Improvements In:

Facilitators Provide:

1. Personal futures

planning

2. Individualized team

development and

facilitation

3. Facilitation of

futures plan supports

-Education support

-Employment

Support

-Mentoring

-Braided resource

development

-Community

connections

Self-Determination

Capacity & Opportunity

Student Engagement

Behavioral,

Cognitive, & Affective

Social Support

Source & Type

Longer-Term

Outcomes

• Improved

emotional &

behavioral

functioning

• Improved

engagement in

home, school,

community

activities

• Improved and

increased social

supports (social

capital)

RENEW Theory of Change

Context: Youth with SMHC who: •Are disengaged in home, school community •Youth who are involved in jj system •Youth who are falling behind in school

renew.unh.edu

9

RENEW Conceptual Framework

Education

Disability

Children’s Mental Health

School-to-Career Transition

Self Determination

Interagency Collaboration

& Wraparound

Youth, Family, RENEW

renew.unh.edu

RENEW Goals & Principles

RENEW Goals

• High School Completion

• Employment

• Post-secondary Education

• Community Inclusion

RENEW Principles

• Self-Determination

• Unconditional Care

• Strengths-Based Supports

• Flexible Resources

• Natural Supports

5/30/2014 10

renew.unh.edu

RENEW Model Elements

4-Phase Process

renew.unh.edu

RENEW 4-Phase Process

Phase 1:

Engagement and futures planning

Phase 2:Team Development- Initial Planning

Phase 3: Implementation and Monitoring

Phase 4:

Transition to Less Intensive

Supports

RENEW Facilitator's Training © Institute on Disability, University of New Hampshire 12

renew.unh.edu

RENEW Strategies

1. Personal Futures Planning

2. Individualized Team Development & Facilitation

3. Implementation and monitoring of individualized school and vocational supports – Braided (individualized) Resource Development

– Flexible, or Alternative Education Programming

– Individualized School-to-Career Planning

– Naturally Supported Employment

– Mentoring

– Sustainable Community Connections

13

renew.unh.edu

Phase 1: Example of Youth’s Future Planning

5/30/2014 14

renew.unh.edu

Collaboration and Insights from Exeter

School District

Grace Laliberte

Carol Mastacouris

Exeter High School

Carol James, Exeter Alternative School

5/30/2014

15

renew.unh.edu

Exeter High School and the RtI model

• 2012-2013: A district-wide RtI committee was formed.

• 2013-2014: A planning/preparatory phase with expected roll out of RtI in the district in Fall 2014.

• Area of focus to date: English/Language Arts – Scores on statewide assessments have proven that the

work we are doing is making a difference for our students.

• Math Interventions have been added this year.

• Interventions for students with behavioral / emotional difficulties were not existent, until implementation of RENEW.

5/30/2014 16

renew.unh.edu

Seven Goals of RENEWed Opportunities in the Seacoast

1. Deliver intensive RENEW services to 32 youth with EBD, and/or youth at risk of dropping out to re-engage them with their schools and develop plans for graduation and beyond.

2. To build capacity to recover students who have dropped out and retain high risk students.

3. Provide TA to schools to ensure effective delivery of services and project’s goals are met.

4. Offer FREE professional development opportunities to RENEW trainees.

5. Train youth graduates to be RENEW mentors. 6. Analyze outcomes and disseminate results. 7. Enhance the collaborative working relationship between the

school and the community mental health center.

renew.unh.edu

Funding Stream

• Fuller Foundation

• New Hampshire Charitable Foundation

• People’s United Community Foundation

• The Cogswell Benevolent Trust

renew.unh.edu

The School Perspective

• To build more responsive and effective systems to connect mental health and schools.

• Both systems had previous training in RENEW. This project reflects a “shared agenda” with purposeful collaboration to serve youth and families.

• Emphasis on data-based decision making and on implementation of an evidence –informed intervention.

• Strong training, coaching and implementation support. • Represents system structures to provide interventions and progress

monitoring features. • Community partners helped reinforced to staff that disengagement

was not just about lack of interest, motivation, family issues that there was something.

• Better able to support students and youth back in the community.

5/30/2014 19

renew.unh.edu

Interconnected Systems Framework for Schools & School Mental Health

Tier 3: Intensive Interventions for Few Individual Student and Family Supports

Systems Planning team coordinates decision rules/referrals for this level of service and progress monitors

Individual team developed to support each student

Individual plans may have array of interventions/services

Plans can range from one to multiple life domains

System in place for each team to monitor student progress

renew.unh.edu

RENEW & Exeter Alternative School

Meeting Needs Across the Continuum

5/30/2014

21

renew.unh.edu

The Need…

● Students who attend the Alternative Education Program typically lack the skills to effectively plan for their future.

● Students sometimes feel alone and are confused about who can support them with their decisions.

renew.unh.edu

Why RENEW? ● RENEW offers a way for the student to look at

their world and begin to organize a future.

● RENEW provides one on one support with a mentor who assists the student in developing short term and long term goals.

renew.unh.edu

Future Directions… ● RENEW needs to be part of the curriculum so

that every student in Alternative Education can benefit from the support and organization that the students receive.

● A RENEW participant, says,

“It’s helped me get through a lot of different obstacles in my life.”

renew.unh.edu

Collaboration and Insights from Seacoast

Mental Health

Nicole Quinn, BA

CAFS Outreach Specialist Seacoast Mental Health

Center

renew.unh.edu

The Role of Mental Health on Teams

• More efficient access to needed information. • Earlier access to the RENEW intervention. • Effective cross-team structure promotes better

communication & coordination of services. • Able to stream line the process. • Cross-team leadership promotes common language &

approach to address needs of the school & community. • Greater ability to focus on the organizational structures

of both systems . • Able to provide school staff with insight into beneficial

RENEW practices and helpful tools.

5/30/2014 26

renew.unh.edu

Old Approach vs. New Approach Past …

• “Working in a vacuum” • Difficulty accessing school

information • Schools lacked knowledgeable of

agency’s practices and expectations

• Agency not knowledgeable about school practices and expectations

• Everyone was disconnected and working towards different goals

• Everyone utilizing different practices or interventions

• Unable to access client during school hours

Current…

• More cohesive partnership • Greater awareness e of each others

practices and system • Working towards the same goals &

utilizing the same practices to achieve the goals

• Client can see that everyone is on the same page and working for their benefit

• Readily access school information • Provide school with relevant client

information • Provide “bigger picture” of who client

is both in and out of school • Provide an opportunity to access

RENEW through the school for clients who do not qualify for SMHC

• Increased client engagement

5/30/2014 27

renew.unh.edu

Case Example A Blended Approach

5/30/2014

28

renew.unh.edu

Case Example

• Student involved in RENEW for 1 year

• RENEW Facilitator: Mental Health Outreach Specialist

• Completed all MAPS

• Began initiating small goals

• Ongoing family involvement

After purposeful collaboration…

5/30/2014 29

renew.unh.edu

Schools & Mental Health Working Together

Collaborative meeting scheduled to support youth’s goals and next steps:

• Mental Health Agency and family present to give unique perspective of the youth

• Key stakeholders from the school needed to support youth’s goals and next steps

• Critical school data needed to make decisions:

Credits, Transcript, Behavioral Incidents, Attendance

5/30/2014 30

renew.unh.edu

Student Focused Planning

5/30/2014 31

renew.unh.edu

Sharing a Unique Perspective

5/30/2014 32

renew.unh.edu

Collaborating Around Youth’s Goals

5/30/2014 33

renew.unh.edu

RENEW Youth Mentor Role

Justin Tilbe

IOD

University of New Hampshire

RENEW Graduate

5/30/2014

34

renew.unh.edu

Youth Mentor’s Role • To give a perspective to youth and facilitators

on the RENEW process

• To check with youth to see if the needs are being met

• Provide feedback to the youth from own personal experience

• Talk with youth on how they feel about their facilitator & the process

5/30/2014 35

renew.unh.edu

Why is this Important?

• Help youth speak freely to the youth mentor

• Not a significant age difference

• Providing opportunities to relate based on shared experiences.

5/30/2014 36

renew.unh.edu

Moving Forward…

• Time set to meet one on one with youth and youth mentor.

• To start from the very beginning when RENEW is first talked about with youth

• Being part of Implementation Team to help structure the process

• Establish lunch meetings with students

5/30/2014 37

renew.unh.edu

Looking Ahead

5/30/2014

38

renew.unh.edu

Next Steps to Consider in Moving towards a more Blended System

• Streamlined referral process • Increased collaboration • Increased ability to identify students that may or may not

be on each other’s radar • Continue to collaborate in a cohesive and honest manner • Cross system problem-solving & leadership on all 3 tiers • Continued coaching, training & implementation support • Continued emphasis on data-based decision making • Dedicated funding support • Team develops clear role & functions for all • Plan for sustainability

5/30/2014 39

renew.unh.edu

5/30/2014 40

For more information contact:

Kathy Francoeur, Research Associate

10 West Edge Dr.

Durham, NH 03824

(603)862-0318

Kathyrn.francoeur@unh.edu

Thank you!