Using an Interconnected Systems Framework
in Now Is The Time, Project AWARE. This Is The first episode in a 3-part series
developed to support the technical assistance needs of the Now Is The Time, Project AWARE
grantees, funded through the Substance Abuse and Mental Health Services Administration,
also known as SAMHSA. SAMHSA oversees several initiatives under
the President’s “Now Is The Time”, or NITT, Plan. These initiatives include both Healthy Transitions
and Project AWARE. AWARE is an acronym standing for Advancing
Wellness & Resilience in Education. Project AWARE was established to improve mental
health literacy among youth-serving adults and to build cross-system capacity for comprehensive
mental health approaches in states and communities. This 3-part series was developed to begin
to respond to a wide variety of needs around the Interconnected Systems Framework (ISF)
expressed by NITT Project AWARE grantees. While some districts involved in Project AWARE
are currently and actively involved in implementing ISF, many districts requested an informative
session on ISF, PBIS, and MTSS because they are unfamiliar with these. This series presents an overview of content
covered in the Now Is The Time TA Center regional trainings on this topic. This first episode will focus on increasing
your understanding of a Multi-Tiered System of Support framework and increasing your understanding
of the critical features and rationale behind the ISF. ISF is not required by Project AWARE. It is simply one way to organize and frame
Project AWARE efforts. This training series will help grantees break
down the concepts of ISF and apply them to specific projects. Should you choose to implement ISF, additional
and more customized support from ISF experts and your TA team are available. Please see the contact information at the
end of each episode, or contact your designated Technical Assistance Liaison. As we learn about ISF, be thinking about how
each piece could relate back to the four NITT AWARE goals. Build and/or expand capacity at the state
and local levels to make schools safer; improve the school climate; increase awareness of
mental health issues; and connect children and youth with behavioral health issues with
needed services. During the episodes, you will see and hear
many acronyms. Here’s a quick key: PBIS stands for Positive Behavioral Interventions
and Supports. This is also synonymous with terms like School-wide
Positive Behavior Supports; MTSS stands for Multi-Tiered System of Support; SOC stands
for Systems Of Care; and IS stands for Implementation Science. We realize that schools, districts, and states
will be at varying places with ISF overall, let alone school mental health and PBIS. Identifying progress for each, through the
Stages of Implementation model, can help teams understand their purpose over the course of
the training. Take a moment to determine at what stage of
implementation your school, district, or state is – and then note the related tasks of
focus that align with that stage. You may want to pause the presentation in
order to do so. One stage not noted here is sustainability. Many implementation models include this as
a final stage, but here it is implied that sustainability is planned for throughout each
of these implementation stages. There is more in-depth information in the
ISF monograph via National PBIS at www.pbis.org. First, we’re going to describe the primary
aspects of, and the rationale behind, the ISF. So what is an Interconnected Systems Framework,
and why do some schools or districts use it? The ISF represents the structure and process
of the interconnection between multi-tiered systems of support, like PBIS, and school
mental health. In short, ISF is the combination of two school
initiatives: PBIS and SMH (school mental health) – which gives us the equation of PBIS +
SMH=ISF. By strategically and intentionally combining
these two, it improves the overall supports and outcomes for students and addresses the
gaps and limitations of both PBIS and school mental health. Detailed information about this process and
research surrounding it can be found in the ISF monograph. Since 2008, leaders from and connected to
the University of Maryland Center for School Mental Health and the Office of Special Education
Programs’ Technical Assistance Center on Positive Behavioral Interventions & Supports have been
working collaboratively to establish a common framework that links SMH and PBIS. The collaboration with 4 state partners and
10 school districts across 6 states has resulted in a concept paper where examples and pilot
sites are discussed extensively. This monograph is titled: Advancing Education
Effectiveness: Interconnecting School Mental Health and School-Wide Positive Behavior Support
– Susan Barrett, Lucille Eber, and Mark Weist, Editors. Now let’s do a quick check for understanding. True or false? “We have both PBIS and school mental health
supports in my district. We must have an ISF.” False. While both might exist, they may not be integrated
together. Additionally, both might exist in varying
degrees of implementation throughout your district in different buildings. So why should we invest in using an Interconnected
Systems Framework? The ISF leverages and integrates the individual
strengths of both PBIS and school mental health. It addresses gaps and limitations of both
PBIS and school mental health when used independently. It improves outcomes for students through
earlier access to a wider range of evidence-based practices. It increases systems functioning within the
school, with community mental health providers, and with families. It allows for a wide scope of outcomes to
be analyzed at multiple levels, including the individual student, grade, and building,
district, and community. The ISF allows for cross-system training that
promotes increased understanding and communication. And finally,
It decreases stigma due to the availability of services across settings – a true continuum
of care. Let’s do another quick check for understanding. True or false? “Our district has someone that sits on various
interdisciplinary teams, committees, or workgroups to help improve outcomes for students. We must have an ISF.” False. Remember, ISF=PBIS + SMH. While most districts have something similar
to the first statement, let’s make a distinction about ISF. The relationship is intentional; not happenstance. Additionally, by having PBIS in the above
equation, it is assumed that PBIS and SMH are blended by utilizing MTSS principles to
form an ISF. Let’s start by developing an understanding
of what defines an MTSS. MTSS was actually developed out of a public
health model years ago. It’s a way to organize and deliver a differentiated
level of services to a given population – with a focus on promotion and prevention, early
identification, and intervention. MTSS is NOT a curriculum – it’s a framework
that you insert systems and practices into that are guided by data. It is distinguished by 3 tiers, or intensities
of services, intended to deliver: “Core,” or universal Tier 1, to ALL of the
targeted population, and focuses on proactive or preventative measures;
Tier 2 to an identified part of the targeted population when a lower-level problem has
been identified for support; and Tier 3 to a very small percentage of the targeted
population that has more intensive needs. It becomes a continuum of interventions and
supports which people access as needed as they are identified via decision rules. They never stop receiving Tier 1, and other
supports from Tier 2 and 3 are layered on top of it for only as long as needed; thus,
“Core + More.” All interventions and supports are evidence-based,
stakeholder focused, and culturally and linguistically relevant and appropriate. Within each tier, data, systems, and practices
are utilized to impact outcomes. Examples of services using an MTSS framework
include Academic RTI, or Response to Intervention; RTI-B, or Response to Intervention-behavior;
PBIS; medical services; drug and alcohol prevention and treatment; and so on – really, anything! Now that we know what an MTSS is, we can plug
in the two initiatives that we will structure within it to create an ISF. Note the similarities between the two, but
the distinction that PBIS is always conducted within an MTSS. ISF would incorporate SMH into MTSS framework
as well, and blend it with PBIS. To further expand this understanding, check
out the MTSS applied principles contained within PBIS. Please note that this is a very simplified
explanation of PBIS. Now that you understand the structure of an
MTSS framework, let’s examine the pros and cons of stand-alone PBIS and SMH. PBIS pros include: a decrease in problem behaviors
and improvements in school climate, attendance, academic achievement, and social competence;
while cons include: PBIS may not fully address the emotional needs of all students with more
complex mental health issues – which is sometimes the root cause of so-called problem
behaviors; resources and structures at the upper tiers are less well-developed and validated;
and PBIS is less well-developed and validated in high schools. Pros of school mental health include: early
identification of possible conditions; improved prevention strategies and service access;
and decreased stigma; while the cons of school mental health include: difficulty implementing
school mental health programs due to too few staff with too many additional and unrelated
duties; a lack of integration among school-based and community providers; and unrefined use
of data to drive decision-making. Altogether, by partnering these together within
an MTSS framework, you can see the potential expansion of the reach of the supports offered
and development of better systems and data. Thank you for viewing the first episode in
this 3-part webinar series. The second episode will cover the “how” of
ISF, and the third episode will cover the ISF outcomes and tools. Project AWARE grantees can request more targeted
and intensive TA through their designated TAL and/or CCC Coach. Such TA may be in the form of coaching and
consultation from your designated TAL/CCC Coach and/or more formalized, intensive coaching
and consultation from a subject matter expert. Contact information for the developers of
this content is listed here should you have any questions or need additional information.

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