(Neal Horen) This is Neal Horen,
the Co TA Director for the LAUNCH TA Center,
and today is the first of what will be
five core LAUNCH strategy sessions
and those will have two components.
So first will be in a webinar like this where we
will try and have content,
presentations by grantees in terms of their content,
what they're doing, time for discussion,
and then a follow-up discussion hour relatively close in time.
Because of the time of year we're in,
we decided to have the discussion hour for this in January,
but we will do one of these sets for each of the core strategies.
I believe in February is what we're shooting for for home visiting,
but we're gonna focus on mental health consultation today.
And we always like to put up this disclaimer that if you like
what you hear it's all us.
If you don't, keep in mind that this is not work
that CMHS or SAMHSA or any of those folks--
we are responsible, so don't go complain to them.
As I mentioned yesterday on our rehearsal,
Deborah and I from the team
like to be in 1970s noir movies
and only do black and white, so the whole presentation,
just imagine we're in black and white.
I'm not sure why we're in black and white, but that's me.
This is Deborah who is the Co-Director of Research and Evaluation
for our TA Center.
And so, with that, here is what we're trying to do.
We're gonna do some lessons learned.
We've--you know, some of us have obviously worked
with many of you over the years,
obviously are currently working with you in terms of our TA Center.
We've read through reports, we're on grantee calls,
we're on FPO calls, and so we've tried to put together
some lessons learned of where we think folks are at.
We thought it would be very important to also have
some of you talk about the work that you're doing
and, in particular, are two examples of folks
from Louisiana and Cherokee Nation.
Deborah and I had asked them to maybe think a little bit
about where did we start, what do we think we're gonna do,
what were some of the twists in the road that sort of sent us
maybe in a little bit different direction and where are we at now.
And I think what you'll see in their presentations is
a great deal of thought that has gone into,
and a great deal of similarities, quite frankly,
in terms of how they've approached this
and what they think are sort of the pieces for them.
They have different approaches, they're doing very different things,
and yet are both doing some very effective
infant and early childhood mental health consultation work.
So you'll hear from them
and we'll have time for Q&A after that.
There are a number of other centers that have done work on this
including some that have been funded
by Head Start, and another great one,
that we hope all of you are familiar with all of these,
but just in case, we'll walk you through
some of the resources from the Head Start TA Center
that has done some work and the Center of Excellence
for Infant and Early Childhood Mental Health Consultation
that has done this work as well.
There are some great resources on all of these.
Hopefully many of you have already seen them,
but we wanna spend a little bit of time walking through those resources.
Here's what we're hoping happens today.
We really want to talk a little bit
about what we think we've learned over the years
and in a conversation that we had with Jan Oppenheim
how, you know, we've come to think
of these five strategies
and how, over the course of the lifetime of Project LAUNCH,
the thinking about what do we mean when we say
this core strategy is about mental health consultation
or this one's about home visiting,
what does that mean and how does that relate
to all the other work that you do within your states
and communities, within your tribal nations,
within the territories?
How does it all fit together in terms of the thinking
about what that strategy is about
and what it means practically as you're trying to implement this,
and what are the implications for workforce development
and financing and sustainability and all.
And I know I'm upsetting people
who are on a daily basis trying to figure out,
well, what are we gonna do about financing and evaluating
and sustaining this particular strategy,
but that's one of the things we wanna do.
In that, we really felt like these two examples and we,
could have picked, quite honestly,
when we thought about who could present,
these are but two of the examples
amongst all of you that could present.
There are any number of others who could present
on some really good work that they're doing
in terms of mental health consultation,
but we wanna understand some of the barriers
and facilitators within the sites
and what makes this easier or harder to do
and how do you sort of deal with that.
How do you sort of figure out what's the knot in our system
and how do we untie it, how do we get around it, kind of thing.
And then we really want you to sort of think
about some of these resources that are out there.
There's a lot of interactive resources that are, quite honestly,
self-guided so that you can use them in your work,
but we wanna make sure that you're all familiar with them,
and then take advantage of your TA navigator
who can really help you with that in coordination with your FPO
to really think through which of those resources would be helpful,
given where we're at developmentally
in our early childhood system,
so we'll talk about those resources,
and then obviously, this is another place
for you guys to share with one another,
"Oh, well, we tried to do that, but it didn't work,"
or, "Oh, we never thought about that.
"It was great to hear Louisiana talk about that
because that makes us think that we could do something like that."
So we want you to be sharing throughout.
Use the chat function if you have things to say,
use the Q&A function to sort of think through
particular questions you have.
We'll do our best to answer, and if not,
we'll always come back around and make sure
that everybody's questions get answered after the webinar.
We are recording today, so for those folks on your team
who somehow had something more important than to listen
to us talk about mental health consultation,
there'll be a chance for them to listen to it.
But that's where we're at.
And we actually wanted to start with a little poll,
and just to get a sense of where folks are at.
So, you know, when we think about mental health consultation
there's really sort of different places
where people are at developmentally.
Maybe you had a really strong mental health consultation system
before you even got a Project LAUNCH Grant
or maybe you didn't, and so we thought
could folks tell us maybe you think your efforts
should win you a prize.
Like, if there was a prize for mental health consultation
that we could get Jan to give out and her team.
Or maybe you're moving along at the pace you sort of expected.
You really thought, "Yeah, this is about what we thought."
Maybe it's been more challenging
and, hopefully not, but maybe there are some of you who are like,
"I don't even know what you mean
when you say mental health consultation."
So I see some folks are voting, thank you.
And we'll just give you a little bit of time there
as folks are sort of throwing in where they're at.
I see a number of folks feeling like it's been challenging
and this is helpful for us to know.
I mean, I think for many of us, we had an inkling.
So as you're coming on, just sort of tell us where you're at
with mental health consultation efforts.
A great number of you feel like it's been more challenging
and maybe more challenging than you thought it might be.
And some of you feel like it's moving along
at the pace you expected.
I don't know if we have any prize winners
or people who are that confident,
but that's really helpful.
So let's go ahead and take that poll down
and get back to our slides please.
Been working with my two-year-old on this,
the whole please thing.
And, as Deborah knows
and many of my friends on the TA Center,
it's not my strength.
So thanks for answering that poll.
We do have a sense, it seems like for a number of you
this has been a bit more challenging as a strategy.
So I'm gonna turn it over to Deborah
who's gonna sort of do some definitional pieces.
Again, for some folks, some of this may be old hat.
For others, you may be like,
"Ooh, I didn't really think about it that way."
And you'll see at the bottom before you start, Deborah,
that a number of this has been taken
from our sister center, our partner here,
the Center of Excellence
for Infant and Early Childhood Mental Health Consultation
which, hopefully, you'll learn a great deal about today as well.
All right, Deborah, all you.
(Deborah Perry) Okay, thanks so much, Neal,
for passing off the baton, so to speak.
I was also gonna highlight the fact that a lot of the slides
that we're using here just to kind of set the groundwork
and set the stage are slides that we created
through our SAMHSA-funded Center of Excellence
for Infant and Early Childhood Mental Health Consultation,
which Neal and I are very excited to be a part of also.
So if you see things that you like, reach out to us.
We can probably get you copies of these to use
with your partners as you're doing this work.
I think the first thing we wanted to do is
just kind of do some definitional things.
And you can see here, this is a definition
that has evolved over many, many years.
We--Neal and I were both very fortunate to have
Roxanne Kaufman as our mentor
when we were young and growing up in this field
and a lot of the work
on early childhood mental health consultation
came out of some work that was funded by SAMHSA
back in the day, in 2000 actually,
where we pulled together a group of experts in the field
to kind of define what mental health consultation is
and this definition has kind of been distilled down
from a lot of thinking in this area
and I think the parts that I wanna emphasize here
are that mental health consultation
is a multi-level preventive intervention
and I think those two pieces are really important
that we're always thinking about mental health consultation
as an indirect approach where the consultant
is working with someone who's working
with children and families.
And so it's that sort of indirect multi-level
that it's really designed to go upstream
and try to identify children with
or at risk for mental health concerns,
whether it's very young children in the context of their families
when we're more talking about home visiting,
or in childcare or Head Start,
and that the overall goal is,
you know, both health-- mental health promotion and prevention.
And I think that that's why
it's such an important strategy for LAUNCH,
that it really gets at a lot of the core things
that LAUNCH is trying to achieve.
Another slide here to kind of just talk about
what the work looks like.
And, again, I think you can see the graphic on the right side
is talking about sort of people who a mental health consultant
might be working on behalf of or with
in the service of children and families.
And I think one of the things that this slide
is intended to emphasize
in this idea of everybody brings their wisdom to the circle
and learns from each other is that mental health consultation
is guided by a particular stance in the work
and one of those things about the stance
is that the mental health consultant is not the expert.
They don't come in with an expert stance.
They come in with a stance of humility,
of curiosity, of wondering,
and that the folks who are working
with those children and families firsthand
bring equal expertise to the conversation.
And that it's through really building relationships
with those folks and in those community contexts
that the work gets done.
And I think the third bullet on this slide really emphasizes
just how important culture is and, again,
as we were talking about, it's a multi-layered intervention.
It's--culture is also seen at multiple levels.
So if a mental health consultant,
for example, is going into a Head Start Center,
they really need to understand the culture of Head Start
and what values and beliefs Head Start
really carries with them in their work.
Equity is always an important theme
in terms of mental health consultation,
in part because a lot of this work
got promoted
by some early work that Walter Gilliam did at Yale
around preschool expulsion,
and many of us were able to mobilize those data
on higher rates of expulsion
for kids in preschool settings
and those data underscored that young black boys and girls
were getting disproportionately expelled
from those preschool settings.
So really understanding that mental health consultation has
a social justice angle to it
and that we need to keep that kind of in the forefront
as we're doing this work.
A lot of times we talk about sort of different kinds of ways
that mental health consultants can enter the work,
and here we have
sort of three different focuses of the work.
For some mental health consultation efforts,
the work is really focused on needs of an individual child or family,
and the consultant is really working on behalf
of that child's individual needs
and developing a plan and working with the parents,
the teachers or the home visitors
to really promote that individual child's social
and emotional development.
There can also be a point of entry,
particularly with teachers and with home visitors,
thinking about those two,
where you're entering the work on behalf of a group of children
and it's easiest to think of this, I think,
with classrooms so that you're--
the consultant's entering a classroom
working with a teacher
on behalf of an entire group of children.
And while they may be thinking about individual children's needs,
their--the work is actually trying to craft
the environment of that classroom
to meet the needs of all children.
And that's where you can also really think about things
like the teacher-to-teacher relationship
and how that's affecting the classroom quality
as well as with home visitors,
really thinking about how to support their work,
for example, with moms who may be experiencing
a high burden of depressive symptoms.
So it's thinking about individual families,
but working on behalf of a group of them.
And then programmatically, I think again when we think
about the preschool or Head Start environment,
a mental health consultant is really working to really change
policies and practices so they might be working on what is
the way to avert expulsions, what kind of policies
can we put in place so that we make sure
that the children aren't being expelled.
And around home visiting, it could be how do we help families
stay engaged in the program, how do we make sure that we
don't lose them before the program is finished.
So each of those three things, and the way I've described them,
it sounds like they're independent things that might happen,
but almost always they're very interrelated
and mental health consultants are often working
at multiple levels in their work.
This is a little flow chart that was informed
by some of the work that we have been doing
at Georgetown to try to describe
the process of consultation.
You know, it's not meant to be
as linear as it appears on this slide,
but the idea is that there is sort of a flow to the work
and the first phase really is around initiation
where the consultant is going in
and really clarifying what the expectations are,
making sure that the folks who are receiving consultation
understand what it is and what it's not.
You know, it's not therapy.
In the case of classroom-based work,
we're not going to pull the kids out of the classroom
and take them down the hall and work with them.
We're really working to build the capacity of those teachers,
of those home visitors, to do the work for themselves.
The second phase really is around exploration
and, again, being curious about what kinds of things
the consultee wants to work on, prioritize,
and what kinds of skills and attitudes they
may wanna explore with the consultant.
Then you move to a plan development,
and really agreeing on what the nature of the work
is gonna be, implementing that plan,
and then revisiting the plan and updating it as needed.
And then, again, sort of starting over again
in terms of new areas or activities that you
might wanna work on.
When we, as Neal said, we did have a chance
to both, in a formal way, kind of look over
the plans and reports that you've sent in to SAMHSA,
to your Federal Project Officers over the years,
as well as many of us have been working directly
with grantees for many years, and so we wanted
to just kind of pull out a couple of lessons learned
or themes that we saw in the work.
I think what's really exciting about LAUNCH
is that mental health consultants are working in multiple sectors
and settings, you know.
I've highlighted early care and education,
childcare, and Head Start being examples of that,
and home visiting, but it's also the case
that many LAUNCH Grantees have mental health consultants
embedded within primary care settings,
and so the fact that that work
would look very different in each of those settings
may be one of the things that's challenging.
As y'all had said,
some of this is very challenging.
So for figuring out what-- how to fit a mental health consultant
into those different sectors and settings can be challenging.
Also we noted that a lot of current grantees
are integrating the pyramid model into their work
and, for anybody who doesn't know
what the Pyramid model is,
this also used to be called CSEFEL,
the Center for Social Emotional Foundations for Early Learning,
and this really is a set of practices
that mental health consultants can use
in the service of mental health promotion and prevention.
It was really designed around childcare and Head Start,
but I do think that it has some relevance
to other sectors and settings as well.
And then I think another theme that we saw
was that a lot of LAUNCH Grantees
may have been doing work in a particular sector
and the LAUNCH funding allowed them to kind of expand
to a different setting, and I was very privileged to be
the evaluator for the Maryland LAUNCH Grant
and, in that example,
they were able to kind of go beyond some of the work
that they had been doing through their own statewide system
of mental health consultation and take it into school systems
for the early elementary and that was a growth--
growing edge for them in their LAUNCH work.
We also noted some cross-cutting implementation issues
and these are some of the challenges
that we noticed a lot of grantees are struggling with,
and so some of you guys,
maybe these may resonate for you.
First of all, you know, it's very--
we have not enough mental health professionals
in the country in general,
and they definitely are not evenly distributed across the country,
so just finding any mental health professional to do this work
can be challenging in some places.
And especially challenging to find mental health professionals
who have infant and early childhood expertise,
that's particularly challenging.
And it's even more challenging to have people
who have actually done the work
in community-based settings such as childcare
or Head Start or home visiting.
So that's been an ongoing challenge,
I think, that folks are struggling with.
There's always the corollary to that which is there's
very limited bilingual staff and a lot of materials
are not available in Spanish
so that folks are struggling with that,
particularly in communities where they're working
with non-English speaking families or childcare providers.
Another thing that's very challenging is,
as states have been expanding
their quality ratings improvement systems
and other ways to support childcare
with inclusion specialists around kids with disabilities
or, as I mentioned, the CSEFEL/Pyramid model,
sometimes you're finding that a whole bunch of people
are running in and out of, particularly, this childcare
and Head Start centers and sort of defining
different roles and talking about scopes of service
and kind of how you coordinate all that work
can be a problem, you know, that folks are running into.
We continue to struggle in this country broadly
with how to pay for promotion--
mental health promotion and prevention services.
And so mental health consultation is also a service
that's often hard to figure out how to pay for,
particularly once the LAUNCH Grant ends.
And so this is an area, for example,
where the Center of Excellence has been doing, I think,
some important work, and we can talk more about that
as we hear from the two grantees
who are gonna share their specific experience.
So I think I'll stop there.
I'll turn it over to our LAUNCH colleagues
who are actually doing this work, and we'll,
after the second presenter,
I will take some live comments and questions.
If you have any questions as they're talking,
please feel free to type it
into the question-and-answer box.
Okay, I'm turning it over to
(Neal) Mary Margaret. (Deborah) Mary Margaret.
(Mary Margaret Gleason) So, I'm very excited
to be here today on this webinar.
I'm part of a team presentation,
so I'll be starting and then Jody West,
my colleague from Louisiana LAUNCH
will be doing the second part of our presentation.
Just a little bit of a background on us.
Our team is depicted here.
I've put this up for a couple of reasons.
One is because Jody who's the-- one of the mental health consultants,
and I who--a child psychiatrist and pediatrician,
I'm doing the clinical direction part of our project,
are here to represent a much larger group of people,
and you all know that a LAUNCH team
is a large group with many moving parts,
and I've put this up to acknowledge our many colleagues,
but also to emphasize how much goes on in a LAUNCH team
and how important it is to think about
who's on a LAUNCH team and then think about
the relationships within the team and then what the team
has with the rest of the community and the state.
And I just put this slide in to share with you that we do have
a website, which I think is important to acknowledge
because with Project LAUNCH,
one of the things we know is there's just so much information,
and what we've tried to do is distill
some of the information into more manageable components
for our community partners in particular.
This slide here is our--
is the front of our LAUNCH web page.
We're in year five of Project LAUNCH, so it's an interesting time
to be thinking about what we were thinking when we started
and what we're thinking now.
This slide here represents our big view of Louisiana LAUNCH.
We serve an area in the southwest portion of Louisiana,
and our model includes three areas
or three domains of consultation in primary care,
early intervention or IDEA Part C,
and in early care and intervention or child care.
And that is, I would say, a really powerful part
of our Project LAUNCH model.
In addition, we won't be talking much about it,
but I wanted to highlight that consultation
without thinking about community messaging,
education of the community, increasing awareness
of the power of early intervention,
and networking with other child-serving partners
and other partners who may affect
the lives of young children, is critical.
And we also are grateful to work with our state team,
working on that last piece that Deb mentioned,
the sustainability, and thinking about how, at the state level,
some of the principles that have been effective in LAUNCH
can be disseminated.
We have made some changes in the model, but I'll go through
those in each of the-- as we talk about
each component of our Louisiana LAUNCH.
This is an analogy to the idea
of the multiple levels of mental health consultation.
What we try to do is put this together to define how we
break down the global idea of consultation.
And our consultation model affects children
who can range from typically developing
to children with already identified special needs.
And everyone in between.
So in primary care, we can target the needs
of almost 95% of children in the community
or in the US right now
because most children have healthcare coverage.
Child care serves most children as well
or can serve many children.
We've focused our child care consultation
on the needs of lower income children
and ideally focused on family-based centers
and then, obviously, the early intervention children
are children who already have
at least one domain of development,
or in Louisiana, two domains of development affected
and might be needing more intensive services.
So this is our grid that we want to be thinking about as we work
with providers in all three domains.
We want to make sure that we're focusing
on supporting healthy development for everyone
especially in the typically developing children,
that we are systematically identifying children
who have risk factors
or have early developmentive symptoms
of early childhood mental health problems.
We wanna make sure our providers feel comfortable
once they've identified someone
doing something, saying something,
having a plan for first line management
of early mental health issues
and recognizing that their first line management
may actually mitigate the problem for some children,
but that some children will need
that specialty mental health services
that Deb was talking about, that is often so hard to find.
But our goal is that our providers know how to link
with the existing, more intensive services in our community.
I don't wanna go through this too much because I think
the basic principles, I think, we just heard about more--
much more eloquently.
But we did try to define
what does it mean to do mental health consultation.
What is the core of consultation that we can share
across all three domains.
And I didn't realize I have a mistake on this slide.
I apologize.
The most important thing, I think, is being
strength-based and strength-focused.
And within our consultation model, we've defined that
as finding the strength in the children,
the families, the providers, and within our team,
trying to recognize and appreciate the strengths
that everyone is bringing to this process.
This bullet is the one that has the error.
It should say providers not primary care providers.
But the idea is that we want to acknowledge what our partners
are bringing to the conversation,
either about children or about systems,
and help them recognize the many things
that they're doing that already promote
early childhood wellbeing.
We did go beyond some of the traditional
early childhood mental health approaches
by borrowing from the pediatric world.
The idea of the common factors approach was developed
by Larry Wissow and Marilyn
who's also been involved with their LAUNCH.
And the idea is that the providers that we serve
didn't by accident not become mental health providers.
They were on their own specific plan
and their own specific path to their profession.
And so they should have tools to support mental health,
promote mental health, and address in some way
the needs of children with mental health needs.
But they don't need to become mental health professionals.
And the common factors approach distilled
some of the most commonly used components
of evidence-based practices into a tool kit,
essentially, for providers,
initially pediatric providers, but in our project, everyone,
to use when they see a child with a mental health concern.
The early childhood common factors tool kit
is mostly focusing on positive parenting principles,
positive caregiving principles in the child care setting,
helping people be aware of the strategies for relaxation
and de-escalation of intense emotions.
And also focusing on the parent-child relationships
and parent wellbeing.
And when our providers can do those things,
they are creating tremendously positive environments
for the children they serve.
The other part of our approach in Louisiana LAUNCH
is to promote effective communication strategies.
Again, using a mnemonic that was developed for pediatricians
that is derived from motivational interviewing
and good clinical practice.
I'm not gonna go through the mnemonic,
but it actually is evidence-based
and has been shown to decrease parents' stress,
among other things, and increase referral success.
The last thing is that we know, and is true for today too, said--
remembering everything that's said verbally is impossible,
and so having our providers have concrete tools
that they can share with parents
and cheat sheets that they can use in the form of handouts,
written information, is an important component
of what we do, what we try to do across the three domains.
So our pediatric primary care model is fairly similar
to the way we imagined it to begin with.
The team includes a licensed social worker,
and I float along on every team.
We offer all of the pediatric providers in our LAUNCH region
onsite or offsite consultation.
Meaning we can schedule a half-day a week
or even a full day a week
in a practice to be there for curbside consults
when they have a question about a patient
who came in for a well child visit, for example,
or for them to schedule people for us to see
that they have questions about.
Ideally, we see them together and then collaborate on a plan.
We can also do more extensive diagnostic evaluations,
which are done in our offices and tend to include me
and tend to be about either medications or diagnosis.
We also help them out with consults by phone
and we have one provider who kind of regularly calls me
at 7:30 in the morning to talk about questions he has.
The model offers a range of services
and we try to provide
what the primary care provider wants from us.
So it may be the onsite, it may be the offsite,
it may be using website resources more,
it may be a consultation about screening.
We respond to their needs.
Some of the really neat innovations that have come from
that are in the Family Medicine residency.
We've been offering them didactics because they
didn't have faculty who could teach the residents
about early childhood mental health and development.
The level of stress in all residencies has been going up
and the rates of burnout are going up.
And so now our mental health consultant
offers a processing group for the residents
at the program where we consult,
which is pretty exciting.
And we are now partnering
with our state developmental screening task force
to expand the dissemination of screening.
The piece that has-- the two pieces that have,
I think, been more challenging: we had hoped to do
more perinatal consultation and that has--
we've learned that that would have taken
a larger workforce than we have,
and so that's something that we do
in the context of Family Medicine,
but less--we have fewer partners who are OBs
because of cultural issues in building those connections
and the time that it would take to build
relationships with two different specialties
for one single mental health consultant.
The other thing I'll say about this pediatric community is it
tends to be more traditional, so building the relationships
between a really skilled social worker
and the pediatricians took a little bit longer
because they weren't used to having
a social worker on their team,
and I think there were some cultural patterns
that we have needed to work with them to understand
how they defined their needs
and how we could help them see the value.
In terms of our childcare model,
this was one that we started,
really, based on an existing very successful model of consultation around
the state and we were lucky to already have state consultation.
I think Deb brought that up,
that some places have built on existing models.
And we really are excited that we were able to do that,
and that we have Alison Booth,
who runs the state consultation program,
also on our LAUNCH team.
The model that she developed and that we've continued is
a hybrid model that's primarily center-focused,
but also doing child-focused consultations.
The consultant is on site every other week
in the centers offering consultation,
and we've expanded a little bit because our team's bigger
that I can see children about whom there are specific questions
or we can consult about medical concerns.
So we've had some children who have had
pretty unusual medical issues
that we've been able to have conversations about
to expand the information that the consultant has.
I think the one thing that we had hoped to do was to have
more family-based centers and that's been a challenge for us.
The family-based centers tell us that they just don't have time
to even during nap time because they don't have extra people
to have conversations with a consultant
and, as a group,
they've also shared that they're not totally sure
they trust people coming in.
And so we've done some consultation,
but not as extensive as we had thought we would
with the family-based centers.
So now I'm going to turn it over to Jody to talk about
our early intervention model, which was the newest model,
and I'll just say that the early intervention model
did come from a hybrid of the childcare model
and existing primary care models,
and it's been very exciting to see what Jody's done with it.
(Jody West) Thank you, Mary Margaret.
I'm the mental health consultant that focuses
on early intervention in Louisiana,
and like Mary Margaret said,
it was developed specifically for this project.
And we do focus on the system,
the whole system of early intervention
in the three parishes that we cover to support
identification of mental health needs for young children.
A consultation can be direct or indirect, and by direct we mean
actually in the home with the family present.
Indirect, in this context, means I consult with provider in early--
with our early intervention program,
through a phone call or a face-to-face meeting,
but just not in the home with the family present.
All of our consultation is provider-driven
so I am sought out, I'm asked, I'm invited, to come in
in the majority of the consultations
that I do participate in do occur during home visits.
I wanna speak a little bit
about the level of community engagement
that our project has had to embark in.
Like Mary Margaret spoke earlier,
that consultation cannot happen without the context
of the whole system and the system of care
that occurs in the community.
We have a Community Early Childhood Council
that is comprised of agencies in our communities
that have a stake in the game.
They have the same mission,
the same goal of supporting families
and supporting young children, and we gather quarterly
and we have offered some programs
such as mini grants where we offer
some funding for programs that they are incorporating into their project,
so an example of that is we had a primary care practice
that wanted to incorporate or promote literacy
so we have a program called Red Beans, Rice, and Reading,
which is pretty local to Louisiana where families come in.
Provide--we provide a meal and access to books for families,
encourage reading, and they leave with a full belly
and a book for their child.
So that's just an example of some of the outreach
and the community engagement that Project LAUNCH Louisiana
has participated in.
We've also have billboards that we've put up around town
so this, in the picture, if you can't read it, it says,
"How you respond to your child's feelings makes a difference,"
and it links them to our website
which has all the resources that Mary Margaret spoke of earlier.
We participate in health fairs, parent education events,
and we promote Vroom app, we promote literacy,
we promote interacting with appropriate toys
and age-appropriate toys for families.
And we've also incorporated training
for therapists in our community
on evidence-based practice of PCIT
which is Parent-Child Interactive Therapy.
Most therapists that see children in our community
start at 5 or 6.
By providing training and certification for PCIT,
they can start as young as 2.
So that way, there is access to mental health intervention
for some of our youngest children.
By the numbers for the two years that we have listed here, these--
the partners are the number of consultees
that have participated with Project LAUNCH Louisiana
and the bottom box talks-- speaks to the number of consults
that those partners have engaged in.
So we're growing, we're constantly adding providers.
One of the challenges has been how to manage as you're--
as the practice grows, as the consultation grows,
how do you manage your time, their time,
and part of the challenge that I have as someone
that does consultation in home visits across three parishes
is managing that time,
and managing how I can be in multiple locations at the same time.
Because, again, they invite me in.
So I'm not in charge of my own schedule a lot of times.
That's been a definite challenge.
The next slides, we have a couple of graphs
that we wanna just share.
One of the things that we wanted to point out
is that before consultation begins across all three of the domains,
we do ask that the consultee
complete a survey of questions
that gathers their input and their information
about how they feel certain areas.
So by asking these questions, we're gathering
their sense of competency, their sense of confidence,
and their sense of resources in the community.
So this slide right here speaks to the consultee's ability
to identify mental health needs,
their own feelings of their ability
to identify mental health needs.
And you can see that their first set of bars speaks
to that they--their feeling of adequately being able to identify
mental health needs was roughly about 55%,
and then over the years it's increased.
The next set of bars reflects the folks that felt
inadequate or grossly inadequate
in their ability to identify mental health needs
and it's going down over the years.
So we wanna see the first set of bars, the confidence
and the feeling of competence that our consultees have
increasing and their feelings of incompetence decrease.
So the next few slides just speak to that.
So the ability to meet mental health needs in the community,
their feelings about access to therapists
for young children in the community.
Again, we wanna see that they feel more adequate versus inadequate,
and then access to child/adolescent psychiatrists
and developmental behavioral pediatricians.
Something to point out, we wanna stress
that there has not been an increase in the access
of developmental pediatricians in our area.
It's just that their feeling and their perception
that there's more resources available,
because part of our consultation process
is to help connect them to resources,
to educate them on what is available,
has been effective.
So, just in closing, we also did focus groups with the consultees
to get their input about how it's been helpful,
if it's been helpful, and how we can change our own processes
in consultation to improve the work that we're doing.
And many of these quotes just show
how it's about increasing their own feelings
that there are resources for them.
We want to eliminate burnout.
We want to help them feel less stress in their job
and feel more-- be more available
to the families they serve.
So these slides just talk about some of the quotes
and just to point out what I feel has been
the most poignant is the first one
where it speaks about how, "The families are always
"in dire need by the time they get to us,
"so now we have more knowledge and access to help the family.
I carry that burden and now I feel better about it."
This is so important because there's-- the folks that work in these systems
or the next patient, the next client,
the next child that comes in to their system,
they're dealing with the most vulnerable folks in our community
and so they're always gonna have this, and I'm doing air quotes,
a "burden" of trying to help families.
And if we can help them feel more confident and competent in their job,
then we've achieved the goal that we have
for our Project LAUNCH here in Louisiana.
(Neal) Thank you, Jody, who,
just so everyone knows, I'm like, pressuring folks
and saying, "Hey, we've got to get to the next one,"
so I really appreciate all that you
and Mary Margaret just shared.
I know it's a lot.
We had a couple of little side conversations here in the chat,
that, now that you guys are done, you can sort of go look at
while we turn to another example.
And if you have questions, go ahead and keep putting them
in the chat-- there is a Q&A box
and I'd feel awful if Joanne had to put that up
and no one used it,
so put your questions in there as well.
We'll make sure we leave some time.
We can move through sort of the other parts of this
more quickly if we need to.
I wanna make sure that Juli has some time to share the great work
that they've been doing in Cherokee Nation.
So I'm gonna turn it over to you, Juli.
And, folks, again, use the Q&A and the chat if you can.
(Juli Skinner) Hello, thank you.
Thank you all for staying on board right now.
I know it's getting later, so I really hope I can give
a good idea what we're doing at Cherokee Nation.
We're doing a lot with mental health consultation
within the five LAUNCH strategies, I think all of them.
I talk to people about this, around the strategies
and how they all are inter-related and connected.
So we're gonna start with our program,
just to give you a background
of what we do at Cherokee Nation.
And we are The HERO Project toward children's behavioral health
and we work with our families at multiple levels,
like what we said earlier.
Multi-level is very, very important in the work that we do.
So the background of our project is that we're a Cherokee Nation.
Cherokee Nation is the largest tribe in the United States.
We are located in Northeastern Oklahoma.
We have over 340,000 citizens at this current time.
We also have a jurisdiction service area
of over 9000 square miles.
And this is important to keep in mind our geographic.
So that's a lot of ground to cover,
and so we had to keep that in mind
when we were thinking about implementation of our strategies
and especially mental health consultation.
We have a lot of rural areas, and also to keep in mind is that we
don't exist in a reservation.
I know a lot of tribes do, but Cherokee Nation,
we are interwoven into the communities that we serve.
So it's not just a Native American population that we serve,
although we have a very large one,
we're also have-- we're integrated.
So that--this is another thing that we keep--kept in mind
and something that we really wanted to focus on
was the public health approach,
to really keep in mind that we wanted to get
all of our population that we work with.
So Project LAUNCH, for our project here,
we serve four target counties
out of the 14-county service area that we had.
We had to just take four
because of the amount of work it would require.
At Cherokee Nation we have over 11,000 employees,
and 58% of this workforce comes from Health,
so that kind of gives you an idea how large we are.
We have one hospital and eight clinics that we serve.
The hospital is located in Tahlequah
and that's where our HERO Project is also located,
in Tahlequah, with our hospital, so.
So some of the factors that went into how we do our work.
So, what we wanted was mental health consultations.
When we first originally wrote for the grant, you know,
we were looking at this and we thought,
"This is some great ideas, this is what we wanna do."
We looked at eventually starting in our primary care level
with developing a mental health consultation model
that would incorporate our primary care
and something that we initially wanted to start with
that when we started working within the strategy
of mental health consultation, we realized pretty quickly
that we needed to change this model a little bit
because I felt like, you know, with this area,
we really wanted to spread out
and try to reach as much of our population
in those four target counties as possible.
And that I felt like that we might get more of our buy-in
from a different intervention.
So we also wanted to do was hire a mental health consultation
to work with our classrooms
within our Cherokee Nation Head Start.
We have a really large Head Start and early Head Start group
within Cherokee Nation, and so they're in all 14 counties,
and so that's one thing that we wanted to work on,
but we figured out pretty quickly that that was
something we wanted to work towards
and we wanted to start with something else first.
And we'll talk about that.
So I've put this together to kind of give--
I'm a very visual person, so don't mind my,
you know, crude picture of this, but I wanted to show
the foundation of how we defined mental health consultation.
When we went there, that was the foundation of everything that we do
at the HERO Project for mental health consultation.
But we took this definition from Green, Everhart, Gordon, and Geffman
that, "The goal of the program level mental health consultation
"is to develop the capacity of a program and its staff members
"to successfully work with children
with emotional and behavioral challenges."
And when we looked at it from that angle, we thought,
"You know, we really wanna get into the community."
We really want this to be community-driven,
because sustainability isn't just about finance.
It's also about mindset and how people do things.
So we picked PAX.
PAX, originally, we had put that in our family strengthening area.
But then we thought, you know, we can actually turn this around
and make it more towards mental health consultation
because of that definition.
If we empower our teachers, we empower the community
and our parents through this model,
then I think it's gonna sustain a lot longer.
So, you know, we have a lot of work that we've built
around with our community action teams, we call them action teams.
You'll probably hear me refer that-- refer to them a lot.
Those are parents and caregivers
that we have organized into action teams
and everything we know
in the five LAUNCH strategies they know.
So everything that we learned, we taught them.
And so they really caught on to PAX.
We introduced PAX to them and they ran with it.
So they're the ones that really got PAX
into the communities that I'm gonna talk about,
so that family, parent engagement strategy
that we really use.
So with PAX, the idea of PAX, was that we wanted to increase
nurturing environments by reducing toxic influence
affecting adults and students, reducing exposure
to problematic behaviors from adults or other children
and increasing teacher and student cognitive flexibility.
And finally, PAX will develop the capacity
of these school districts to successfully work
with children with emotional and behavioral challenges.
So those were the big ideas, and once we felt that we
could spread that into our communities,
that our teachers would get this, our parents would get this,
that we could probably make a lasting change
and we'll go as far reaching as we possibly could
in the time that we had.
So our next step for PAX, this'll introduce you.
I'm not sure how many people are familiar
with the PAX Good Behavior Game.
We'll talk a little bit about that.
So PAX Good Behavior Game are simply,
"PAX is a school-based intervention
"with several decades of research
providing its-- proving its effectiveness."
So basically, PAX teaches children's
cognitive, emotional, and behavioral skills
necessary for lifetime success.
So that through this intervention, students will learn cooperation,
delayed gratification, impulse control, and self-regulation.
Numerous studies show these skills that are run through PAX
increase children's test scores,
high school graduation rates are increased,
as well as college acceptance and attendance.
Also PAX is dramatically proven to decrease detention,
suspensions, physical injuries, mental health diagnoses
and reduction of alcohol and drug use over a child's lifetime.
There's over 30 years of research behind PAX.
PAX not only helps children with risk factors already in place,
but also protects the other children around them
as well as the staff that care for these children
on a daily basis.
So before starting with--we did
an environmental scan and really noticed and recognized,
you know, our population, Native American population,
has a high incidence of adverse childhood experience.
So we looked at PAX to really affect change with our teachers.
So our teachers, you know, there's a lot of incidences
of over-prescription of ADHD.
There's a lot of kids who are on medication that when we
really look at the trauma, the high trauma rates
that we have in our Native American communities,
we know a lot of that can look like ADHD,
but is really in fact trauma.
So teaching our teachers, arming them with this knowledge,
was really crucial for us, we felt,
to really make the most impact for our children
and the other children that are in our communities.
We really--the public health approach is very crucial
to the work that we wanted to do.
And so, our model for the PAX Good Behavior Game
is that teachers will undergo a training provided by PAX
to implement in the classroom.
So we have two Project LAUNCH staff.
We titled them Evidence-Based Intervention Specialists
and that's exactly what they do.
They do a lot of research and they implement
evidence-based research and interventions
into our communities and they monitor
progress of PAX through classroom observation
for classrooms from pre-K to 2nd grade.
So teachers are taught and coached on PAX
and their delivery of PAX in their classrooms.
And so our goal is to get them, you know,
certified and trained in PAX and then be like a partner,
a PAX partner and to work with them on implementing PAX
and doing classroom observation, actually providing
the support of this intervention into the classrooms.
So, in addition to PAX implementation,
other activities that we also worked with
were workforce development training with Early Head Start,
Head Start, Early Educators, and program consultation.
So let me just give you an example.
So we were doing-- we were talking
to our action team members
in one of our communities and they had loved this idea.
They just thought, "Wow, this is like something that we
"really need in our community.
"Can we talk to the teachers in our school districts and see
if we can, like, get this in there quicker,"
'cause they wanted it, like, yesterday.
When we started talking about what we wanted to do,
they were, like, "We need to get on this faster, you know,
this is something that we really needed."
So they did, they went back to their school districts
and talked to the school superintendents,
and next thing I know we're scheduled to teach
87 teachers with a Triple P Seminar,
which is talking about social emotional development in children.
I was, like, "Oh, my gosh, 87 teachers, can we handle this?"
So we did, we took six staff and trained 87 teachers
in social emotional development with the Triple P Seminar series
and it went over-- I couldn't believe it,
that we were able to do that.
But that community buy-in was so impactful
and, to this day,
this community is really strong in PAX
and really been working with this on this intervention.
Some of the reasons we changed our model,
and not that we haven't,
we're not gonna go back and do the other,
but the reason we wanted to start this way was sustainability.
That is huge.
Anything that, you know, we do within our LAUNCH strategies
we wanna sustain it.
So keeping in mind before we start something can we continue
to finish it and can we continue to do it
even after the money is over.
So, Cherokee Nation in the past, you know,
we're so large and we've received
different grants from other different departments
and the things we heard--
was parents were saying, like,
"You guys start something, you never finish it.
"So I don't even know if I believe any of the programs
that you do because it's gonna go away."
So that was one thing we kept in mind after we did
our environmental scan and why we changed
in our grant application,
you know, we wanted to have this idea that when you do
that environmental scan, it was an eye-opener.
So that was crucial and one of the reasons we changed our model to really--
and to use PAX instead of the other way first.
Partnerships, we partner with school districts,
with teachers, with school administrators,
that increase the parts of the collaboration,
the coordination, so now schools have a resource for children.
When they had issues in the classroom and teachers
were suddenly starting to figure out,
"Hey, maybe if I change how I teach
"or change and add this to my classrooms,
this might change some behaviors I'm getting from these kids."
'Cause one of the side effects, I guess you could say side effects,
of PAX is that it's almost like there's a behavioral vaccine,
so kids, suddenly they're able to regulate their emotions
where they weren't able to before,
and when teachers were realizing they had more time to teach
in classrooms instead of erasing school behaviors,
that was a game changer for a lot of teachers.
The teachers that have really used PAX have seen
a really remarkable change
in the work that they're doing with their students,
so that has been huge.
In the beginning, with our teachers,
I'm--may be getting a little ahead of myself,
but I wanna say this so I don't forget this.
That teachers, sometime, you know, begin with,
"Well, if we just get the school administrators on board
"because the parents think it's a good idea,
that's good enough," but no, we had to realize
we've got to get our teachers on board too.
It wasn't just about getting the school administrators to say,
"Yes, we're gonna do this,"
because if teachers don't buy into it,
they're not gonna, you know, continue to do this.
So we really went back to the drawing board
to develop a pre-service training for PAX
so teachers understand what trauma is,
understand what social emotional health looks like
and then why that's important and something that we
might wanna teach in our classrooms.
So PAX is very short, too.
When they realize that this takes minutes to do PAX.
You might do it once or twice a day, and the reward was amazing.
They really liked it.
So also, another reason we changed our model was we're covering
a large rural population, so we have a lot of areas
where there's not a lot of services there because it's very rural
and we wanted to try to reach all these rural, rural school districts.
So we had a lot of those.
You know, we have a lot of communities
that are just--they have this bold community schools
that, you know, that may only be the only resource for that community,
so we wanted to really reach all of those.
Also empower the community.
So they take this intervention.
We teach it, provide it, implement it,
show them how to do it.
Be a partner and supporter of them,
and they run with it.
So it was really that empowerment that we really wanted to go for.
And also want it to last.
And we felt that PAX was, like, a way to really last
as long as those teachers are there for them to last.
And some school districts are, like, really excited
about, you know, 'cause it's-- we train four different classrooms,
and so these students are able to get PAX
for the first four years of their school, so something
that they're gonna be able to see for a long time,
what this intervention does for their program.
So here's our current progress.
I actually had one other evaluation come out,
but I didn't have time to fit on the slide.
This got out last night, so who was served so far?
So this is a little bit higher,
but in 2014, with ten teachers from one school.
In 2015 we added 26 more school teachers,
preschool to 2nd grade.
In 2016 we had 13 teachers added in that area of Wagoner,
and then we had, in 2017, four teachers
from Watts in Adair County were trained.
So that's our newest cohorts that we've been working with.
So we have nine schools total and we've trained
60 administrators, counselors, and teachers.
We have 27 classrooms implementing PAX
and over 1,300 students.
So there's probably a little bit more than that now.
That's what we've been doing so far.
And how is it working?
So we did a baseline,
so one of the things in classroom observations
is the counting of spleems.
And spleems is basically those behaviors that you
don't want to see in students,
those behaviors that are like when the students
aren't paying attention, they're disrupting class
or maybe, you know, not paying attention
and focused on something else that they shouldn't be.
And so those are the baselines that we did before we did
the intervention and across those four schools.
Then what they look like two years later of what--
the spleems counts went way down for everyone.
Like, where all the schools that participated went way down
by about 60% to 70% on average is when those schools went down.
So some of the challenges that we had was in the beginning,
we had talked a little bit earlier about,
was gaining that teacher buy-in.
Like, we had to go back and say,
"You know, we know it's a good idea
and our parents think it's a good idea,"
but getting the parents or the teacher to really understand,
because you have a teacher who's been doing a teaching
a really long time and you don't wanna come in and say,
"I know more than you."
That's not the way to go.
You really want them to understand, you know,
that maybe they don't understand the best way to deal with them,
so really getting that one-on-one relationship
going with those teachers so they understand it's, like,
"Hey, this is how I can use PAX.
It's not just another thing you have to do in your classroom."
But really, like, relating with them on the issue
and really getting their buy-in was really, really crucial,
so that's something that we went back
and did some pre-service training for teachers and we saw
a lot better impacts with those schools
because the teachers are more willing to wanna do this.
'Cause a lot of times, I don't know how your schools are in your area,
but in order to do some of these trainings for PAX,
their school days are so set already.
They schedule their school days way out.
So our teachers, they had to come in on their day off
to get this PAX training.
And so to get that many teachers to come in and do
this PAX training, we knew that, hey, like,
maybe we're doing something right here
that we are getting that buy-in
because they're having to come on their day off.
They're not being compensated.
So we got them some free food.
So that's one way. They got free food.
But they also got this amazing intervention.
They had to sit through this intervention, this training,
for eight hours and they were willing to do it.
And so that was really great.
Retention is key.
That's something also that we had to go back and, like,
really, like, hey, we need to do retention activities
with our teachers, keeping them engaged,
doing some more follow-up, refresher trainings on PAX is important.
Teachers are very, very busy, but it helps to keep them engaged
by going back and offering that support.
We do those classroom observations and using that time
to, like, if you need help, you need some assistance,
if there is a referral we need to make, let us know.
So there's things like that we've been able to do.
So some of the things we did for that was
very, very key, was just keeping that engagement
with those teachers going.
Some cultural considerations again.
We implement PAX in schools from our four target counties.
And these children are from all different races
and economic backgrounds.
We felt it was important to pick this evidence-based intervention
because it would meet the need of all of our population,
and so far it's been great.
No matter what background the child's come from,
they all have engaged in this game.
They love it.
It's like when you have a child, you know,
you maybe come from a trauma background,
you have--you're used to a very chaotic background,
and you come to class and you're expected
to sit in class and sit still and be quiet
and only talk when you're spoken to,
so sometimes our kids really struggle with that.
But when this game happens, maybe one of the things
that they get to do, they call it wacky prizes, is that they get to,
like, for 30 seconds scream or yell or holler
or clap or stomp their feet for 30 seconds
and then they go back to working
in classroom assignments, and so that was huge.
You wouldn't really think that that would make
that much of a difference, but it really, really does
for those students that--they have that outlet.
You know, so instead of getting, like, a monetary prize
'cause that's something that we were asked,
"What do I have to pay?
Do I have to go buy this, buy that?"
No, it's simply like tapping your pencil on your desk
for 30 seconds or, you know,
jumping up and down for a minute,
you know, or whatever, you know.
You--that's something that your classroom
and you decide what that looks like.
So it really helps teachers when they understand
that they do have some, you know, involvement here
and developing of those wacky prizes.
That was something big they really liked.
So, future plans.
So one of the things that we're working on,
the other part of our mental health consultation plan,
is that we also have a Systems of Care Grant,
and we were able to use this as seed money to hire
a child psychologist who has a strong background
in mental health consultation.
So now we're gonna go back and start implementing
more of our mental health consultation model
into our Head Starts and our Primary Care Centers.
We have integration into our Primary Care.
We're gonna work on those.
We have someone co-located there, and we do
a referral pathway with them.
So that's some things we're being able to do.
We're trying to hire a child psychiatrist
to come on board to help with that
in the health consultation piece.
And we also have earned revenue from our billing,
which will help pay for mental health consultation
in the classrooms for Cherokee Nation Head Start
and so we hope to start that sometime next year.
So that's just something that we're continuing to work on
while we're still doing PAX.
So there are some of the plans that we have
and how we're gonna sustain our program.
Because of our revenue, we're able to generate
enough revenue to support mental health consultation
and expand it for a very--
So I want to talk about engagement.
So this is an infographic that we did.
We put together about the Pax Good Behavior Game
'cause when we go and talk
to schools and teachers about this program,
we wanna leave them with something to look back to
about what this looks like for them.
So this is a example of some statistics on PAX
and what that would look like for them.
So that's all I have. Thank you.
(Deborah) Great, thank you.
Wow.
I'm just--I don't even know what to say because you all packed
so much great information
into those little short periods of time
that Neal and I gave you.
So thank you to all three of you
for doing, really, an outstanding job of sharing
the, you know, just some of the details of what you're doing.
I wanna invite folks on the phone
and, you know, if you haven't used the chat box yet,
that Q&A box is empty, just waiting for someone
to ask a question.
I know some people have been typing into the chat box
and I saw that we have a question
about kind of expanding on the billing process.
So, Juli, can you talk a little bit about that,
or if the person who asked the question wants
to un-mute their phone and actually ask the question,
you know, in greater detail,
we'd love to have that happen too.
So, Juli, you wanna just say
a little bit more about billing and--
(Juli) Okay, so what we were able to do
is hire on clinicians that are--in our state,
the tribes have a compact with the state to pay--
it's through their passthrough
so the feds actually pay our-- it's Medicaid.
I have a Medicaid rate. And our Medicaid rate is $391.
So whenever we hire a clinician, any--every encounter that we
have, they pay $391 per encounter.
So that's--when you look at-- if you have--on our staff,
we have six clinicians on staff and so that generates
a certain amount of revenue and that's able to help pay
for the additional services that we want,
so clinical services are paid for
by our tribal money, and then whatever--
the revenue that we generate, we had to create this.
So we actually had to go back and build the system
within our health system.
'Cause before, Cherokee Nation was not billing
for behavioral health and so when we started
the HERO Project we knew that's what we wanted to start doing.
And so we had to, like, build an infrastructure
within our health system
to bill for behavioral health for our tribe.
And so we've been able to generate that money
to create this opportunity to have
something like mental health consultation
in the services that we're not able to bill for,
so through our contract with the state we're not allowed
to bill for case management, for example.
So that's gonna pay for our case management,
it's gonna pay for our psychologist to do
the mental health consultations.
So we're able to generate extra revenue to pay for those services.
(Deborah) Great, thank you.
That's really, I think, really innovative and exciting.
I did see in the chat box also
that Yakama has been using
the PAX program as well,
and that Alicia Gary mentioned that they're looking at it.
So definitely, you know, sharing those details,
I know people were really excited about maybe having you
share that infographic, which was beautiful, Juli.
So maybe we can get that to put up with the LAUNCH resources.
Any other questions before I hand it over to Neal
to kind of finish up and sharing
some of the other resources
that we thought you might find helpful in your work?
Thank you, Juli, for all of that,
and Jody and Mary Margaret.
Really phenomenal presentations and exciting work
that you're all doing.
Neal?
(Neal) Yeah, so I guess now this is payback time.
So where I'm trying to get the folks in Louisiana
and the folks in Cherokee Nation
to sort of take all the work they've done over the years
and do it in 20 minutes,
I'm gonna go ahead and take 10 minutes to talk
about every single resource we think might be helpful
that we've ever developed over the last 10 or 15 years.
So I'll move through it relatively quickly.
Just a reminder, we didn't mention at the beginning,
but on the left-hand side where it says "Files"
you can download the presentation.
We're recording it so if folks wanna listen,
but there's also a way to download the PowerPoint,
you'll have that.
Obviously, we want you, we encourage you,
to reach back out to your partners
here amongst the grantees
in terms of all the information they shared.
And so I sort of did this chronologically.
Janet asked me, "How do we talk about this?"
So I would say that one of the first places
was this ecmhc.org, this--
the Center for Early Childhood Mental Health Consultation
that Deborah really led for us.
This is some work that folks at Georgetown did.
And if you haven't been on there,
we really think you should go on there.
There's still great information on there.
There's tool kits on there.
There's online tutorials so you can bring new consultants on.
There's all kinds of information about stress and relaxation,
which we are finding in our work has been very helpful.
It was funded by the Office of Head Start,
so it is more geared towards Head Start.
I don't think that that would preclude you
from using some of this information
if you're doing mental health consultation
in early intervention, home visiting,
in primary care, but this would be one place to start.
So this is, you know, for many of us,
this is one of the first places where we really try to gather,
and Deborah did such a nice job of pulling in all the experts
from around the country to put many of these things together.
Another effort that was funded by folks at Head Start
and the folks at Child Care, was sort of our next iteration.
And you can see the easy-to-remember link
down in the bottom left.
Most of us have memorized it, but I put it there just in case.
But on this one, you'll find it's much more interactive,
and so you click on one of these bubbles
and it sort of takes you through, for example,
in reflective practice you actually see,
and just a shout-out to my Louisiana friends,
you see Sherry Haller from Louisiana doing reflective supervision,
and then there's guiding questions for folks to think about,
"Well, why did the person do this?
"Why did they ask this?
What is the purpose of reflective supervision?"
You click on the role of a mental health consultant
and there's all kinds of interactive material
plus resources on there.
And so this is a great place.
Again, it is geared towards Head Start, but we have found
that many folks find this information to be helpful
no matter what setting the mental health consultant,
wherever they're working.
But this has got a number
of sort of different areas in there.
Highly interactive and, in fact, this is still being updated.
There are two modules, one on parent/family engagement
and one on cultural considerations
that are being worked on this current year
that will be going up, hopefully soon.
That's all I can say, knowing how long it takes
to get things up online, but that's where that's going.
So those are two
that have come along in the past.
We want to spend a little bit more time talking
about the more-- the newer center
and this is one of the exciting things
besides the fact that we continue to get to work
with Jan Oppenheim and folks,
is that the folks at SAMHSA have really coordinated
their efforts with the folks at HRSA and ACF.
And so we have real partnership at a federal level
to drive the work in terms
of infant and early childhood mental health consultation.
Meetings monthly, products that are put out for everyone,
the universal webinars, those kinds of things,
are really geared towards all the audiences,
that the folks in the maternal infant
and early childhood home visiting program
out of HRSA and MCHB,
the Head Start and Child Care folks at ACF and obviously
all of our partners at SAMHSA.
And so this really is, unlike the other two,
which really in some ways are more geared
towards mental health consultants and program directors,
this is really geared towards folks who are working
at the state or tribal or territorial levels,
to think through how do we do this sort of across the state?
How do we do this across the entire tribal nation?
How do we do this within the entire territory?
And so what's in there, and you can see at the bottom left
the link to get there,
are a number of resources for state and local leaders
as well as tribal and territorial that get at how you develop models,
how you address workforce development,
and how you maybe think about some of your communication.
So I'm just gonna take a few minutes
to sort of walk through this.
It has interactive modules, and I don't know,
maybe all of you have been on it and will tell if, by the end,
it's just me and Deborah and Jody, Mary Margaret,
and Juli talking to ourselves,
but there's a lot of interactive modules in all those.
What we sought to do here was to not just give you papers to read,
but to really have you walk through this.
And I'll walk through a couple of these with you.
Lots of resources. This is where you can go.
But, like, for example, in the model section,
and this is what the-- these are screen shots.
What you'll find is that within the model section,
there's a vision statement
and there's all kinds of planning guides.
And so in each section we have a vision,
and that vision really is that, long-term, what will we like?
Well, we'd like states and tribes and territories
and communities to be evidence-based,
data-informed, culturally responsive,
equitable, and sustained.
And how to sort of maybe develop national models.
In order to do that, we have an interactive planning guide.
And I know for some of you, you may have done
a process similar to this.
What we have found with some of the pilot sites
that we're working with on the Center of Excellence
is that it's helpful no matter where you are in your process.
It really takes you through thinking about,
you know, your theory of change and your population of focus
and dosage, and all the other sorts of things
that we know are really important components.
So it really can walk a leader and their team
through all of these components, getting ready,
planning to develop your model, taking action,
those kinds of things.
And a results page is generated after you complete each part,
which really then can drive you to think about
so what do we need to do?
Given what the results are saying,
what would be a good next step?
And then there are resources with-- nested within there.
So, for example, if one of the recommendations
that comes out of this is,
"Hey, maybe we need to do a needs assessment,"
we actually have a sample needs assessment
that you can use.
So there's very specific recommendations
to the sort of team in terms of your level of readiness.
Same thing in terms of workforce development,
this is another section, another part of the tool box.
And what you'll see is that there's a vision for this,
that we would like it to become sort of a mental health discipline,
and that folks
in the infant and early childhood mental health consultation workforce
really can effectively meet the needs of young children across the nation
and there's real professional development involved.
And shockingly, there's an interactive guide,
which we think is a great starting point,
a place to really think about
what does your workforce look like.
And, you know, Deborah and I certainly could tell you,
as could the rest of the TA team,
as we've talked with folks, as we've looked at materials,
we know that the workforce development
is such a critical issue, not just for this core strategy,
but really across all five.
But in particular, as Deborah mentioned earlier on,
that this is one of the areas where we find folks are really struggling.
How do I find the right people to do this kind of work?
We haven't heard from anyone,
"We don't think mental health consultation
is important or really a good thing for our system,"
you know, obviously quite the opposite
if you're on Project LAUNCH,
but what we've heard is it's not so easy
to really develop that workforce.
So we feel like there's a great starting point.
The other piece is around communication,
that we all talk to each other
and sort of feel like, "Yeah, I know what you're talking about,
I know what you're talking about."
But when you're talking to, you know,
government officials in a territory,
you're talking to tribal council,
you're talking to legislators, you're talking to folks
who may not necessarily be steeped in all of this,
it's really important to have some real strong communication tools.
And what you'll find in the communication section
are all kinds of resources and slides,
and many of them you've actually seen--
several of them you've seen today
are on some of the other webinars.
We've sort of done them for you, so you can sort of use these.
We have social media messaging sorts of things
around early childhood mental health,
infographics that you can use to help bolster
your elevator speech or your argument
that you'd like to make.
The other piece and, as we've been talking today,
unwittingly, not only did the folks from Louisiana
and Cherokee Nation agree to present on a webinar,
but unwittingly agreed
that they're gonna now start to share resources
and help us build up this resource bank.
We feel like if we can,
and obviously folks need to be comfortable,
but the more folks are sharing,
the more we can get things in this resource bank,
then you don't have to start from scratch.
You all, all the other folks who are doing this work
as Project LAUNCH Grantees, you can say, "Oh, I need this.
Oh, it--let's check the resource bank."
So that's really a place where,
in addition to the resources that we have
in these other centers that are online for you,
the resource bank is gonna be another place for you all
to be gathering that.
And we really want folks to think about this as an opportunity
to not have to do certain kinds of work
and I'm, as those of you who know me know,
I don't wanna do any work, so if I can find it somewhere else,
I'm just gonna grab it and use it.
That's really what these resources are,
that's what the resource bank is about, is really providing you
with the kinds of materials that will help you.
I thought as many folks were, like,
"Oh, I'd like to get that PAX infographic,"
well, I think that's a great example.
The PAX infographic,
some of the infographics from the Center of Excellence.
All these resources are there and your TA Navigators
can really be helpful in terms of saying,
"What do you think about this?"
And it was great to sort of listen to Mary Margaret, Jody,
and Juli sort of talk through this
because in some ways,
they've created their own resources and, I think,
have probably at times been able to sort of pull from other places.
So that's great.
As I mentioned, we know that many of you are going to make
a New Year's resolution
to be on more calls and webinars.
I don't think that any of us
get to be on webinars and calls enough,
so we know that to fulfill that resolution,
we wanted to get, right off the bat,
into a discussion hour.
So right after the New Year,
Thursday January 4, 3 o'clock Eastern,
we're gonna have a discussion hour.
So it'll be a good opportunity to talk through what are you doing,
what are you doing well, what are you having trouble with,
all those kinds of things.
And that will be our sort of next piece of this.
And then, don't forget,
tomorrow for those of you who are Expansion Grantees,
there's a community of practice call tomorrow, December 15,
and then, as I mentioned, the discussion hour.
And then we will be sending some more details,
but we're gonna start a webinar series
around the opioid epidemic and the first webinar
will be January 17.
And then just to make sure that every week in January has
at least some contact with your TA team,
the evaluation training practice on the 25th.
The call on the 4th is at 3 o'clock East Coast.
Thank you, Kari, for putting that in there.
Last thing, if you need to get in touch with us,
obviously go--you can go through your TA Navigator.
You always have the option of talking with your FPO
which will get you back to your TA Navigator.
And here's our email and toll-free number.
If there are any other questions, please let us know.
Thank you, Joanne, and thanks again to Deborah
who I can always twist her arm and make her work with me
but really to you,
Jody and Mary Margaret and to Juli.
Hopefully, folks got as much out of this as I certainly did
and learned a lot from our grantees.
Have a good rest of the day
and we'll be talking soon, take care.
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