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Can parents help parents treat students with serious emotional disturbances?

This article was originally published in The Notebook. In August 2020, The Notebook became Chalkbeat Philadelphia.

Achieving greater parent and caregiver involvement for students receiving behavioral health treatment services is a main goal for behavioral health workers and the School District in the coming school year.

In this Q&A with the Notebook, Kamilah Jackson, deputy chief medical officer of child and adolescent services at Community Behavioral Health, the city’s mental health agency; and Valarie Oulds, program manager at the department, discuss a pilot behavioral health treatment service funded primarily by Medicaid. Starting in five elementary schools in the fall, the new program will hire parents who have experience navigating the behavioral health system themselves.

Notebook: You’ve always expressed interest in getting caregivers more involved in students’ treatment. You already require lead clinicians to spend at least one-third of the time they engage in treatment each week with the student’s caregiver. What’s different about this project?

Kamilah Jackson: We will be adding a family support specialist to each team of professionals in school and community treatment services. These will be parents of students who have been in the behavioral health system themselves. They’ll bring different life experiences and a different perspective to help engage caregivers in the treatment process. We know from many years of research that this leads to better treatment outcomes for children.

The pilot treatment service, called Community and School Support Team (CASST) is designed for children with serious emotional disturbance and will be offered year-round, not just during the school year.

It is important that the family specialist have the experience of being a caregiver for children who have had similar challenges with mental health issues or issues with the mental health system as the families of children being served by CASST.

Who will be doing this and where?

Jackson: We have selected five schools in partnership with the School District of Philadelphia. All have shown commitment to supporting positive school climates through specific efforts such as Positive Behavior Interventions and Supports (PBIS).

The schools, spread geographically through the city, are: Gen. George G. Meade, Penrose, Rowen, Jay Cooke, and John Welsh. A large number of providers have applied to do the pilot and we’ll select two. Based on the results of the evaluation of the first year of the pilot service, we may expand the program to other schools.

How did this come about?

Jackson: We held focus groups with families who have received school services in the spring and early summer of 2014 and learned that the department, providers, and the schools could do a better job engaging families.

We realized that there were children out there receiving a complement of behavioral health treatment services without the behavioral health outcomes we were looking for.

And we thought that in many cases, lack of caregiver involvement was a ”missing piece.” We also realize the power of a caregiver who has gone through the experience being able to reach out to another caregiver as they partner with treatment service providers.

Clinicians on the team may not have had similar experiences and even if they have, there are professional boundaries to consider. As a psychiatrist, it would be considered inappropriate with regard to professional standards of care for me to share my personal life with a patient.

What are some of the barriers to parental involvement?

Valarie Oulds: Parents are often under great stress themselves. Sometimes we tend to forget that. They may not have had the best experience in schools themselves.

Making them feel welcome starts in the front office of the school. The atmosphere is set at the principal level. With treatment providers, parents have to be engaged from the outset and feel that they are not being blamed for their child’s behavioral health problems.

How will you pay for family peer supports in this pilot?

Jackson: We’ll have to find ways to finance this through existing resources. The current school-based services are paid for by Medicaid dollars, but Pennsylvania’s Medicaid plan does not cover a family support specialist. We’ll be working with our partners at the state to identify ways to support this work in the pilot as well as to create opportunities to continue to support this in the future rollouts.

How will you know if the pilot has succeeded?

Jackson: We’ll be looking for concrete results. These will include improved clinical functioning, including improvements in the ability to function in the home, with peers, in the community and in school (including attendance, advancement to the next grade level, and academic performance, etc).

Paul Jablow is a regular freelance contributor to the Notebook.

Follow @PaulJ1940

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