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Mapping Canadian KD/KE Activities in Mental Health
This page contains a mapping exercise to identify Canadian activities that are developing and exchanging knowledge related to school-based and school-lined mental health promotion. All comments and edits/updates are welcome. To make a comment, use the "thread" tool found at the bottom of the page. To edit/update the pages, use the "EasyEdit" tool found at the top of the page.
Map of Knowledge Development and Exchange Activities: School Mental Health in Canada
This chart attempts to map out the current knowledge development and exchange activities on school mental health that are underway in Canada. The goal of this chart is to inform decision-making about which trial projects should be developed as part of our KTE plan and which ought to be recommended to MHCC for long term consideration as part of an ongoing KE plan.
The chart below makes reference to the diagram seen here, which shows different types of knowledge management activities.
The chart below also uses an international set of ten broad school health strategies that are based on the lessons learned around the world (International School Health Network, 2009). These ten points are based both on the research evidence that has accumulated as well as the experience from several decades of work. The ten points also include newer concepts such as ecological and systems-based approaches that are drawing increasing attention to ideas such as capacity-building, attention to local context and systems change.
Map of Knowledge Development and Exchange Activities: School Mental Health in Canada
This chart attempts to map out the current knowledge development and exchange activities on school mental health that are underway in Canada. The goal of this chart is to inform decision-making about which trial projects should be developed as part of our KTE plan and which ought to be recommended to MHCC for long term consideration as part of an ongoing KE plan.
The chart below makes reference to the diagram seen here, which shows different types of knowledge management activities.
The chart below also uses an international set of ten broad school health strategies that are based on the lessons learned around the world (International School Health Network, 2009). These ten points are based both on the research evidence that has accumulated as well as the experience from several decades of work. The ten points also include newer concepts such as ecological and systems-based approaches that are drawing increasing attention to ideas such as capacity-building, attention to local context and systems change.
| School Health Promotion Strategies | Applications to Mental Health | What is known about current use of and needs SMH knowledge in Canada? (Top section of KDE cycle) | Current Canadian Knowledge Development Activities (Lower right hand side of KDE cycle) | Current Canadian Knowledge Translation and Exchange Activities (Bottom section of KDE cycle) | Existing Dissemination and Communications Channels (Lower left corner of KDE cycle) | Current Canadian Knowledge Uptake and Implementation Programs (Left side of KDE cycle) | |||||
| Overview | | · The CHEO project has consulted 10-15 key individuals and organizations about their knowledge needs in SMH · The CASH CoP has consulted about 131 and 140 respondents in two polls and about 100 education, health and law enforcement individuals in a CoP symposium discussion about SMH knowledge needs. The following SMH topics were identified as being of more interest: (engaging educators, state of current practices, school environment and inter-disciplinary, inter-agency coordination) The preferred methods for knowledge exchange were: Communities of Practice, attending workshops, webinars, conversations with colleagues See full report · Cameron Wild of the University of Alberta has surveyed Alberta stakeholders on their knowledge needs · A previous CHEO project has identified knowledge needs and issues from a convenient sample of Ontario school boards. · An international survey of school principals included over 100 respondents and identified several immediate concerns of school-based administrators as being: on the polls and consultation | · The CHEO project will survey school boards about their current practices and knowledge needs · The PHAC Best Practices Portal has identified 35 programs based on RCT’s that have been identified in systematic reviews · Health Evidence (www.health-evidence.ca) has identified 21 systematic reviews on SMH and assessed their quality. A wider search on MH found 97 reviews that were also assessed. · The CHEO project will identify systematic reviews describing best practices in SMH and addictions · A CCSA project have identified over 50 evaluated programs in substance abuse prevention · A CASH project on substance abuse has identified over 100 substance abuse programs from credible sources such as SAMHSA, BP Portal, EPPI, DARE etc · A JCSH project is conducting a literature review on SMH and is identifying Canadian programs and resources · A CCSA project has published Canadian standards in school substance abuse prevention · The CASH Toolbox on SMH has identified over 200 research reviews, landmark studies, reports and planning/educational resources. Another 1800 resources and citations are to be reviewed and selected for the toolbox. · The Kutcher Evergreen project is identifying ways and means to promote child and youth mental health. | · The MHCC is developing a knowledge exchange centre and program. · The PHAC Best Practices Portal and the MHCC will be signing a MOU on web-based KE. This will be aligned with similar partnerships with over 40 other organizations concerned with health promotion. · The CASH CoP on SMH brings together 125+ local agencies, school boards, provincial officials, federal officials, university researchers etc on SMH. It organizes webinars, web meetings, and maintains a toolbox of over 200 research links and resources/ reports. · The JCSH brings together PT and federal healthy school coordinators · The CACE-CASH CoP on disadvantaged schools brings together PT and federal officials on community schools. · The CASH CoP on safe and caring schools includes a FPT network of government officials. · | · CTF and CASH have established a teachers/front-line practice-based magazine that will become electronic this year · CASH has secured the cooperation of a SH Contact person in every school board, health authority and is building a list of police services people. | | |||||
| 1. Address the needs of the whole child in a positive, principled values-based approach over the life course. Understand the health/social problems and the impact of the school on those problems. |
| | | | | | |||||
| 1.1 Programs should address the needs of the whole child (intellectual, social, physical, psychological, emotional) and identify and address all of the health/social/economic problems, assets, factors and conditions that affect their health, learning and development. The child's development will be affected by several social determinants. There are several behaviour theories to explain the complex interactions that occur among the child, family, neighbourhood, community and the school. |
| Findings 1. There appears to be vague and competing interpretations of key behaviour theories underlying SMH. Resilience is a prime example. Attachment theory is another with very simplistic applications to “school connectedness” which often turn into exhortations for teachers to ne nicer to their students. On the other hand, social intelligence theory has led to the development of the SEL approach in many, many schools. | · | · Health Canada has funded an Encyclopedia summary project on Resilience · PHAC will consider an Encyclopedia summary on social intelligence (SEL) · MHCC has indicated interest in an Encyclopedia project stigma/health belief | | | |||||
| 1.2 Programs should seek to prevent specific health and social problems and reduce harms but also build positive individual resilience and personal assets as well as family, community and organizational strengths by promoting health, cohesion and social development. | For mental health, we suggest that the spectrum or tapestry of mental health be grouped in three areas in order to plan interventions; positive mental health, mental health problems and mental illness. Interventions need to be developed and coordinated to addressed these MH assets and deficits as specifically as possible. Positive mental health includes: emotional intelligence and development, brain development/ maturation, mindfulness/self-knowledge, critical thinking/self-control, spirituality, social skills, attachments to parents, peers, school, community and activities that promote physical health Mental Health Problems that affect mental health include: vulnerability in transition to a new school, vulnerability in transition from pre-school to kindergarten, vulnerability while in transition between primary and secondary school, vulnerability while in transition between secondary school and college/university, training or work, lack of personal resilience, bereavement, stress/distress, social Isolation/loneliness/social exclusion, divorce/family breakdown, homelessness/ transience, trauma from natural disasters, INTERSECTIONS WITH OTHER HEALTH & SOCIAL PROBLEMS AND CONDITIONS including child abuse & neglect/family violence, child sexual abuse, unintentional/intentional pregnancy, addiction (Including alcohol, tobacco, gambling etc), bullying/aggression, sexual orientation/gender ambiguity/ homophobia, chronic diseases (Cancer, Diabetes etc,), economic disadvantage/ poverty, cultural or geographical Isolation, cultural oppression/colonization Mental Illness & Disorders (school programs can help to delay or manage onset) include: compulsive behaviours, anxiety, phobias, ADHD, FASD, behaviour disorders/delinquency/criminal behaviours, depression, aggression, self-harm, suicide, obsessive behaviours, stigma preventing help-seeking behaviours, bi-polar disorders | | · PHAC has funded several projects that will develop Canadian models of Positive MH programs · MHCC is funding several projects and activities on anti-stigma | · CASH is anticipating a small grant from the TD Bank to sponsor a series of web meetings to clarify key concepts in SMH. These concepts will form the basis of several topics to be developed in the international School Health Encyclopedia program. · CASH has secured funding to do an encyclopedia project on multi-intervention programs on the intersection of aggression and MH | | | |||||
| 1.3 Programs should promote values and principles such as empowerment, equity, ethics, social responsibility | For mental health, these values and principles include Cultural Diversity, Inclusiveness, Gender Equity | | · | · The Kutcher Evergreen program has developed a set of values statements on child and adolescent MH | | | |||||
| 1.4 Programs should be based on a recognition that health and social behaviours, personal health & physical conditions as well as knowledge/attitudes and skills occur and develop over the life course. | For mental health, programs should be based on evidence and experience in dealing with these important age-related concepts: · Adolescent Development, · Brain Development, · Child Development, · Developmental Tasks and Stages, · Early Childhood Development, · Transitions, · Life-long Learning | | | | | | |||||
| 1.5. Programs should be based on a clear, evidence-based understanding of the nature and prevalence of the health or social problems being addressed. | For mental health, this means we need to assemble and monitor a well-regarded set of statistics on mental health and childhood/adolescent mental illnesses. | Currently, these data are not readily available | · | · CASH is working with Kutcher and several national NGO’s to develop a common understanding and factual basis for understanding the prevalence of MH problems in Canadian youth | | | |||||
| 1.6 Programs should be based on a clear understanding of the influence of the social and physical; environment of the school on the health or social problem being addressed. | For Mental Health, the aspects of the school's environment and school practices that need to be addressed include: the physical environment of the school(lighting, air quality, etc), the social environment (school discipline, staff-student relations, parent involvement, student-student relations, the transitions between levels of schooling, school practices and policies on promoting/failing and recognizing students and other aspects. Interventions should seek to change these factors while recognizing that many of these aspects are embedded in societal, community and family norms. | Recent research shows that attempts to modify the school climate may not affect those students who need to connect to the school more than the others or all of the students may not notice such attempts. Other recent research shows that students who start to fail at school in grades as early as the first grade, can be predicted to have mental health problems by the end of elementary school | · | · CASH has published an Encyclopedia paper and webinar on transitions from elementary to secondary schools | | | |||||
| 2. Serve all children, especially vulnerable and disadvantaged children, families and communities | For mental health, these more vulnerable groups need adapted or tailored programs aboriginal students, minority students, adopted children, children of addicts, children with disabilities, special needs | | · | · The CHEO project will fund CASH to do a brief consultation on aboriginal needs and initiatives in SMH | | | |||||
| 2.1 Programs should address the needs of all children, but should also include special measures for more vulnerable children, families and sub-populations, or for particularly high risk behaviours or situations. (eg Children of alcoholic parents) | | | | | | | |||||
| 2.2 Programs should explicitly address social, economic, cultural or geographical determinants and seek to alleviate disadvantages relating to such families or communities. | | | | | | | |||||
| 3. Understand the local context | | | | | | | |||||
| 3.1 Program planning should take into account the different, overlapping and interacting contexts (home, school, neighbourhood, community) that affect the health, learning and development of children and families. | | | | | | | |||||
| 3.2 Program planning should first understand the community context and then specifically address the elements of that context that most affect children and youth | For mental health, we need to adapt programs for these neighbourhood situations: rural communities, disadvantaged communities, religious/ethnic communities, affluent communities, communities disrupted by natural disasters, war, violence such as school shootings | | | | | et | |||||
| 4. Strive towards a Comprehensive Approach | | | | | | | |||||
| 4.1 Policy-makers, officials, administrators, and practitioners should build a comprehensive approach while simultaneously addressing specific urgent issues or the elements/programs within a coordinated set of interventions. This means that data on child/youth needs (See list of behaviours/conditions above) as well as other needs and capacities should be assessed. Relevant multiple interventions should then be identified and coordinated in a recognized school multiple intervention program. | For mental health, this means that we should plan, implement and evaluate programs that are based on these concepts: ecological and systems approaches, comprehensive monitoring & reporting systems, data-based decision-making, formal needs assessments, capacity assessments, intervention mapping, strategic issue & trend management, capacity-building. | | | | | | |||||
| 4.2 Holistic approaches can address clusters of problems and conditions using combinations of synergistic programs policies, services and other interventions | For mental health, we can cluster programs as universal (positive mental health), targeted (mental health problems)and indicated (mental illnesses) See the specifics above | | | | | | |||||
| 4.3 Programs should be developed and implemented at multiple levels within systems and across several systems and then delivered using the school as a hub. | Plans for SMH program development, implementation and evaluation should have explicit descriptions of the roles, tasks and responsibilities of health, social and education ministries, local school boards, health authorities, social agencies and schools staff and other MH professionals. | | · | · The CASH national Community of Practice has identified the articulation and integration of roles of school psychologists, guidance counsellors, social workers, MH workers and others etc as a priority topic. Nova Scotia is developing protocols. This topic will be considered as a joint activity | | | |||||
| 5. Use multiple, coordinated evidence-based interventions (Def) in comprehensive approaches, coordinated agency-school programs or in whole school strategies (policy, instruction, services, social & physical environment) | | | | | | | |||||
| 5.1 Policy-makers, officials, administrators, and practitioners should select evidence-based programs, policies and practices. | | | | | | | |||||
| 5.2 Multiple programs should be delivered in several domains. These include: | | | | | | | |||||
| a) Policies, mandates & procedures adopted and implemented by school boards, health authorities, other agencies and ministries (eg School Health Policies) | For mental health, this includes education, health, social service and law enforcement ministries, local health authorities, social service agencies, police departments and school boards | | | | | | |||||
| b) Instruction & informal education | For instruction about and for mental health, we need specific applications to these concepts:: · Curriculum (Def) · Curriculum Design (Scope & Sequence) (I) · Curriculum Supplement (Def) · Health Learning Outputs (KAS) · Health Literacy (KAS) · Instruction (Def) · Instructional Program (Def) · Internet-based Learning (I) · Peer-led Instruction (I) · Student Assessment in Health, Social Development · Take home learning activities (I) As well, we need MH applications in Techniques in Educational Programs · External Presenters (I) · Learning Theories (T) · Learning Styles (T) · Student Health Report Cards · Teacher Education (I) · Teacher In-service training (I) · Teaching/Learning Materials (I) · Teaching Methods (I) | | | | | | |||||
| c) Health, social & other services | For mental health, we need to consider these services: · After school Programs · Brief Counselling · Comprehensive Guidance Programs (I)Guidance & Counselling Services (I); Role of Guidance Counsellor · Health Care/Preventive Health Services (I) Including role of Physicians in Schools (I), working with Physicians Offices in Community (I) , Role of School Nurse Health Clinics in Schools · Learning Assessment Services · Administering Medications in schools (I) · Mental health Services (I); Role of mental health workers · Pastoral Services; role of pastor, cleric sychology Services (I); Role of School Psychologist (I) · Restorative Justice Programs; Student Courts · Addictions Services; Role of Addictions worker or School Resource Officer · School Dropout Prevention/Remedial Education Services (I) · Social Services; Role of School Social Worker (I) · Special Education Services (I) The following Elements of Service Delivery also need to be considred in relation to MH · Coordinated Case Management (S) · Early Identification and Referral (S) · Screening (I) · Coordination with Treatment (S) · Re-integration into schooling (S) · Student Health Records (I) · Youth-friendly services (A) | | | | | | |||||
| d) Positive social environment and social support (school climate) (Def) & trusting relationships) | For mental health, all of the following interventions can be considered: · Classroom Management (I) · Community Awareness Campaigns (I) · Community Organizations, coordination (I) · Community Service Programs (Post-Sec) (I) · Community Use of Schools (I) · Media Campaigns (I) · Social Marketing Campaigns (I) · Mentoring Programs (I) · Parent Information, Involvement, Education and Support Programs (I) · Peer Helper Programs (I) · School Activities (I) · School Climate Programs (I) · School Clubs (I) · School Discipline & Rules (I) · Student Leadership Programs (I) · School Sports (I) · School Security (I) · Staff Wellness (I) · Influence of the Internet as a Social Setting (I) · Youth Empowerment (A) · Youth Engagement (A) · Parent Involvement (A) · Community Involvement (A) | | | | | | |||||
| e) Healthy physical environment & practical resources | Elements of the Physical Environment that are particularly relevant to mental health are: · Lighting (HPC School Grounds | | | | | | |||||
| 6 Identify the local mechanisms/drivers of change, implementation and sustainability and use evidence-based implementation strategies | | | | | | | |||||
| 6.1 Identify, consider and use key mechanisms and local drivers | | | | | | | |||||
| 6.2 Use an evidence-based implementation process and model that includes a) required parent involvement b) required student involvement c) required community involvement d) required staff involvement e) required expert review f) required consultation and g) evaluation and reporting procedures | | | | | | | |||||
| 6.3 Consider carefully how the innovation will be distributed, disseminated or diffused (brought to a larger scale) | | | | | | | |||||
| 6.4 Consider and select the systems change approach and model that is most appropriate to your circumstance | | | | | | | |||||
| 7. Coordinate multiple programs, policies, services, practices | | | | | | | |||||
| 7.1 Policy-makers, officials, administrators, and practitioners should select or develop a "school multiple intervention program (SMIP) that can be an approach, coordinated program or whole school strategy coordinate several programs, policies, practices and services across five domains (policy, instruction, services, social environment, physical environment/resources) to achieve maximum impact in whole school and school-community strategies. | For Mental health, the following SMIP models are relevant: · Alternative Schools (SMIP) · Child-Friendly Schools (SMIP) · Effective Schools (SMIP) · Effective Behaviour Support Programs (SMIP) · Inclusive Schools (SMIP) · Indigenous School Health (SMIP) · Safe and caring Schools (SMIP · Social and Emotional Learning (SMIP) · School Substance Abuse Prevention (SMIP) · Wrap-around Services/Coordinated Service Delivery/Full Service Schools (SMIP) | | · Several national organizations (members of the CASH NGO Network) are developing a consensus statement on SMH to fill the vacuum of a lack of a common understanding on school-based and school-linked programs and comprehensive approaches. This Canadian statement will be used as an advocacy tool and will also be shared with a similar cross-border discussion. | | | | |||||
| 7.2 Policy-makers, officials, administrators, and practitioners should seek to influence the whole school environment, not just deliver programs or interventions within the school | | | | | | | |||||
| 7.3 Policy-makers, officials, administrators, and practitioners should initiate, and support community-school Interactions. | | | | | | | |||||
| 8. Seek congruence with education mandate, constraints | | | | | | | |||||
| 8.1 Policy-makers, officials, administrators, and practitioners should seek congruence with the educational mandate of school | For mental health, this means careful integration with: · School Accountability & Reporting Systems (I) · School Improvement Processes & Programs | | | | | | |||||
| 8.2 Policy-makers, decision-makers and practitioners should anticipate competition and conflicts caused by divergence or competition with the academic/ educational roles/needs of the school. | For mental health, this means particular attention to student promotion and student recognition policies and procedures. There is a direct tension between the school’s mandat5e to accredit student learning (which includes failing students) and their mental health and connectedness to school. | | | | | | |||||
| 9. Build capacity at all levels in the multiple systems that need to engaged with school health promotion, social development, safety and the environment. | This means that we need to identify applications of these concepts to SMH: · Capacity-building (S) · Capacity Assessments (I) · Continuous Improvement (S) · Organizational Development Theories; Learning Organizations (T), Total Quality (T) Management & Leadership (T) · Organizational/System Capacity (OC) | | | | | | |||||
| 9.1 Build different types of capacities including: a) Coordinated policy/leadership b) Staff assigned to coordination at all levels c) Formal & informal mechanisms for cooperation d) Ongoing knowledge synthesis & exchange (OC) e) Ongoing Workforce development (OC) f) Monitoring & Reporting & Evaluation (OC) g) Joint issue management, priority-setting, trend analysis h) Explicit sustainability planning | For mental health, this means that we need to identify SMH applications of these concepts: · Coordinated Policy (OC) · School Mental Health Networks (S) Coordinators; roles, competencies, training · Coordination Mechanisms (OC) · Consensus/Shared Vision Statements (S) · School Health Committees (I) · Inter-ministry Agreements · Inter-agency Agreements · Communities of Practice/Knowledge Networks (S) · Cost-benefit, cost-effectiveness (T Staff development Theory (T) · Adult Learning (A) · Competencies, of staff (Def) · Reflective Professional Practice (A) Data-based Decision-making (S) · Indicators (O) Indicator Development (OC) · Logic Models (A) · Monitoring & Reporting Systems (I) · Program Evaluation (I) · Self-Assessment Tools & Programs (I) · School Award and Accreditation Programs (I) · School Recognition Programs · Research Methods (A) · Research Issues (A) · Surveys, Survey Development (OC) · Issue Management (OC) · Intervention Mapping (I) · Institutionalization (Def) · Sustainability of Programs (A) · Sustainability Planning (I) | | | | | | |||||
| 9.2 Build capacities at all levels (government, agency, school, professional, community) | | | | | | | |||||
| 10. Use a strategic approach to system characteristics and organizational cultures. | | | | | | | |||||
| 10.1 Understand the nature of open systems impact of openess | | | | | | | |||||
| 10.2 Understand decision-making in loosely-coupled systems | | | | | | | |||||
| 10.3 Understand the features of professional bureaucracies | | | | | | | |||||
| 10.4 Know about working across multiple systems | | | | | | | |||||
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dmccall |
Latest page update: made by dmccall
, Feb 3 2011, 9:21 PM EST
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