Adapting and implementing TeamSTEPPS in school mental health

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PROJECT SUMMARY Children obtain more mental health services through schools than through any other public system or agency. School-based mental health care often is provided by community mental health clinicians contracted to deliver school-based services. A rate-limiting step to the team's success in providing effective, evidence-based care is that the mission and work of the mental health teams, whose focus is on behavioral health service delivery, is not always consistent with the educational mission and needs of under-resourced schools. Participants will be drawn from school-based teams in Philadelphia's community mental health network and public schools. Existing methods to enhance the adoption, implementation, and sustainability of evidence-based practices have not addressed the challenges that this common model of collocated services poses, such as disparate goals and lack of coordination and collaboration. Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) has been widely disseminated in health care settings and provides a promising strategy for addressing communication and climate in school mental health teams. Philadelphia provides an ideal context in which to explore the impact of TeamSTEPPS on inter-organizational processes because Philadelphia relies heavily on mental health agencies to provide services in schools. Most students are low income minority children, allowing us to simultaneously address multiple AHRQ priority populations. We propose to take a participatory approach to collaboratively identify solutions to challenges in collocated school- based mental health services based upon the feedback of stakeholders using TeamSTEPPS to support mental health team-school collaboration. Consistent with AHRQ priorities to minimize adverse events, maximize recovery and support 360° person-centered team-based care, we propose the following aims. First, in Aim 1 we will capture key stakeholder perspectives about challenges in collocated school mental health services through formative work to inform collaborative planning and capacity building activities in Aim 2. Then, in Aim 2 we will identify inter-organizational challenges and required components of TeamSTEPPS to adapt. We will establish an advisory board and adapt TeamSTEPPS. The product of Aim 2 will be an adapted TeamSTEPPS, directed toward both school mental health and school-employed personnel, and specific, tailored implementation strategies to improve services in schools in conjunction with TeamSTEPPS. Finally, we will explore the feasibility, acceptability, and utility of TeamSTEPPS and the strategies generated in Aim 2 on inter- professional collaboration, teamwork, and student outcomes in eight schools.