Pennsylvania’s own Benjamin Franklin said, “If you want something done, ask a busy person.” No doubt that Student Assistance Program (SAP) liaisons have full plates with limited resources combined with a dedication to helping as many students as possible – no matter the number of hours it takes.
Megan E. Johnston and her Cumberland and Perry Counties team in Carlisle, Pa., are extremely busy people and yet they implemented the Elementary School-based Program (ESAP) five years ago to address the needs of K-5 students.
Megan has worked for 15 years within the Mental Health/Intellectual & Developmental Disabilities (MH.IDD) office across the two counties located to the left of Harrisburg. She is a 2023 recipient of the state’s Dennis Marion Impact Award for government employees whose work has led to significant improvements in Pennsylvania’s behavioral health service delivery system. She currently serves as the coordinator for the Child and Adolescent Service System Program (CASSP) and ESAP liaison supervisor. In those roles, Megan oversees the K-12 student mental health services and uses bhworks student mental health software system. The data has shown that their kids are staying in services longer and providers are trying to keep up like everyone else in Pennsylvania and across the United States.
“The job is overwhelming and multifaceted,” Megan said. “Student assistance is funneled through three systems: Education, Drug and Alcohol, and Mental Health. Our county office funds Mental Health liaison services for K-12 and contracts out for the secondary levels (middle and high school).
First Comes CASSP
Pennsylvania received the first federal CASSP grant in the 1980s and over time started building the local infrastructure for a comprehensive system of care. According to its written description, CASSP ensures that “services and treatment for children and adolescents with or at risk of serious emotional disorders are planned collaboratively with the family and all agencies involved in the child’s or teenager’s life.” It recognizes that students often require services from a variety of agencies such as child welfare or juvenile justice, and addresses the needs of the whole family to include parent health care.
For over 30 years now, Cumberland and Perry County funds have provided free, voluntary CASSP, Elementary Program, and more recently added
Mental Health ESAP Liaison services, including:
● Advocacy
● Basic needs - food/clothing, shelter, housing
● Behavioral Management
● Community Resources
● Counseling
● Financial Matters
● Medical needs and Insurance
● Parenting
● School concerns
● Summer programming
● Support Groups
The CASSP elementary referrals (students are not interviewed) come from the school districts, parents, CASSP staff, and other stakeholders. The only requirement is that they must be elementary-aged students. Every referral received they are screening out the families’ Social Determinants of Health (SDOH), i.e. housing, food, transportation, and clothing needs, and dentistry is included.
CASSP Principles
Pennsylvania identified the need for CASSP principles, which Megan describes as “the bible for children’s mental health services.” The principles in operation mean that the program elements will be:
● Child-centered
● Family-focused
● Community-based
● Multi-system meaning all involved agencies and the family collaborate to establish goals,
develop a service plan, find the necessary resources to implement the plan, provide support to the family and child, and evaluate progress
● Culturally competent
● Least restrictive/least intrusive
ESAP Established Just Ahead of the Pandemic
In addition to CASSP, Cumberland and Perry county school districts decided to implement ESAP five years ago. ESAP is a free, voluntary program with short-term prevention and intervention services used to assist families in accessing appropriate supportive services for their child to be successful within the home, school, and community. ESAP is an integrated team process used to mobilize school resources to remove barriers to learning and to enhance children’s mental health by supporting and strengthening families.
Megan explained, “ESAP is a school team approach in breaking down the student’s needs and requires signed permissions from the guardian to begin the process. These permissions provide consent for the Mental Health Liaison to conduct an assessment with the student.”
Megan offered an example to show the differences between ESAP and CASSP. In ESAP, if one parent declines consent, they can’t provide services. “However we can support the student and family through CASSP Elementary in which the staff provides the guardian with the resources and supports based on the needs presented by the school and through the discussion of needs with the guardian,”Megan said. “When supporting a student through ESAP, we send the bhworks software assessment to the guardian(s). We additionally utilize another assessment tool when interviewing the student. We document every case activity within bhworks and utilize SAP 2.0 to screen out SDOH and access community connectedness and needs.” Connecting students to community-based activities based on
their strengths helps foster resilience, communication skills, and normative socialization opportunities.
“Both programs foster a holistic and eclectic approach,” Megan continued. “We actively manage families’ needs.”
She manages this program with five staff liaisons who cover 49 elementary buildings. She says right now the biggest challenges are keeping up with the demand of need and referrals; trying to navigate complex systems with limited resources; and engaging parents.
During and since the pandemic, they never stopped providing services when the students were or are virtual. They always had access to basic needs including food drop off and the in-person support always available.
Megan and her staff during the summer support a local school-operated food program to feed students in need, offer social emotional programming for groups, and disseminate various resources of need; the most recent one being a support guide pertaining to mindfulness. They also take that time to update resources listed in what is now a 19-page document that includes links to helpful videos, podcasts, articles, libraries and YWCAs to use, a list of occupational therapists, and a social fit program.
Preventing Staff Burnout & Keeping Healthy
One thing that helps Megan and her team with stressful circumstances is having open communication and teamwork. “We have strong communication as a team and work with each other to provide support when staff get flooded with referrals. We are able to accept cases virtually from any school/town as a team and support each other in staffing CASSP Elementary cases.
“Our support for each other helps alleviate other job stressors. Additionally, our flexible work schedule helps staff with their work/life balance which is another key indicator for a healthy work environment. It’s extremely important to have a collaborative team that supports each other to prevent burnout and retain staff,” said Megan who picks up cases when needed to ease the referral load.
Starting an ESAP in your PA County
Megan offers the following advice to add elementary age children to your SAP. “The key factors in building a new program include the following: continuous proactive communication, strong relationship building, ongoing training, flexibility, and monitoring the progress as well as the barriers. Change creates challenges and it’s important to monitor not only the success but also the barriers that the team faces so that the program can continue to grow for success. It takes time for a new program to get going [a few years], and patience is an important factor.”
No doubt the effort is worthwhile when identifying elemenary student needs and providing services.
Editor’s Note: Megan can be reached to answer any questions from her colleagues about this article at 717-240-6450 or mejohnston@cumberlandcountypa.gov.