mtssaiconcierge/candi_qa_mtss huggingface dataset:
Role: MTSS_Coach
Question: Are there evidence based protocols that exist in the schools to support referral for mental health services as both tier 2 and tier 3? if so can you please describe as well as share links for exemplars?
Answer: Referrals to mental health should be the exception, not the rule...referral by definition means to transfer responsibility to another person and that perpetuates the expert model (magic fairy dust approach) When we add community employed experts,  build capacity of everyone in the system and focus on creating healthy environments we set up a system that enables this to occur.  What if we used request for assistance instead of “referral” and we not only increased support for students, but we also increased support for staff and families. The trick is that we make the request for assistance process easy, clear and we provide quick response time.
Role: MTSS_Coach
Question: Why do schools struggle with creating functional MTSS teams?
Answer: There has to be an investment in prevention at the district community level. Union, board and leaders across disciplines need to have a clear understanding of what it is and what it takes to develop .
Role: MTSS_Coach
Question: Give examples of functional, effective MTSS teams and how they balance their responsibilities.
Answer: I am working with a school district who has multiple MTSS teams that do not communicate.  What are some strategies I can use to help them?  Leadership at the district and school level needs to be involved with agreement about how MTSS is useful. There needs to be a leadership team that includes people who can make decisions around consolidating teams, data, changing policy, job descriptions, professional development and coaching support. They need to see the value in using MTSS to achieve their goals.
Role: MTSS_Coach
Question: Suggest and help define an MTSS coordinator role.
Answer: A coordinator can start the communication and collaboration process, then develop it with feedback from implementers.
Role: MTSS_Coach
Question: My district would like to include youth voice on their MTSS Teams.  How can they go about identifying students for this role and what are appropriate expectations of them?
Answer: Make diversity the rule—get input from a range of students that represent the school community. Formal and informal avenues work.
Role: MTSS_Coach
Question: How can I simply explain fidelity and implementation measures to a district who is just beginning to develop their MTSS?
Answer: Implementation inventories are just that, inventories! You take stock of where you are and make short- and long-term plans based on what you learn from doing them. Fidelity and implementation inventories are created by researchers who have identified what they think are all the most important elements of a functioning MTSS. There is always room for growth, and updates are made over time, but overall you can count on the latest inventory to help you consider all the ways to make sure your MTSS functions efficiently and effectively, making your lives easier and leading to better outcomes! Completing an inventory is also a great way to keep a written historical record for your school as staff move in and out of the district and you learn what works best to optimize your system.  Think of fidelity as a way to measure the implementation process.  Your programmatic efforts will shape/direct how to monitor fidelity.
Role: Clinical_Staff
Question: What is MTSS, PBIS, ISF, RTI?  All these acronyms are floating around.  I need succinct answers. My next meeting is in 15 minutes.
Answer: Ok let’s look at your question from a high level and then I will share brief specifics about each. MTSS, PBIS, ISF, and RTI are all frameworks and approaches to meeting the diverse needs of the student population in your school or district.  All of these function to organize resources-the adults, programs, and practices- needed to meet the social, emotional, behavioral, and academic needs of the students. They all share similar foundations but have unique scopes of practice and outcome targets.  The features true to each model are teaming, a tiered delivery system, evidence-based practices, data-informed decision-making, screening, and progress monitoring.  Multi-tiered System of Supports (MTSS) is a broader framework that illustrates the core features of this organizational process, serving as a key resource to facilitate integration, cohesion, and efficiency of all practices that enhance academic, behavioral, and social-emotional support.  Positive Behavior Intervention and Supports (PBIS) is a proactive approach that works to positively impact all students by improving the school climate through strategies that define, teach, and support appropriate student behaviors. Interconnected Systems of Framework (ISF) offers a roadmap that supports the integration of mental health services into the school setting through collaboration between school and community mental health professionals throughout the tiered delivery system. Response to Intervention (RTI) is a process to help schools focus on high-quality interventions that are matched to academic and behavioral student needs and monitored frequently.  Your school or district may have elements all, some, or Pending Privacy Clearance of these systems in place, but the good news is, given your question it sounds like they are beginning the process of building or enhancing these structures. After your meeting, it may be helpful to review the “Core MTSS” course from the SBHA LMS.
Role: Clinical_Staff
Question: I am new to my district and have been invited to join an MTSS team. I am not clear on what they mean when they say I am an MTSS Team member. What is expected of me on this team?
Answer: So MTSS teams are made up of leaders in the district who have the responsibility of creating and managing the practices and procedures that support students.  Essentially this group of adults looks at the “who”, “what”, and “how” of the game plan to support all students (universal/Tier 1), some students (targeted/Tier2), and individual students (Intensive/Tier 3) for the district.  At the district level, you will be sharing this responsibility with district administrators, lead educators, community representatives, MTSS coach, and other professionals with a vested interest in promoting the academic, behavioral, and health outcomes of students.  At the most foundational level, you would be expected to be an active member of the team by attending scheduled meetings, coming prepared to those meetings, and completing assigned action items that result from MTSS meetings. Working with the assumption that you are the individual who is representing the provision of mental health services for the district you would be engaging with the core features of MTSS through your professional lens- providing feedback on evidence-based practices and programs that can be deployed at each tier to enhance mental health and well-being of students (and staff), supporting the collection, analysis, and reporting of mental health data, and supporting the progress monitoring of mental health interventions at each tier.  You can think of yourself as both a mental health provider and consultant in this role.  An effective way to understand expectations as a new team member would be to ask your other team members directly. You can always reach out to an MTSS Coach through the SBHA as well!
Role: Clinical_Staff
Question: I work in a large school district.  It seems like every student who has an issue, behavior, emotion, and/or mental health is immediately referred to me.  I can’t keep up.  What can I do to inform a more preventative approach in my school?
Answer: When the majority of students seem like they have a concern, chances are they aren’t learning or living in a healthy environment, so it is important to focus on Tier 1 and have a team that can quickly triage students who may be in crisis and connect to intensive supports.
Role: Clinical_Staff
Question: My school does not use a universal screening system. What screeners can I recommend for use that capture internalizing and externalizing behavior? Can you give me a list of all available screening tools and a description of each.
Answer: Installing a screener is much more than providing a list to choose from.  It requires having systems in place across tiers of support with teams who can quickly connect students with elevated risk to be connected to someone who can provide a diagnostic assessment and provide more support.
Role: Clinical_Staff
Question: Discuss the most prominent universal social emotional behavioral health screeners used by school districts. Compare and contrast.
Answer: Believe it or not there are hundreds of empirically studied screeners out there! For routine practice, there are a handful that stand out based on research in schools. Some of these cost money to use, some are free, and some only cost if you need a full data system to conduct screening. Most schools are so big that they do need a data system to quickly tabulate and communicate information to users. The Student Risk Screening Scale – Internalizing and Externalizing (SRSS-IE) can be freely accessed, as can the SAEBRS Social, Academic, and Emotional Behavior Risk Screener (SAEBRS) and Strength and Difficulties Questionnaire (SDQ) paper versions. The electronic versions have a cost. The Behavior Assessment System for Children (BASC) and Behavior Intervention Monitoring Assessment System (BIMAS) are also commonly used screeners with a cost. The Early Identification System (IES) is available to some predominately rural states for free and includes links to evidence-based intervention matched to student needs. These systems often have a demonstration site or coordinator that can show you what the product actually looks like, how it functions, and any associated training and support needs.
Role: Clinical_Staff
Question: Can you describe what PCOMs is and how clinicians use it in schools?
Answer: Sure! I would describe PCOMS as a student-centered approach to therapy. The PCOMS system gives clinicians access to common measures of student well-being and a session rating scale, which lets a student indicate if they are finding the therapy experience supportive each time they meet. The student completes the surveys and then the clinician and student discuss them together to make sure they agree on therapy goals, that treatment is effective, that progress is made, and that the student has independence in directing their own life. Clinicians can use this information to build and maintain a therapeutic relationship and make clinical decisions such as treatment adjustments. PCOMS can be used regardless of diagnosis.
Role: Clinical_Staff
Question: Please give examples of effective Tier 1 mental health strategies for schools experiencing  community trauma (insert examples of community trauma)
Answer: There are several ways to universally promote mental health in schools experiencing community trauma. Teachers and staff can foster supportive relationships first and foremost. Good relationships help students manage difficult emotions. Teachers and staff can greet, smile at, and call students by name. They can listen to them, call attention to their strengths, and offer students choices around school activities and routines. Routines help establish safety by creating classroom environments that are predictable. These routines can include time for movement and developmentally appropriate mental health promoting activities such as mindfulness, art, music, and time in nature. Older students may benefit from being given the opportunity to spend time on meaning-making activities such as community service, writing, and activism. Most of these activities can be embedded in the school’s academic curricula and support the development and activation of personal strengths, social skills, and coping skills. Schools must also resist re-traumatization. Discipline policies and procedures should be restorative, not punitive. School mental health clinicians can offer suggestions about what might be best depending on the nature of the trauma and SAMHSA’s guiding principles for being trauma informed.
Role: Clinical_Staff
Question: My services fall into tier 2 and 3 of our MTSS.  I am wondering how I can be more involved at Tier 1.
Answer: MTSS teams are ideally set up to maximize everyone’s skills and talents. It’s likely that your specialized skillset inclines team members to think of you at advanced levels of support, but you also have a great deal to offer at Tier 1. You can ask to be included in Tier 1 meetings, especially for planning and implementation support for Tier 1 practices and curricula. Based on the concerns you are seeing among students receiving  Tier 2 and Tier 3 services and your knowledge of Tier 1 mental health supports, you can make professional suggestions on which are likely to be most effective. As teachers and staff implement, you can serve as a go-to support person. Your role will have to allow for meeting and consultation time, so you might need to negotiate that with your supervisor and team. It might also require shifting some responsibility or a change in funding structure. Don’t give up if there are a few hoops to jump though first! It might be helpful to connect with someone who has done this in another school or district.
Role: Clinical_Staff
Question: List the responsibilities of an LPC, LMSW, LMFT within a school building integrated MTSS framework.
Answer: As a mental health provider you will have impact across all tiers of support, MTSS implemenation for School behavioral health, and teamining.  You will provide mental health support at Tier 3 to indiviudla clients and families, you will provide small group support at tier 2. For teamining you will act as a consultant and collaborator playing an active role in MTSS team meetings, providing data and insight for the students/families under your care, and support the development of universal strategies for mental health promotion and wellness at tier 1.  You wull lead, or a minimum, be included in crisis response planning and teaming, support conducting assessments and safety planning, and connecting to community based resources (think case managment). You may also lead professional develpment for mental health associated content, vulnerable population, and refferral processes.
Role: Clinical_Staff
Question: I am worried that my district’s protocol for suicide prevention is not good.  Can you tell me what things should be in the suicide protocol and who should be involved? Can you also provide me examples of safe protocols?
Answer: Prevention protocols should include screening and assessment of suicide risk, safety planning, clear guidelines for what to do at each desingated level of risk, parental notification guidelines, resources to share with parents to aid in their ability to create safety.  The protocol should reduce vicarious trauma and reactivity, while increasing protective faccors and safety.  The protocol should also include key personnel involved (i.e. crisis response team lead and contact information and subsequent team members). Roles should be clearly identified an start with asking about suicide (whole school staff), and then what to do after a student responds yes-  a flow chart is great for this effort as it simplifies the process into a visual framework.  AFSP and SAMHSA offer great examples for best practices.
Role: Clinical_Staff
Question: List and describe evidenced based strategies for de-escalation in a classroom setting.
Answer: First and foremoste, ensure immediate safety first, get support from an admin or sro if need be. Remain calm and regulate yourself first, be mindful of "how" you are communicating use open and supportive body language and a calm, slow paced tone, breathe.  Offer space, standing too closely can feel like escalation- you may even offer to change the environment, especially if other students are around. Act with empathy (even if it is challenging in he moment), validate and reflect the feelings you are aware of.  Dont over complicate the conversaton, your focus is on getting the student back to baseline and navigating the moment- use simple neutral language that is focused on bringing the student out of the reactive mindset.  You can offer choises so the student has a sense of agency- would you like to take a short walk with me or go take some time to talk with your school counselor.  You can engage clinical coping tools like breathing and grounding techniques.  If the associated behavior is violent or aggressive, you must follow  your schools protocol, it is best to review these processes prior to the situationns arising.
Role: Clinical_Staff
Question: My district recently experienced a death by suicide of a student. This is impacting the students, teachers, and the staff.  What resources are available? What is my role?
Answer: The National Association of School Psychologists has resources for children experiencing grief at https://www.nasponline.org/resources-and-publications/resources-and-podcasts/school-safety-and-crisis/mental-health-resources/addressing-grief. On that page, you will also find links to assist teachers, administrators, and caregivers.