Final Evaluation Design:
Students Transitioning from Section 23 To Community-Based School Programs
Background
The Ontario Education Act enshrines the right of youth to have access to an education, regardless of whether or not they are physically present in a community-based school. This type of programming include homeschooling, but more often refers to in-risk students whose needs cannot be met by a traditional school setting. These specific programs are referred to as Children and Youth In Care (CYIC), or Care, Treatment, Custody and Corrections (CTCC) programs. The common umbrella term for these programs is Section 23, which is the aforementioned section of the Education Act.
A 2016-2017 review found that in Toronto, there are 63 different Section 23 programs with 734 spaces, generally operating at 80% capacity (East Metro Youth Services, 2017). These programs, whether providing short- or long-term care, aim to reintroduce their students into community-based schools whenever possible. Part of this process involves creating transition planning that focuses on gradual reintegration, as well as providing information and support to educational staff at both ends of the transition (Ministry of Education, 2016).
Research shows that these transitions are not always effective. Youth drug treatment programs, for example, find that 47% of their students resume full drug use within one year of their transition, and that the transition time is when they are at highest risk for relapse (Finch, Lawton-Krupp, and Moberg, 2014). Children’s aid programs found that students considered the transitions “jarring” and did not make connections with their community school, especially those transferred to a new school boards (Directions, 2017). Regardless of the type of programming, many transitioning students felt hindered in their progress by stigma and a lack of preparation for post-secondary education. (Directions, 2017)
Situation
At any given time in Toronto, there are hundreds of children and youth who are transitioning between community-based schools and Section 23 programs. These transitions vary in terms of length, rationale, number of instances, quality of supports offered, and rate of success. For a variety of reasons, including the high turnover rate of CYIC programs, there is little data available to indicate how successful these transitions are in both the short- and long-term.
Policy Problem
There are several reasons, at the institutional level, that could contribute to poor transitioning for students in Section 23 programs. One is that there is a lack of research that specifically focuses on children and youth in care and treatment programs. The result is that policy for these children is often designed around research for in-risk students in general, as opposed to in-risk students who cannot be housed in a community-based school (Directions, 2017). Another potential reason is the perceived lack of communication between the different agencies involved in programming for these students. The program goals of the various ministries involved are not aligned, and there is significant ambiguity around who is responsible for the implementation and success of these programs. (East Metro Youth Services, 2017) Finally, there are limited resources available for both the sending and receiving programs. Staff in community-based schools feel they are not equipped to handle the needs of these transitioning students (Directions, 2017), which can lead to the students being kept longer in the Section 23 program not for any discernible need, but simply because the receiving school needs more time to prepare. (East Metro Youth Services, 2017) This puts an additional strain on the Section 23 system and, more importantly, the in-risk student.
Literature Review
Leonard and Gudino (2016) hypothesize that students who move schools frequently - in this population sample, due to being involved in foster home care - experience social stress which can negatively impact their academic success and social networks (Leonard and Gudino, 2016). Of the 420 students in the research sample, taken from the National Survey of Child and Adolescent Well Being (NSCAW), 72% had been in at least 2 different schools during the 36 month study period; 46% had been in a minimum of 3 different schools (Leonard and Gudino, 2016). Interestingly, the authors found that there was no statistically significant correlation between home instability and school engagement with these students, findings which Leonard and Gudino note do not match the existing literature around the subject (Leonard and Gudino, 2016). Another possibility is that the act of removal from a home is not necessarily a negative factor if that home is a source of trauma for the student. The authors note that “if youth removed from home can have the benefit of remaining with familiar teachers, established social networks, and familiar settings, children may have the [ability] to have their emotional needs met.” (Leonard and Gudino, 2016) This study shows that moving between programs is not necessarily inherently detrimental to student academic success and mental health, but reinforces the idea that the transition must be managed carefully.
Blake, et al. (2016), examine the Bridge for Resilient Youth in Transition (BRYT) program model at Brookline High in Brookline, Mass. In essence, this program provides a school-within-a-school transition for students coming in to or out of school due to not only mental health issues, but also concussions or any other serious health issue requiring hospitalization. (Blake, et al., 2016) The authors found 6 similar programs across the state. Collectively, three-quarters of the students enrolled in these BRYT-model programs were concurrently in out-patient hospital programs, while 73% had at one point been fully or partially hospitalized for psychiatric concerns. The expectation for students in the BRYT-model programs was that their transition period would last between 8-12 weeks; the median stay in the program was 10 weeks. (Blake, et al., 2016) The study found that these programs were highly successful. Student participation in the program began on average at 75% in the first week of admission but was down to 17% in the final week. The authors frame this as a positive, as it indicates students relying less on the program and being able to integrate themselves back into the school over time. (8) This would, however, as Blake, et al. state, require a team of teachers-slash-mental health practitioners who have not only clinical expertise “but also a caseload and schedule that allows them the flexibility and time necessary to help students navigate the academic, emotional, and social challenges they will inevitably face” with transitioning back to school. (2016)
Simone (2017) provides a qualitative counterpoint to the more quantitative Leonard and Gudino article by interviewing multiple students who were housed in psychiatric facilities, then transferred to BRYT-style programs across Massachusetts. These interviewees, ranging in age from 15 to 19, each identified key issues vis-a-vis reentry: concern over the perception of their peers during their attempt to reintegrate, and their worry that they would be unable to catch up with their courses. (Simone, 2017) Interestingly, these students all reported that having intake meetings with hospital and school staff helped ease these stresses. Completing their school work gave them a positive sense of accomplishment. This was facilitated through a variety of means, including: smaller class settings in the BRYT program; teachers giving accommodations or modifications to the late assignments, or simply removing them; and a continual focus from staff on reintegration, not staying permanently in BRYT. Simone also notes that these students had a better rapport with their teachers once the cause of their “poor behaviour” had been demystified. In line with this is the fact that although these students continued to struggle with mental health issues, they eventually saw school as a place where they could practice coping mechanisms and management strategies, rather than a place to be avoided at all costs. (Simone, 2017)
Lens - Sense Making & Co-Construction
(Datnow and Park, 2009)
Foregrounding
When viewing this issue through the sense making and co-construction lenses, the issues that are foregrounded are whether or not a student can successfully transition back into the school community, and the ability of the staff and receiving program to facilitate this transition. Another issue that is foregrounded is how individual schools navigate the return of individual students; each will have their own strengths, weaknesses, and needs that must be addressed on a case-by-case basis.
Backgrounding
What is least important in this lens is the role of the prescribed curriculum in meeting the needs of transitioning students. The pressures on both staff and students of meeting the curriculum requirements can be more of a hindrance than a help in the case of students with mental health issues.
In The Frame / Out Of The Frame
With this policy problem, what is “in the frame” is the attempts of the school program to successfully facilitate a transition, and its ability to adapt to changing situations (the student relapsing, changes of medication, etc.) What is “out of the frame” are the decisions made by medical staff in the care and treatment programs - medication, therapeutic techniques, etc. However the sense making and co-construction lens suggests that these hospital contexts need to be considered as well, regardless of their place “higher” or “lower” on the policy chain.
Arena of Action
This lens indicates that top-down policy is not the only motivating factor in organizational behaviour, and that different interpretations of implementation can occur in different settings. Thus, the arena of action is focused on how individual school programs can design their own policies, based on staff experience, on a school-by-school basis, to best meet the myriad needs of this fragile student population.
Locus of Control
The locus of control ultimately rests with the school administration, who work with hospital staff to determine the pace and schedule of the students’ transition back to school.
Potential Policy Solution
One possible policy solution to this issue is to provide funding, resources, training, and staffing to schools specifically for the purpose of creating classrooms devoted solely to transitioning students back from extended hospital stays, particularly for psychiatric hospitalization, into the mainstream school community.
Who has the authority to make changes?
The authority to provide additional funding lies with the Ministry of Education. Individual school boards would then identify which schools in their area would best put this funding to use based on the needs of their student population. At the school level, administrators would be responsible for staffing the programs, and classroom teachers would be responsible for delivering the programming to support the transitioning students.
Who needs to know about this?
It could be argued that the Ministry of Education, the Ministry of Children and Youth, and the Ministry of Health and Long-Term Care all have a vested interest in solving this issue; a successful implementation of a solution would reduce the number of youth moving multiple times between hospitals and schools, which reduces the strain on those services. School boards would also need to know, as mental health is an increasingly pressing need in school communities across Ontario which teaching staff find themselves under-equipped to deal with. Parent councils at individual schools may also be a potential audience, particularly if their school has a high rate of recidivism amongst transitioning students; the mental health and successful transition of a student is something that reverberates well outside the classroom, into the home and the hospital program as well. Finally, Section 23 programs and their ilk would need to know as they are at the front lines of balancing the educational and medical needs of students.
Conversations to Consider
Mental health is no longer the stigmatized subject it once was, although there is still work to be done in this area. It is not a “third rail” issue that any particular political party or level of government would want to avoid; indeed, politicians from across the political spectrum now only speak about their own struggles with poor mental health. Thus, regardless of whichever party is in power or whatever their goals are, this is a policy issue that can gain traction. In a climate of austerity the idea of putting more funding into education, for something that benefits an often-hidden cohort of students, may not be palatable, however, without some societal pressure.
It is also important to consider that multiple agencies and ministries could potentially be involved in crafting this policy as it cuts across a variety of sectors - namely, education and health care. Recognizing the needs, expectations, and demands of those separate actors would be critical in ensuring a successful implementation of this policy. Teacher unions should also be consulted to ensure that the work asked of teachers, and the conditions of the transition classrooms in terms of number of students, hours worked, personal safety, etc., do not violate the terms of their collective agreements.
Next Steps
While this policy is geared towards providing assistance for students and staff at the secondary level, there is a considerable amount of work to be done in this area at the post-secondary level as well. A 2017 MacLean’s article found that 15 universities across Canada - including Queen’s, Ryerson, and York - reported students feeling “overwhelmed” between 50 - 60% of the time on a daily or weekly basis. (Hutchins, 2017) The University of Toronto recently found itself embroiled in controversy in June 2018 when it enacted a policy that would allow them to place students with mental health issues on mandatory leave if the school deems it necessary. This policy was met with criticism from multiple student groups, as well as the Ontario Human Rights Commission. (CBC, 2018) Although post-secondary institutions increased their mental health budgets by 35% in 2017, (Bowden, 2018) it is increasingly students who are taking the lead in meeting these needs. One example is Waterloo student Tina Chan, who created kits to help students experiencing panic attacks. The university purchased 7,100 of her kits, which were given to first-year students in the fall of 2018. (Bowden, 2018) This suggests that, at the post-secondary level, a variety of policy approaches ranging from mandates to capacity-building will be necessary to ensure students struggling with these issues can return to their studies in a supportive, structured environment.
Bowden, Olivia. (2018, September 3rd). "Students push for mental health support." The Hamilton Spectator. Retrieved from https://www.thespec.com/living-story/8866484-students-push-for-mental-health-support/
Policy Problem
There are several reasons, at the institutional level, that could contribute to poor transitioning for students in Section 23 programs. One is that there is a lack of research that specifically focuses on children and youth in care and treatment programs. The result is that policy for these children is often designed around research for in-risk students in general, as opposed to in-risk students who cannot be housed in a community-based school (Directions, 2017). Another potential reason is the perceived lack of communication between the different agencies involved in programming for these students. The program goals of the various ministries involved are not aligned, and there is significant ambiguity around who is responsible for the implementation and success of these programs. (East Metro Youth Services, 2017) Finally, there are limited resources available for both the sending and receiving programs. Staff in community-based schools feel they are not equipped to handle the needs of these transitioning students (Directions, 2017), which can lead to the students being kept longer in the Section 23 program not for any discernible need, but simply because the receiving school needs more time to prepare. (East Metro Youth Services, 2017) This puts an additional strain on the Section 23 system and, more importantly, the in-risk student.
Leonard and Gudino (2016) hypothesize that students who move schools frequently - in this population sample, due to being involved in foster home care - experience social stress which can negatively impact their academic success and social networks (Leonard and Gudino, 2016). Of the 420 students in the research sample, taken from the National Survey of Child and Adolescent Well Being (NSCAW), 72% had been in at least 2 different schools during the 36 month study period; 46% had been in a minimum of 3 different schools (Leonard and Gudino, 2016). Interestingly, the authors found that there was no statistically significant correlation between home instability and school engagement with these students, findings which Leonard and Gudino note do not match the existing literature around the subject (Leonard and Gudino, 2016). Another possibility is that the act of removal from a home is not necessarily a negative factor if that home is a source of trauma for the student. The authors note that “if youth removed from home can have the benefit of remaining with familiar teachers, established social networks, and familiar settings, children may have the [ability] to have their emotional needs met.” (Leonard and Gudino, 2016) This study shows that moving between programs is not necessarily inherently detrimental to student academic success and mental health, but reinforces the idea that the transition must be managed carefully.
Blake, et al. (2016), examine the Bridge for Resilient Youth in Transition (BRYT) program model at Brookline High in Brookline, Mass. In essence, this program provides a school-within-a-school transition for students coming in to or out of school due to not only mental health issues, but also concussions or any other serious health issue requiring hospitalization. (Blake, et al., 2016) The authors found 6 similar programs across the state. Collectively, three-quarters of the students enrolled in these BRYT-model programs were concurrently in out-patient hospital programs, while 73% had at one point been fully or partially hospitalized for psychiatric concerns. The expectation for students in the BRYT-model programs was that their transition period would last between 8-12 weeks; the median stay in the program was 10 weeks. (Blake, et al., 2016) The study found that these programs were highly successful. Student participation in the program began on average at 75% in the first week of admission but was down to 17% in the final week. The authors frame this as a positive, as it indicates students relying less on the program and being able to integrate themselves back into the school over time. (8) This would, however, as Blake, et al. state, require a team of teachers-slash-mental health practitioners who have not only clinical expertise “but also a caseload and schedule that allows them the flexibility and time necessary to help students navigate the academic, emotional, and social challenges they will inevitably face” with transitioning back to school. (2016)
Simone (2017) provides a qualitative counterpoint to the more quantitative Leonard and Gudino article by interviewing multiple students who were housed in psychiatric facilities, then transferred to BRYT-style programs across Massachusetts. These interviewees, ranging in age from 15 to 19, each identified key issues vis-a-vis reentry: concern over the perception of their peers during their attempt to reintegrate, and their worry that they would be unable to catch up with their courses. (Simone, 2017) Interestingly, these students all reported that having intake meetings with hospital and school staff helped ease these stresses. Completing their school work gave them a positive sense of accomplishment. This was facilitated through a variety of means, including: smaller class settings in the BRYT program; teachers giving accommodations or modifications to the late assignments, or simply removing them; and a continual focus from staff on reintegration, not staying permanently in BRYT. Simone also notes that these students had a better rapport with their teachers once the cause of their “poor behaviour” had been demystified. In line with this is the fact that although these students continued to struggle with mental health issues, they eventually saw school as a place where they could practice coping mechanisms and management strategies, rather than a place to be avoided at all costs. (Simone, 2017)
Lens - Sense Making & Co-Construction
(Datnow and Park, 2009)
Foregrounding
When viewing this issue through the sense making and co-construction lenses, the issues that are foregrounded are whether or not a student can successfully transition back into the school community, and the ability of the staff and receiving program to facilitate this transition. Another issue that is foregrounded is how individual schools navigate the return of individual students; each will have their own strengths, weaknesses, and needs that must be addressed on a case-by-case basis.
Backgrounding
What is least important in this lens is the role of the prescribed curriculum in meeting the needs of transitioning students. The pressures on both staff and students of meeting the curriculum requirements can be more of a hindrance than a help in the case of students with mental health issues.
In The Frame / Out Of The Frame
With this policy problem, what is “in the frame” is the attempts of the school program to successfully facilitate a transition, and its ability to adapt to changing situations (the student relapsing, changes of medication, etc.) What is “out of the frame” are the decisions made by medical staff in the care and treatment programs - medication, therapeutic techniques, etc. However the sense making and co-construction lens suggests that these hospital contexts need to be considered as well, regardless of their place “higher” or “lower” on the policy chain.
Arena of Action
This lens indicates that top-down policy is not the only motivating factor in organizational behaviour, and that different interpretations of implementation can occur in different settings. Thus, the arena of action is focused on how individual school programs can design their own policies, based on staff experience, on a school-by-school basis, to best meet the myriad needs of this fragile student population.
Locus of Control
The locus of control ultimately rests with the school administration, who work with hospital staff to determine the pace and schedule of the students’ transition back to school.
One possible policy solution to this issue is to provide funding, resources, training, and staffing to schools specifically for the purpose of creating classrooms devoted solely to transitioning students back from extended hospital stays, particularly for psychiatric hospitalization, into the mainstream school community.
Who has the authority to make changes?
The authority to provide additional funding lies with the Ministry of Education. Individual school boards would then identify which schools in their area would best put this funding to use based on the needs of their student population. At the school level, administrators would be responsible for staffing the programs, and classroom teachers would be responsible for delivering the programming to support the transitioning students.
Who needs to know about this?
It could be argued that the Ministry of Education, the Ministry of Children and Youth, and the Ministry of Health and Long-Term Care all have a vested interest in solving this issue; a successful implementation of a solution would reduce the number of youth moving multiple times between hospitals and schools, which reduces the strain on those services. School boards would also need to know, as mental health is an increasingly pressing need in school communities across Ontario which teaching staff find themselves under-equipped to deal with. Parent councils at individual schools may also be a potential audience, particularly if their school has a high rate of recidivism amongst transitioning students; the mental health and successful transition of a student is something that reverberates well outside the classroom, into the home and the hospital program as well. Finally, Section 23 programs and their ilk would need to know as they are at the front lines of balancing the educational and medical needs of students.
Conversations to Consider
Mental health is no longer the stigmatized subject it once was, although there is still work to be done in this area. It is not a “third rail” issue that any particular political party or level of government would want to avoid; indeed, politicians from across the political spectrum now only speak about their own struggles with poor mental health. Thus, regardless of whichever party is in power or whatever their goals are, this is a policy issue that can gain traction. In a climate of austerity the idea of putting more funding into education, for something that benefits an often-hidden cohort of students, may not be palatable, however, without some societal pressure.
It is also important to consider that multiple agencies and ministries could potentially be involved in crafting this policy as it cuts across a variety of sectors - namely, education and health care. Recognizing the needs, expectations, and demands of those separate actors would be critical in ensuring a successful implementation of this policy. Teacher unions should also be consulted to ensure that the work asked of teachers, and the conditions of the transition classrooms in terms of number of students, hours worked, personal safety, etc., do not violate the terms of their collective agreements.
Next Steps
While this policy is geared towards providing assistance for students and staff at the secondary level, there is a considerable amount of work to be done in this area at the post-secondary level as well. A 2017 MacLean’s article found that 15 universities across Canada - including Queen’s, Ryerson, and York - reported students feeling “overwhelmed” between 50 - 60% of the time on a daily or weekly basis. (Hutchins, 2017) The University of Toronto recently found itself embroiled in controversy in June 2018 when it enacted a policy that would allow them to place students with mental health issues on mandatory leave if the school deems it necessary. This policy was met with criticism from multiple student groups, as well as the Ontario Human Rights Commission. (CBC, 2018) Although post-secondary institutions increased their mental health budgets by 35% in 2017, (Bowden, 2018) it is increasingly students who are taking the lead in meeting these needs. One example is Waterloo student Tina Chan, who created kits to help students experiencing panic attacks. The university purchased 7,100 of her kits, which were given to first-year students in the fall of 2018. (Bowden, 2018) This suggests that, at the post-secondary level, a variety of policy approaches ranging from mandates to capacity-building will be necessary to ensure students struggling with these issues can return to their studies in a supportive, structured environment.
REFERENCES
Bowden, Olivia. (2018, September 3rd). "Students push for mental health support." The Hamilton Spectator. Retrieved from https://www.thespec.com/living-story/8866484-students-push-for-mental-health-support/
Directions Evidence and Policy Research Group, LLP (2017). Evaluation of the Innovative Programs for Students in the Care of, or Receiving Services from, Children’s Aid Societies: Final Report. Toronto, ON.
East Metro Youth Services (2017). Section 23 Working Group Summary: Final Report. Toronto, ON.
Finch, Lawton-Krupp, and Moberg (2014). Continuing Care in High Schools: A Descriptive Study of Recovery High School Programs. Journal of Child & Adolescent Substance Abuse, Vol. 23, 116-129.
Hutchins, Aaron. (2017, April 20th). Are universities doing enough to support mental health?MacLean’s Magazine. Retrieved from https://www.macleans.ca/education/depth-of-despair/
Leonard, Skyler S. and Gudino, Omar G. (2016) Academic and Mental Health Outcomes of Youth Placed in Out-of-Home Care: The Role of School Stability and Engagement. Child Youth Care Forum. New York. 45:807-827.
Ontario Ministry of Education. (2016-17) Guidelines For Educational Programs for Students in Government Approved Care and/or Treatment, Custody and Correctional (CTCC) Facilities. Ottawa, ON: Queen’s Printer for Ontario.
Simone, Daniel J. (2017) “Getting Back To School - Understanding Adolescents’ Experience Of Reentry Into School After Psychiatric Hospitalization”. Doctoral thesis. 50-93. Retrieved from ERIC.
The Canadian Press. (2018, June 27th). U of T approves policy that could place students with mental health issues on leave. CBC News. Retrieved from https://www.cbc.ca/news/canada/toronto/university-toronto-mental-health-mandatory-leave-1.4725104
White H, LaFleur J, Houle K, Hyry-Dermith P, Blake SM. (2017) Evaluation of a school-based transition program designed to facilitate school reentry following a mental health crisis or
psychiatric hospitalization. Psychol Schs. 54:868–882.
