On this episode of PDXPLORES, Evan Elkin, Executive Director of Reclaiming Futures, a sponsored project of the Regional Research Institute within the School of Social Work, discusses his work creating public health systems enlisting, training and retaining community members as peer counselors within underserved, remote communities, with the goal of fostering equity, inclusion and partnership for BIPOC and LGBTQ+ high school students in need.
Follow PSU research on Twitter: @psu_research and Instagram: @portlandstateresearch
On this episode of PDXPLORES, Evan Elkin, Executive Director of Reclaiming Futures, a sponsored project of the Regional Research Institute within the School of Social Work, discusses his work creating public health systems enlisting, training and retaining community members as peer counselors within underserved, remote communities, with the goal of fostering equity, inclusion and partnership for BIPOC and LGBTQ+ high school students in need.
Follow PSU research on Twitter: @psu_research and Instagram: @portlandstateresearch
Welcome to PDXPLORES, a Portland State Research Podcast featuring scholarship, innovations, and discoveries pushing the boundaries of knowledge, practice, and what is possible for the benefit of our communities and the world. My name is Evan Elkin. I'm the Executive Director of Reclaiming Futures, which is a sponsored project of the Regional Research Institute within the School of Social Work at Portland State University. Reclaiming Futures is a national organization, and we describe ourselves as a public health organization that works at the intersection of justice and public health. And we work primarily in youth serving systems like juvenile justice, schools, and child welfare. And we look for bringing about public health equity, access to services, and fairness. Since our mission and the thrust of this grant both align in terms of seeking to serve underserved communities, there were a lot of these schools that were already on our radar from our previous work. So we had some existing partnerships that we could draw upon when we were initially planning this. The other thing that we did is we looked at data. We looked at local data for school districts around the state and we looked for what the Department of Education grant was asking for, like which local education agencies, districts, etc. where deficits of mental health professionals or low ratios of counseling staff to students. Some of those data are publicly available. So one of the first things we did was we scanned data and reporting. Sometimes journalists reporting. We did a search to try to figure out where in Oregon were the most underserved communities. But really the most important thing that we did is we asked our community partners that we had planned to partner with for this grant. We call them our cultural partners, the Latino network, the Northwest Portland Area Indian Health Board and a group in Southern Oregon called La Clinica. We asked them in terms of their understanding of the networks of schools that they work with, which would be the most effective, impactful partners to pursue. And once we did that, we did sort of a lengthy round of conversations. I was on the phone with school district personnel for several weeks before this grant was due. Getting a gauge of, like, do they need the kind of support we were offering? Are they ready for it? And do the numbers that we found that were publicly available, did they match their own sense? Did they really have a serious deficiency in mental health staff in their school? And most of the time, these things lined up, and we had very eager partners, and we made difficult choices. We could have chosen at least double the number of partnerships that we did for this particular grant. We decided for this project to target a few different sub populations or types of communities of need. Tribal communities, tribal schools, that is. Rural frontier communities and their schools. And urban communities of poverty where there's a predominantly Latinx community. And so, the schools that we're partnering with for this project represent each of those three categories. And for example, we're in the Hillsborough School District here in Portland and the Reynolds School District. Malheur County is one of our partners, which is one of our most rural eastern counties. And we are working with a couple of different tribal schools, including a school called the Chumawa School, which is a boarding school of very long standing in Indian country. The grant initiative was rooted in the applicants were to be an institution of higher education. So that was our starting point. The initial conversations about this, whether we were going to put in a proposal or not, started here at the university with our School of Social Work. With PSU as the starting point and geography as the factor, we had to look, you know, in the radius around Portland State University. Where would students who go through the Social Work school here and get placed in internships? How far would they be likely to travel? I mean, PSU is a school of national reputation, and certainly students who get their MSW degree do end up placed around the country and employed around the country. But we decided to focus regionally and geographically in accessible areas within these two states, that students at PSU would likely to be placed for their internship training. The answer to the question who this program is serving is kind of complex. There are three or four answers to that. Obviously we're serving students in middle and high schools in the communities where we're trying to build up the workforce and enhance the mental health practices of those schools. But really also our population that we're hoping to support are the graduate students themselves who are coming through PSU and are entering the workforce. In addition to that, you know, we think about the pipeline of professionals and folks who may be preparing or contemplating entering the workforce but haven't quite, for example, finished their bachelor's degree or thinking about getting an MSW, and those people might be employed at the school, they might actually be employed within our community partners, and so we're really looking at both building a workforce and looking at various places where those folks might be hiding and might be enticed to take that next step in their professional development. But really, bottom line, we're looking to serve the young people who are students in these underserved schools. That's where the impact is going to be felt the most, I think. Rural communities have less of everything. They get fewer federal grants. Many school districts don't have a grant writer to pursue federal grants. Populations are lower. But it's known in our field that in terms of health care providers, psychiatrists, mental health care providers, school social workers, their numbers are really low compared to urban and suburban areas. The main way that rural areas are underserved is that they really are understaffed. I read a statistic recently that only 5% of rural counties have a child psychiatrist living in the county. Not that all of our work funnels toward child psychiatry. There's quite a few tiers in the ecology of mental health in and around schools and kids, but all the numbers are low. They're all deficient in staff. Schools in rural communities and in communities of poverty have a higher percentage of families that are un- or underinsured and more stress that's caused by untreated chronic medical conditions. There tends to be more loss associated with the fact that health care is minimal in those areas. Chronic poverty carries its own stressors and this is a highly traumatized community with higher rates of drug use and drug overdose. Our partners in Malheur County have very high rates among the middle and high school populations of fentanyl overdoses. And so there's no question that in these smaller communities where help seeking is also quite stigmatized, that people suffer silently, suicide rates are higher and it's definitely a highly distressed community. All of these marginalized populations, BIPOC and LGBTQ folks, experience all kinds of bias and discrimination, and that affects their access to care. And it's interesting in our work in schools, we know that folks in those categories, their behavior is more likely to trigger a disciplinary response than a caring public health response, rather than to ask why someone felt frustrated and threw a chair, then you just suspend that person and get them out of the classroom. Disabled folks, gay and lesbian kids, transgender kids, and kids of color are much more likely to be dealt with in the discipline system than they are through whatever public health pathways that exist in the schools. One of the factors here that goes back to something I said earlier is that we have this working hypothesis that some of the workforce that we hope to have emerge and enter the workforce and sustain themselves in jobs as mental health professionals. We've used the term hiding in plain sight in these schools. Someone who may have not finished their bachelor's degree, but has a role in a school working with kids, does it quite well, maybe a few credits shy of getting their bachelor's degree, or have their bachelor's, but never thought of themselves as a candidate for a master's program-- to some degree is looking further than where you would typically look, the pipeline of students with bachelors coming into an MSW program and then exiting and going on internships and then getting a job-- but looking in the communities themselves and looking within the populations we're serving themselves. So looking at Latinx candidates, looking at people who live in rural areas and looking at Native Americans who might be interested but never thought it possible. So trying to remove some of the barriers, keeping some of those folks from having either the funding, the confidence, the mentoring, and just the inspiration to enter the workforce. To try to take that attitude and look at the profession as a continuum, literally from high school to graduate school. And looking at where people are in that continuum and offering support. The DOE request for proposals itself suggested that you could focus on high school students as potential professionals down the road and to develop programming. We didn't do that per se, although we're looking for opportunities within the way that we end up rolling this out, but looking for ways in the schools to inspire young people to get on a college and graduate track to think about, "Hey, I want to be a mental health professional. I had a good experience." Or, "I was put on an advisory committee in my school to think about mental health in my school." So, it really is looking at the whole professional life span of a person from high school to when they graduate and get on the job market. There's another factor, too, which is it's a high burnout profession. This was really something we think about, and it's something that the Department of Education thought about in the way they designed this RFP, is rather than-- I mean, no one does this really, although you hear war stories of, you know, some young intern from an MSW program being thrown into a high need school where there's a lot of interpersonal violence and a lot of kids who need referrals and just sort of an atmosphere of chaos-- is what the DOE asked us to do before you send any intern into any of the schools where we're working is to lay down a foundation of responsible mental health practice which is really what Reclaiming Futures does as we think about the whole public health continuum from prevention, how do you do early identification of problems, once you identify problems what is that conversation like that you have with a young person so you get the most motivation out of them to take the next step and maybe see a counselor, really to see them as collaborators, and then triage people so that you know who needs what level of care. And so the requirement from the DOE before you applied for this fund was to propose a model that you would implement in the school so there's a solid foundation. So sending an intern into a school that has a solid foundation of universal screening of kids, an atmosphere of destigmatizing mental health so that kids feel comfortable coming forward is a very different experience and probably a burnout buffer then simply just identifying the schools that have the biggest and most problems and sending bodies in there to try to like deal with it. I think that's a factor too in removing barriers and keeping people in these positions. That's the key. There was a huge amount of burnout throughout COVID. COVID wasn't the only cause. I think it was a very distressed and stressed workforce going into COVID, but the workforce really diminished as a result of the emotional burnout and the difficulty that was happening for everyone. So paying attention to who the staff are, how they're trained, that they can do their jobs well, that they're entering into a system, they're not just being thrown in and asked to be heroic. That's the idea, is to create a workforce that aligns with the communities that we're serving, that looks like them, that has the same cultural experience. That's the nature of our strategy here, is to try to build, for example, the field of tribal youth mental health, or tribal school based mental health, which isn't necessarily really a field. I think there are some schools that do it well. There are some experts, but there isn't a unified field. So one thing we're hoping to do is to contribute to the articulation of those fields. Same for Latinx . What does it mean to do mental health in a rural community? What are the special training considerations? And I think the thing that gets us much further down the road of successfully doing that is to also recruit graduate students from those communities. So they come in with the lived experience in the cultural perspectives and those subfields will build up with a human resource that comes from sort of a grassroots strategy like this. So for that, we're really relying heavily on our community partners to identify candidates and identify a strategy for tapping into potential candidates to come to PSU and get their MSWs. So the school districts that we're partnering with, the main thing they have to do is really host these interns, give them a place to work, and provide some support and welcoming, and make them part of the staff. A lot of the schools that we're working with are not strangers to the process of having social work interns. A lot of them have had them for years. Sometimes they have them, but they haven't had enough of them, or they had a program. Many of them had a program with PSU that lapsed and they lost touch with it and they weren't getting interns. So, they have to create a welcoming environment for interns to come in and they have to want to have them there. And secondarily, they play a part in the mentoring and supervision of that person. That will be in partnership with us. We provide the coursework, the training, the academic advising, and a certain amount of the supervision, but also in conjunction with our community partners. For example, the Latino Network is our cultural partner for our school districts in Hillsboro and Reynolds. And they will take part in the actual supervision of that MSW student. They'll meet with them and provide the required hours of supervision that that MSW student needs to have in order to advance toward graduation. It's a collaboration between the school, the school district, the community partner, and PSU all coming together to support that social work student to get them through the process successfully. That's mainly what we mean by the grow your own approach, is to allow this workforce to emerge from the communities, rather than the assumption that we're airlifting MSW students in from the ivory tower to go work in these potentially far flung places. I mean, Malheur is like an eight hour drive from here. All of the coursework can be taken remotely. Placement can happen in the schools in Malheur. So really, theoretically, a candidate from Malheur County could do their coursework online. Do their placement at a local high school or middle school where they live. And then our hope is that if all goes well, that person gets potentially offered an ongoing position in that school to continue employment there. So this project has a lot of moving parts, and we conceptualized it in four, and there may be a fifth element. But first is a school wide mental health framework, or a public health oriented mental health framework, that does a school wide universal screening and triage engagement process, so that schools know who needs what kind of help and how urgently. And we have a system developed for that. So that's the first element of this project is to get that in place in the schools and that literally will be the first thing that we do. We're already in the process of scheduling training and getting schools ready for learning this framework and adopting this practice. The second is the specialized MSW training track that PSU has committed to create, which is to create a track for MSW school based social workers specializing with these particular populations. So there will be specialized elective and required courseworks and Latinx mental health and tribal mental health. And PSU has had courses like this in the past, but this will create a focus specialized track for folks whose professional aspiration is to graduate with an MSW degree and work in these communities with these particular populations. So the third piece is kind of interesting, and that's a partnership within PSU with a group called the System of Care Institute, which is directed by Brooke Reiser. It's been a longtime partner with the state of Oregon. They do continuing education training. professional trainings of various kinds with both state agencies, tribal communities. They've been kind of a specialist in providing supplemental certifications and trainings for existing professionals. With that partnership, the System of Care Institute is going to build out a whole raft of continuing education courses that both our social work students can take, but also the staff at the schools and in our community cultural partners to just generally buoy the professional knowledge of all of the people surrounding the kids in these schools and hopefully push the field along. And as I mentioned earlier, we're hoping that that piece of the puzzle might also push somebody into readiness to then maybe go back to graduate school. Someone who's maybe been working with a bachelor's in a school for a period of time, wanting to go further, that the CEU program can actually kickstart that. When you think about burnout and what are the things that keep someone from leaving the field, competency and being able to up their skills. And so we're going to offer a smorgasbord of skills that are specifically relevant to school based mental health and specific to these populations. Some of those haven't been designed yet, and we're going to tap our community cultural partners to help us design those. We want to design them responsively, so we've been asking our school partners and their mental health and policy folks, "What kinds of trainings does your staff need?" We're documenting those conversations and we're going to build out training programs around what they actually need rather than us telling them what they need. Since we know that entering into a school system, that they all will already have existing initiatives and student support models, one of our chief goals is to try to integrate what we're doing with existing practices and enhance them rather than to run roughshod over the things that people are already doing. And, for example, PBIS, or Positive Behavior Intervention Systems, is something that a lot of schools do. That if that's the case in one of the schools that we're entering, we will, as activity number one, we'll sit down and talk about how our work is going to affect either positively or step on the toes of existing initiatives. It's really important to us that we don't just become the next new initiative that drives school staff crazy, that they don't understand how it fits. So we really want to ask them those kinds of questions. Things like restorative discipline practice, which has become really popular in schools, is rather than engaging in exclusionary discipline practices like suspending and expelling kids from school, kids are pulled into a circle conversation with the person that they may have harmed, or the community that they've harmed, to talk it out and get to the root causes of what might have led to whatever the behavior incident was or the harm that was caused and then collaborate on a solution. And a lot of folks who do restorative practice really see that as part and parcel to building a healthy mental health community. Conflict resolution, tolerance, these kinds of things really help the person on both sides of the conversation in a disciplinary matter. Being seen and heard really is one of the fundamental things about adolescent mental health. Adolescents need to be understood and respected. So, if there are things going on in a school that are initiatives that are not formally seen as mental health, we do want to know about them and figure out how to integrate what we're bringing to the table. And really, the main thing we bring to the table, other than interns and staff-- you know, the actual support folks to do the work, to do the counseling-- we bring this universal mental health model, where every kid in the school does sort of a mental health checkup and check in process. So that you find out about kids who might be suffering before a chair gets thrown or before there's an incident or before you find out that a kid has been feeling suicidal because they try to do something to harm themselves. And so we have this proactive universal screening model that we bring to the table that fits really well with a lot of the other initiatives that schools are using these days. For each of the populations that we endeavor to serve with this grant, we selected what we're calling a cultural partner. These are community based organizations that have, in all three cases of the three that I'll describe, have long histories of working with these populations. So the Latino Network is a well established group here in Multnomah, Washington County, and more recently in Clackamas County, serving the Latinx community and families in a number of different domains, in schools, after school programs, alternatives to incarceration and diversion programs and juvenile justice. They have a wealth of experience with this population and we decided to team up with them to help design the curricula for the social work, the specialized social work track in the case of the Latinx populations, and really to be, you know, an equal partner with us in the delivery of this public health service to these schools. And the objectives are really the same for all three. So it's the Latino Network, the Northwest Portland Area Indian Health board, which has been around for a number of years and focuses on both mental health and community wellness and tribal communities across the Pacific Northwest and the group in Southern Oregon called La Clinica, whose focus is on rural mental health. And so the objectives for all three of these cultural partners are the same. It really is to help us articulate and define these new professional subtracts within the social work school and deliver culturally responsible and responsive services to students. The school wide mental health model that we've been talking about is something that falls into a category in the field that's referred to with an acronym called SBIRT, Screening Brief Intervention and Referral to usually services of some kind or to Treatment. And the S in SBIRT is screening, and so there needs to be some sort of screening. We always say that screening is just sort of a more structured and formalized way of noticing that something might be wrong. Like, I might look at you and see that you have a red eye or something like that. And I'm thinking, "Wow this guy might have an eye infection." So screening is really about a preliminary and surface level assessment of whether somebody might have a problem that you then need to explore further. We've been developing screening brief intervention and referral models at Reclaiming Futures for a number of years for different populations. And we're really interested in both the screening. What kind of questions do you ask? Do you only ask about problems? Do you also ask about strengths and positives and positive relationships? Coping? We're really interested in screening tools that are more balanced, that ask not just questions about problems, but also about assets that a person has, good relationships, supportive relationships, coping strategies that they're already using. So a screening tool that asks those questions leads naturally into a conversation. You could imagine if you asked a kid at the same time about anxiety, and also how do you cope with anxiety, you've got a story right there. So if you then follow that up with what we call a brief intervention, where we say to the young person, "So we did the screening with you and it got a lot of strengths. You mentioned a couple problems you're struggling with and that you have a few ways to deal with it. Can you tell me more about that? Tell me how you're able to kind of get through the day or you know, tell me how this plays out or when does this happen?" And what you're doing is you're putting the young person in the driver's seat. And you're treating them as a equal collaborator in a conversation that could lead to planning for some sort of support down the road. Nobody goes to therapy, or treatment, or follows up on any kind of support recommendation if they're not motivated to do that. The strategy that we use for the brief intervention after we do the screening is rooted in something called motivational interviewing. It's a form of active listening that tries to get a person to get in touch with their motivation to make better decisions. positive change. And it's really an appreciative and respectful way to talk to somebody. It really resonates with teenagers. The screening tool that we use is called Check Yourself. It was developed by the Seattle Children's Research Institute. It's sort of an amalgam screening tool. It contains a number of validated screening tools that are out there that have been research tested to be an accurate screening, for example, depression or anxiety. But we surround that within Check Yourself with all kinds of other questions about strengths. It's about coping, about relationships, and relationship safety. It's interesting, it also delivers some feedback to the young person. It's designed to be delivered on an iPhone or an iPad. The young person takes it on their own, there's no person administering it, so they take it privately. It's been designed and vetted with teenagers in mind, and we've gotten lots of feedback, and kids seem to really resonate with it. And that tool then produces a report that summarizes Things that the young person said and that becomes a conversation piece for a brief conversation with the young person. Really what you're... what you're trying to get at is, "What do you need? Is there something you need? Is there a connection that we can make for you with somebody who could support you?" And very, very often everything is really fine and it maybe needs to be heard and a little extra support. When you talk about a program like this it sounds like, you know, we're really digging in, and we're going to find all kinds of pathology. But really, it's a way of appreciating where kids are at, and giving kids a chance to be heard, and it really has a strong impact. At the community level, kids feel more connected to their school after this program has been implemented. It's one of our more interesting and strongest findings that kids will tell you after they've been a participant in the screening and brief intervention program, that they feel more connected to the adults in the building. They feel listened to and cared for, that someone has their back. One of the findings that we're most proud of from the work is that we're actually making a difference in how kids feel when they walk into the building of their school. Recruiting for this project, recruiting potential MSW students, is going to be a collaboration between PSU and our community partners and the school districts. We're developing recruitment materials. We're already in preliminary conversations. When we've onboarded school districts as partners, many of them are already thinking about people in their community that they might suggest. So we're really looking to recruit from the communities where we're working, rather than to just take the existing body of MSW students at PSU and try to interest them in these unique placements. I think that will also happen. I think there are existing students who are already in the School of Social Work pipeline who will hear about this program. Um, and will be really interested that this might match with their interests. But it's going to be a give and take between the communities, the community partners, and the schools to try to create a new recruitment strategy for PSU. And PSU School of Social Work is not a stranger to recruiting outside of the city limits of Portland. But this is an exciting opportunity for us to increase our enrollment in this specific way. We really hope that as a result of the internship experience that social work students consider staying on in full time employment in the schools where they are offered employment. We talk about it as an informal contingency. We let them know that if they are offered, we'd really like them to accept a position, but really we hope to inspire them. We hope to give them the right skills to create an experience that they want to continue as their first job after graduate school. We're also providing a stipend for the social work interns for placement in the various school districts that we're partnering with. Faced with whether to go back to graduate school or to look for a full time job, finance is the big decision maker here, and so we're trying to remove what I think is the chief barrier, particularly in these underserved communities, to try to inspire folks to spend at least that first year or second year internship continuing to pursue their graduate education. I think that's a big one. Honestly, it's the specific training and skills that we're giving them, and the fact that we're honoring the communities that they come from by helping them participate in the creation of a new field, really. The competitive preference priorities were outlined by the Department of Education. It's part of the competitive nature of the grant. So applicants were given priority, for example, if they were a minority serving institution, which Portland State University is. Priority in the competition for these grants was given to universities that can demonstrate that they promote inclusive practices. Both of those, the serving of minorities and promoting inclusive practices, are really big mission elements for Portland State University. These were aspects that really stood out, I think, for the grant reviewers, and made Portland State University really a strong candidate, because those are strong mission elements and priority areas for us as well, not just for the grant. Having a good plan for increasing the number of qualified providers, that's really the mission of this grant initiative, is to put more qualified mental health providers in schools. It's actually a really interesting and well designed initiative by the Department of Education. The way that they set this up, they're not just simply saying, "Here's a bunch of money, school district, to hire some new professionals, so that you have practitioners to pick up the pieces when kids fall apart." They're looking at the career lifespan of a person, and they're asking universities like PSU to design a strategy for really increasing the numbers over time, and to really think about career development, workforce development. That was another area in our proposal to the DOE where we really stood out. We had a really innovative and strong proposal for how to build this sort of lifespan continuum approach to recruitment. The Bureau of Indian Education is sort of the analog agency to the Federal Department of Education, setting policy and providing funding and supporting equitable education opportunities for young people in Native communities. It was really important to us. to get the blessing of the Bureau of Indian Education in our design and since we are making this foray into working in tribal communities and tribal schools. So it was really important to us to develop a relationship with the leadership of the Bureau of Indian Education. This letter didn't just drop out of the sky, it's the result of really getting to know them and work with them and share our strategy, let them give us feedback in the strategy, suggesting schools that we might work with. And interestingly, the Bureau of Education had reached out to me separately. It had seen a presentation that I had given about our universal screening model and had approached me right around the same time that this grant opportunity came out from the DOE and I had already been in conversation with them. So they really emerged as an important partner, as sort of a give and take. They're deeply underfunded as a federal agency. They're understaffed. I think-- I forget what the statistic I was told. So one person that I talked to at the Bureau of Indian Education said that she has 139 schools in her portfolio that she supports as a single person in the agency to kind of oversee their needs. So it's one of those just sort of extremely underfunded, understaffed agencies. And so anything we can do to provide some supplemental support is something that we'd really like to do by mission and is really welcomed by the Bureau of Indian Education. And I'll be honest that having a letter from them was really important in our conversations with potential tribal schools. I think for good reason, schools in Indian country are cautious about federal initiatives and what's required and what actually the goals and what's really in it for them. And I think it was really helpful for me and my negotiation with the tribal schools that we're hoping to support to let them know that we've been in conversation with the Bureau of Indian Education. We do a lot of tribal oriented work at Reclaiming Futures and so we understand a lot of the issues and we have a lot of trust in local tribal communities and so it was just an important closing of the loop to get this letter. The Bureau of Indian Education and Reclaiming Futures and then this project are in close alignment in a lot of the goals, which are equitable access to care, to the services that a young person in a school setting needs to succeed and to graduate. So I really think we're really closely aligned. I don't think there are any major differences in our agenda in a project like this. They're, at the federal level, an ideal partner with a shared mission with us around equity. This is a five year commitment that we're making to these school districts and other education agencies that are partnering with us and that with a five year relationship and the amount of training and support we're going to give them, we really hope that we're going to be able to make a difference and leave a pretty deep footprint in this kind of practice, that they'll be able to sustain it and that it becomes their daily way of practicing and really affects their communities. Five years can go pretty quickly, but we're really thinking about sustainability from day one with these schools. Because I think the danger with grant funded programs is that the funding comes in, the program comes in, and then when the funding expires, so does the work. And so we're really mindful of not having that happen for schools, that their practice is influenced positively by what we are bringing to the table, that relationships are sustained, that they continue to have a relationship with PSU and continue to take interns for years to come. I think if we have successfully implemented our school wide universal mental health screening program, it will feel almost seamless to the culture and climate of the environment of the school. And I think that's our indicator of success. For a young person, it feels natural to be asked how they're feeling. And we've seen this happen in the schools where we've done our screening and brief intervention program, that you find that kids will refer their friends to say,"This kid wasn't in school the other day. He didn't get to do the screening. I really think you probably want to approach him and do the screening." Where it becomes something that feels positive and welcome in the environment. It's sort of woven into the fabric of the building. Ultimately, the goal of the internship placement program is for folks to be inspired after they finish their MSW to continue in the field and continue to work as school social workers. You know, in addition to giving stipends to help support them through the process and giving them specialized training and honoring their cultural roots, those that come from the communities that we're trying to serve, we're also looking to support them after the fact. We're covering the costs of their clinical supervision for a year after they finish the project, which is how you move somebody toward becoming a licensed social worker who can then supervise. And so really the main goals are to sustain, build a workforce that wants to stay working in schools and then can rise up the chain and become supervisors and just sort of to nourish the system a little bit. The main evaluation concerns of a program like this from the funder's standpoint is "Are we actually producing MSW interns, placing them in schools? Are the students then staying on and becoming employed by those schools?" I think those are concretely the kind of outcome measures that we're most concerned about and that are mostly being held to account by the funder, which is a very valid thing. That's the core of what we're doing. But I also think that this sort of ambitious goal that we have of creating this new field of tribal student mental health, Latinx student mental health, and mental health for students in rural communities. This is a pretty ambitious and somewhat subjective process where I think the proof will be in the pudding. Do people feel more connected to services? Does the stigma sort of fall away in these communities? And stigma is a big one in a lot of these communities, particularly in rural communities, where seeking help when you're not well is a sign of weakness in rural communities. So I think taking the pulse and really getting a sense of whether we've succeeded in creating a culturally responsive set of programs. And I think we'll know that with how the climate feels, with feedback, we'll probably do focus groups down the road to see if people agree with us that this has been achieved. And also by who applies for this program at PSU. If this is a sought after and successful program, I think we'll know that we achieved something. I'm Evan Elkin and my mission, professionally, and the organization that I run, Reclaiming Futures, is to create public health systems for communities that are typically underserved and where injustices interfere with their ability to achieve wellness. Thank you for listening to PDEXPLORES. If you liked what you heard on this episode, please rate and follow the show anywhere you get your podcasts.