General Awareness

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General Awareness
School-Based Behavioral Health Services

• Developed by Heidi Morgan Beth Kolb
• Edited by the Systems Integration Team
• February 15, 2007

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What will we talk about today?
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What do you think?

• When you hear the words
• Mental Health Disorders
• Substance Abuse

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Myths Facts

• Mental illness is not the same as mental
  retardation.
• The only reason why children misbehave or fail in
  school is to get attention.
• Mental illnesses are brought on by a weakness of
  character.
• Children with mental illness can do well in
  school.
• Females aged 12 to 17 are more likely than their
  male peers to report that LSD, cocaine, heroin,
  and crack are fairly or very easy to obtain.

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Myths Facts

• 6. Medication alone is more effective than
  counseling/therapy.
• 7. Children do not experience mental illness.
  Their actions are products of poor parenting.
• 8. According to the Centers for Disease Control,
  20 of ninth-graders report that they tried
  alcohol before the age of 13 and had used alcohol
  within the past month.
• 9. Students who have attention problems probably
  have ADD/ADHD.
• Myths and Facts adapted from http//allmentalheal
  th.samhsa.gov/myths/facts.html and
  http//www.adolescent-substance-abuse.com

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How big is the concern?

• There is a growing and unmet need for mental
  health services for children and youth
• 1/5 children and adolescents experience
  significant mental health problems during their
  school years (US Department of Health and Human
  Services, 1999, Mental Health A Report to the
  Surgeon General)
• Among the 2.2 million adolescents (aged 12-17)
  who reported a depressive episode, in the past
  year, nearly 60 did not receive any treatment
  (SAMHSA (2005) NSDUH Report)

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Facts How big is the concern?

• Burke County school-age population
• 5-18 years 18,505 (Census, 2000)
  see www.census.gov
• Burke County estimates
• Foothills Local Management Entity estimates that
  ONLY 14 of children in need of services, receive
  services.

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Facts How big is the concern?

• Among youth aged 12-17 in 2000, 9.7 had used an
  illicit drug within the past 30 days.
• Monitoring the Future Study (2005)
• Percent engaged in binge drinking within the past
  2 weeks
• 11 of 8th graders (3 out of 30 students)
• 22 of 10th graders (7 out of 30 students)
• 29 of 12th graders (9 out of 30 students)
• Adapted from http//www.adolescent-substance-abus
  e.com and http//www.niaaa.nih.gov (Alcohol
  Alert,
• January, 2006)

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Facts Why school-based mental health?
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Facts Why school-based mental health?

• Students mental health impacts academic
  achievement
• 25-90 of children with emotional/behavioral
  problems demonstrate academic achievement
  deficits (Nelson et al., 2004)
• 50 of children with severe emotional or
  behavioral disturbance drop out of high school
  (ODMH/ODE, 2003)
• Reading difficulties are predictive of antisocial
  behavior and vice-versa (Trzesniewski et al.,
  2006)
• Best predictor of teen well-being is a feeling of
  connection to school (REF)

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Facts Why school-based mental health?

• The Surgeon Generals Report concluded that
  primary care and schools are the major settings
  for the potential recognition of mental disorders
  in children and adolescents, yet trained staff
  are limited, as are options for referral to
  specialty care (US DHHS, 1999).
• Quoted from http//www.omh.state.ny.us/omhweb/EBP
  /children_sbmh.htmWhy

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Facts Why school-based mental health?

• more than ¾ of children receiving mental health
  services were seen in the education sector, and
  for many this was the sole source of care.
  (Burns in Adelman Taylor, 2004)

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Facts Why school-based mental health?

• Accessibility
• Transportation
• Less stigma
• Finances
• Lack of parental follow-through
• Improved communication

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Facts How does this relate to school?

• A comprehensive program of intervention that
  combines teacher training, parent education, and
  social competency training for children had
  long-term positive impacts, including
• Enhanced commitment and attachment to school
• Less school misbehavior
• Better academic achievement
• (Hawkins, et al., 1999)

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Facts How does this relate to school?

• Interventions that strengthen students social,
  emotional, and decision-making skills also
  positively impact their academic achievement
  higher grades and standardized test scores
  (Fleming et al., 2005).

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Warning Signs What do we look for?

• Poor social skills
• Disruptive behaviors
• Angry outbursts
• Attention/concentration problems
• Odd/unusual behavior
• Low self-esteem
• Low/change in academic performance

• Sad or withdrawn
• Tardies/Truancy
• Recent loss
• Changes in appearance
• Physical complaints/ problems
• Change in sleep pattern
• Stress at home
• Lack of motivation

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Intervention What can we do at school?
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Intervention What can we do at school?

• Greet student
• Show interest
• Make positive comments
• Listen
• Be supportive/caring

• Establish routine
• Prepare for change
• Foster parent/teacher communication
• Teachable-moments
• Encourage

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Intervention What else can we do?

• Consultation is the key!
• Parent
• School support staff (i.e. counselor,
  psychologist, social worker, nurse, student
  assistance counselor, behavior specialist,
  substance abuse counselor, etc.)
• School-based team (BAT, SST, SBMH Team)
• Utilize educational/intervention
• resources (see handouts)

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Interventions What therapeutic approaches may be
used?

• Play Therapy
• Cognitive Therapy
• Behavioral Therapy
• Cognitive-Behavioral Therapy
• Counseling individual or family
• Medication
• Other art, music, recreational therapies, and
  cultural approaches

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Internet Resources

• See attached resources
• Also available at
• www.burke.k12.nc.us/mentalhealth

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References

• Adelman, H. Taylor, L. (2004) . UCLA Mental
  Health Project. Center for Mental Health in
  Schools. http//smhp.psych.ucla.edu/.
• Fleming, C. B., Haggerty, K. P., Brown, E. C.,
  Catalano, R. F., Harachi, T. W., Mazza, J. J.,
  Gruman, D., H. (2005). Do social and behavioral
  characteristics targeted by preventative
  interventions predict standardized test scores
  and grades? Journal of School Health, 75,
  342-349.
• Hawkins, J., Catalano, R., Kosterman, R., Abbott,
  R., Hill, K. (1999). Preventing adolescent
  health-risk behaviors by strengthening protection
  during childhood. Archives of Pediatric
  Adolescent Medicine, 153, 226-234.
• Census 2000. http//www.census.gov/
• Burke County Public Schools Mental Health Grant
  Proposal Increasing Access to Behavioral Health
  Services in Schools.