Download Handout - Minnesota School Psychologists Association

Mental Health: what is it & why it
matters for school success
Tina’s Soapbox
Understanding Child & Adolescent
Mental Health & Its Influence on
Educational Outcomes
Christina K. Houck, EdSp, NCSP
MSPA Conference 2017
Learning
Intentions for
today:
1.
To increase personal
knowledge-base about
common mental health
disorders in children
and adolescents & its
prevalence rates.
2. To increase personal
knowledge regarding
the importance of early
intervention, role of
schools and educators,
and
3. To understand the
educational model of
mental health and
mental distress & SEL
MENTAL HEALTH
"a state of well-being in which the individual realizes his or
her own abilities, can cope with the normal stresses of life,
can work productively and fruitfully, and is able to make a
contribution to his or her community".
~The World Health Organization
The Role of Schools
Increasingly, federal, state and local leaders are
looking to schools to help identify children with
mental health treatment needs.
In light of the Newtown tragedy and other school
shootings, Minnesota Governor Dayton and Senator
Franken have made it a priority to have a state-wide
discussion of how mental health impacts of our
schools.
The Role of Schools
The educational model for Mental Health: to
expand the scope of teaching and learning to
include social/emotional functioning and stress
management.
“Rather than see behaviors as intentional and directed at school
staff-she did that to anger me, he is doing that for attention-it is
necessary to understand that all behavior has purpose”.
~Dr. Anne Gearity
What do you think happens when
a student’s mental health needs
are NOT addressed?
Students with ‘serious emotional
disturbance’ are at risk for
educational failure.
•
•
•
•
•
•
•
fail more classes;
miss more days of school;
earn lower grades;
repeat more grade levels;
drop out at a higher rate;
have more difficulty finding and keeping a job; and
are more likely to be involved with the criminal justice
system.
- U.S. Department of Education
Long-Term Consequences of Untreated
Mental Health Disorders
 Students with mental health disorders have the HIGHEST
failure and drop out rates of students in ANY disability
group.
 65% of boys and 75% of girls in U.S. juvenile detention centers
have one or more psychiatric disorders.
PAY NOW OR PAY LATER
Over an entire work life, high school graduates earn an
additional $450,000.
Employee-paid fringe benefits add $116,000 to this amount.
On average, a career criminal accrues $65,000 in costs to social
services and corrections through age 12 and $230,000 through
age 14.
In a lifetime, these costs total nearly $5.7 million.
Major depressive disorder
is the leading cause of
disability among
Americans age 15 to 44.
World Health
Organization
The two most prevalent mental
health disorders in students:
anxiety & depression
The Trouble with Anxiety…
“Anxiety distorts. Anxiety causes a person to react from the gut
instead of responding through intellectual reflection. The gut
rules in anxious displays and that anxiety impairs functioning.
The more chronic and unrelenting the anxiety, the more
dysfunctional a person’s behavior becomes in the wake of that
anxiety.
For example, a healthy individual can experience transient, timelimited bursts of anxiety that subside quickly, allowing the person
to return to a more normal, relaxed state fairly quickly – not
without evidencing some anxious behavior in the process – yet it
does not become their undoing.
But the more anxious a person is, even a relatively small burst of
additional anxiety can suddenly unglue them and push them into
more chronically dysfunctional behavior. This can happen at any
time and it is a cumulative process.”
~Dr. Ellen K. Rudolph (journalist & educator)
Anxiety compounds.
~Cosmic Bard (blogger)
Anxiety’s Physiology
 The amygdala modulates the fear and anxiety.
 People with anxiety disorders have shown
heightened amygdala responses to typical cues to
anxiety.
 Amygdala and other limbic systems structures are
connected to the pre-frontal cortex of the brain.
Triggers of Anxiety





Change
Fear of a specific fear related object (fire alarm)
Fear an unpleasant event will occur
Fear of separation
Depression/negative feelings of self worth (I feel
stupid at school)
School-based Triggers
 Talking to teacher, peers, reading in front of
classmates, walking, eating in front of others, taking
tests, sports
 Negative social interactions: teasing, bullying,
relational aggression among girls
 Body dysmorphic disorder
 Somatoform disorder
 Learning difficulties/underlying SLD
Theory
 Cognitive theory has explained anxiety as:
the tendency to overestimate the
potential for danger
Patients with anxiety disorder tend to imagine the
worst possible scenario and avoid situations they think
are “dangerous”
The Anxiety Trick
 www.anxietycoach.com
 See Handout for deeper explanation.
 Remember: The way to disarm the Anxiety Trick is to
increasingly spend time with anxiety, to expose
yourself to the thoughts and sensations, and allow
them to subside over time.
Managing the Psychosomatic Symptoms
 Medications
 Routine-schedule
 Visual reminders to upcoming change
 Shift their thinking: ‘distract’ the thinking
 Challenge irrational thoughts: but without a
power struggle-provide them evidence & data
 *Examine if I am a trigger or reminder of
anxiety. Ask the question: am I anxious too?
Managing Anxiety




Provide Calm and Gentle Reassurance
Challenge Irrational Thoughts
De-AWFUL-ize the situation
Know that you can be effective by being empathic.
***Be aware of the ANXIETY TRICK at work in the student.
Resources &
References
 www. Anxietycoach.com
 www. Adaa.org
 www.emedicine.medscope.com
Anxiety Girl!
Able to jump to the worst
conclusion in a single
bound!
Anxiety: the key points
 Anxiety can impact classroom and everyday
functioning in many ways: However, there are many
effective interventions that can be used at home and in the
classroom.
 Anxiety disorders in children are brain-based.
 Children do not recognize their own anxiety.
 In adolescents, more females than males are affected.
 Studies show that young people are more likely to have
an anxiety disorder if their parents have anxiety
disorders: Anxiety begets anxiety.
Depression is:
 A mood disorder
and
 A sleep and energy disorder
and
 A thinking disorder
DEPRESSION
What does Depression Feel Like?
Certainty that an acute episode [of depression] will last only a
week, a month, even a year, would change everything. It would
still be a ghastly ordeal, but the worst thing about it -- the
incessant yearning for death, the compulsion toward suicide -would drop away. But no, a limited depression, a depression
with hope, is a contradiction. The experience of convulsive
pain, along with the conviction that it will never end except in
death -- that is the definition of a severe depression.
~ George Scialabba
Causes of Depression
 Million Dollar question?
 we still do not know what causes mental illness.
 MH Professionals believe that all mental disorders are
caused by a complex interaction and combination of
biological, psychological and social factors.
bio-psycho-social model of causation
 A treatment approach that focuses exclusively on one of
these factors is not likely to be as beneficial as a treatment
approach that addresses both psychological and biological
aspects (through, for example,
psychotherapy and medication).
EFFECTIVE & Efficient
Treatment for Depression

Biological: (biofeedback, regulating breathing,
pharmacological)

Psychological: Cognitive Behavior Therapies

Social: being a part of a community; having sense of purpose
and belonging

Spiritual: nourishing a feeling of connectedness to something
greater than one’s self
Fact or Fiction?
 Four million children and adolescents in the U.S. suffer from
a serious mental disorder that causes significant functional
impairments at home, at school, and with peers.
 Of children ages 9 to 17, 21% have a diagnosable mental or
addictive disorder that causes at least minimal impairment.
 Half of all lifetime cases of mental disorders begin by age 14.
 Despite effective treatment being available, there are often
long delays between the first onset of symptoms and when
people receive treatment.
 An untreated mental disorder can lead to a more severe,
more difficult to treat illness, and to the development of cooccurring mental illnesses.
Fact or Fiction?
Fact:
Only 20% of children with
mental disorders are
identified & receive mental
health services
Suicide
Suicide is the third leading cause of death in youth aged
15 to 24. More teenagers and young adults die from
suicide than from cancer, heart disease, AIDS, birth
defects, stroke, pneumonia, influenza, and chronic lung
disease combined.
Over 90% of children and adolescents who
commit suicide have a mental disorder.
National Strategy for Suicide Prevention: Goals and Objectives for Action. Rockville, MD: U.S. Dept. of Health and
Human Services, Public Health Service, 2001.
Shaffer, D., & Craft, L. “Methods of Adolescent Suicide Prevention.” Journal of Clinical Psychiatry, 60 (Suppl. 2), 70-74,
1999.
Health and Economic Prevalence
States spend nearly $1 billion annually
on medical costs associated with
completed suicides and suicide
attempts by youth up to 20 years of
age.
Kochanek KD, Murphy SL, Anderson RN, Scott C. Deaths: Final data for 2002. National vital statistics
reports; vol. 53 no 5. Hyattsville, Maryland: National Center for Health Statistics. 2004.
NGA Center for Best Practices, Youth Suicide Prevention: Strengthening State Policies and School-Based
Strategies
Early Identification,
Evaluation, and Treatment
are Essential to Recovery and
Resiliency
Untreated Mental Health Problems:
 develop into more serious psychosocial impairments as a
child matures;
 have a negative impact on learning; and
 lead to placement in more restrictive settings (e.g.,
juvenile detention facilities and care and treatment
centers).
• Robert Friedman, Ph.D. University of South Florida
With medication, psychotherapy, or combined
treatment, most youth with depression can be
effectively treated.
Youth are more likely to respond to treatment if
they receive it early in the course of their illness.
Research supports early
Identification
 Many mental health problems can be identified and
treated much earlier
 Early identification and intervention is cost effective
 Untreated and undertreated mental health problems get
worse over time
 Failure to identify mental health problems causes
increasing and additional complications for families,
schools and communities
DHS Bulletin #04-68-05
Logic
Model
Student,
family, &
Community
benefit
Early Warning
Signs
Life
demands
are being
met
Intervention
Symptoms
Reduced
A proactive cycle
Given the chronic nature
of depression, effective
intervention early in life
may help reduce future
burden and disability.
Early Intervention is KEY!
 Reduces overall effects a disorder has on a child
and family

Lessens the duration and severity of the
disorder on a child
Children’s Mental Health is Important
in the Educational Setting
Mental health is the springboard of
thinking and communication skills,
learning, emotional growth, resilience
and self-esteem
Surgeon General’s Report on Mental Health (1999)
Importance of Children’s Mental
Health & the Educational Setting
Receptive, motivated learning for
children requires a foundation of
emotional well being for each child
~Surgeon General’s Report on Mental Health (1999)
Role of Educators
 Recognize and understand behaviors
and symptoms seen in the classroom:
objective identification
 Implement interventions and
supports for what you see, not for the
diagnosis that may be in place
 Increase knowledge of children’s
developmental and life experience
challenges
Children
experiencing strong
emotions may not be
able to take in new
information.
Strategies that work:








Talk to student in private
Use a calm voice
Clearly explain the problem
Remain focused on the behavior (separate personal
traits from behavior-use people first language)
State the consequences
Identify student’s strengths
Acknowledge improvements
Pay attention and consider that there usually are a
multitude of antecedents that may display the same
sort of behavior. Identify and measure these!!!!
Things to Consider
 Simple classroom and environmental
modifications
 Importance of parent/school
partnerships
 Culturally appropriate mental health
services
 Positive behavioral interventions
and supports
Strategies to support Mental
Health Challenges
 Praise student when positive behaviors are
displayed
 Consequences should be specific, immediate, and
well-balanced
 Be consistent
Strategies to support Mental
Health Challenges
 Consistent predictable patterns for the daily
schedule : unpredictability and the unknown will
make a child more anxious, fearful and symptomatic.
 Validate experiences positively rather than
discounting or minimizing the child’s feeling and fears
with statements such as “that must have been scary”
or “grown-ups can be confusing sometimes”. What’s
personal takes up mental space.
Brains of children are CONSTANTLY
shaped by experiences.
We must promote
change by cultivating healthy social emotional
habits.
~R. Davidson (CASEL presentation, 2012)
Emotional States,
Learning & the Brain*
* Inextricable connection
Evidence-Based
The Collaborative for Academic and Social Emotional
Learning (CASEL) has identified 26 “Select SEL Programs”
that are especially effective and comprehensive in their SEL
coverage, their documented impacts, and in staff
development.
CASEL Review
• CASEL’s extensive review of available programs revealed a
common core among effective classroom-based programs:
• increase children’s sense of connection or attachment to school
• teach children skills for setting goals, solving problems, achieving
self-discipline
• developing character and responsibility
The How of SEL
Within the school setting:
SEL can best be accomplished through a layered approach of SEL
skills lessons, infusion into the curricula and classroom
practices, and an environment of safety, respect, and caring which
models SEL values.
~Anchorage District Social Emotional Learning Standards
The ‘How’ of SEL
 Skill lessons:
 Stand alone curricula (i.e. PATHS, Second Step, MindUP!,
Learning to Breathe)
 Teaching self-regulation through strategies such as the
Incredible 5 point scale, How Does Your Engine Run, A 5 is
Against the Law?
 Using classroom models specific to teaching SEL concepts.
The ‘How’ of SEL
 Infusion into the curricula and classroom practices
(Generalization):
 SEL Learning Intentions
 SEL Formative Assessment
 Standard practice for problem solving
 Daily practice of focused breath, centering/grounding, brain breaks)
 Rituals/Routines (restorative circles, community builders, morning
meetings)
 Intentional integration in all core curriculum areas to teach skills (in
math, in reading, etc.)
The ‘Language’ of SEL
 Environment of safety, respect, and caring which
models SEL values for Students and STAFF:
 Effective Praise
 Greeting students by name, etc.
 Collaborative Proactive Solutions (CPS)-Ross Greene
 Restorative Circles
 Nurtured Heart Approach-Howard Glasser
What we also know….
 Students with disabilities need to have more
frequent and intense SEL instruction
 SEL instruction must be linked to the student’s
social skills deficits
 The most effective SEL instruction combines
modeling, coaching and reinforcements
IMPROVED NEURAL
CONNECTIONS
 When we are in a relaxed state, it is easier for
“good” neural connections to be made.
 We need our students to make MANY positive
neural connections in order to learn.
So, what can we do?
Its so simple but frankly….its
not.
1. We need to invest more resources on
student support services than on instruction.
2. We need to influence how our schools
support our work-moving away from just
testing to increased direct support to students
and families.
http://nces.ed.gov/fastfacts/
Conclusion
Important Messages About Child and Adolescent Mental Health:
Every child's mental health is important
Many children have mental health challenges
These problems are real, painful, & can be severe
Mental health challenges can be recognized & treated
Caring families and communities working together can help
 National Mental Health Information Center
Thank you!!!