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Transcript
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!!!