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In Many Minneapolis Schools, the Therapist is Just Right Down the Hall

When Cathy Moen’s son, Elijah, was in first grade, he was diagnosed with attention deficit hyperactivity disorder. She took him to the pediatrician, who put him on medication and suggested therapy.

The medication part was easy. But getting him therapy proved more difficult — not because Moen couldn’t find a therapist or didn’t have insurance, but because of logistics.

The appointments were always during the day, and between her work schedule and the traffic, it was nearly impossible for them to make it.

But she soon learned Elijah was able to see a therapist in his Bloomington school. More than 15 years ago, Minneapolis Public Schools helped pioneer a national model of bringing community mental health care directly to its students. Today, most of the public schools in Minneapolis — more than 50 of them — have a therapist on site, and many other districts, like Elijah’s, have followed suit.

These days, Elijah’s therapist simply walks down the hall and pulls him from class.

“This is like a godsend,” said Moen.

The family’s health insurance pays for the care the same way it would if the student were being seen in the clinic. The school program was designed so that no student in need will be turned away for lack of insurance.

The Minneapolis program has also provided a road map for schools across the country as more administrators realize that mental health is as important to students’ future success as academics. Studies have shown that students are more likely to show up for appointments when the therapists are on-site.

More and more states are making mental health care in schools a priority. At least two states have recently passed laws that require schools to teach mental health. And more are considering it.

But the benefit of having a therapist on-site goes beyond just getting students to see a therapist. In Minneapolis, it’s also helped make mental health a school-wide priority — and helped get counselors, teachers and others more involved, said Mark Sander, who helped start the district program.

A man wearing a button down shirt.
Mark Sander is the director of school mental health at Hennepin County and Minneapolis Public Schools.
Christine T. Nguyen | MPR News

“Those teachers start learning more and more [about mental health],” said Sander, who directs school mental health for the district and the county.

He said as they learn more about mental health, teachers are feeling like, “‘OK, I get it. And now, you know, I’ve got this other student who’s not diagnosed with anxiety but has some of those anxiety features. And now I know how to better support them.”

At South High School in Minneapolis, the therapists sit in the school clinic, the same one where students go if they feel sick during the day or to get a physical so they can play sports.

The issues the students bring to the therapist run the gamut from stress about grades and colleges to anxiety related to a bad situation at home.

Farah Hussein is a therapist at South. She said it’s hard being a teenager, and she tries to help.

“There’s a lot of conversations about, ‘Who am I? Where do I fit in the world? Where do I belong?’ and just a lot of distress in exploring that,” she said.

All of this has important implications for the students’ well-being beyond just their mental health.

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A group of people sit around a conference table in a school.
Collaborative mental health meetings at South include the school’s social workers, counselors, nurses, psychologists, school-based clinic therapists and occasionally administrators.
Christine T. Nguyen | MPR News
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A sign reads "Mental Health" on a wooden shelf with books.

 

Sharon Hoover, who co-directs the National Center for School Mental Health at the University of Maryland School of Medicine, said more schools are collecting data on outcomes of in-school mental health programs, and the results are clear.

“They are more likely to have good attendance and to graduate and to get improved grades. We even have documentation of having better standardized test scores when you put universal systems in place like classroom-wide social emotional learning,” she said, all of which makes for happier, better adjusted students.

Cathy Moen, the mother whose son, Elijah, is in therapy in school, said she doesn’t know if it’s the medicine, or the therapy, or just that he’s growing up, but she — and his teachers — are already seeing a difference.

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Why Don’t Teachers Get Training on Mental Health Disorders

I love teaching writing; it’s where revelations happen, where children plumb the dark corners, nudge the sleeping dogs, and work out solutions to their most convoluted dilemmas. As much as I adore reading student work, I still get a little nervous about what I’ll find there. Among the stories of what my teenage students did last summer and what they want to be when they grow up are the more emotionally loaded accounts: firsts (periods, kisses, or failures), transitions (moves, their parents’ divorces, or custody disputes), and departures (dropouts, graduations, or suicide attempts).

Over the years, my students have entrusted me with their most harrowing moments: psychotic hallucinations, sexual molestation, physical abuse, substance abuse, HIV exposures, and all sorts of self-injurious behavior ranging from cutting to starvation to trichotillomania. When students write about delicate and dangerous experiences, there are decisions to be made and judgments to be called. And yet, for much of my career, I have been horribly unprepared and have failed to secure the services my students needed as a result.

Teachers are often the first person children turn to when they are in crisis, and yet they are, as a profession, woefully unprepared to identify students’ mental-health issues and connect them with the services they need—even when those services are provided by schools. Aside from the obligatory professional-development session on mandatory reporting laws for child abuse and neglect we have to attend during new faculty orientation, teachers receive little or no education in evidence-based mental-health interventions. According to Darcy Gruttadaro, Director of Advocacy and Public Policy at the National Alliance on Mental Illness, “Most teachers are not trained about mental health in their formal education and degree programs, and yet an unidentified mental-health condition often interferes with a student’s ability to learn and reach their full academic potential.”

According to the National Institute of Mental Health, approximately one in five children currently have or will experience a severe mental disorder. For some disorders, such as anxiety, the rates are even higher. For people who do experience mental-health disorders, most experienced their first symptoms before young adulthood. Half of all people with mental disorders experienced the onset of symptoms by age of 14; 75 percent by age 24. Half of these students will drop out of school. As suicide is the second-leading cause of death among adolescents and young adults, lack of appropriate mental-health interventions and treatment can mean the difference between life and death. Given the amount of time children spend at school, teachers are likely be the ones to identify and refer children for mental-health services. For children fortunate enough to be identified and given access to those services, treatment will mostly likely take place at school, as schools serve as the primary providers of mental services for children in this country.

However, all the mental-health services in the world won’t help if teachers don’t understand the nature of the services available in school and can’t identify the students in need of intervention.

In 2011, researchers at the University of Missouri looked at whether teachers understood the 10 evidence-based mental-health interventions or resources their schools employed. The results were disheartening, to say the least. While two-thirds of the surveyed teachers held graduate degrees, and the remaining third had earned undergraduate degrees, more than 80 percent had never heard of some of the interventions or strategies their own school utilized. Half of the teachers surveyed did not know if their schools provided functional behavioral assessment or intervention planning at all. Given that the response rate for this study was only 50 percent—and it’s likely that teachers with a heightened interest in student mental health would be more likely to respond to the survey—these results probably overstate teachers’ understanding of the tools their own school districts use to support students’ mental and emotional health.

As an increasing number of schools roll out evidence-based mental-health programs such as Positive Behavioral Interventions and Supports (PBIS), teaching that promotes appropriate student behavior by proactively defining, teaching, and supporting positive student conduct, and Trauma-Sensitive Schools, programs aimed at reducing the effects of trauma on children’s emotional and academic well-being, educators need to be at least minimally conversant in the terminology, methods, and thinking behind these strategies. These programs provide strategies that can be highly effective, but only if the teachers tasked with implementing them are sufficiently trained in the basics of mental-health interventions and treatment.

Teachers routinely receive first-aid training in CPR, EpiPen use, and safe body fluid cleanup, but it’s rare for schools to offer training in mental health, said Todd Giszack, Academic Dean of Fork Union Military Academy in Fork Union, Virginia. Recognizing that schools are responsible for their students’ mental, as well as physical health, Fork Union Military Academy designed and implemented its own curriculum with the help of two mental-health professionals, and now offers eight-hour certification programs in Mental Health First Aid. “It has taken two years, but nearly all of our faculty and staff has become certified in Mental Health First Aid. This has allowed our school community to become familiar with trends and warning signs associated with adolescent emotional and mental health” Giszack said.

Dr. Michael Hollander, Assistant Professor in Psychology at Harvard Medical School and director of Training and Consultations on the 3East Dialectical Behavioral Therapy program at McLean Hospital in Belmont, Massachusetts, urges teachers to use caution when intervening in students’ mental-health crises. “In my experience, teacher response tends to be bi-modal; either they get solicitous, over-involved, and in over their head, or they mistake mental health issues for behavioral problems that require in-class discipline.”

Programs such as NAMI’s Parents and Teachers as Allies presentation are beneficial, Dr. Hollander said, because they help teachers understand both the benefits and limitations of in-class interventions. Despite his worries about teacher-facilitated mental health interventions, he’s grateful for the trend toward a greater understanding of students’ mental health. “We have arrived at a place where we finally understand that teaching is not just about educating someone’s rational mind, but also educating their heart,” he said.

Children with untreated mental-health issues can get by. They can limp along toward adulthood until an inevitable, eventual mental-health crisis lands them in the hospital, in jail, or even at an inpatient drug and alcohol rehabilitation facility for adolescents, where I teach. But by then, a lot of damage has been done to their young minds and hearts—damage that could have been prevented if they had received support when their symptoms first appeared.

As I read their essays about crippling childhood anxiety, alcoholic parents, and/or domestic violence, I can’t help but mourn for all the lost opportunities and squandered potential that was wasted on the way.

SOURCE

Teaching Kids About Mental Health Matters

Trigger Warning: Suicide

One November day in Gaston County, NC, traffic was at a stand-still on I-85. It was unfortunately caused by a 16-year-old who took her life on the highway. As cars grinded to a halt, a pick-up truck was rear-ended by someone not paying attention. The driver of that truck lost his life.

If someone had recognized the warning signs of suicide in this young girl and gotten her help, two deaths could have been avoided that day.

This incident really affected me. I’m from Gaston County and with all the advocacy work I do in Charlotte as a member of NAMI Charlotte and as a new state board member of NAMI NC, I felt that I had neglected my hometown as a mental health advocate. Also, I know what it’s like to feel the pain of wanting to take your own life.

I felt that way twenty-two years ago on Valentine’s Day, 1995. Thank goodness, my aunt heard my cry for help, knew the warning signs and saved my life. When you go through something like that, I feel you are obligated to turn around and help others who are dealing with the same pain.  I knew I had to do something in my hometown.

Starting The Conversation In School

I went to Ami Parker, Director of Counseling Services for Gaston County Schools, and told her, “I don’t want to see what happened to the young lady on the Cox Road Bridge happen to another child.” I asked her to consider a Mental Health Awareness Week in the Gaston school system. And Ami didn’t hesitate. She even took it a step further, planning for the children to take the lead.

She knew kids would respond better to kids and the conversations they would start amongst themselves—and they did. They went online and got information to present to other students that would get them involved. Because of this, kids from middle to high school were truly engaged in the week-long Mental Health Awareness Week. They created posters and banners from everything that said, “See the person, not the illness” to “Our school is StigmaFree.”

I can’t tell you how proud I am of the kids being so engaged and involved. One middle schooler told me that she rode the bus with a boy who cut himself. She had told him to “quit cutting” himself, but he didn’t. In this teachable moment, I told her that she did the right thing, but he needed more help than she could give. And she needed to let someone know he needed help. The young girl agreed that she would.

This is exactly why events like these are so important. It starts conversations among children. If we can start conversations with children, maybe those conversations can spread to parents.

Steps To Spread Awareness To Schools

If you want to have a Mental Health Awareness Week in your local school, start with the school’s counseling department, like I did. Make sure you’ve done your research on mental health, stigma and suicide, so when you talk to a counselor they’ll see you’ve done your homework. Most counselors would be glad to help you bring this deserving cause to the attention of the principal and teachers. I am so proud of and thankful for Ami Parker and her willingness to be proactive with bringing awareness to mental health. And I’m sure there are more people like her out there. We dedicated our event to the young girl who died by suicide in November, in hopes to stop others kids from going down the same path.

Kids are our next generation. We should be teaching them about the importance of mental health and the warning signs of mental illness. If we teach them well enough, maybe stigma won’t exist once their generation grows up. Maybe they will know when to ask for help and when to offer someone support. Maybe lives will be saved. With the looks of things, I think Gaston County schools are off to a very good start.

By Fonda Bryant

Fonda Bryant is very active in the community bringing awareness to mental health. She has been a volunteer with NAMI Charlotte for over three years and recently was elected to the state board of NAMI NC.  She also volunteers with MHA of Central Carolinas and with the AFSP. She speaks to the rookie classes of CMPD, and is vocal about mental health, whether on television, in the newspaper or radio, her passion for mental health knows no boundaries.

https://www.nami.org/Blogs/NAMI-Blog/May-2017/Teaching-Kids-About-Mental-Health-Matters

The Importance Of Maintaining Mental Health In College

Did you know that colleges and universities are more aware of college students’ mental health needs now than ever before? Thanks to current research findings, they are doing a much better job understanding the link between mental health and academic success.

The American College Health Association informs colleges (and all of us) that mental health needs are almost directly related to measures of academic success. Their 2015 survey found that students who reported psychological distress also reported receiving lower grades on exams or important projects; receiving lower grades in courses; receiving an “incomplete” or dropping courses altogether; or experiencing a significant disruption in thesis, dissertation, research or practicum work.

Thus: Students should place a priority on maintaining their mental health while in college. This can be challenging while also becoming a successful student. So, how can you manage this balance? Here are some tips:

Engage In A Self-Assessment Process

Getting to know yourself is foundational to your success. Being self-aware will not only help you identify your strengths and weaknesses, but it can also help you identify which learning strategies and mental health coping strategies are most effective for you. Your college’s counseling center might have resources and individuals to help you perform a fuller, more in-depth assessment, if you’d like help.

Develop A Support Network

Form a group of friends. Having people you can count on to talk to and spend time with can make a huge difference on your college experience. If you’re going through a hard time and don’t feel comfortable talking to your friends about it, seek help professional help. Your school likely has a counseling center for that purpose. And it’s essential to keep all your doctor and therapy appointments. It’s also important to have support academically if you need it. Go to your school’s tutoring center and remember: College faculty and staff are there to help you. Don’t be afraid to ask questions or request extra help if you need it.

Get Organized

Being organized reduces stress and improves performance. At the beginning of each semester, set up a student success notebook with all your course syllabi, needed books, assignments and tests highlighted. If you get organized at the beginning of the semester, it will help you to always have important information at your fingertips. There will be little chance of losing key information and becoming overwhelmed with confusion about what you should be doing.

Take Care Of Your Physical Health

Eat regular meals (this is especially true before you go to class or take a test!), exercise and get plenty of sleep. Some activities like meditation and yoga will also help with stress. Speak with your counselor or therapist about when to take any medication you may be on to best support learning and healthy sleep.

Master Time Management

Class activities, tests and quizzes, homework and social commitments—even the everyday pressures of life—can lead to time management overload. And when time management skills are pushed to their limits, stress levels can rise to unhealthy levels. Procrastination creates major, unnecessary stress. So: Be on time to class. Turn in assignments on time. Set up a study schedule and stick to it. And make sure you balance your work schedule with time for leisure.

As you head off to college, embrace a success-oriented mindset with the goal of shaping your life and making a difference in the world around you. Have confidence in your ability to succeed. Remember to always value yourself. Treat yourself with kindness and respect and avoid being overly self-critical. Let others know if you need help. Develop an understanding of the resources you need and the resources available to you. These include not just what your college offers, but organizations like NAMI, The JED Foundation and The Steve Fund. There are millions of like-minded individuals rooting for your success.

You will gain self-esteem, empowerment and motivation to keep going with each success. It doesn’t matter if those successes are big or small—you will find that your successes will help you define your path.

Jay Feldman has a doctoral degree in Psychology and has pursued research as a professional focus. He is currently a Senior Research Associate at RTI, International.

Deborah Tull has a doctoral degree in Psychology and has pursued research and college and university mental health program development as a professional focus.

https://www.nami.org/Blogs/NAMI-Blog/September-2017/The-Importance-of-Maintaining-Mental-Health-in-Col