13th Annual Oklahoma Transition Institute October 15-17, 2018 Supporting Youth and Young Adults in Transition with Mental Health and Substance Use Challenges 2:15-3:30 Let’s plan on leaving the last 15 minutes for questions from the group.

What is the issue? 1 in 5 youth aged 13–18 (21.4%) experiences a severe mental disorder at some point during their life. For children aged 8–15, the estimate is 13%.

What is the issue? Half of all chronic mental illness begins by age 14 three-quarters by age 24 Despite effective treatment, there are long delays—sometimes decades—between the first appearance of symptoms and when people get help.

What is the issue? Over one-third (37%) of students with a mental health condition age 14­–21 and older who are served by special education drop out — the highest dropout rate of any disability group.

First Time Substance Use What is the issue? First Time Substance Use The average age of substance use for the first-time user is 12-13 years old. Research shows that the older a person is when they first use a substance, the lower their risk of developing a substance use disorder. Therefore, it is paramount to focus not only on treatment of substance use, but also prevention, especially in early adolescence.

What is Substance Use Disorder? What is the issue? What is Substance Use Disorder? When the recurrent use of alcohol and/or drugs causes clinically and functionally significant impairment. According to the DSM-5, a diagnosis of substance use disorder is based on evidence of: Impaired control Social impairment Risky use Pharmacological criteria The DSM-5 defines substance sue on a scale of mild, moderate, or severe based on the number of diagnostic criteria met.

Types of Substance Use What is the issue? Experimental- use that occurs out of curiosity about a drug and its effects. Occasional- use that is sporadic and occurs when the substance and or opportunity is available. Situational- use that occurs only in certain situations, such as when hanging around a particular group of people or during the holidays. Intensive- use that becomes more and more frequent and begins to become a problem. Compulsive- use that is no longer in one’s control.

Risk Factors What is the issue? Community- In communities with heavy substance use, youth and young adults may perceive it as common practice, and the act becomes normalized. Family- Parenting styles, the parent/child relationship, parental involvement are all important factors influencing youth and young adult substance use. Genes- When a child has a parent who has a substance use disorder, the child is four times more likely to use substances. This doubles to eight times more likely to use substances when both parents have a substance use disorder.

Risk Factors continued What is the issue? Risk Factors continued Peers- Peers are an important part of youth and young adult development, as youth and young adults are often concerned with belonging to and identifying with a peer group. Peers’ perceptions of others’ substance use, and whether or not they use substances, impact whether or not a youth or young adult chooses to use. Individual- Religious beliefs, involvement in extracurricular activities, individual perceptions of the harm of substance use, personality, and self esteem contribute to whether or not a youth or young adult chooses to use substances. Brain Development-Due to the development of a youth and young adult’s brain, their ability to reason and understand consequences of impulsive behaviors is not fully established until around 22 to 25. Males often take longer to develop than females.

What is the issue? Warning signs Declining grades Increased school absences Changes in peer groups Isolation form others Increased agitation Defensive or secretive behavior It is important to seek screening and/or assessment from a trained professional when attempting to determine whether or not a youth or young adult is using substances, as these warning signs can also be signs of depression or other issues.

Substance Use Impacts What is the issue? Physical Health Family/Relationships Legal issues and Delinquency School Job

Increasing mental health supports in school There is consensus that optimal mental health should be pursued through both reducing/eliminating psychopathology, and through maximizing positive wellbeing

Increasing mental health supports in school This age period offers optimal opportunity to promote positive mental health that may support healthy emotional development into adulthood

What type of supports can we turn to? Embedding mental health services, or increasing professional competency of existing school staff in mental health interventions has been scientifically proven to reduce impact of severe mental health challenges in their student bodies. (Fazel , 2014) Fazel, M., Hoagwood, K., Stephan, S., & Ford, T. (2014). Mental health interventions in schools 1: Mental health interventions in schools in high-income countries. The Lancet. Psychiatry, 1(5), 377–387. http://doi.org/10.1016/S2215-0366(14)70312-8

Increasing mental health supports in school School administration could be convinced to hire on site staff who will be granted same training opportunities

Who can help ? Local community mental health agencies near your schools with Systems of Care contracts have equipped personnel who receive optimal trainings ( Wrap, TIP, BHA, A-CRA) in order to effectively provide mental health and substance abuse supports to this age group in and out of school settings

Wraparound Planning process Family Driven Youth Guided Strengths based Formal and Natural supports Team Based Life Domains Culturally and Linguistically Competent

TIP Transition to Independence Process Planning Process Strengths Based Key Players Youth Driven Transition Domains Tailored Personal Choice and Responsibility Build Competencies

Behavioral Health Aide BHA Behavioral Health Aide Support in the classroom Coping Skills New Habits Social Opportunities Wellness Self Care

A-CRA Adolescent Community Reinforcement Approach Appropriate for youth and young adults 12-24 years old with substance use disorders and/or co-occurring disorders Seeks to increase the family, social, and educational/vocational reinforcers to support recovery Includes three types of sessions: individuals alone, parents/caregivers alone, and individuals and caregivers together. Clinicians choose from a variety of 19 A-CRA procedures based on individual need. Has been implemented in outpatient, intensive outpatient and residential treatment settings

What is needed of you? Consistency Cooperation Collaboration Communication Continuing education Consistency - Ability to follow up with students and their families on concerns, referrals, and action steps determined in IEP and 504 plans Cooperation – Working diligently with outside agencies and providers to ensure that access to their services is disrupted minimally, while being mindful not to disrupt the child's education and school work load Collaboration – creating comprehensive IEP/504 plans that include the mental health provider with clear and realistic action steps and objectives for all parties involved Communication – Actively advocating for your needs as an educator while being open to learning from what the student, provider and family members need to make the plans successful Continuing education – ensure that while you will not be directly providing mental health treatment, getting trained in tools and skills to enhance your literacy on the subject can be therapeutic for your students enough to reduce in class challenges

resources State-wide Mobile Crisis Youth Lines Designed for youth and young adults up to age 25 with mental health and emotional distressing emergencies. Provides on site or by phone crisis intervention and safety planning to prevent harm and hospitalization 833-885-CARE

Additional resources Resources Partnership for Drug-Free Kids- an organization committed to helping families struggling with their child’s substance use. Parents Helping Parents- and Oklahoma-based organization of “caring parents offering hope through resources, education, and shared experience” Community Reinforcement and Family Training, or CRAFT- a scientifically proven approach to help parents change their child’s substance use by staying involved in a positive, ongoing way.

Lifelines Suicide Intervention Training Continuing Education If you as an educator, administrator or otherwise community involved person want to learn skills and tools to be a support to a student struggling with mental health challenges, consider taking the following trainings. Lifelines Suicide Intervention Training Adult and Youth Mental Health First Aid QPR – Question, Persuade, Refer SafeTalk/Assist Add information on dealing with TRAUMA and understanding how it affects classroom behaviors and impacts transition planning for students SHARE training is available to anyone Pam has the CORE stuff and RPC curriculum available and is training staff in the Norman public schools Seeking Safety training might also be useful to school counselors Bringing in local experts on MH/SU for staff development

Resource Parent Curriculum Continuing Education If you as an educator, administrator or otherwise community involved person want to learn skills and tools to be a support to a student struggling with mental health challenges, consider taking the following trainings. SHARE Resource Parent Curriculum Seeking Safety Add information on dealing with TRAUMA and understanding how it affects classroom behaviors and impacts transition planning for students SHARE training is available to anyone Pam has the CORE stuff and RPC curriculum available and is training staff in the Norman public schools Seeking Safety training might also be useful to school counselors Bringing in local experts on MH/SU for staff development

Contact Information For any questions related to Systems of Care services for Young Adults, continuing education opportunities and how special education services can work with mental health and substance use providers please do not hesitate to contact us! Andru Dallaly , M.Ed. Field Programs Coordinator – Youth and Young Adult Services Lahcen.dallaly@odmhsas.org Nancy Falcon Systems of Care Coach and Trainer Nancy.falcon@odmhsas.org 405-593-7182 cell (leave message please)