Development of School Mental Health Programs Sheldon D. Glass, M.Ed, M.D. Assistant Professor of Psychiatry, Johns Hopkins School of Medicine Member, National Advisory Council, Johns Hopkins School of Education

The Need is Great 2.2 Million Depressed Adolescents in the Past Year 60% did not receive treatment NIMH studies: 50% lifetime cases of mental illness begin by age 14, 75% by age 24 Studies over last 10 years: significant percentage of youngsters have psychiatric problems Center for Disease Control May 16, 2013

The Need is Great 1 in 5 youngsters have a mental illness Most Prevalent Mental Illnesses: o ADHD (6.8%) o Conduct Disorder (3.5%) o Anxiety (2.1%) o Depression (2.1%) o Autism Spectrum Disorder [ASD] (1.1%) Center for Disease Control May 16, 2013

The Need is Great CDC: 20% of child population have mental illness o Illicit Drug Disorder (4.7%) o Alcohol Abuse Disorder (4.2%) o Dependant on Cigarettes in Prior Month (2.8%) Center for Disease Control May 16, 2013

The Need is Great 13% of youth aged 8-15 live with a mental illness severe enough to cause serious impairment Only 20% receive services 80% untreated Center for Disease Control May 16, 2013

Models of School Mental Health Consultation Consultation: o To Administrators o On Behavior o On Student Performance Outcomes o For School Based Health Centers o For Special Education Programs

Consultation to Administrators Greater Sensitivity to Feelings Improved Ability to Listen Awareness of Behavior Norms Frequent in Groups Acceptance of Different Attitudes & Value Willingness to Discuss Staff Problems and Personal Feelings in an Open Manner Changed Attitudes Towards Children with Problems

Behavioral Consultations ●Individual Behavioral Problems ●Patterns of Behavior Unique to School Environment ○Absenteeism ○Disciplinary Referrals ○Retention (Non-Promotion) ○Dropping Out Focus programs; for example, reduce smoking, drug abuse, gang involvement, suicide prevention

School Based Health Centers Several Hundred in the United States o Direct Service Rather than Consultation o Self-Contained within the School o Serves Children that are of Concern o Wider Psychiatric and Medical Clinical Services to a Large Group of Students

Primary Mental Health Project Screened 1st Grade Classes The PMHP 11 Question Inventory: 1.Fights with Other Students 2.Has to be Coached to Work with Others 3.Restless 4.Unhappy or Depressed 5.Disrupts Class 6.Becomes Sick when Faced w/ Difficult Situation 7.Obstinate 8.Feels Hurt when Criticized 9.Impulsive 10.Moody 11.Difficulty Learning

Primary Mental Health Project Behavior Described on Scale of: o Never, Seldom, Moderately Often, Often, Most of the Time, All of the Time Intervention: Designated Children Met 1-3 Times/Week with a Trained Person Results: Improvement in All Areas “Except” Acting Out & Aggressive Behavior No Control Groups

Common Models of School Mental Health Consultation for the Psychiatrists Incidental Consultation Case Problem - Program Consultation Comprehensive (System) Consultation

Education Model Processes of Teaching and Learning

Changes Over Next 20 Years (Breaking Down the Silos) Adelman and Taylor “Classroom Climate” Social System Organization Social Attitudes Staff and Student Morale Power, Control, Guidance, Support and Valuation Structures Curriculum and Instructional Practices

Technology Integration of Technology into the Classroom o Enhancing/Reinforcing the Learning Process o Stimulating Creativity and Research Abilities

Technology “When Used for Challenging Activities such as Simulations it was very Beneficial” “When Used to Drill Students on Fundamental Skills it had a Negative Impact on Achievement” -Harold Wenglinsky (“Positive Benefits for Educational Technology”)

Technology Enhancing Skills for Analysis & Problem Solving Participating Individually AND as a Member of a Team Reaching Different Types of Learners Assessing Student Understanding through Different Means Increasing Role of Teacher as Advisor, Coach, and Content Expert

Phases of Project Development 1.Introductory Phase 2.Resistance Testing Phase 3.Productive Phase 4.Termination Phase

Starting a New Program Everything Goes through Five Drafts Concept of Flexibility (In Design) Natural Resistance Best of Group Members Planning for Success Time Valuation / Data Retrieval Systems Approach HIPAA

Long Range Planning Process Phase I - Pre Planning: Mission Beliefs Policies Strengths Weaknesses Management Style Organization Current Game Plan Competition Environment o Social o Political o Technical o Economic

Long Range Planning Process Phase II - Planning Objectives Programs Action Plans Cost / Benefit Analysis Base Line Planning GAP GAP Analysis Validation of Objectives Selection of Options

Long Range Planning Process Phase III - Post Planning Resource Plans: o Financial o Manpower o Facilities Planning Schedule Valuation/Data Retrieval