Center Mental Health Consultant (CMHC) Orientation to Job Corps

Job Corps’ Mission As a national, primarily residential training program, Job Corps' mission is to attract eligible young adults, teach them the skills they need to become employable and independent, and place them in meaningful jobs, higher education, or the military.

Regional Health Specialists (RHS) Provide technical assistance to center health staff Conduct center assessments Provide training to regional and center staff Available to answer your questions Can help you understand policies Provide up-to-date information that will assist you in your efforts to meet program requirements Conduct monthly teleconferences

Regional Office Center Assessments (ROCAs) Every 1 to 2 years, Health Specialists and Assessors visit each center as part of a Regional Office Center Assessment (ROCA) team Using the Program Assessment Guide (PAG), in conjunction with the Policy and Requirements Handbook (PRH), this team will conduct an overall assessment of your center’s health and wellness program

Important Resources PRH—The Policy and Requirements Handbook PAG—The Program Assessment Guide COP/SOP—Center or Standard Operating Procedures DRG—Desk Reference Guide TAGs—Technical Assistance Guides

Job Corps Career Development Services System (CDSS) Includes four CDSS periods within which health and wellness services and activities are conducted: –Outreach and Admissions (OA) Period –Career Preparation Period (CPP) –Career Development Period (CDP) –Career Transition Period (CTP)

Mental Health and Wellness Program Requirements The PRH requires that each center provide a mental health and wellness program that includes basic mental health services by a qualified licensed mental health professional. As the CMHC, you must be an independent practitioner licensed as a clinical/counseling psychologist or clinical social worker in the state of the Job Corps center where you are providing services. The minimum staffing pattern is 6 hours per 100 students per week –For instance, if the OBS of your center is 300, you would be expected to work at least 18 hours each week on center

Mental Health and Wellness Program Overview Program includes the early identification and diagnosis of mental health problems, basic mental health care, and mental health promotion, prevention, and education designed to help students overcome barriers to employability. The program utilizes an employee assistance program (EAP) approach that includes short- term counseling with an employability focus, referral to center support groups, and crisis intervention.

Mental Health and Wellness Program Overview Five main components of CMHC position –Assessment –Mental Health Promotion and Education* –Consultation and Training* –Disability Program Support (including applicant file reviews)* –Treatment –Note: 50% of your time must be used for a combination of the areas indicated with an * above

ASSESSMENT

Assessment Evaluation of Applicant Folders –Appendix 609—Direct Threat Assessments –Appendix 610—Health Care Needs Assessments –PRH 6—6.14: Disability –CMHC Desk Reference Guide Job Corps Health Questionnaire (ETA 6-53) Direct Threat Assessment Guide and Form Sample accommodations for students with mental health disabilities Contact your RMHS when you are ready to complete your first recommendation for denial

Assessment Social Intake Form—review within 1 week Intake assessments of referred students Assessment of Need for Medical Separation –Medical Separation with Reinstatement (MSWR) –Medical Separation (straight separation) –See PRH 6.12, R11, CMHC DRG, and TAG E for more information on medical separations Reference forms are available in the DRG: referral/feedback form, intake form, success management plan.

PROMOTION AND EDUCATION

Promotion And Education Center-wide emphasis on promoting positive mental health and preventing mental health problems through providing students with education on how to deal with stress, recognizing signs of depression, and helping them learn when to ask for help. Introduction to center life: students are oriented to the HWC and services available to them, build motivation for healthy living and preventative care. Increase comfort-seeking care.

Promotion And Education One-hour presentation during CPP by the CMHC to introduce mental health program, services available, and teach basic skills in identifying and coping with mental health crisis CDP and CTP continued education/prevention activities At least one annual center wide activity

Promotion And Education Marketing Mental Health and Wellness –Include posters in the dorms, cafeteria, classrooms, and hallways advertising mental health and wellness services –Be visible on center: walk around, introduce yourself to students –Include pamphlets and flyers in your office and in the health and wellness center waiting area –Get free items from SAMHSA

CONSULTATION AND TRAINING Part of Promotion, Prevention, And Education

Staff Consultation The CMHC is required to: –Consult with the center director, management staff, and health and wellness manager regarding mental health-related promotion and education efforts for students and staff. –Coordinate with other departments/programs on center, including, but not limited, to residential, recreation, student government association, and HEALs, to develop integrated promotion and education services. Written documentation of the above is required

Annual Required Staff Trainings Minimum required five hours of annual training in adolescent growth and development for all staff. Topics could include: effective communications, anger management, sexuality, suicide prevention, behavior management system, zero tolerance policy, appropriate staff/student boundaries, sexual assault prevention and response, sexual harassment and related social skills training, crisis intervention techniques, and safety issues.

Training Resources SafetyNet Toolkit can be accessed on the Health and Wellness tab of the Job Corps Community website. It contains brochures, presentations, and other valuable information on Bullying, Suicide, Injury, and Violence prevention. Information is available at: Staff trainings can be located in SIMON. TAG D Mental Health Staff Development Training Modules – D_PartII_Oct2006.pdf D_PartII_Oct2006.pdf The CMHC Desk Reference Guide provides helpful templates and suggestions for staff trainings on mental health related topics.

DISABILITY PROGRAM SUPPORT

Disability Program Support Job Corps is required to ensure its program and facilities are accessible and provide reasonable accommodation to individuals with disabilities to prevent discrimination on the basis of disability. Each center should have a disability coordinator (DC) who ensures the center is providing services to students with disabilities as required by the PRH and Workforce Investment Act (WIA) regulations.

Disability Program Support File Review Team (FRT)—Typically includes the CMHC, Disability Coordinator(s), CP, TEAP to review health/mental health/AOD information of applicants for the program; Requires contact with the applicant Reasonable Accommodation Committee (RAC)—You will be part of the RAC for students with mental health diagnoses. Gather information to determine reasonable accommodation needs of applicants and students. Requires contact with the applicant and student. Appendix 609 and 610 –Required forms for recommending denial of applicants due to direct threat or health care needs (see assessment section of presentation for details)

TREATMENT

Authorizations: Consent to Treat The Job Corps Health Questionnaire (ETA 6- 53), which authorizes basic/routine health care, is placed in the student health record (SHR). If the student is a minor, the form should be sent to the student’s parent/legal guardian for signature. Additionally, each applicant and/or applicant guardian to Job Corps is also required to sign the Mental Health and Wellness Informed Consent Form. If applicant is a minor, the form should be sent to the student’s parent/legal guardian for signature.

Components of Program Brief Therapy –Short-term counseling defined as no more than 6 sessions with mental health checks as needed. Coordinate care with TEAP for students with co-occurring disorders Groups –Collaboration with counseling staff in developing and/or leading psycho- educational skill building groups to promote

Components of Program Counseling –Regular case conferences with counselors, and other appropriate staff based on individual student needs Chronic Mental Health Conditions Psychotropic Medications Crisis Intervention and Psychiatric Emergencies Community Referrals Referral and Feedback System

Documentation Process and Procedure Your assessment, treatment, and case management notes must be legible and included in the student health record Intake notes should indicate reason for referral, presenting problem, history of presenting problem, mental status exam, diagnostic impression, and clear treatment plan

Documentation Process and Procedure Progress notes should indicate assessment, progress, and treatment plan Documentation of referral information and feedback should be included (required written referral/feedback process) Sample documents are included as attachments in DRG

Psychotropic Medication Your role is to help evaluate any students already on medication and to identify any other students who may need to be referred to the center physician or consulting psychiatrist for a medication evaluation.

Crisis Intervention The CMHC is responsible for developing and providing staff training and crisis intervention for topics such as emotional reaction to HIV testing, rape, suicidal behavior, death, or other serious loss. As CMHC, you are also responsible for drafting center procedures for emergency psychiatric situations such as suicide attempts, psychotic episodes, urgent referrals, and danger to self and others.

Role of CMHC in Instances of Death A Critical Incident Debriefing Document is available on the Health and Wellness website at cuments/critical-incident-crisis- intervention.doc or from your RMHS cuments/critical-incident-crisis- intervention.doc

Psychiatric Emergencies Three types of emergency psychiatric services –Temporary Isolation –Physical Restraint Staff may not use handcuffs, mace, pepper spray (or any derivatives) on students. May not last more than 1 hr with a physician order –Hospitalization Voluntary Involuntary

ADDITIONAL AREAS

Additional Center Support Programs Tobacco Use Prevention Program (TUPP) Sexual Assault Response Team (SART) Family Planning Healthy Eating and Active Lifestyles (HEALs) HIV/AIDs **See PRH Chapter 6 – 6.11 for more information

Center Information System (CIS) A helpful tool for communication, monitoring, and feedback on case management plans is the Center Information System (CIS) located within Citrix. Consult with the HWM to learn more about CIS.

Useful Websites Job Corps Community website ( –Health and Wellness: Provides information on Job Corps health and wellness issues, announcements of conferences and other events, health-related directives and technical assistance guides, and regional health information. There is a section just for mental health and wellness. Ideas for promising practices can be found at: mh mh –Job Corps Disability: click on JC Community, then Disability. Provides a tutorial and information on the Job Corps disability initiative including legislation, common disabilities, and reasonable accommodation issues. –Event registration page: Register for upcoming webinars. JAN ( is a free service that provides information on job accommodations and the employment provisions of the Americans with Disabilities Act (ADA).

Regional Mental Health Specialists Region 1 –David Kraft, MD, MPH –Maria Acevedo, PhD (Puerto Rico) r.net Region 2 –Valerie Cherry, PhD m Region 3 –Suzanne Martin, PsyD, MPH Regions 4 –Lydia Santiago, PhD et Region 5 –Helena MacKenzie, Region 6 –Vicki Boyd, PhD