1. The American Psychiatric Foundation
Typical or Troubled? ®
Know the Difference, Make a Difference
A Program of
The American Psychiatric Foundation
1 • Typical or Troubled?®

2. Introductions Please briefly state your: 1) Name
2) MHP, counselor, other?
3) School or Organization?
4) Typical or Troubled?

3. Mission of APF
To advance public understanding that mental illnesses are real and can be effectively treated.
Established 1991—Diverse Board of Directors
Charitable Arm of American Psychiatric Association
Raise Funds and Awareness
Conduct Public Education & Outreach Programs
Patient, Family and Community Focused

4. Approximately 1/3 of adolescents with major depressive disorder also suffer from another mental disorder.
False
It’s 2/3 4

5. Mental Illness in U.S. Children
20% of youngsters age 9-17 have diagnosable psychiatric disorders with at least minimum impairment
10% suffer from severe mental illness causing significant impairment
Fewer than one in 5 receive needed treatment in any given year
Note that one out of five kids in the pediatrician’s office has an emotional disorder

6. Mental Illness in U.S. Adolescents
Those who develop a mental disorder, 90% have early warning signs by age 15…….some even earlier
Anxiety disorders often begin in late childhood, mood disorders in late adolescents, and substance abuse in early 20’s.
Suicide third leading cause of death among teens 15 to 24 years old.
Unlike most cancers or heart disease, young people with mental disorders suffer disability when they are in the prime of their life. (NIMH)

7. Mental Illness in U.S. Adolescents
Despite effective treatments, there are long delays — sometimes decades — between first onset of symptoms and when people seek and receive treatment (NIMH)
Early identification and connecting to help is critically important

8. No help = Pain Suffering Failing
Those with a untreated mental health disorder, three times more likely to develop a subsequent disorder, compared to students with no previous disorder
8 • Typical or Troubled?®

9. HELP = Better academic achievement
Less substance abuse
Improved chances for their future
9 • Typical or Troubled?®

10. Research on greatest impact
Who do we target for education for greatest impact?
Research shows:
School personnel – teachers and other school personnel:
Trusted and listened to by kids
Interactive with parent, kids and counselors
Want to help, believe it is their job to help teens
Want to avoid consequences of not acting
Want information from a credible source– not misinformation
Want to know the difference between typical or troubled
Needed now more than ever

11. Typical or Troubled? ™ Program Objectives
Goal: Reduce the gap between on-set and treatment
Objective: Educate school personnel about teen/adolescent mental health
Science of mental illness
Notice, Talk, Act
Notice the early warning signs
Talk with students
Talk to parents – imperative and a barrier
Act – by connecting to the school referral process - refer to treatment
Target audiences for education:
Teachers, coaches, bus drivers, administrators, and other school personnel, administrators

12. What’s in it for them?
This is what teachers / school personnel tell us……
See the signs and don’t know what to do, want to know
Want to help, most believe it is their job to help teens
Want to avoid consequences of not acting
Appreciate information from a credible source– not misinformation
Want to know the difference between typical or troubled
Want to know how to refer
Don’t want to be “jr. psychiatrists”
School personnel – teachers and other school personnel:
Trusted and listened to by kids
Interact with students, parents and counselors

13. School Community Informed Program
Research based program
Community informed every element
Materials developed with school community and experts
Focus groups tested
Piloted and revised
Evaluated over 7 years

14. Typical or Troubled?™
Local urban, rural and suburban schools from Alaska to Florida
Implemented in 900 school sites and or districts
Educating 90,000+ school personnel
Connecting with more than a million students

15. Increased Knowledge of Mental Health 2008-- 2009 -- 2010

16. I know how to….if I see the warning signs

17. Qualitative Evaluations 2013:
Typical or Troubled? TM
“Large training, part of an all-day, in-service training with 350 attendees. Local media (TV and print) reported on adolescent mental health .” Ben Harrington- MHA of East Tennessee (rural area)
“ I’ve gotten over 100 referrals since the training.” Christina Fontenot- Ville Platte High School (rural area)
Very well received! Local psychiatrist presented …we loved having them and the teachers had a lot of questions which they could answer. Teachers felt empowered - knew the referral process. Patti Morton- FCUSD Health Programs
“ Most exciting this year -- added a youth speaker which was very well received!” JoDee Buis- Orange County Public Schools in Orlando, Florida
INCREDIBLE RESPONSE from CA Department of Mental Health:
“ In days following, a tremendous amount of teachers approached me one-on-one to talk about the problems they were seeing with their students.”
© 2012 American Psychiatric Foundation

18. Qualitative Evaluations
“In-service training with 350 attendees. Local media reported on adolescent mental health.”
Ben Harrington- MHA of East Tennessee
“Teachers, staff and administrators have been very proactive. I’ve gotten over 100 referrals since the training.”
Christina Fontenot- Ville Platte High School
Information very well received! Local psychiatrist presented …we loved having them and the teachers had a lot of questions which they could answer. Teachers felt empowered, better understood the referral process.
Patti Morton- FCUSD Health Programs
© 2012 American Psychiatric Foundation

19. Measures of Success Expanded Awareness of NTA and mental health issues
Collaboration
Educating Parents
Increased Referrals
Preventing Tragedy
Ready to Implement - Curriculum
Catalyst for Referral Process 19

21. Instructions, Customization, Teams

22. Article & Handouts
22 • Typical or Troubled?®

23. Evaluations, Suggestions
23 • Typical or Troubled?®

24. Checklist
24 • Typical or Troubled?®

25. 25 • Typical or Troubled?®

26. Typical or Troubled?® Modeling and Practice
Section 1: Introduction
Section 2: Early Warning Signs

27. Section 3: Mental Health Disorders Section 4: Connecting to Help
Modeling and Practice
Section 3: Mental Health Disorders
Section 4: Connecting to Help
Section 5: Referral Process
Section 6: Managing Classroom, Engaging Parents, Resources
Jim leads

28. SAMPLE SLIDES Presentation for Teachers & Staff
Typical or Troubled?®
Know the Difference, Make a Difference
A Program of the American Psychiatric Foundation
SAMPLE SLIDES
Presentation for
Teachers & Staff
28 • Typical or Troubled?®

29. Normal teen development
TODAY’S PRESENTATION
State of the problem
Treatment
Steps to take
Warning signs
Normal teen development
Types of mental health problems
Referral process
Talking to parents
Managing the Classroom
29 • Typical or Troubled?®

30. (Insert Name of School)
30 • Typical or Troubled?®

31. Everyone Can Make a Difference
School Staff
Parents
Every
Adult
31 • Typical or Troubled?®

32. Abuse of alcohol/ drugs
Physical complaints
Abuse of alcohol/ drugs
Depression
Self-injury
Threats to run away
Aggression
Intense fear of becoming obese
Frequent outbursts
Nightmares
Inability to cope
Marked change in school performance
Threat to
harm self or others
Sexual acting out
Unusual behavior
32 • Typical or Troubled?®

33. Teen Mental Health Disorders
Mood disorders
Anxiety disorders
Psychotic disorders
Behavioral/disruptive disorders

34. Troubled?
Typical?
34 • Typical or Troubled?®

35. Complex period of rapid change, transition
Challenges: fitting in, defining identity, competing demands (school, home)
Sometimes - other home issues (divorce, violence or substance abuse)
Bottom line: May display alterations of mood, distressing thoughts, anxiety, and impulsive behavior.
Typical Teens
35 • Typical or Troubled?®

36. Experiencing more than normal developmental challenges
Without treatment, more likely to have serious problems:
Academic
Relationships
Employment
Signs of
Trouble
36 • Typical or Troubled?®

37. Typical or Troubled?® FREQUENT ? EXTREME ?
As you NOTICE signs, ask yourself, are they:
FREQUENT ?
(e.g., student is quiet, withdrawn over multiple days/weeks)
EXTREME ?
(e.g., violent outburst)
If either:
TALK with student
ACT by communicating what you’ve seen/heard with school MH staff
37 • Typical or Troubled?®

38. Customizable
38 • Typical or Troubled?®

39. The Team

40. PROCESS IN A SCHOOL
TEACHER identifies a cause for concern in a student
TEACHER talks to student
TEACHER notifies SCHOOL COUNSELOR assigned to student (or CASE MANAGER for special ed students)
STUDENT and SCHOOL COUNSELOR meet
If problem identified as a behavior/conduct problem, student is sent to ASSISTANT PRINCIPAL –
PARENT involved
SCHOOL SOCIAL WORKER or PSYCHOLOGIST or other is engaged if needed – PARENT involved
SCHOOL COUNSELOR handles problem OR
SCHOOL COUNSELOR provides information on outside resources
SOCIAL WORKER
MH COUNSELOR
PSYCHOLOGIST
PSYCHIATRIST
40 • Typical or Troubled?®

41. REFERRAL HANDOUT Break into small groups
Teams from school/districts include counselor/school champ and MHP
Those with one presenter join in small group
Discuss the referral process in your school – what happens first, who do teachers connect to? Next, After that?
Write it down – KEEP IT SIMPLE
Fill in referral slide boxes
Remember you are not designing the system – you are communicating what happens

44. Lessons Learned Over a Decade
Work with and in the Educational System
National and local partners
Messenger as important as message
In-Service -- Scheduled presentation
ACT - No One Size Fits All – Referral Process
How to TALK to students/parents
NOTICE Early Warning Signs – How does it appear in the class room

45. NOTICE
TALK
ACT
45 • Typical or Troubled?®

46. Changing a Life’s Course
46 • Typical or Troubled?®

47. TAP - Technical Assistance Partnership Program Innovation Grant
Typical or Troubled?®
TAP - Technical Assistance Partnership Program
Innovation Grant
Standard Grant
Applications being accepted – March 31st deadline