Mental Health and Schools

1. Mental Health and Schools A Primer

2. Overview Why Mental Health and Schools? Development and Mental Health Risk and Protective Factors Mental Health Disorders 101 Treatment Options What You Can Do

3. MENTAL HEALTH QUIZMatch the behaviors on the right to the mental health diagnoses on the left.(behaviors can be used for more than one diagnosis) ADHD __________________ Depression __________________ 3. Oppositional Defiant __________________ 4. Bipolar __________________ 5. Anxiety __________________ 6. PTSD/ Trauma __________________ Reactive Attachment __________________ A. difficulty concentrating B. angry/ anger outbursts C. argumentative D. irritability E. tearful F. talkative G. preoccupation with thoughts/objects H. sleep difficulties I. forgetful J. bullies K. fidgets L. distant/ detached

4. Why Mental Health and Schools?

5. Because Schools Are The Most Universal Natural Setting • Over 55 million youth attend 114,700 schools (K-12) in the U.S. • 6.8 million adults work in schools • Combining students and staff, approximately 20% of the U.S. population can be found in schools during the work week. University of Maryland & Prince Georges County Public School System, “Mental Health 101 for Non-Mental Health Providers.

6. } Because Schools Are The Most Universal Natural Setting 20% • Schools provide a uniquely appropriate setting through which all children can access the full continuum of mental health services. } 80%

7. Because Our Students Have Mental Health Needs • Between 20% to 38% of youth in the U.S. have diagnosable mental health disorders • Between 9% to 13% of youth have serious disturbances that impact their daily functioning • Only one-sixth to one-third of youth with diagnosable disorders receive any treatment Adapted from: University of Maryland & Prince Georges County Public School System, “Mental Health 101 for Non-Mental Health Providers.

8. Because Those Needs Impact Our Classrooms • Loss of instructional time • Lack of academic progress • Negative class climate • Parental complaints • Teacher stress

9. Because Those Needs Impact Our Schools • AYP performance • Negative effect on school culture & climate • Teacher turnover • Safety & security • Negative effect on attendance, discipline, school suspension and graduation rates

10. Because Those Needs ImpactOur Communities • Increased crime rates • Increase in juvenile delinquency • Failure to graduate productive members of society • Continuation of the problem cycle TENNESSEE

11. And Because Those Needs Impact Individual Learners • Low academic motivation • Academic underachievement • Poor relationships • Low self-concept • Defiance/non-compliance with authority figures

12. Because Those Needs Impact Learning Learning Psychological Needs Environmental Needs Biological Needs Maslow’s Hierarchy of Needs

13. Mental Health & Schools:A Win-Win for All • Schools win since mental health is directly linked to educational outcomes. • Children & families win since accessible, affordable mental health services are most easily and consistently provided in an educational setting.

14. Development and Mental Health

15. Stages of Development

16. Students who are exhibiting typical behavior are more likely to have: Concerning behaviors at the same rates of frequency and intensity as the general peer group One or two concerning behaviors at a time No impairment in functioning Students who are exhibiting troubled behavior are more likely to have: Concerning behaviors at frequencies and intensities that exceed those of the general peer group Clusters of concerning behaviors Significant impairment in one or more areas of functioning Guidelines for making the distinction Typical or Troubled?

17. Risk and Protective Factors

18. Risk & Protective Factors Risk and protective factors refer to the elements of an individual’s life that act to decrease or increase the likelihood of positive outcomes. High levels of protective factors are associated with increased resiliency. Risk Protective

19. Two Key Environmental Stressors • Living in poverty • Exposure to Trauma

20. Key Biological Stressors • Physical health disorders • Mental health disorders with primary biological etiology

21. Identifying Risk and Protective Factors Practice Activity

22. The Human Brain

23. The Brain

24. The Emotional Brain

25. The Amygdala & Mental Illness Amygdala Healthy Patient Depressed Patient

26. Stress Containment Analogy Response generated by the Frontal Lobe Response generated by the Limbic System

27. Mental Health Disorders 101

28. Disorder Classifications Disruptive Behavior Disorders Mood Disorders Anxiety Disorders Attachment Disorders Autism Spectrum Disorders Psychotic Disorders

29. Disruptive Behavior Disorders • Attention Deficit Hyperactivity Disorder • Oppositional Defiant Disorder • Conduct Disorder • Intermittent Explosive Disorder

30. Attention Deficit Hyperactivity Disorder • Difficulty paying attention • Easily distracted • Unorganized • Often loses things • Often fidgets • Talks excessively • Often interrupts others

31. Oppositional Defiant Disorder • Argues with adults • Actively refuses to comply with adults • Annoys others • Blames others for misbehavior • Angry and resentful • Spiteful and vindictive

32. Conduct Disorder • Often bullies, threatens or intimidate others • Physically cruel to people and/or animals • Deliberately destroys property • Often lies (cons others) • Truancy

33. Intermittent Explosive Disorder • Several episodes of failure to resist aggressive impulses • The degree of aggressiveness expressed is out of proportion to the precipitating stressor

34. Mood Disorders • Depressive Disorder • Bipolar Disorder

35. Depressive Disorder • Depressed or irritable mood • Fatigue, low energy or sluggishness • Sleep disturbances • Diminished ability to concentrate • Diminished interest or pleasure in most activities

36. Depression in Childhood • Excessive irritability • Social withdrawal • Negative self-talk, pessimism • Increased sensitivity to rejection • Vocal outbursts or crying • Physical agitation • Expressions of turmoil or confusion • Increased dependency on caregivers (i.e. clinginess) • Thoughts of death or suicide

37. Bipolar Disorder • Key diagnostic feature: Mania • Manic episodes are characterized by: • Inflated self-esteem • Distractibility • More talkative than usual &/or rapid, pressured speech • Decreased need for sleep • Flight of ideas/racing thoughts • Increase in goal-directed activity or in activity level

38. Bipolar in Childhood • Rapid & severe cycling with chronic irritability • Few clear periods of wellness between episodes • Explosive, lengthy & often destructive rages • Hyperactivity, agitation & distractibility • Impaired judgment & impulsivity • Highly risky behavior • Excessive, unexplainable silliness • Inappropriate or precocious sexual behavior

39. Anxiety Disorders • Generalized Anxiety Disorder • Obsessive-Compulsive Disorder • Posttraumatic Stress Disorder • Acute Stress Disorder • Adjustment Disorder

40. Generalized Anxiety Disorder • Excessive uncontrollable worry • Restlessness • Irritability • Difficulty concentrating • Sleep disturbance • Easily fatigued

41. Obsessive-Compulsive Disorder • Recurrent thoughts or impulses that cases distress • The thoughts and impulses are not excessive worries about real life problems • Repetitive behaviors • The repetitive behaviors are used to reduce distress

42. Post-Traumatic Stress Disorder • Exposure to a traumatic event • The traumatic event is frequently re-experienced • Presence of avoidance or emotional numbing • Increased arousal or vigilance

43. Acute Stress Disorder • Same as those for PTSD • Symptoms are present for no more than 4 weeks

44. Adjustment Disorder • Emotional or behavioral symptoms develop as a result of an identifiable stressor • Reaction to event out of proportion to event itself • There is significant impairment in social/ educational functioning

45. Reactive Attachment Disorder • History of severe abuse, neglect and/or disrupted caregiving relationships in early childhood • A severe need to control everything and everyone • Hypervigilance • Superficially charming and engaging, particularly around strangers • Indiscriminate affection, often to strangers; but not affectionate on caregiver’s terms • Trouble understanding cause and effect • Poor impulse control • Little or no empathy

46. Autism Spectrum Disorders • Asperger’s Disorder • Autism Disorder

47. Asperger’s Disorder • Impairment in social interaction • Restricted repetitive and stereotyped patterns of behavior, interest or activities • The disturbance causes significant impairment • Delays not present until after age 3

48. Autism Disorder • Impairment in social interactions • Impairments in communication • Restricted repetitive and stereotyped patterns of behavior, interest or activities • Delays are present prior to age 3

49. Autism Video Clip

50. Psychotic Disorders • Schizophrenia • Schizoaffective Disorder • Brief Psychotic Disorder