2018 Texas Focus: On the Move! Mental Health Education ... · 2018 Texas Focus – Mental Health...
Transcript of 2018 Texas Focus: On the Move! Mental Health Education ... · 2018 Texas Focus – Mental Health...
Texas School for the Blind & Visually Impaired Outreach Programs www.tsbvi.edu | 512-454-8631 | 1100 W. 45th St.| Austin, TX 78756
2018 Texas Focus: On the Move! Mental Health Education Program for School Personnel: Parents and Teachers as Allies Saturday, March 3, 2018 9:45-11:15 AM
Presented by
Karen Ranus, Director
National Alliance on Mental Illness (NAMI)
Austin, TX
Developed for
Texas School for the Blind & Visually Impaired
Outreach Programs
2018 Texas Focus – Mental Health Education Program for School Personnel – Ranus, K. Page 1
“Parents and Teachers as Allies”
Creating the Partnership
to Address Children’s Behavioral Health Challenges
Karen Ranus
Slide 2: Agenda • Early Warning Signs
• A Parent’s Perspective o How Families Are Affected
• A Student’s Perspective: o Growing Up with a Mental Health Condition
• Question and Answer
Slide 3: How many of you have been… • Overwhelmed by a child whose behavior seems of out control?
• Frustrated with parents who seem in denial?
• Concerned about a teen who is struggling, isolated or unhappy?
Figure 1 Graphic of a head with the "wheels turning" and ideas surrounding it.
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Slide 4: Why does it matter? A student’s mental health effects:
• Ability to learn
• Attendance
• All relationships:
• peers, family, school, community
• Physical health
• Developmental milestones
• Long-term success
Slide 5: Facts About Mental Health and Youth • 13% (ages 8-15) and 20% (ages 13-18 ) of youth live with a mental health condition
• 50% of mental health conditions have signs and symptoms by age 14
• Average delay between onset of symptoms and treatment is 8-10 years
Figure 2 Smiling children lay on the ground in a circle touching heads
Slide 6: Risks of Not Intervening • 50% of students 14+ with mental illness drop out of high school
• Twice as likely to use drugs or alcohol
• 70% of youth in justice system have mental health issues
• Suicide is the 2nd leading cause of death, ages 15-24
Figure 3 A teen in handcuffs
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Slide 7: The Good News • Childhood = most observed years of life
• Best observers: parents and teachers
• Early identification & care = better outcomes
Figure 4 Mother, father, and son meet with a teacher.
Slide 8: Your Role Is Important! • You are a skilled and expert observer
• Information about behaviors at school can help identify mental health issues earlier
• Doctors can more effectively treat with full array of facts from both home and school
• Parents and teachers focus on shared commitment: helping the child
Slide 9: Opportunities for Observation
Figure 5 Graphic showing opportunities for observation: Classroom, Extracurricular Activities, With Peers, Lunchroom, Playground, Library
Classroom
Extracurricular
With Peers
Lunchroom
Playground
Library
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Slide 10: Teachers ask How do you know when it’s typical behavior or something more serious?
Slide 11: Keys to Early Recognition A child with mental illness has thoughts, moods, and/or behaviors that are constant, unrelieved and challenging.
Severe: impacts daily life
Persistent: ongoing
Slide12: Early Warning Signs You Might Observe Slide 13: Have You Observed Signs of Attention-Deficit/Hyperactivity Disorder (ADHD)? Inattentive Behaviors
• Doesn't pay attention to details
• Highly distractible
• Doesn’t listen Hyperactive/Impulsive Behaviors
• Fidgets, squirms, can’t stay seated
• Bothers others
• Disruptive
SP Figure 6 Graphic SP for Severe and Persistent
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Slide 14: Observations from Home • Something “off” from the beginning
• Never slows down
• Exhausting & demanding
• “Always in trouble”
Figure 7 A young boy screaming
Slide 15: Impact in Adolescence Hyperactivity frequently diminishes, but:
• 50% of youth experience o poor performance, difficulty with relationships, o low self-esteem
• Dropout rate 12x higher than peers without ADHD
• 50% experience conduct disorder
• Increased risk of alcohol and drug use
Slide 16: Have You Observed Signs of Anxiety Disorders? • School avoidance, excessive absences
• Excessive worry about school, how they look
• Concerned about social standing among peers
• Dread they will do things wrong; perfectionist
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Slide 17: Observations from Home • Refuses to sleep alone or in the dark
• Avoids peer events or sleepovers
• Claims sickness to avoid school
• Meltdowns when parents try to force activities
Figure 8 A little girl looks unhappy and leans her head on her hand.
Slide 18: Observations in Adolescence • Fear of specific social/performance situations
• Avoidance of situations; intense distress
• Inability to initiate or maintain conversations
• Sweating, trembling, nausea, dizziness
Slide 19: Have You Observed Signs of Depression? • Mad, sullen, angry
• Anxious
• Withdraws, isolates
• Unable to have fun
• Talking/writing/drawing about death or suicide
Slide 20: Observations in Adolescence • Sad, hopeless, crying, lethargic, sleepy
• Withdraws, isolates
• Drugs, alcohol, self-harm
• Stops caring about appearance
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Slide 21: Observations from Home • Well adjusted child becomes a totally different kid
• Wears good face in public, displays worst symptoms at home o Unpleasant & hard to like o Irritable & aggressive o Seems to hate self and everything else o Nothing pleases them
Figure 9 Teenage girl slumps against a wall as she sits on the floor with her knees up and head on her hand.
Slide 22: Have You Observed Signs of Bipolar Disorder? • Over-reactive: irritable, oppositional, negative behavior
• Multiple mood shifts
• Hyperactivity/decreased need for sleep
• Hypersexual comments or behaviors
Slide 23: Observations from Home • Irregular sleep cycles night terrors, nightmares
• Violent rages or tantrums
• Severe separation anxiety/refusing to go to school
• Extreme physical sensitivity: clothes, temperature, environment
Figure 10 A desperate mom watches and her daughter has a meltdown.
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Slide 24: Observations in Adolescence Manic Phase
• Rapid and insistent speech, “pressured speech”
• “All or nothing” mentality
• Aggressive, touchy, irritable, “in your face” manner
• Hypersexuality
Slide 25: Observations in Adolescence Depressive Phase
• Moodiness/ Irritability
• Tremendous fatigue, lethargy
• Self-isolation
• Suicidal thoughts and attempts
Figure 11 An adult tries to console a young girl.
Slide 26: Observations from Home • Sleeping issues: too much or not enough
• Grandiosity
• Reckless, thrill-seeking behavior: o drug & alcohol use o sneaking out at night
• Suicidal thoughts and attempts
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Slide 27: Have You Observed Disruptive Mood Dysregulation Disorder (DMDD)? Core feature of DMDD is chronic, severe persistent irritability with two prominent symptoms.
• Severe temper outbursts out of proportion
• Outbursts inconsistent with development o On average 3-4 times/week
• Between outbursts: irritable/angry mood o most of day, o nearly every day o noticed at home and school
Slide 28: Observations from Home • Difficulty getting along
• Low frustration tolerance
• Family activities very challenging
• Family walks on eggshells to prevent tantrums
Figure 12 A young boy screams.
Slide 29: Obsessive Compulsive Disorder (OCD) • Average age of onset: 10 years old
• Symptoms similar at any age
• Co-occurring disorders o 20-40% of adolescents with eating disorders have OCD o Adolescents with OCD are at high risk for other severe anxiety disorders &
depression o 30% of individuals with OCD also have motor tic disorders.
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Slide 30: Have you observed signs of OCD? Obsessions
• Fear of contamination/germs
• Fixation on numbers or words; lucky/unlucky
• Need for exactness Compulsions
• Rituals (hand washing, grooming, cleaning)
• Repetitive counting, touching, writing, erasing
• Continuous checking, collecting, questioning
Figure 13 A child washing her hands
Slide 31: Observations from Home • Parents “must cooperate with compulsive rituals” to placate child and avoid
confrontations
• Often isolates due to exhaustion from hiding behaviors
• Rituals swamp home life; more subdued in public
Figure 14 A teenage girl with her head in her hands.
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Slide 32: Have You Observed Signs of Oppositional Defiant Disorder (ODD) & Conduct Disorder (CD)?
• Negative and hostile
• Persistently arguing with adults
• Intensely rigid and inflexible
• Aggressive and cruel, bullying
• Destructiveness
• Lack of remorse
Slide 33: Observations from Home • Families often report feelings of:
o Anger with lack of cooperation o Shock & embarrassment of behaviors o Worry about danger to self & others o Being overwhelmed by criticism
• Can’t take their child anywhere
Figure 15 A little girl screams in a little boys ears as he covers them and closes his eyes.
Slide 34: Observations in Adolescence
• “Cocky” or “Tough” demeanor: low self-esteem
• Drug and alcohol use
• Causing harm to others: o physical abuse o intimidation
• Frequent encounters with criminal justice
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Slide 35: About Childhood Schizophrenia • Childhood form is rare: 1 in 40,000 under age 15
• Expression can be severe causing pronounced disruption of brain development
• Defining sign is slow, gradual emergence of psychotic symptoms
• Often preceded by developmental disturbances
Slide 36: Have You Observed Signs of Childhood Onset Schizophrenia? Rarely observed before age 5 and can be differentiated from autism by later onset
• Early pattern of inhibition, withdrawal and sensitivity
• Little or no eye contact or expression of body language
• Inability or disinterest in making friends
• Confusion about what is real; hallucinations, delusions
Slide 37: Observations from Home • Hears voices saying things about him/her
• Stares at things not there
• Has no interest in friendships
• Prefers isolation
Figure 16 A little boy looks out at the rain thru a window
Slide 38: Observations in Adolescence • Bizarre actions and incoherent speech
• Delusions (false beliefs)
• Hallucinations (seeing/hearings things not there)
• Flat, blunted emotional responses
• Brief laconic replies and decrease in fluency of speech
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Slide 39: Observations from Home • High functioning teen starts “falling apart”
• Becomes unrecognizable to family or friends
• Unpredictable, bizarre behaviors
• Shy, reclusive child becomes more so
Slide 40: 5 Minute Stretch Break Slide 41: A Parent’s Perspective How Families are Affected
Slide 42: The Predictable Stages of Emotional Reactions I. Dealing with Catastrophic Events
• Crisis/Shock
• Denial
• Hoping-against-hope Needs: Support, comfort, empathy, help finding resources early intervention, prognosis, NAMI
II. Learning to Cope
• Anger/Guilt/Resentment
• Recognition
• Grief Needs: Vent feelings, keep hope, education, self-care, networking, skill training, letting go, cooperation from the system, NAMI
III. Moving into Advocacy: Charge!
• Understanding
• Acceptance
• Advocacy/Action Needs: Activism, restoring balance in life, responsiveness from system, NAMI
Slide 43: A Student’s Perspective Growing Up with a Mental Health Condition
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Slide 44: Sharing Observations with Parents • Follow school protocol
• Understand and use “Predictable Stages of Emotional Reactions”
• Remove feelings of blame
• Communicate empathy & compassion
Figure 17 Teacher talks to the parents and the child.
Slide 45: Empathy is the Doorway to Partnership video
Slide 46: Ten Key Messages • Mental health disorders are medical illnesses.
• Mental illness is not the family or child’s fault nor a sign of parental failure.
• Anger, grief and denial are predictable, common and normal responses.
• Bad behavior may not just be bad behavior.
• There are specific, observable early warning signs of mental illness.
Figure 18 Adult and child hands hold a small budding plant.
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Slide 47: Ten Key Messages • In partnership with the family, there are ways to promote student success in the
classroom.
• A psychiatric evaluation and treatment is often necessary in order to achieve recovery.
• Family-school collaboration are essential to early identification & intervention.
• Recovery is possible. There is hope.
• Reducing stigma helps reduce the gap between onset and treatment.
Figure 19 Smiling family members pose for photo
Slide 48: NAMI Austin is a Community Resource
Figure 20 People in a support group
Figure 21 NAMI Austin logo
• We offer resources for parents o Support groups o Classes o Lending library o Information
• Education and accurate information are key to understanding
• Peer support diminishes isolation
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Slide 49: NAMI Austin Child & Youth Programs www.namiaustin.org – Education /Parents and Teachers as Allies
Figure 22 Screenshot of NAMI Austin website
Slide 50: NAMI Austin Child & Youth Program
Figure 23 NAMI Basics logo
Free 6-week education program for parents and caregivers of children and teens who are experiencing signs of behavioral or mental health concerns or who have a diagnosis.
Figure 24 NAMI Ending the Silence logo
Free 50 minute presentation about mental health designed for middle and high school students.
Slide 51: NAMI Austin 512-420-9810
www.namiaustin.org
2018 Texas Focus – Mental Health Education Program for School Personnel – Ranus, K. Page 17
Texas School for the Blind & Visually Impaired
Outreach Programs
Figure 25 TSBVI logo
Figure 26 IDEAs that Work logo and US Dept. of Education OSEP disclaimer