Module 3Module 3

Connecting School Mental Connecting School Mental Health Services to Youth in Health Services to Youth in

Foster CareFoster Care

Test Your KnowledgeTest Your Knowledge

The only difference between school mental The only difference between school mental health and outpatient mental health is the health and outpatient mental health is the location. location. (T/F)(T/F)

School mental health services are only School mental health services are only available to children with special education available to children with special education needs or mental health diagnoses. needs or mental health diagnoses. (T/F)(T/F)

Most children experience some degree of Most children experience some degree of mental health issues. mental health issues. (T/F)(T/F)

School mental health services are primarily School mental health services are primarily concerned with diagnosing and treating concerned with diagnosing and treating mental health issues. mental health issues. (T/F)(T/F)

School mental health services can improve School mental health services can improve access to mental health services for access to mental health services for children in foster care. children in foster care. (T/F)(T/F)

Lesson ObjectivesLesson Objectives

Participants will be able to: Participants will be able to: Define school mental health and Define school mental health and

understand the services provided by understand the services provided by school mental health programs. school mental health programs.

Identify children who could be served Identify children who could be served in school mental health programs. in school mental health programs.

Discuss three advantages of school Discuss three advantages of school mental health. mental health.

Understand how school mental health Understand how school mental health is relevant for children in foster care.is relevant for children in foster care.

Brainstorming Brainstorming ActivityActivity What is School Mental Health, and What is School Mental Health, and

what are its advantages?what are its advantages?

Why Provide Mental Why Provide Mental Health in Schools?Health in Schools?

Most children experience some degree Most children experience some degree of mental health issues of mental health issues (e.g., anxiety (e.g., anxiety about school performance, unhealthy peer about school performance, unhealthy peer pressure, grief and bereavement, depression, pressure, grief and bereavement, depression, etc.). etc.).

Mental health issues affect students’ Mental health issues affect students’ school performance and engagement.school performance and engagement.

Though 20% to 38% of American youth Though 20% to 38% of American youth have diagnosable mental health have diagnosable mental health disorders, only a small percentage of disorders, only a small percentage of these youth receive treatment. these youth receive treatment.

Schools provide a natural and Schools provide a natural and convenient setting for addressing convenient setting for addressing mental health issues. mental health issues.

Small or Large Group Small or Large Group ActivityActivity Take five minutes to brainstorm Take five minutes to brainstorm

how school mental health relates how school mental health relates to children in foster care.to children in foster care.

What is School Mental What is School Mental Health?Health? School mental health clinicians School mental health clinicians

provide a full continuum of mental provide a full continuum of mental health services for students, and health services for students, and are based within a school setting. are based within a school setting.

The goal of school mental health is The goal of school mental health is to work collaboratively with all to work collaboratively with all members of the school community members of the school community to improve students’ educational to improve students’ educational success and social-emotional success and social-emotional wellbeing.wellbeing.

What Mental Health What Mental Health Services are Provided at Services are Provided at

Schools?Schools? Assessment Assessment Individual therapyIndividual therapy Group therapyGroup therapy Family therapyFamily therapy Classroom Classroom

preventionprevention Small group Small group

preventionprevention Psychiatrist Psychiatrist

consultation consultation Crisis Crisis

managementmanagement

Teacher & staff Teacher & staff consultation consultation

Consultation with Consultation with outside providersoutside providers

School-wide mental School-wide mental health promotion health promotion

After school After school enrichment & enrichment & recreational recreational activities activities

Who Provides School Who Provides School Mental Health Services?Mental Health Services?

Either school employees or providers who Either school employees or providers who are employed by an outside agency are employed by an outside agency (hospital, outpatient mental health center). (hospital, outpatient mental health center).

School mental health clinicians have School mental health clinicians have various training and backgrounds various training and backgrounds (e.g., (e.g., social workers, psychologists, school counselors, social workers, psychologists, school counselors, and licensed clinical practicing counselors).and licensed clinical practicing counselors).

Often, several professionals at the school Often, several professionals at the school building provide school mental health building provide school mental health services to students and ideally these services to students and ideally these individuals collaborate and work as a team. individuals collaborate and work as a team.

Who is Served?Who is Served?

Services provided to children in Services provided to children in regular and special educationregular and special education

Preschool through 12Preschool through 12thth grade grade Presenting problems range from Presenting problems range from

typical developmental issues to typical developmental issues to more severe behavioral disorders more severe behavioral disorders

Case Study: JacobCase Study: Jacob

Imagine that in a team meeting, Imagine that in a team meeting, you hear about a student named you hear about a student named Jacob (SEE NEXT SLIDE). Jacob (SEE NEXT SLIDE).

Work with a partner to discuss Work with a partner to discuss how to proceed with this student. how to proceed with this student. More specifically, discuss your More specifically, discuss your thoughts about the thoughts about the appropriateness of referring Jacob appropriateness of referring Jacob for school mental health. for school mental health.

Case Study: JacobCase Study: Jacob

Jacob is a 6th grade student at a middle Jacob is a 6th grade student at a middle school and has been in the foster care school and has been in the foster care system for over one year. He was placed in system for over one year. He was placed in foster care during 5th grade because his foster care during 5th grade because his father is in prison for violating his probation father is in prison for violating his probation by stealing a car. Unfortunately, Jacob’s by stealing a car. Unfortunately, Jacob’s mother passed away when he was two years mother passed away when he was two years old. Although Jacob has experienced many old. Although Jacob has experienced many difficult situations, his 5th grade teachers difficult situations, his 5th grade teachers said that he is well-adjusted, intelligent, and said that he is well-adjusted, intelligent, and a “star student.” At the beginning of 6th a “star student.” At the beginning of 6th grade, Jacob’s teachers report that he is not grade, Jacob’s teachers report that he is not completing class work or homework. Some of completing class work or homework. Some of the teachers think he just needs to adjust to the teachers think he just needs to adjust to middle school and the larger workload; middle school and the larger workload; however, one of the teachers thinks that however, one of the teachers thinks that Jacob may need to “talk to someone.” Jacob may need to “talk to someone.”

Why is School Mental Health Why is School Mental Health Important for Youth in Foster Important for Youth in Foster Care? Care?

Children in foster care have a high risk of Children in foster care have a high risk of developing mental health issues.developing mental health issues.– 54% had > 1 mental health problems54% had > 1 mental health problems– 25% had PTSD25% had PTSD

Children in foster care experience Children in foster care experience difficulty accessing mental health services difficulty accessing mental health services (e.g., transportation/distance issues, wait lists, (e.g., transportation/distance issues, wait lists, stigma) stigma)

School mental health services can help to School mental health services can help to address some of the access issues faced address some of the access issues faced by children and adolescents in foster care.by children and adolescents in foster care.

Brainstorming ActivityBrainstorming Activity

Discuss the advantages and Discuss the advantages and disadvantages of school mental disadvantages of school mental health services. Brainstorm about health services. Brainstorm about ways that children in foster care ways that children in foster care might benefit from the available might benefit from the available options. Think about the range of options. Think about the range of services that can be provided (e.g., services that can be provided (e.g., assessment, prevention, or assessment, prevention, or treatment). treatment).

Advantages of School Advantages of School Mental Health for Youth in Mental Health for Youth in Foster CareFoster Care Provides on-site services (can walk-in) Provides on-site services (can walk-in) Reduces stigma by providing services Reduces stigma by providing services

within school setting. within school setting. (Since clinician is (Since clinician is involved in prevention involved in prevention and and intervention intervention activities, connection with a provider doesn’t activities, connection with a provider doesn’t necessarily indicate that child is in treatment).necessarily indicate that child is in treatment).

Allows frequent and regular Allows frequent and regular communication with teachers to discuss communication with teachers to discuss academic and socio-emotional difficulties. academic and socio-emotional difficulties.

Increase child’s sense of school Increase child’s sense of school connectedness.connectedness.

Allows coordination of community and Allows coordination of community and educational resources for children. educational resources for children.

Disadvantages of School Disadvantages of School Mental Health for Youth in Mental Health for Youth in Foster CareFoster Care Sessions may interfere with academic Sessions may interfere with academic

time. Address this issue by pulling time. Address this issue by pulling children from non-academic classes, children from non-academic classes, having shorter sessions (20-30 having shorter sessions (20-30 minutes), and/or rotating schedules so minutes), and/or rotating schedules so the same class is not always the same class is not always interrupted.interrupted.

Students are seen during school day Students are seen during school day and therefore without parent/guardian and therefore without parent/guardian present. However, regular contact with present. However, regular contact with parents and guardians is necessary and parents and guardians is necessary and strongly encouraged. strongly encouraged.

In the event of a school transfer, the In the event of a school transfer, the student would need to transfer to a new student would need to transfer to a new school mental health clinician (if the school mental health clinician (if the services were available).services were available).

Moving Towards Action Moving Towards Action ActivityActivity Pair off and create a sheet of questions Pair off and create a sheet of questions

to use to inquire about what mental to use to inquire about what mental health services and other forms of health services and other forms of student support (e.g. Student Support student support (e.g. Student Support Teams) might be available in a school, Teams) might be available in a school, as well as the steps required to link the as well as the steps required to link the child or adolescent with those child or adolescent with those services. services. Answers will vary here Answers will vary here depending on the school system.depending on the school system.

Additional Optional Activity: Additional Optional Activity: Discuss how you would help a child or Discuss how you would help a child or adolescent get connected with a adolescent get connected with a school mental health clinician. school mental health clinician.

Retest Your KnowledgeRetest Your Knowledge

1) The difference between school 1) The difference between school mental health and outpatient mental mental health and outpatient mental health is the location. health is the location. (False)(False)

Explanation:Explanation: The goal of school The goal of school mental health is to become a vital mental health is to become a vital part of the school culture, and to part of the school culture, and to reach reach allall children, teachers, and children, teachers, and administrators at the school by administrators at the school by providing universal and prevention providing universal and prevention activities as well as more targeted activities as well as more targeted intervention services. intervention services.

Re-Test Your Knowledge Re-Test Your Knowledge (cont’d)(cont’d)

2) School mental health services are only 2) School mental health services are only available to children with special available to children with special education needs or mental health education needs or mental health diagnoses. diagnoses. (False)(False)

Explanation:Explanation: Children of all ages and Children of all ages and grades who are in regular or special grades who are in regular or special education can participate. education can participate.

Re-Test Your Re-Test Your Knowledge Knowledge (cont’d)(cont’d)

3) Most children experience some degree 3) Most children experience some degree of mental health issues. of mental health issues. (True)(True)

Explanation:Explanation: Most children experience Most children experience some degree of mental health issues. some degree of mental health issues. About 20% to 38% of youth in the About 20% to 38% of youth in the United States have diagnosable mental United States have diagnosable mental health disorders. health disorders.

Re-Test Your Re-Test Your Knowledge Knowledge (cont’d)(cont’d)

4) School mental health services are primarily 4) School mental health services are primarily concerned with diagnosing and treating concerned with diagnosing and treating mental health issues. mental health issues. (False)(False)

Explanation:Explanation: School mental health services School mental health services range from classroom and school-wide range from classroom and school-wide prevention activities and group counseling to prevention activities and group counseling to more targeted diagnosis and treatment for more targeted diagnosis and treatment for individual mental health issues. Moreover, individual mental health issues. Moreover, mental health services are utilized by mental health services are utilized by children with a range of concerns from typical children with a range of concerns from typical developmental issues (e.g., peer developmental issues (e.g., peer relationships, healthy identity development) relationships, healthy identity development) to severe behavioral disorders (e.g., Major to severe behavioral disorders (e.g., Major Depressive Disorder, Conduct Disorder). Depressive Disorder, Conduct Disorder).

Re-Test Your Re-Test Your Knowledge Knowledge (cont’d)(cont’d)

5) School mental health services can 5) School mental health services can improve access to mental health improve access to mental health services for children in foster care. services for children in foster care. (True)(True)

ExplanationExplanation: Provides on-site services : Provides on-site services in the most convenient and natural in the most convenient and natural setting possible!setting possible!

Practical ResourcesPractical Resources Advocating in School for the Children in Your CareAdvocating in School for the Children in Your Carehttp://www.nfpainc.org/uploads/http://www.nfpainc.org/uploads/

Advocating_in_School_for_the_Children_in_Your_Care.pdfAdvocating_in_School_for_the_Children_in_Your_Care.pdfThis brief article from the National Foster Parent Association and This brief article from the National Foster Parent Association and Casey Family Programs is aimed towards foster parents, and gives Casey Family Programs is aimed towards foster parents, and gives tips on how to become educational advocates for the foster tips on how to become educational advocates for the foster children and youth in their care.children and youth in their care.

Educational Advocacy Curriculum Educational Advocacy Curriculum http://www.nfpainc.org/uploads/EDUCATIONAL_ADVOCACY.pdfhttp://www.nfpainc.org/uploads/EDUCATIONAL_ADVOCACY.pdf

This training encourages and prepares foster parents to become This training encourages and prepares foster parents to become educational advocates for the foster children and youth in their educational advocates for the foster children and youth in their care. It is designed for foster parents and social workers. care. It is designed for foster parents and social workers.

Child Welfare Trauma Training ToolkitChild Welfare Trauma Training Toolkithttp://www.nctsn.org/nccts/nav.do?pid=ctr_cwtoolhttp://www.nctsn.org/nccts/nav.do?pid=ctr_cwtool

The Child Welfare Trauma Training Toolkit is designed to teach The Child Welfare Trauma Training Toolkit is designed to teach basic knowledge, skills, and values about working with children basic knowledge, skills, and values about working with children who are in the child welfare system and who have experienced who are in the child welfare system and who have experienced traumatic stress.traumatic stress.

Practical ResourcesPractical Resources School Mental Health.org:School Mental Health.org: www.schoolmentalhealth.orgwww.schoolmentalhealth.org

This website provides information and fact sheets on children’s This website provides information and fact sheets on children’s mental health for providers, educators, families and youth. mental health for providers, educators, families and youth. Specific information about mental health for youth in foster care is Specific information about mental health for youth in foster care is also available at this site. also available at this site.

Casey Family Programs:Casey Family Programs:http://www.casey.org/Resources/Publications/http://www.casey.org/Resources/Publications/

MentalHealthReview.htmMentalHealthReview.htmPublished in 2006, this review surveys major findings gleaned from Published in 2006, this review surveys major findings gleaned from studies about the evidence base for mental health care and about studies about the evidence base for mental health care and about related class action law suits. The review also outlines steps that related class action law suits. The review also outlines steps that will improve the mental health services delivered to children and will improve the mental health services delivered to children and youth in foster care.youth in foster care.

http://www.casey.org/Resources/Publications/EndlessDreams.htmhttp://www.casey.org/Resources/Publications/EndlessDreams.htmThe Endless Dreams video showcases the great potential of schools The Endless Dreams video showcases the great potential of schools to support and enrich the lives of youth in care. The video features to support and enrich the lives of youth in care. The video features a young woman in care and describes how life in foster care a young woman in care and describes how life in foster care impacts her education. Casey Family Programs offers this 15 impacts her education. Casey Family Programs offers this 15 minute video upon request at no charge. For a copy of the video, minute video upon request at no charge. For a copy of the video, please send e-mail to contactus@casey.org.please send e-mail to contactus@casey.org.

AcknowledgementsAcknowledgements

Funding for this project was supported by: Funding for this project was supported by: Maryland Mental Health Transformation Maryland Mental Health Transformation

Grant # 5 U79SM57459-02 from SAMHGrant # 5 U79SM57459-02 from SAMH

The Center for School Mental Health is The Center for School Mental Health is supported in full by Project #U45 MC supported in full by Project #U45 MC 00174 from the Office of Adolescent 00174 from the Office of Adolescent Health, Maternal, and Child Health Bureau Health, Maternal, and Child Health Bureau (Title V, Social Security Act), Health (Title V, Social Security Act), Health Resources and Services Administration, Resources and Services Administration, Department of Health and Human Department of Health and Human Services.Services.