Transcript Student Mental Health - ESC of Lorain County

Mental Health and
Student Success
Helping Teens with Their Mental Health Issues
Presented by Kathleen Kern, Ph.D
Lorain County Board of Mental
Health
Mental Health and Your Students
According to the CDC study of youth aged 917, if you are a teacher with 30 students in
your class, within the last six months:
 4 are likely to have an Anxiety Disorder
 2 will have a Mood Disorder
 3 will have a Disruptive Disorder
Closer to Home
In a 2009 survey of over 10,000 6th, 8th, 10th and 12th
graders in Lorain County:
 35 % of students indicated that they were
depressed more days than not last year.
 33% report that they sometimes believe that they
are no good at all.
 14% of students report that they are inclined to
think of themselves as a failure.
 8% of students across grades 6,8,10 and 12
indicated that their worries always interfere with
their ability to get things done.
Objectives
To understand:
 The Origin of Mental Health Problems.
 The impact of trauma on mental health
 The role of schools in early identification
and resiliency building
 Characteristics indicative of student
behavioral health concerns
 The resources that are available in our
county
Mental Health Problems:
Nature AND Nurture
There is a huge amount of research pointing to the
mental health disorders having a genetic
component.
Historically, we understood mental illness through
The Diathesis-Stress Model.
The Vulnerability-Stress–Protective factors model
tells us that protective factors may mitigate stress
and reduce likelihood of symptom expression.
(Analogous to Health)
Vulnerability:
Biology of Mental Illness



Studies have noted rates of child psychiatric diagnosis
among offspring ranging from approximately 30% to
50%, as compared to an estimated rate of 20% among
the general child population. Estimates of heritability
factors are as follows:
Bipolar Disorder 59% (NIMH, 1998), with
Schizophrenia slightly higher
Various studies estimate the overall heritability rate for
major depression are about 39%
Environmental Stress-Trauma
ACES Study of 17,000 Kaiser Permanente Members is
California connected Adverse Childhood Experiences
to negative outcomes in adulthood.
 Abuse (Emotional, Physical or Sexual) Abuse
 Neglect (Physical or Emotional)
 Mother Treated Violently
 Household Substance Abuse
 Household Mental Illness
 Parental Separation or Divorce
 Incarcerated Household Member
Long Term Impact
Analysis of he ACE Score data indicates that as the number of
ACE increase, the risk for the following health problems
increases in a strong and graded fashion:
*alcoholism and alcohol abuse
*COPD
*fetal death
*health-related quality of life
*illicit drug use
*heart disease
*liver disease
* STDs
*risk for intimate partner violence
*smoking
*multiple sexual partners
* unintended pregnancies
*adult unemployment
*suicide attempts
An Example:
Depression and Trauma
(www.Acestudy.org)
Trauma Has Multifaceted Impact





Changes Brain (chemically and structurally)
Educational Impact
Impact on Perceptions
Relations with other
Behaviors (Health and Risk)
Trauma’s Biological Impact: Lateral
Ventricles Measures in an 11 Year Old Maltreated Male with
Chronic PTSD, Compared with a Healthy, Non-Maltreated
Matched Control

Non-Maltreated
Maltreated
Ventricles
Trauma’s Educational Impacts of
Trauma





Greater than 50% of abused children have problems at school
(including conduct problems)
Greater than 25% of abused children require special education
services
Several studies suggest that child abuse and neglect reduce a
child’s IQ (nest slide)
Maltreated children have lower social competence (which is a
significant predictor of academic achievement). They may have
reduced empathy or emotional intelligence.
Children can experience changes in perception that interfere with
learning and social skills

According to Dr. Frank Putnam, MD, Cincinnati Children’s Hospital
Cumulative Trauma Lowers
Intelligence
Impact on Social Functioning:
Physically Abused Children See Anger
Where Others See Fear
Graphic by: Seth Pollak, courtesy PNAS
Trauma Symptoms in Adolescents
Adolescents – Avoidance, problems with
attention and concentration, nightmares,
hypervigilence, possible depersonalization, selfinjuries or risk taking behaviors, substance
abuse, intermittent anger/aggression caused by
survival instinct, perceptual changes, brainrelated changes, and the avoidance that
interferes with changing cognitions
Take Home Points



Many mental health disorders have a genetic
component that is activated by a stressful environment.
This environmental stress can actually change the
functioning in the brain (Demonstrated with Depressed
and PTSD clients).
Children who experience multiple Adverse Childhood
Experiences (Traumatic Events) are at great risk for
poor, long-term outcomes, if there is no intervention.
The Third Factor: Resiliency




In Lorain County and surrounding areas, our students
are faced with many challenges (poverty, violence in
home and community, etc.)
Some of these are beyond our ability to immediately
impact. What we CAN do is strengthen the children for
the challenges that they will face.
According to Emmie Werner and the Research on
Developmental Assets, building a child's strengths can
make a huge difference.
Children can manage amazing adversity if they feel safe
and supported and can learn different ways to cope.
Developmental Assets
Since 1990, the Search Institute studied
more than one million students and 213
communities.
The Institute articulated 40 Developmental
Assets
 20 Internal Assets
 20 External Assets
Which assets can schools influence?
Assets in Schools








Positive other adult relationship (3+ non-parent
adults)
Caring school climate
Parent involvement in school
Service to others (one or more hours per week)
Safety: youth feel safe at school
School boundaries: clear rules and
consequences
Adult role models
High expectations
Assets in Schools







Creative activities (3+ hours/week)
Youth programs (3+ hours/week)
Achievement motivation
School engagement
Homework
Bonding to school
POWER OF ONE CARING ADULT
(Demonstrated by research and practice)
The Informed Adult…



Knows how to set up an environment to build
resiliency (including safety, predictability)
Knows how to recognize possible mental health
symptoms and how to add needed protective
factors, including treatment
Is willing to reach out to youth building rapport,
asking about the youth’s well being, providing
support and connection
The Good News



Effective Treatment is Available
A growing body of research demonstrates the
efficacy of mental health interventions for
children and families.
Trauma Focused Cognitive Behavioral Therapy
has been proven to effectively reduce symptoms
associated with trauma and to increase
functioning.
TFCBT



The only treatment proven effective for the
treatment of sexual abuse.
The Goal is to integrate the trauma as an event
that occurred but did not define the youth.
Includes Pyschoeducation, Building Cognitive
and Emotional Coping, Direct Discussion of
the Trauma and Sharing of the Child’s Story
with a non-offending adult (Very Important).
Resources in Lorain County
Services will be determined according to symptoms
and best practices but parents should be aware
that in Lorain County:
 Seven agencies offer mental health services for
children within the Network
 Four offer TFCBT
 Three offer child psychiatry
 Four offer a sliding fee scale that goes down to
zero, depending on income
 All services are confidential
Non-Emergency Resources




A continuum of care is available so that the needs of
the child or adolescent can be matched with the
appropriate level of care.
Contact information for all agencies, and a weekly
update that indicates which agencies have openings
within fourteen days can be found at www.lcmhb.org
Parents or Educators who have questions should not
hesitate to email or call
[email protected]; 440-233-2020 (x4239)
Review of Objectives
and Questions
Understanding
The
the Origin of Mental Health Problems.
impact of trauma on mental health
The
role of schools in early identification and resiliency
building
Characteristics
concerns
The
indicative of student behavioral health
resources that are available in Lorain County
Interesting Resources
National Child Traumatic Stress Network has
amazing resources for educators, parents, social
workers, etc. (www.NCTSN.org)
 For more information on the ACES Study
http://www.cdc.gov/ace/index.htm
 To learn about your own ACE score
acestudy.org/

Thank You
Kathleen Kern, Ph.D.
Lorain County Board of Mental Health
[email protected]; 440-233-2020 (x4239)