‘Mental Health First Aid’ helps schools reach out to troubled kids

22 Apr

Anna M. Phillips has wrote the New York Times article, Calming Schools by Focusing on Well-Being of Troubled Students which describes how one New York school is dealing with its troubled children.

Mark Ossenheimer, principal of the Urban Assembly School for Wildlife Conservation in the Bronx, threw out a name to add to the list of teenagers in trouble.
Several teachers and a social worker seated around a table in the school’s cramped administrative offices nodded in agreement. They had watched the student, who had a housebound parent who was seriously ill, sink into heavy depression. Another child seemed to be moving from apartment to apartment, showing up at school only sporadically. And then there was the one grappling with gender-identity issues. Soon the list had a dozen names of students who could shatter a classroom’s composure or a school windowpane in a second.
Convening the meeting was Turnaround for Children, a nonprofit organization that the young-but-faltering school in an impoverished neighborhood near the Bronx Zoo had brought in this year to try to change things.
“This is the condition our organization was created to solve,” said Dr. Pamela Cantor, Turnaround’s founder and president. “A teacher who works in a community like this and thinks that these children can leave their issues at the door and come in and perform is dreaming.”
In focusing on students’ psychological and emotional well-being, in addition to academics, Turnaround occupies a middle ground between the educators and politicians who believe schools should be more like community centers, and the education-reform movement, with its no-excuses mantra. Over the past decade, the movement has argued that schools should concentrate on what high-quality, well-trained teachers can achieve in classrooms, rather than on the sociological challenges beyond their doors.

One strategy in helping children to succeed is to recognize and treat depression.

How Common Is Depression In Children?

According to Mary H. Sarafolean, PhD, in the article, Depression In School Age Children and Adolescents:

In general, depression affects a person’s physical, cognitive, emotional/affective, and motivational well-being, no matter their age. For example, a child with depression between the ages of 6 and 12 may exhibit fatigue, difficulty with schoolwork, apathy and/or a lack of motivation. An adolescent or teen may be oversleeping, socially isolated, acting out in self-destructive ways and/or have a sense of hopelessness.
Prevalence and Risk Factors
While only 2 percent of pre-teen school-age children and 3-5 percent of teenagers have clinical depression, it is the most common diagnosis of children in a clinical setting (40-50 percent of diagnoses). The lifetime risk of depression in females is 10-25 percent and in males, 5-12 percent. Children and teens who are considered at high risk for depression disorders include:
* children referred to a mental health provider for school problems
* children with medical problems
* gay and lesbian adolescents
* rural vs. urban adolescents
* incarcerated adolescents
* pregnant adolescents
* children with a family history of depression

If you or your child has one or more of the risk factors and your child is exhibiting symptoms of prolonged sadness, it might be wise to have your child evaluated for depression.

How to Recognize Depression In Your Child?

MedNet has an excellent article about Depression In Children and how to recognize signs of depression in your child.

Signs and symptoms of depression in children include:
* Irritability or anger
* Continuous feelings of sadness, hopelessness
* Social withdrawal
* Increased sensitivity to rejection
* Changes in appetite — either increased or decreased
* Changes in sleep — sleeplessness or excessive sleep
* Vocal outbursts or crying
* Difficulty concentrating
* Fatigue and low energy
* Physical complaints (such as stomachaches, headaches) that do not respond to
* Reduced ability to function during events and activities at home or with friends, in school, extracurricular activities, and in other hobbies or interests
* Feelings of worthlessness or guilt
* Impaired thinking or concentration
* Thoughts of death or suicide
Not all children have all of these symptoms. In fact, most will display different symptoms at different times and in different settings. Although some children may continue to function reasonably well in structured environments, most kids with significant depression will suffer a noticeable change in social activities, loss of interest in school and poor academic performance, or a change in appearance. Children may also begin using drugs or alcohol,
especially if they are over the age of 12.

The best defense for parents is a good awareness of what is going on with their child. As a parent you need to know what is going on in your child’s world.

Ann Schimke posted at Chalkbeat Colorado in the article, A new tool in schools’ mental health tool box which describes Mental Health First Aid:

Called Youth Mental Health First Aid, the training originated in Australia and was unveiled in Colorado last year. There is also an adult version of the training, introduced here in 2008, called Mental Health First Aid or MHFA.
Both are gaining momentum in what mental health advocates say is a welcome development in a state saddled with one of the highest suicide rates in the country and more than its fair share of school tragedies, including a deadly shooting at Centennial’s Arapahoe High School in December and a self-immolation at Westminster’s Standley Lake High School in January.
Olga Gonzalez, a community outreach worker who participated in the recent Greeley training, said she regularly fields questions from parents who are worried about their children but don’ t know where to turn. She recounted how one family she’d worked with discovered their son had started using drugs. Another learned that their son had stolen credit card information from a customer while manning the cash register at the family’s store.
“He has money in a savings account, you know. He just did it,” she said. “I wasn’t sure what kind of support he needs.”
Youth Mental Health First Aid aims to answer such questions for people who are not mental health professionals but who work closely with young people and their families. The target audience includes lay-people like teachers, coaches, guidance counselors, school nurses and even bus drivers.
Advocates for MHFA say Colorado now has one of the largest contingents of certified instructors—around 230 so far. In addition, it’s among only a handful of states to dedicate public funds to the trainings, with $750,000 appropriated for the program next year.
“We have been at the forefront of this since the beginning,” said Brian Turner, director of Mental Health First Aid Colorado at the Colorado Behavioral Healthcare Council.
Preparing first responders
The concept behind both versions of MHFA, much like medical first-aid, is to equip first responders with the know-how to address emerging mental health or addiction problems. The youth version is also meant to help distinguish between true mental health issues and the normal mood swings and behavior changes that characterize the life of a teenager…
In fact, encouraging youth to seek professional help is one of five action steps—condensed in the acronym ALGEE–outlined in the training. The other four include “Assess for suicide/self harm,” “Listen non-judgmentally,” “Give assurance/information,” and “Encourage self-help/other support.”
Turner said having concrete action steps is important because “there’s a big difference between learning about mental health and substance abuse problems and being able to do something about it.”
During the Greeley training, participants were asked to come up with gestures that would convey each of the five action steps. Soon, in an effort to commit the steps to memory, Vaughn and co-trainer Noelle Hause were leading the group in miming actions like non-judgmental head-nodding and reassuring arm-patting.
Reaching out to schools
While Turner said Youth Mental Health First Aid is not yet widely offered by school districts, there is growing interest. Among the districts that have offered it for at least some staff are Douglas County, Aurora, Thompson, and Weld County District 6.
Barb Becker, division director for community programs at the Arapahoe/Douglas Mental Health Network, said the one-day format make it a very doable training for educators.
“It just gives a really good overview,” she said, adding, “It takes away some of the stigma associated with mental health….” http://co.chalkbeat.org/2014/04/16/a-new-tool-in-schools-mental-health-tool-box/

Here is a description of Mental Health First Aid:

Mental Health First Aid is an 8-hour course that teaches you how to help someone who is developing a mental health problem or experiencing a mental health crisis. The training helps you identify, understand, and respond to signs of mental illnesses and substance use disorders.

Tony Jorm and Betty Kitchener.
Mental Health First Aid was created in 2001 by Betty Kitchener, a nurse specializing in health education, and Anthony Jorm, a mental health literacy professor. Kitchener and Jorm run Mental Health First Aid™ Australia, a national non-profit health promotion charity focused on training and research. More information on the history of the course is available at Mental Health First Aid Australia.
The United States is just one of the many countries that have adapted the program from Australia. Check out the countries at Mental Health First Aid International.
Who We Are
Mental Health First Aid USA is coordinated by the National Council for Behavioral Health, the Maryland Department of Health and Mental Hygiene, and the Missouri Department of Mental Health. In 2008, we worked with the program’s founders to adapt Mental Health First Aid for the U.S. We ensure the quality and standardization of the program nationwide, certify instructors to teach Mental Health First Aid in local communities, and support program growth. http://www.mentalhealthfirstaid.org/cs/about/

Here is The National Registry of Evidence-based Programs and Practices (NREPP) review of Mental Health First Aid.

Intervention Summary
Mental Health First Aid
Mental Health First Aid is an adult public education program designed to improve participants’ knowledge and modify their attitudes and perceptions about mental health and related issues, including how to respond to individuals who are experiencing one or more acute mental health crises (i.e., suicidal thoughts and/or behavior, acute stress reaction, panic attacks, and/or acute psychotic behavior) or are in the early stages of one or more chronic mental health problems (i.e., depressive, anxiety, and/or psychotic disorders, which may occur with substance abuse).
The intervention is delivered by a trained, certified instructor through an interactive 12-hour course, which can be completed in two 6-hour sessions or four 3-hour sessions. The course introduces participants to risk factors, warning signs, and symptoms for a range of mental health problems, including comorbidity with substance use disorders; builds participants’ understanding of the impact and prevalence of mental health problems; and provides an overview of common support and treatment resources for those with a mental health problem. Participants also are taught a five-step action plan, known as ALGEE, for use when providing Mental Health First Aid to an individual in crisis:
• A–Assess for risk of suicide or harm
• L–Listen nonjudgmentally
• G–Give reassurance and information
• E–Encourage appropriate professional help
• E–Encourage self-help and other support strategies
In addition, the course helps participants to not only gain confidence in their capacity to approach and offer assistance to others, but also to improve their personal mental health. After completing the course and passing an examination, participants are certified for 3 years as a Mental Health First Aider.
In the studies reviewed for this summary, Mental Health First Aid was delivered as a 9-hour course, through three weekly sessions of 3 hours each. Participants were recruited from community and workplace settings in Australia or were members of the general public who responded to recruitment efforts. Some of the participants (7%-60% across the three studies reviewed) had experienced mental health problems.

Descriptive Information
Areas of Interest Mental health promotion
Outcomes Review Date: May 2012
1: Recognition of schizophrenia and depression symptoms
2: Knowledge of mental health support and treatment resources
3: Attitudes about social distance from individuals with mental health problems
4: Confidence in providing help, and provision of help, to an individual with mental health problems
5: Mental health
Outcome Categories Mental health
Social functioning
Ages 18-25 (Young adult)
26-55 (Adult)
55+ (Older adult)
Genders Male
Races/Ethnicities Non-U.S. population
Settings Workplace
Other community settings
Geographic Locations Urban
Rural and/or frontier
Implementation History Mental Health First Aid was developed in 2001 at the Australian National University. The program was first used in the United States in 2007, and since then, the program has trained over 1,500 instructors in 45 States, the District of Columbia, and Puerto Rico. These instructors have taught the course to more than 38,000 people in a variety of communities. The program has been implemented internationally in Australia, Cambodia, China, England, Finland, Hong Kong, Ireland, Japan, Nepal, New Zealand, Scotland, Singapore, South Africa, Sweden, Thailand, and Wales.
NIH Funding/CER Studies Partially/fully funded by National Institutes of Health: No
Evaluated in comparative effectiveness research studies: No
Adaptations Mental Health First Aid has been adapted for youth participants (i.e., those under age 18), using age-appropriate examples and format. The program has been translated into Vietnamese for use in Vietnamese communities in Australia.
Adverse Effects No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories Universal
Learn More – Click on each category bar below or the buttons at the right to expand or collapse the sections.

If you or your child needs help for depression or another illness, then go to a reputable medical provider. There is nothing wrong with taking the steps necessary to get well.


GAO report: Children’s mental health services are lacking https://drwilda.com/2013/01/12/gao-report-childrens-mental-health-services-are-lacking/

Schools have to deal with depressed and troubled children https://drwilda.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

University of Cambridge study: Saliva test may detect depression in kids https://drwilda.com/2014/02/23/university-of-cambridge-study-saliva-test-may-detect-depression-in-kids/

Study: Some of the effects of adverse stress do not go away https://drwilda.com/2012/11/09/study-some-of-the-effects-of-adverse-stress-do-not-go-away/

American Psychological Association: Kids too stressed out to be healthy https://drwilda.com/2014/02/12/american-psychological-association-kids-too-stressed-out-to-be-healthy/

Where information leads to Hope. © Dr. Wilda.com

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