EBD Blog

Right here in my home commonwealth of Virginia last week, Mira Signe, Vicki Hardy-Murrell, John Morgan, and Margaret Nimmo Crowe explained why it is important that government and private organizations attend to and address issues in children’s mental health. By explaining that Virginia has inadequate services and that one in every five children or youths experience mental health problems at some time during their lives, they made the point that that there is a tremendous need for public focus on these issues. This was the kick-off event for the Campaign for Children’s Mental Health.

The Campaign for Children’s Mental Health is a 3-year sustained effort to make mental health services more available and accessible to Virginia children in need. It will strongly endorse Governor-elect McDonnell’s call for system improvements; urge the General Assembly and state and local government to work collaboratively with the administration to address system deficiencies; and conduct a high-profile three-year advocacy and education drive to build public and political support for improved mental health services for children.

Only about one in 20 of Virginia’s children have access to the key services listed in the accompanying box. So, four out of five children who need these services do not have access to them.

No, Virginia, this is not an acceptable way to treat our children. Let’s do better.

• Down load the press release (source of the excerpt quoted here).
• Read coverage in these newspapers:
  • Lynchburg News and Advance—Coalition pushes mental-health care for children
  • Washington Examiner&mdash:Advocates start bid to expand children’s mental health services under bleak budget;
  • Richmond Times Dispatch— Coalition advocate mental-health care for children
  • Washington Post (blog)—New coalition has AG’s support for mental health reforms
• Visit (and support) the Web site of the Campaign for Children’s Mental Health.
• Download pdfs of “Survey of Community Services Board Child and Adolescent Services” and “Review of Community Services Board Child and Adolescent Services“; these are report by James W. Stewart, Inspector General for Virginia’s Mental Health, Mental Retardation & Substance Abuse Services (now called Behavioral Health and Development Services). The list of key services comes from these reports;
• Visit the < href="http://www.facebook.com/pages/The-Campaign-for-Childrens-Mental-Health/183467424796?v=wall" target="_blank">Facebook page;
• Listen to a brief (3+ min) interview with Ms. Crowe from WMRA: Pushing for Children’s Mental Health Reform.

Writing under the headline “Pros and cons of screening teens for depression,” Brendan Borrell examined some of the issues that sometimes roar around surveying youths to identify those who are depressed or at risk for depression. Mr. Borrell’s article, which is one in a series of articles about depression appearing in the Los Angeles Times, addressed concerns such as parental reservations about testing of their children without permission, false positive identification of a high percentage of students, and the absence of adequate treatment for many who need help.

Mr. Borrell established the importance of the issue in his lead:

By the time a teenager graduates high school, about one out of nine of his or her peers has attempted suicide. Suicide is the third leading cause of death among young people, behind car accidents and homicide, and 10% to 12% of teens ponder suicide every day.

Continue reading ‘Screening teens’

Tom Jackman’s article about Danny Watt to which I referred a few days ago (see this post) is generating a lot of discussion on the Post’s Web site. The comments on Mr. Jackman’s story are informative. For example, at least a half dozen mention having a family member with mental illness. Link to the comments.

The Substance Abuse and Mental Health Services Administration, which is a part of the US Department of Health and Human Services, maintains a Web site where users can search for and learn more about methods for preventing or treating some Emotional and Behavioral Disorders. It’s called the “National Registry of Evidence-based Programs and Practices” (NREPP) and, for those who are concerned about employing or recommending evidence-based practices, it’s worth reviewing.

The National Registry of Evidence-based Programs and Practices (NREPP) is a searchable online registry of mental health and substance abuse interventions that have been reviewed and rated by independent reviewers.

The purpose of this registry is to assist the public in identifying approaches to preventing and treating mental and/or substance use disorders that have been scientifically tested and that can be readily disseminated to the field. NREPP is one way that SAMHSA is working to improve access to information on tested interventions and thereby reduce the lag time between the creation of scientific knowledge and its practical application in the field.

NREPP is a voluntary, self-nominating system in which intervention developers elect to participate. There will always be some interventions that are not submitted to NREPP, and not all that are submitted are reviewed. In addition, new intervention summaries are continually being added. The registry is expected to grow to a large number of interventions over the coming months and years. Please check back regularly to access the latest updates.

Although NREPP originally focused on substance abuse, its coverage is broader now. Look for resources about, for examples, Across Ages; Aggressors, Victims, and Bystanders: Thinking and Acting To Prevent Violence; Al’s Pals: Kids Making Healthy Choices; All Stars; Caring School Community; CASASTART; Children’s Summer Treatment Program (STP); Coping Cat; Creating Lasting Family Connections (CLFC)/Creating Lasting Connections (CLC); Early Risers “Skills for Success”; Families and Schools Together (FAST); Guiding Good Choices; Incredible Years; Keep A Clear Mind (KACM); Keepin’ it REAL; Lions Quest Skills for Adolescence; Multisystemic Therapy (MST) for Juvenile Offenders; Multisystemic Therapy With Psychiatric Supports (MST-Psychiatric); Positive Action; Primary Project; Project Northland; Project Towards No Tobacco Use; Project Venture; Promoting Alternative THinking Strategies (PATHS), PATHS Preschool; Protecting You/Protecting Me; Right Decisions, Right Now: Be Tobacco Free; SAFEChildren; Second Step; SMARTteam; Storytelling for Empowerment; Strengthening Families Program; Strengthening Families Program: For Parents and Youth 10-14; Success in Stages: Build Respect, Stop Bullying; Too Good for Drugs; and Too Good for Violence;

Summer in the US finds children and youths out of school and, perhaps, less vulnerable to some of the problems that are associated with the social and academic demands that are part of schooling. As a result, perhaps fewer of the familiar problems illustrated in this poster are apparent during summer.

If summer seems like a relief from such problems, though, that could be an important indicator that those very problems need to be addressed. A few weeks away from school probably will not cure them. Those same difficulties may still be occurring, just less obviously, and they are likely to recur soon.

Individuals or the families of children who experience the kinds of problems noted in the poster should consult the resources available from the US government’s Substance Abuse and Mental Health Services Administration. One will not find easy cures there, but by carefully perusing the resources available one can learn what signs to monitor and where to go to get help.

The image is hot. Click it to get to a good starting place.

Even though many schools in the US have closed for the summer or are about to do so, I want to remind folks that this is not a good time to take a break from considering the mental health needs of children and youth. Although they are likely to wax and wane over time, mental health problems don’t take many vacations.

Learn more about US resources for individual children and youths who have emotional and behavioral disorders by surfing the rich resources assembled by the Substance Abuse and Mental Health Services Administration (SAMSHA) of the US Department of Health and Human Services. Although some of the materials may be a tad out of date (e.g., prevalence figures have been updated for some disorders such as Autism), there are still plenty of valuable materials available from SAMHSA.

Go there! Compare what you see learn there with what’s available at other trustworthy sites. Learn what to do and from whom help is available.

Adolescents who are at risk for later episodes of major depressive disorders differ from their peers who are not at risk on multiple measures of rapid eye movement (REM) and hypothalamic-pituitary-adrenal (HPA) activity during sleep, according to a study by Uma Rao and colleagues that appeared this fall in Neuropsychopharmacology . Early depressive episodes that occur during adolescence are strongly associated with other later problems in other areas such as interpersonal relationships, pregnancy, educational attainment, employment, and suicidal behavior; finding predictors of later problems is important for primary and secondary prevention.

Rao and colleagues compared youths at risk for major depressive disorder with peers using electroencephalographic (EEG) and HPA measures. They then followed the youths for 5 years and correlated their EEG and HPA measures with the chances of later episodes of depression. Here’s the abstract:
Continue reading ‘Sleep predictors of later depression’

The US National Academies Press announced the publication of a book entitled Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities that discusses prevention of problems during childhood, adolescence, and young adulthood. Edited by Mary Ellen O’Connell, Thomas Boat, and Kenneth E. Warner, the book represents the work of the Board on Children, Youth and Families. It is available in hardback, as a PDF, or online (the last option is free).

Mental health and substance use disorders among children, youth, and young adults are major threats to the health and well-being of younger populations which often carryover into adulthood. The costs of treatment for mental health and addictive disorders, which create an enormous burden on the affected individuals, their families, and society, have stimulated increasing interest in prevention practices that can impede the onset or reduce the severity of the disorders.

Prevention practices have emerged in a variety of settings, including programs for selected at-risk populations (such as children and youth in the child welfare system), school-based interventions, interventions in primary care settings, and community services designed to address a broad array of mental health needs and populations.

Preventing Mental, Emotional, and Behavioral Disorders Among Young People updates a 1994 Institute of Medicine book, Reducing Risks for Mental Disorders, focusing special attention on the research base and program experience with younger populations that have emerged since that time.

Researchers, such as those involved in prevention science, mental health, education, substance abuse, juvenile justice, health, child and youth development, as well as policy makers involved in state and local mental health, substance abuse, welfare, education, and justice will depend on this updated information on the status of research and suggested directions for the field of mental health and prevention of disorders.

Link to the press release or the ordering page.

MHA Turns 100

Mental Health America, a large and active US group that advocates for people with emotional and behavioral disorders, will focus its centennial celebration around the theme, “’Celebrating the Legacy; Forging the Future’ 1909 – 2009.”

Mental Health America is celebrating 100 years of advocacy, public education, and support for Americans with mental health conditions. Over the past century, we have transformed our nation’s approach to mental health by working to create a just, humane and healthy society in which all people are accorded respect, dignity and the opportunity to achieve their full potential free from stigma and prejudice.

These are the folks who famously recast as a bell the shackles that had been used to restrain people with mental illness. That bell now symbolize improved—but still not perfected—understanding and treatment for people with mental illness. In addition to offering many other valuable services (policy advocacy, hotlines, etc.), MHA educates the public about mental health and mental illness. It provides fact sheets about (to list just a few) anxiety disorders, depression, bipolar disorder, eating disorders, schizophrenia, and suicide.

Go learn more.

Mental Health America
2000 N. Beauregard Street, 6th Floor Alexandria, VA 22311
Phone (703) 684-7722
Toll free (800) 969-6642
TTY 800/433-5959
Fax (703) 684-5968

For schools and local education agencies that are doing a good job of working collaboratively with local mental health agencies or aspire to do so, here is a fine funding opportunity. Wrap-around systems of care have well-known benefits for children and youths with Emotional and Behavioral Disorders.

Grants for the Integration of Schools and Mental Health Systems (Federal Register: January 12, 2009 [CFDA# 84.215M])

Purpose of Program: Grants for the Integration of Schools and Mental Health Systems will provide funds to increase student access to high-quality mental health care by developing innovative approaches that link school systems with the local mental health system.

==> Applications Available: January 12, 2009.
==> Deadline for Transmittal of Applications: February 23, 2009.

Eligible Applicants: State educational agencies (SEAs), local educational agencies (LEAs), including charter schools that are considered LEAs under State law, and Indian tribes.

==> Estimated Range of Awards: $150,000-$400,000.
==> Estimated Average Size of Awards: $325,000.
==> Estimated Number of Awards: 15.

Link to the request for proposals. For more about wrap-around services, see the following sources.

• Burchard, J. D. (2000). How wraparound can help overcome three common barriers to successful transition services. Reaching Today’s Youth, 2(4), 49-51.
• Duckworth, S., Smith-Rex, S., Okey, S., Brookshire, M., Rawlinson, D., Rawlinson, R., Castillo, S., & Little, J. (2001). Wraparound services for young schoolchildren with emotional and behavioral disorders. Teaching Exceptional Children, 26, 54-60.
• Eber, L., Nelson, C. M., & Miles, P. (1997). School-based wraparound for students with emotional and behavioral challenges. Exceptional Children, 63, 539-555.
• Eber, L. (1996). Restructuring schools through wraparound approach: The LADSE Experience. In R. J. Illback & C. M. Nelson (Eds.), School-based services for students with emotional and behavioral disorders (pp. 139-154). Binghamton, NY: Haworth.
• Eber, L., & Nelson, C. M. (1997). Integrating services for students with emotional and behavioral needs through school-based wraparound planning. American Journal of Orthopsychiatry, 67, 385-395.
• Epstein, M. H., Kutash, K., & Duchnowski, A. (Eds.), Outcomes for children and youth with behavioral and emotional disorders and their families. Austin, TX: Pro Ed.
• Malysiak, R. (1997). Exploring theory and paradigm base for wraparound. Journal of Child and Family Studies, 6, 399-408.
• Malloy, J., Cheney, D., & Cormier, G. (1998). Interagency collaboration and the transition to adulthood for students with emotional or behavioral disabilities. Education and Treatment of Children, 31, 303-320.
• VanDenBerg, J. E., & Grealish, E. M. (1997). Individualized services and supports through the wraparound process: Philosophy and procedures. Journal of Child and Family Studies, 5, 7-21.
• Walker, J. S., & Schutte, K. (2003). Individualized Service/Support Planning and Wraparound: Research bibliography. Portland, OR: Portland State University, Research and Training Center on Family Support and Children’s Mental Health.

Just a note to readers that a new little paper back (about 160 pages) that I authored with Rick Brigham (now of George Mason University) will be available before long. It might be used as a text in teacher education (special or general education) or as a resource by parents or anyone who works with children with emotional or behavioral problems. The reference is:
Kauffman, J. M., & Brigham, F.J. (in press). Working with troubled children . Verona, WI: Attainment.

It’s now available in an Advance Reader’s Edition (bound but uncorrected proofs), and we expect it’ll be available in final form in early spring. You may find Attainment Company at http://www.attainmentcompany.com/xcart/home.php . Here’s a Table of Contents:

Chapter 1 Recognizing Early Signs of Behavior Problems: An Overview of Early Intervention and Prevention
Cases in Point
Nathan
Pauline
Larry
Typical Responses to Early Signs of Behavior Problems
Understanding Normal Development and Differences
The Concept of Normal
Differences That Are Not Normal
Definitions of Disorders for Special Education
General Guidelines for Judging Signs of Behavior Problems
Signs of Problems in Infancy
Signs of Problems in Toddlerhood
Signs of Problems in the Early School Years
Signs of Problems in Middle Childhood
Signs of Problems in Adolescence
The Need for Early, Accurate Labels
The Dimensions of Early Intervention and Prevention
Summary
Chapter 2 Understanding Causes
Cases in Point
Mark
Tommy
Increasing and Decreasing Risk
Major Causal Factors
Biological Factors
Genes
Temperament
Brain Malfunction
Other Health-Related Issues
Family Factors
Family Definition and Structure, Including Substitute Parents
Family Interactions
School Factors
Insensitivity to Individuality
Inappropriate Expectations
Inconsistent Management
Instruction in Nonfunctional or Irrelevant Skills Ineffective Instruction in Critical Skills
Undesirable Models
Destructive Contingencies
Social and Cultural Factors
Mass Media: Television, Movies, and Music
Peers
Neighborhood and Urbanization
Ethnicity, Social Class, and Poverty
Summary
Chapter 3 The Dilemma of Early Identification: To Identify or Not to Identify
Cases in Point
Esther P. Rothman
Edith
True and False Identification: Trying to Get Labels Right
At-Risk and Response to Intervention: What Do They Mean?
The “At-Risk” Label
Meanings of Response to Intervention
What’s the Problem? A Caution
Spoiled Identity: Dealing with Pride and Prejudice
Expectations: Setting Them Not Too High and Not Too Low
Social Rejection and Isolation: Facilitating Peer Affiliation
Going From Bad to Worse: Facing The Ultimate Horror
Summary
Chapter 4 Why Responding to Trouble Immediately Is Important
Cases in Point
Dean
Larissa
Behavior Change Is Easier
Chances for Better Life Outcomes Are Enhanced
Academic Progress Is More Likely
Social Acceptance Among Helpful Peers Is Possible
Summary
Chapter 5 General Ideas for Making Things Better
Cases in Point
Derrick
Joshua
A Class That Is Separate and Better
The Centrality of Effective Instruction
The Help of School-Wide Discipline
The Usefulness of Structure and Routine
A Focus on the Positive in Behavior and Consequences
The Importance of Clear Communication
Why Consistent Follow-Through Is Essential
Understanding Cycles of Behavior and Implications for Prevention
Seeing the Cycle or Pattern
Responding Effectively to the Stage or Level
Anticipating the Next Level or Stage
The Use and Abuse of Medication
Summary
Chapter 6 Using Incentives Intelligently
Cases in Point
Rewards Versus Bribes
Andy
Try the Simplest Things First
Telling
Showing Examples
What to Use as Rewards
How to Use Rewards
Getting Started and Moving On
Being As Good As Your Word: Follow-Through
Thinking About Our Fears and Struggles
Summary
Chapter 7 Using Deterrents Deftly
Cases in Point
A Boy with Behavior Problems
Eddie
Commentaries on Punishment
The Necessity of Punishment
Punishment As Part of Teaching
Self-Perception
Keeping Punishment Nonviolent and Matter-of-Fact
Uses and Abuses of Time Out
Exceptions and Evidence Beyond Reasonable Doubt
Making Punishment Consistent, Informative, and Instructive
Making Punishment Stick: Follow-Through
Summary
Chapter 8 Finding Help
Parents as Sources of Support
Working with Consultants
Finding Help in the Literature
Summary

Here’s a special opportunity to learn about how to address challenging behavior problems. This is a star-studded line-up.—JohnL

International Council for Children with Behavioral Disorders

Professional Development

2 0 0 9 International Forum

Achieving Academic and Social Competence: Improving Educational Outcomes for Challenging Students

Tuscany Suites and Casino
Las Vegas, Nevada

January 30-31, 2009

Continue reading ‘CCBD forum 2009′