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.

Hill Walker and colleagues reported that the First Step to Success program benefitted young children at risk for developing emotional or behavioral disorders. In a longitudinal study of the three-year program conducted in Albuquerque (NM, US), the researchers found substantial reductions in disruptive behavior and improvements in social functioning.

In a press release, Professor Walker said, “Albuquerque was the first opportunity we had to mount a large-scale study of the program using a randomized control group, the gold standard for research. First Step has been implemented widely, but not [studied] in this way.”
Continue reading ‘First Step takes off’

“Hold Me Tight, Let Me Go,” a movie about a UK school for children with Emotional and Behavioral Disorders, will air on US television 28 July 2009 on P.O.V. The film, made by Kim Longinotto (pictured at right), features the children and staff at Mulberry Bush School in the Oxfordshire village of Standlake. P.O.V. (Point of View) provides “documentaries with a point of view.”

Variety describes it as a film “mixing ferocity with tenderness, delicacy with tenacity”–exactly like the unusual school it explores. In Hold Me Tight, Let Me Go, one of Britain’s leading documentary filmmakers takes a verité look at Oxford’s Mulberry Bush School for emotionally disturbed children. Mulberry’s heroically forbearing staff greets extreme, sometimes violent behavior with only consolation and gentle restraint. Kim Longinotto’s unblinking camera captures an arduous process and a nearly unhinged environment, but it also records the daily dramas of troubled kids trying to survive and the moments of hope they achieve with Mulberry’s clear-eyed staff.

Watch on YouTube

Link to the US PBS site, where one can learn when the entire film will be available in different areas. Visit the Mulberry Bush organization’s Web site. See the UK’s Office for Standards in Education, Children’s Services and Skills (Ofsted) listing for the Mulberry Bush School. Link to an extended piece, “Inside the home for angry infants: It costs £123,000 a year to send a child to this special school — because nobody else will have them,” by Caroline Scott in the Times Online (11 May 2009). Learn about other P.O.V. shows.

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.

Reporting on US National Public Radio’s Morning Edition, Joanne Silberner presented a story about police officers handling incidents in which they encounter people with emotional and behavior disorders who are behaving in ways that appear threatening to the officers. Although her story uses adult cases for illustrations, this topic should also be of interest for youths who have EBD and for the families of children with EBD.

Here’s an excerpt from Ms. Silberner’s report.

It’s a situation no one wants to see: An armed police officer is called because someone is in the throes of a psychotic episode. “How the officer handles that situation can have a significant impact,” says Russell Laine, head of the International Association of Chiefs of Police.
Continue reading ‘Officer training for handling incidents’

Over on Behavior Mod Info readers can find several entries about the hearings regarding US schools’ use of seclusion and restraint. The hearings were conducted by the US House of Representatives’ Committee on Education and Labor.

(Apologies for the cross-posting to those who read Teach Effectively.)

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

Over on FAQAutism, Cathy Knoll has a pair of posts advising a student teacher about handling outburst by a student with Autism. The student teacher described the situation in this way:

The student teacher wrote that she is in an elementary classroom this semester, and is concerned about a youngster in the class. The student teacher reported the details of an episode that involved changing the regular classroom routine. She said, “One day I let the class vote on our reading activity. Their choices were (1) I would start a new book for our regularly scheduled ‘Read Aloud’ time, or (2) the students would read their new Scholastic News magazine independently at their desks. The class voted to read at their desk and finish a writing project for our bulletin board from earlier in the day. The girl with autism had voted for me to read aloud like I normally do at that time of day. However, the majority won. She couldn’t handle it and started yelling. I asked her quietly and calmly if she would like me to show her the new book that I would start reading to the following day. She screamed at me, ‘No. Never in a million years will I look at that book. I never want to hear you read anything ever again!’ Then she ran across the room and hid in a corner and started rocking back and forth.”

Ms. Knoll characterized the situation in terms of inflexibility and anger management. After remarking that she would not have students vote on activities, she makes a couple of sensible suggestions: (a) “The most effective way to prevent emotional meltdowns for an inflexible student is to develop a regular, predictable classroom routine” and (b) “Jot down quick notes every time he has a tantrum: the time it starts and the time it stops.”

I was pleased to see this tip-toe toward an antecedent-behavior-consequence analysis. Too bad that the recommendations do not go all the way to a functional behavior analysis. There are plenty of good resources on how to affect such analyses. It would be helpful to guide teachers to these methods of ascertaining what environmental features are sustaining a students “tantrums.”

Link to the two posts (#1 and #2) on FAQAustim advising a student-teacher about addressing tantrums.

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.