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.

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 recent posts about news coverage of mental illness (e.g., “Danny Watt’s Story” and “Jani Illustrates Troubles“) has had me thinking about how popular media portray these problems. Over on Psych Central, Margarita Tartakovsky has an article entitled “Media’s Damaging Depictions of Mental Illness” that I recommend to readers of EBD Blog. In addition to discussing myths that are too commonly perpetuated by media such as television and film, she recommends ways to help distinguish between accurate and inaccurate portrayals of mental illness.

Link to Ms. Tartakovsky’s article.

The parents of Daniel Watt, a youth who had multiple problems, told the story of their son’s life and suicide. Tom Jackman of the Washington Post reported the story of Danny and his parents, helping explain some of the problems of addressing the needs of children with multiple diagnoses—co-morbid schizoaffective disorder and substance abuse, in Danny’s case.

Danny Watt once leapt from a moving train. He hurtled through the windshield of a rolling car. Got pummeled by drug dealers. Overdosed. Swallowed rat poison. Tried to hang himself.

In his tumultuous 21 years, Danny Watt danced with death in the most amazing, horrible ways. In the end, two college students spotted him facedown in the cold, murky water of the C&O Canal one afternoon in April 2008. The medical examiner said Danny had drowned.

Continue reading ‘Danny Watt’s story’

In “‘Benefits Go Beyond Sports’: Autistic Children Find an Outlet In Swimming,” Bill Oram of the Washington Post reports about the social benefits of participating in sports.

Justin Etherton, 13, a swimmer in the Montgomery County Swim League, is autistic. Swimming provides him a social outlet, and has been “the best thing that’s ever happened to him and to us,” his mother said.

Read Mr. Oram’s article. Check Toni L. Sandys’ photos.

Children and youths with ADHD and their families ought to know about systems of care. Systems of care are networks of services that are coordinated across different agencies and groups within the community. A system of care focuses on the needs of individuals and should be designed so that it takes advantage of that person’s strengths (i.e., is “strengths based”) and unique characteristics (e.g., ethnic background and native language).

Systems of care have been studied extensively in the disciplines focused on Emotional and Behavioral Disorders. They are not just for kids “lost to the streets.” The coordination of services can be beneficial for individuals with ADHD, too.

Learn more about ADHD and systems of care from the SAMHSA, the US Substance Abuse and Mental Health Services Administration. Download a PDF.

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’

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.

Wednesday Social Programs that Work, an organization dedicated to , recognized the Multidimensional Treatment Foster Care (MFTC) program as having strong evidence of its benefits for youths who have many strongly delinquent behavior problems. The developers of the MTFC program include Patricia Chamberlain, Ph.D., John Reid, Ph.D., Philip A. Fisher, Ph.D., and Gerard Bouwman; they are closely associated with the Oregon Social Learning Center (a long-time resident of EBD Blog’s Web resources list). Over the last ~10 years the researchers have conduct multiple randomized clinical trials testing the intervention, and they have consistently found positive outcomes for the youths and their families.

Multidimensional Treatment Foster Care (A foster care intervention for severely delinquent youths)

Randomized controlled trials show sizable reductions in youths’ criminal activity.

Description of the intervention: The Multidimensional Treatment Foster Care program provides severely delinquent youths with foster care in families trained in behavior management, and emphasizes preventing contact with delinquent peers. Typical community treatment for such youth, by contrast, often involves referral to a group care facility with other troubled youth.

As an example of the program’s behavior management techniques, foster parents track and regulate the youths’ behaviors using a point system, with youths receiving points for positive behaviors (e.g., completing chores, attending school regularly), and losing points for negative behaviors (e.g., not completing homework, or not listening to an adult). As youths accumulate more points, they are afforded more freedom from adult supervision.

The program provides the youths and their families with individual and family therapy during their participation in the program, and program case managers closely supervise the youths/families through daily phone calls and weekly foster parent group meetings. The average length of stay in the program is 6-7 months. The average cost is about $3,600 per month (2008 dollars), which is 30 to 50 percent lower than the cost of residential group care (the typical alternative treatment, in which youths are placed in group homes with other offenders, and often provided family therapy.)

Link for the SPTW Web page about the evidence for MFTC (source for the quoted material) and to the Web site that supports adoption of the program.

The University of Pennsylvania Collaborative on Community Integration has published its latest newsletter. To view this newsletter in fully formated form, click here. You can also find this issue and previous ones in the newsletter archive on the UPenn Collaborative Web site.

Continue reading ‘UPenn newsletter June 08′