2018 texas focus: on the move! mental health education ... · 2018 texas focus – mental health...

Texas School for the Blind & Visually Impaired Outreach Programs www.tsbvi.edu | 512-454-8631 | 1100 W. 45th St.| Austin, TX 78756

2018 Texas Focus: On the Move! Mental Health Education Program for School Personnel: Parents and Teachers as Allies Saturday, March 3, 2018 9:45-11:15 AM

Presented by

Karen Ranus, Director

National Alliance on Mental Illness (NAMI)

Austin, TX

[email protected]

Developed for

Texas School for the Blind & Visually Impaired

Outreach Programs

http://www.tsbvi.edu/

mailto:[email protected]

2018 Texas Focus – Mental Health Education Program for School Personnel – Ranus, K. Page 1

“Parents and Teachers as Allies”

Creating the Partnership

to Address Children’s Behavioral Health Challenges

Karen Ranus

Slide 2: Agenda • Early Warning Signs

• A Parent’s Perspective o How Families Are Affected

• A Student’s Perspective: o Growing Up with a Mental Health Condition

• Question and Answer

Slide 3: How many of you have been… • Overwhelmed by a child whose behavior seems of out control?

• Frustrated with parents who seem in denial?

• Concerned about a teen who is struggling, isolated or unhappy?

Figure 1 Graphic of a head with the "wheels turning" and ideas surrounding it.


Slide 4: Why does it matter? A student’s mental health effects:

• Ability to learn

• Attendance

• All relationships:

• peers, family, school, community

• Physical health

• Developmental milestones

• Long-term success

Slide 5: Facts About Mental Health and Youth • 13% (ages 8-15) and 20% (ages 13-18 ) of youth live with a mental health condition

• 50% of mental health conditions have signs and symptoms by age 14

• Average delay between onset of symptoms and treatment is 8-10 years

Figure 2 Smiling children lay on the ground in a circle touching heads

Slide 6: Risks of Not Intervening • 50% of students 14+ with mental illness drop out of high school

• Twice as likely to use drugs or alcohol

• 70% of youth in justice system have mental health issues

• Suicide is the 2nd leading cause of death, ages 15-24

Figure 3 A teen in handcuffs


Slide 7: The Good News • Childhood = most observed years of life

• Best observers: parents and teachers

• Early identification & care = better outcomes

Figure 4 Mother, father, and son meet with a teacher.

Slide 8: Your Role Is Important! • You are a skilled and expert observer

• Information about behaviors at school can help identify mental health issues earlier

• Doctors can more effectively treat with full array of facts from both home and school

• Parents and teachers focus on shared commitment: helping the child

Slide 9: Opportunities for Observation

Figure 5 Graphic showing opportunities for observation: Classroom, Extracurricular Activities, With Peers, Lunchroom, Playground, Library

Classroom

Extracurricular

With Peers

Lunchroom

Playground

Library


Slide 10: Teachers ask How do you know when it’s typical behavior or something more serious?

Slide 11: Keys to Early Recognition A child with mental illness has thoughts, moods, and/or behaviors that are constant, unrelieved and challenging.

Severe: impacts daily life

Persistent: ongoing

Slide12: Early Warning Signs You Might Observe Slide 13: Have You Observed Signs of Attention-Deficit/Hyperactivity Disorder (ADHD)? Inattentive Behaviors

• Doesn't pay attention to details

• Highly distractible

• Doesn’t listen Hyperactive/Impulsive Behaviors

• Fidgets, squirms, can’t stay seated

• Bothers others

• Disruptive

SP Figure 6 Graphic SP for Severe and Persistent


Slide 14: Observations from Home • Something “off” from the beginning

• Never slows down

• Exhausting & demanding

• “Always in trouble”

Figure 7 A young boy screaming

Slide 15: Impact in Adolescence Hyperactivity frequently diminishes, but:

• 50% of youth experience o poor performance, difficulty with relationships, o low self-esteem

• Dropout rate 12x higher than peers without ADHD

• 50% experience conduct disorder

• Increased risk of alcohol and drug use

Slide 16: Have You Observed Signs of Anxiety Disorders? • School avoidance, excessive absences

• Excessive worry about school, how they look

• Concerned about social standing among peers

• Dread they will do things wrong; perfectionist


Slide 17: Observations from Home • Refuses to sleep alone or in the dark

• Avoids peer events or sleepovers

• Claims sickness to avoid school

• Meltdowns when parents try to force activities

Figure 8 A little girl looks unhappy and leans her head on her hand.

Slide 18: Observations in Adolescence • Fear of specific social/performance situations

• Avoidance of situations; intense distress

• Inability to initiate or maintain conversations

• Sweating, trembling, nausea, dizziness

Slide 19: Have You Observed Signs of Depression? • Mad, sullen, angry

• Anxious

• Withdraws, isolates

• Unable to have fun

• Talking/writing/drawing about death or suicide

Slide 20: Observations in Adolescence • Sad, hopeless, crying, lethargic, sleepy

• Withdraws, isolates

• Drugs, alcohol, self-harm

• Stops caring about appearance


Slide 21: Observations from Home • Well adjusted child becomes a totally different kid

• Wears good face in public, displays worst symptoms at home o Unpleasant & hard to like o Irritable & aggressive o Seems to hate self and everything else o Nothing pleases them

Figure 9 Teenage girl slumps against a wall as she sits on the floor with her knees up and head on her hand.

Slide 22: Have You Observed Signs of Bipolar Disorder? • Over-reactive: irritable, oppositional, negative behavior

• Multiple mood shifts

• Hyperactivity/decreased need for sleep

• Hypersexual comments or behaviors

Slide 23: Observations from Home • Irregular sleep cycles night terrors, nightmares

• Violent rages or tantrums

• Severe separation anxiety/refusing to go to school

• Extreme physical sensitivity: clothes, temperature, environment

Figure 10 A desperate mom watches and her daughter has a meltdown.


Slide 24: Observations in Adolescence Manic Phase

• Rapid and insistent speech, “pressured speech”

• “All or nothing” mentality

• Aggressive, touchy, irritable, “in your face” manner

• Hypersexuality

Slide 25: Observations in Adolescence Depressive Phase

• Moodiness/ Irritability

• Tremendous fatigue, lethargy

• Self-isolation

• Suicidal thoughts and attempts

Figure 11 An adult tries to console a young girl.

Slide 26: Observations from Home • Sleeping issues: too much or not enough

• Grandiosity

• Reckless, thrill-seeking behavior: o drug & alcohol use o sneaking out at night

• Suicidal thoughts and attempts


Slide 27: Have You Observed Disruptive Mood Dysregulation Disorder (DMDD)? Core feature of DMDD is chronic, severe persistent irritability with two prominent symptoms.

• Severe temper outbursts out of proportion

• Outbursts inconsistent with development o On average 3-4 times/week

• Between outbursts: irritable/angry mood o most of day, o nearly every day o noticed at home and school

Slide 28: Observations from Home • Difficulty getting along

• Low frustration tolerance

• Family activities very challenging

• Family walks on eggshells to prevent tantrums

Figure 12 A young boy screams.

Slide 29: Obsessive Compulsive Disorder (OCD) • Average age of onset: 10 years old

• Symptoms similar at any age

• Co-occurring disorders o 20-40% of adolescents with eating disorders have OCD o Adolescents with OCD are at high risk for other severe anxiety disorders &

depression o 30% of individuals with OCD also have motor tic disorders.


Slide 30: Have you observed signs of OCD? Obsessions

• Fear of contamination/germs

• Fixation on numbers or words; lucky/unlucky

• Need for exactness Compulsions

• Rituals (hand washing, grooming, cleaning)

• Repetitive counting, touching, writing, erasing

• Continuous checking, collecting, questioning

Figure 13 A child washing her hands

Slide 31: Observations from Home • Parents “must cooperate with compulsive rituals” to placate child and avoid

confrontations

• Often isolates due to exhaustion from hiding behaviors

• Rituals swamp home life; more subdued in public

Figure 14 A teenage girl with her head in her hands.


Slide 32: Have You Observed Signs of Oppositional Defiant Disorder (ODD) & Conduct Disorder (CD)?

• Negative and hostile

• Persistently arguing with adults

• Intensely rigid and inflexible

• Aggressive and cruel, bullying

• Destructiveness

• Lack of remorse

Slide 33: Observations from Home • Families often report feelings of:

o Anger with lack of cooperation o Shock & embarrassment of behaviors o Worry about danger to self & others o Being overwhelmed by criticism

• Can’t take their child anywhere

Figure 15 A little girl screams in a little boys ears as he covers them and closes his eyes.

Slide 34: Observations in Adolescence

• “Cocky” or “Tough” demeanor: low self-esteem

• Drug and alcohol use

• Causing harm to others: o physical abuse o intimidation

• Frequent encounters with criminal justice


Slide 35: About Childhood Schizophrenia • Childhood form is rare: 1 in 40,000 under age 15

• Expression can be severe causing pronounced disruption of brain development

• Defining sign is slow, gradual emergence of psychotic symptoms

• Often preceded by developmental disturbances

Slide 36: Have You Observed Signs of Childhood Onset Schizophrenia? Rarely observed before age 5 and can be differentiated from autism by later onset

• Early pattern of inhibition, withdrawal and sensitivity

• Little or no eye contact or expression of body language

• Inability or disinterest in making friends

• Confusion about what is real; hallucinations, delusions

Slide 37: Observations from Home • Hears voices saying things about him/her

• Stares at things not there

• Has no interest in friendships

• Prefers isolation

Figure 16 A little boy looks out at the rain thru a window

Slide 38: Observations in Adolescence • Bizarre actions and incoherent speech

• Delusions (false beliefs)

• Hallucinations (seeing/hearings things not there)

• Flat, blunted emotional responses

• Brief laconic replies and decrease in fluency of speech


Slide 39: Observations from Home • High functioning teen starts “falling apart”

• Becomes unrecognizable to family or friends

• Unpredictable, bizarre behaviors

• Shy, reclusive child becomes more so

Slide 40: 5 Minute Stretch Break Slide 41: A Parent’s Perspective How Families are Affected

Slide 42: The Predictable Stages of Emotional Reactions I. Dealing with Catastrophic Events

• Crisis/Shock

• Denial

• Hoping-against-hope Needs: Support, comfort, empathy, help finding resources early intervention, prognosis, NAMI

II. Learning to Cope

• Anger/Guilt/Resentment

• Recognition

• Grief Needs: Vent feelings, keep hope, education, self-care, networking, skill training, letting go, cooperation from the system, NAMI

III. Moving into Advocacy: Charge!

• Understanding

• Acceptance

• Advocacy/Action Needs: Activism, restoring balance in life, responsiveness from system, NAMI

Slide 43: A Student’s Perspective Growing Up with a Mental Health Condition


Slide 44: Sharing Observations with Parents • Follow school protocol

• Understand and use “Predictable Stages of Emotional Reactions”

• Remove feelings of blame

• Communicate empathy & compassion

Figure 17 Teacher talks to the parents and the child.

Slide 45: Empathy is the Doorway to Partnership video

Slide 46: Ten Key Messages • Mental health disorders are medical illnesses.

• Mental illness is not the family or child’s fault nor a sign of parental failure.

• Anger, grief and denial are predictable, common and normal responses.

• Bad behavior may not just be bad behavior.

• There are specific, observable early warning signs of mental illness.

Figure 18 Adult and child hands hold a small budding plant.


Slide 47: Ten Key Messages • In partnership with the family, there are ways to promote student success in the

classroom.

• A psychiatric evaluation and treatment is often necessary in order to achieve recovery.

• Family-school collaboration are essential to early identification & intervention.

• Recovery is possible. There is hope.

• Reducing stigma helps reduce the gap between onset and treatment.

Figure 19 Smiling family members pose for photo

Slide 48: NAMI Austin is a Community Resource

Figure 20 People in a support group

Figure 21 NAMI Austin logo

• We offer resources for parents o Support groups o Classes o Lending library o Information

• Education and accurate information are key to understanding

• Peer support diminishes isolation


Slide 49: NAMI Austin Child & Youth Programs www.namiaustin.org – Education /Parents and Teachers as Allies

Figure 22 Screenshot of NAMI Austin website

Slide 50: NAMI Austin Child & Youth Program

Figure 23 NAMI Basics logo

Free 6-week education program for parents and caregivers of children and teens who are experiencing signs of behavioral or mental health concerns or who have a diagnosis.

Figure 24 NAMI Ending the Silence logo

Free 50 minute presentation about mental health designed for middle and high school students.

Slide 51: NAMI Austin 512-420-9810

[email protected]

www.namiaustin.org

http://www.namiaustin.org/

http://www.namiaustin.org/


Texas School for the Blind & Visually Impaired

Outreach Programs

Figure 25 TSBVI logo

Figure 26 IDEAs that Work logo and US Dept. of Education OSEP disclaimer

2018 texas focus: on the move! mental health education ... · 2018 texas focus – mental health...

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