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Behavioral Health Professional Breakout Track Slide Deck SCHOOL CLIMATE YOUTH MENTAL HEALTH A Whole-School Approach AMY HILL, SYSTEM DIRECTOR OF SCHOOL BASED SERVICES SHELLY FARNAN, SYSTEM DIRECTOR OF DIVERSITY AND INCLUSION WHAT IS SCHOOL CLIMATE? Generally, school climate represents the shared norms, beliefs, attitudes, experiences, and behaviors that shape the nature of interactions between and among students, teachers, and administrators- PBIS Technical Brief School climate refers to the quality and character of school life. School climate is based on patterns of students', parents' and school personnel's experience of school life and reflects norms, goals, values, interpersonal relationships, teaching and learning practices, and organizational structures. –National School Climate Center YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH 4 KEY COMPONENTS • 1. Safety • 2. Relationships • 3. Teaching and Learning • 4. External Environment • Positive School Climate = Academic Achievement and Positive Youth Development YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH SAFETY • Rules- Clear communication about harassment, bullying, physical violence and adult intervention • Sense that students feel physically safe • Sense that students feel emotionally safe YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH RELATIONSHIPS • Connection with adults, engagement, high expectations • Respect for student diversity • Relationship with peers, friendships, involvement YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH TEACHING AND LEARNING • Academic learning- individualized learning, varied ways to show achievement, academic challenge, constructive feedback, encouragement, dialog and questioning • Social learning- empathy, conflict resolution, decision making, responsibility, emotional regulation, social skills, self-relection YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH ENVIRONMENT • Opportunities to participate, extra curricular activities, school life, community involvement, family connections • Building readiness, cleanliness, access to resources/materials, adequate facilities YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH FOUR ELEMENTS OF FLOURISHING The Person Brain Model- Paul Baker YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH T H E E C O - RELATIONAL FUNNEL The Person Brain Model-Paul Baker YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH ASSESSING YOUR SCHOOL CLIMATE • Survey Questions (never, sometimes, often, always) • I like school • I feel successful at school • I feel my school has high standards for achievement • My school sets clear rules for behavior • Teachers treat me with respect YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH ASSESSING YOUR SCHOOL CLIMATE • Survey Questions (never, sometimes, often, always) • The behaviors in my class allow the teachers to teach • Students are frequently recognized for good behavior • School is a place at which I feel safe • I know an adult at school that I can talk with if I need help YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH ASSESSING YOUR SCHOOL CLIMATE Survey Questions for teachers I get along well with other teachers I feel supported as a teacher Teachers at my school have a high standard for success Teachers at my school recognize student success I feel safe at my school Teachers at my school work hard to ensure student success Students at my school show respect for others YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH 5 STEPS TO POSITIVE SCHOOL CLIMATE 1. Make relationships a priority • Students • Staff • Community 2. Provide a safe environment • Teachers can’t teach when they don’t feel safe. Kids can’t learn with they don’t feel safe 3. Communicate well and often • Students • Staff • Community YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH 5 STEPS TO POSITIVE SCHOOL CLIMATE 4. Check assumptions, observe, and question • Identify your own assumptions • Catch yourself making an assumption and make an observation instead • Ask questions and really listen to the response 5. Give everyone a voice • Evaluate and re-evaluate • Take action • Monitor success YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH RESOURCES • https://www.pbisapps.org/Resources/SWIS%20Publications/School%20Climate%20Survey%20Su ite%20Manual.pdf • https://safesupportivelearning.ed.gov/safe-and-healthy-students/school-climate • https://www.schoolclimate.org/ • https://www2.ed.gov/policy/elsec/leg/essa/essaguidetoschoolclimate041019.pdf YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH QUESTIONS? COMMENTS? THANK YOU YOUTH MENTAL HEALTH A Whole-School Approach NETWORKING & VENDOR BREAK YOUTH MENTAL HEALTH A Whole-School Approach Thank You SPONSO RS YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH BREAKOUT 2 1:45-2:45 YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH HELP! THIS CLASSROOM IS IN CHAOS Potential Diagnoses Brewing Under the Surface YOUTH MENTAL HEALTH ADAM ANDREASSEN, PSY.D A Whole-School CHIEF OPERATING OFFICER Approach BURRELL BEHAVIORAL HEALTH Objectives of Presentation • Summarize the most common diagnoses underlying disruptive classroom behaviors • Identify the obvious and subtle differences in these diagnoses including ADHD, PTSD, Disruptive Mood Dysregulation Disorder • Explore contributors and conceptual frameworks for understanding why these behaviors occur • Apply this information to broad strategies for preventing and managing disruptive classroom behaviors YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH May I have fries with that Ritalin? YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH Common Diagnoses Simplified Common Diagnoses Influencing Disruptive Behaviors • Attention-Deficit/Hyperactivity Disorder (ADHD) • Inattentive and/or Hyperactivity/Impulsivity • Aka “ADD” • Posttraumatic Stress Disorder (PTSD) • Strong reactions to reminders of previous traumatic experiences • Anything from avoidance/anxiety to anger outbursts and inattention • Bipolar Disorder • Mood Disorder including both energy increased moods (mania) and decreased energy moods (depression) • Historically overdiagnosed YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH Common Diagnoses Influencing Disruptive Behaviors • Oppositional Defiant Disorder • Generally oppositional behaviors, especially to limit setting • Considered relatively “mild” – anything BUT mild in the classroom • Conduct Disorder • Oppositional and/or indifference to normative expectations by authority figures • Includes conduct problems such as aggression, theft, deceitfulness, lawbreaking, etc. • Disruptive Mood Dysregulation Disorder (DMDD) • Intended as a REPLACEMENT for many Bipolar Disorders • Includes elements of ADHD, Depression, ODD, and Bipolar • General moodiness and reactivity with distress YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH Other Factors and Diagnoses • Autism Spectrum Disorders • Generally characterized by lack of awareness or interest in prosocial behaviors • Often, but not always, influenced by low IQ • Anxiety Disorders • Depressive/Mood Disorders • COMORBIDITY! • ADHD & PTSD • ADHD & Conduct Disorder • ADHD & Mood Disorders YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH ADHD 700% increase of Ritalin prescribed in the US since 1995 Diller, 1998 Total stimulant usage has doubled in the last decade Piper et al., 2016 YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH Common Overlapping Symptoms in the Medical Field Appendiciti Strep s Fever Throat Geller & DelBello, 2008 YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH Common Overlapping Symptoms in Psychological Symptoms Irritability and Hyperactivity Mania (elated mood and grandiosity) Major Depressive ADHD Disorder (no cardinal (low mood symptoms) and anhedonia) Autism (communication and social deficits) Geller & DelBello, 2008 YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH Where are we heading? YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH Prevalence Rates 1% 8% Barkley, 2006 Goldstein, 2012 YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH History and Features of ADHD • Around WWI ADHD symptoms were often associated with an outbreak of encephalitis • Clinicians began to see similar symptoms in other organic based disorders (brain injured child, MBD) • Also “spoiled child” syndrome • 1930’s began to notice improved effects with amphetamine use to control headaches Barkley 2006 YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH History and Features of ADHD • 1950’s movement to hyperkinetic impulse disorder • Later in the decade more specific learning problems were identified rather than generalizing MBD • 1970’s began to focus on impulsivity as well • 1980’s focus on attention problems • Later focus on educational needs • 21st century continues to look at further subtypes Barkley 2006 YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH • Exhibit poor and irregular sleep In • Colic • Feeding problems CONCEPTUALIZING Infancy • Dislike being cuddled or held still for long ADHD • Driven to run rather than walk • Driven to handle everything Toddler • Major problems as adults: • Low self-esteem • Poor social skills Kolb & Whishaw (2003) Halperin et al., 2012 YOUTH MENTAL HEALTH: A WHOLE-SCHOOL APPROACH DISTINCTIVE ADHD FEATURES • Demanding Elementary • Oppositional • Do not play well with others • Poor tolerance of frustration, high level of activity, poor concentration, and school poor self-esteem may lead to a referral • May be failing school • 25-50% have encountered legal problems • Withdraw from school • Fail to develop social relations and maintain steady employment Adolescence • Females with inattention often diagnosed with dysthymia (chronic mild depression) rather than ADHD • Females with combined symptoms (impulsivity, hyperactivity,
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