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School Based Disorder Specific Mental Health

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Mental Health disorders, by definition, affect a students' academic experience. Programs that are specifically and personally created for a student takes thirty minutes a month; to give a teenager access to their full potential. Michael Phelps,  Leonardo DiCaprio, Adele, Steve Jobs all of these well-known people struggle or have struggled with mental illnesses. However, they were able to create amazing careers we see in the news on the daily. Providing correct accommodations will allow for students with similar diffecets to have the same chance.
https://healthcare.utah.edu/healthfeed/postings/2017/04/celebs-mental.php

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Sometimes stigmas toward mental health illnesses stop or discourage parents as well as students from coming forward to receive aid in fear of retribution
http://go.galegroup.com/ps/retrieve.do?tabID=T003&resultListType=RESULT_LIST&searchResultsType=SingleTab&searchType=BasicSearchForm&currentPosition=6&docId=GALE%7CCX3403200402&docType=Topic+overview&sort=RELEVANCE&contentSegment=&prodId=GVRL&contentSet=GALE%7CCX3403200402&searchId=R1&userGroupName=tel_k_smes&inPS=true

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The non-academic interests of providers and academic interests of educators have created an ineffective and incompatible relationship of school based mental health programs and mental health care.
https://gucchdtacenter.georgetown.edu/resources/Call%20Docs/2010Calls/paternite_sbmhOverview2005.pdf

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There are about 90,000 public schools in about 15,000 districts; thus making sure of implementation and agreement within all these schools about disorder specific mental health plans will be difficult to monitor.

http://smhp.psych.ucla.edu/aboutmh/mhinschools.html

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Political agendas and mainstream mental health advocates often want to advance their own agendas and ideas not considering the advancement of mental health programs as a whole. Often people advocate for solutions which are  specific and narrow that exclude portions of the mentally disabled population.
http://smhp.psych.ucla.edu/aboutmh/mhinschools.html

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The U.S. Surgeon General, on mental health (U.S. Department of Health and Human Services, 1999) and children’s mental health (U.S. Public Health Service, 2000) have called attention to the mental health crisis and emphasized the importance of improving mental health care within the school environment.
https://gucchdtacenter.georgetown.edu/resources/Call%20Docs/2010Calls/paternite_sbmhOverview2005.pdf

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School-based planning of,  implementing, evaluating,  continuously improving school mental health practices determined by the needs of the schools community has had positive mental health and academic outcomes.
https://gucchdtacenter.georgetown.edu/resources/Call%20Docs/2010Calls/paternite_sbmhOverview2005.pdf

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Of all youth who have diagnosable disorders, one sixth to one third of them do not receive sufficient treatment
https://gucchdtacenter.georgetown.edu/resources/Call%20Docs/2010Calls/paternite_sbmhOverview2005.pdf

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There is great diversity and and community environments in high schools these days. This has led to the concentration of many different mental disorders. However, schools have been attempting to address all of them under the same umbrella. The students with "special needs" are often marginalized leading to simple, inadequate, or inappropriate resources provided for stuggling students. This method typically does not fare positive results or progress.
http://smhp.psych.ucla.edu/aboutmh/mhinschools.html

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There have been strong positive associations between mental health and academic successes; like wise there is a correlation between negative behavioral and emotional patterns and learning difficulties
https://gucchdtacenter.georgetown.edu/resources/Call%20Docs/2010Calls/paternite_sbmhOverview2005.pdf

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One in five children are effected by mental health disorder; one in ten adolescents are challenged with mental health problems  which effect their day t day lives at school, work, and/or at home
http://www.acmh-mi.org/get-help/navigating/problems-at-school/

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When children are punished for mental illness related misbehavior and failure, it exacerbates their reactions and symptoms greatly as these kids begin to internalize the criticisms for actions they cannot control.

http://smhp.psych.ucla.edu/aboutmh/mhinschools.html

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More than ten million children in the country suffer from mental disorders (3-8% serious) which have short term an long term financial and emotional costs.
http://go.galegroup.com/ps/retrieve.do?tabID=T003&resultListType=RESULT_LIST&searchResultsType=SingleTab&searchType=BasicSearchForm&currentPosition=6&docId=GALE%7CCX3403200402&docType=Topic+overview&sort=RELEVANCE&contentSegment=&prodId=GVRL&contentSet=GALE%7CCX3403200402&searchId=R1&userGroupName=tel_k_smes&inPS=true

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The over the past twenty years, there has been an increased awareness and call for remediation of mental health problems specifically in youth. School Based Mental Health programs have been more recently examined as a valuable resources to aid adolescents who are struggling with mental illnesses.

https://gucchdtacenter.georgetown.edu/resources/Call%20Docs/2010Calls/paternite_sbmhOverview2005.pdf

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The American Disabilities Act (ADA) of 1990 and 2008 amendments requires effective, reasonable accommodations to provide equal access to academic courses and activities to students with psychiatric disabilities.
https://www.washington.edu/doit/academic-accommodations-students-psychiatric-disabilities

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My Argument: Disorder-Specific School Based Accommodations

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My Argument: Disorder-Specific School Based Accommodations

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In order to provide proactive disorder-specific resources, intervention, and protocols beyond providing the basic, mandated mental health legislation; schools should have bi-monthly meetings with students with mental health illnesses and their parents to monitor how intervention methods are working for the student.

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From School Mental Health Project, UCLA Center for Mental Health in Schools

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It is, of course, not a new insight that physical and mental health concerns must be addressed if schools are to function satisfactorily and students are to succeed at school. It has long been acknowledged that a variety of psychosocial and health problems affect learning and performance in profound ways. Such problems are exacerbated as youngsters internalize the debilitating effects of performing poorly at school and are punished for the misbehavior that is a common correlate of school failure. Because of all this, school policy makers, have a lengthy (albeit somewhat reluctant) history of trying to assist teachers in dealing with problems that interfere with schooling. Prominent examples are seen in the range of counseling, psychological, and social service programs schools provide.

Adding to what school education support staff do, there has been renewed emphasis over the past 20 years in the health and social services arenas on increasing linkages between schools and community service agencies to enhance the well-being of young people and their families. This "school-linked services" agenda has added impetus to advocacy for mental health in schools.

More recently, the efforts of some advocates for school-linked services has merged with forces working to enhance initiatives for community schools, youth development, and the preparation of healthy and productive citizens and workers. The merger has expanded interest in social-emotional learning and protective factors as avenues to increase students' assets and resiliency and reduce risk factors.

Thus, varied policies and initiatives have emerged relevant to efforts to enhance mental health in schools. Some directly support school programs and personnel; others connect community programs and personnel with schools. As a result, most schools have some programs to address a range of mental health and psychosocial concerns (e.g., school adjustment and attendance problems, dropouts, physical and sexual abuse, substance abuse, relationship difficulties, emotional upset, delinquency, violence.)

School-based and school-linked programs have been developed for purposes of early intervention, crisis intervention and prevention, treatment, and promotion of positive social and emotional development. And, available research suggests that for some youngsters schools are the main providers of mental health services. As Burns and her colleagues report from the study of children's utilization of MH services in western North Carolina, "the major player in the de facto system of care was the education sector - more than three-fourths of children receiving mental health services were seen in the education sector, and for many this was the sole source of care."

Advancing mental health in schools

Clearly, mental health activity is going on in schools. Equally evident, there is a great deal to be done to improve what is taking place. The current norm related to efforts to advance mental health policy is for a vast sea of advocates to compete for the same dwindling resources. This includes advocates representing different professional practitioner groups. Naturally, all such advocates want to advance their agenda. And, to do so, the temptation usually is to keep the agenda problem-focused and rather specific and narrow. Politically, this make some sense. But in the long-run, it may be counterproductive in that it fosters piecemeal, fragmented, and redundant policies and practices. Diverse school and community resources are attempting to address complex, multifaceted, and overlapping psychosocial and mental health concerns in highly fragmented and marginalized ways. This has led to redundancy, inappropriate competition, and inadequate results.

One response to this state of affairs is seen in the calls for realigning policy and practice around a cohesive framework based on well-conceived models and the best available scholarship. With specific respect to mental health in schools, it has been stressed that initiatives must connect in major ways with the mission of schools and integrate with a restructured system of education support programs and services.

From our perspective, it is time to take a close look at all the pieces. To date, there has been no comprehensive mapping and no overall analysis of the amount of resources used for efforts relevant to mental health in schools or of how they are expended. Without such a "big picture" analysis, policymakers and practitioners are deprived of information that is essential in determining equity and enhancing system effectiveness. The challenge for those focused on mental health in schools is not only to understand the basic concerns hampering the field, but to function on the cutting edge of change so that the concerns are effectively addressed.

Systemic changes must weave school owned resources and community owned resources together to develop comprehensive, multifaceted, and integrated approaches for addressing barriers to learning and enhancing healthy development. Moreover, pursuit of such changes also must address complications stemming from the scale of public education in the U.S.A. Currently, there are about 90,000 public schools in about 15,000 districts. Thus, efforts to advance mental health in schools also must adopt effective models and procedures for replication and "scale-up."

Needed: Strategic approaches & comprehensive frameworks to enhance policy & practice

Although efforts to advance mental health in schools often are hampered by competing initiatives and agendas, the diversity of initiatives has laid a foundation that can be built upon. There is a need, however, for increased emphasis on strategic approaches for enhancing policy and practice. Such strategic approaches can be fostered through efforts to unify thinking about mental health in schools, adoption of well-conceived guiding frameworks, and by support for development of focused networking. To these ends, the Center for Mental Health in Schools at UCLA (1) highlights the need for a broad perspective in thinking about and justifying "mental health" in schools, (2) promotes a working draft of comprehensive and multifaceted guidelines that provide a basis for operationally defining mental health in schools, (3) proposes an integrated framework for promoting healthy development and addressing barriers to learning at a school site in ways that can expand the impact of mental health in schools, and (4) pursues a wide variety of strategies designed to advance the field.

Ending the marginalization

Clearly, enhancing mental health in schools in comprehensive ways is not an easy task. Indeed, it is likely to remain an insurmountable task until school reformers accept the reality that such activity is essential and does not represent an agenda separate from a school's instructional mission. For this to happen, we must encourage them to view the difficulty of raising achievement test scores through the complementary lenses of addressing barriers to learning and promoting healthy development. When this is done, it is more likely that mental health in schools will be understood as essential to addressing barriers to learning and not as an agenda separate from a school's instructional mission.

Then, we must show how all policy, practice, and research related to mental health in schools, including the many categorical programs funded to deal with designated problems, can be woven into a cohesive continuum of interventions and integrated thoroughly with school reform efforts. In the process, we will need to stress the importance of school-community-home collaborations in weaving together the resources for comprehensive, multifaceted approaches.

In sum, advancing mental health in schools is about much more than expanding services and creating full service schools. It is about establishing comprehensive, multifaceted approaches that help ensure schools are caring and supportive places that maximize learning and well-being and strengthen students, families, schools, and neighborhoods.

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It is, of course, not a new insight that physical and mental health concerns must be addressed if schools are to function satisfactorily and students are to succeed at school. It has long been acknowledged that a variety of psychosocial and health problems affect learning and performance in profound ways.

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Achieving equal access through accommodations and universal design

Tens of thousands of students enrolled in American postsecondary institutions report having a mental illness. Recent increases in the size of this group are due in part to improved medications that result in symptoms mild enough for them to enjoy the benefits and meet the challenges of postsecondary education. Students with psychiatric disabilities are entitled to reasonable academic accommodations as provided by the American Disabilities Act (ADA) of 1990 and 2008 amendments. Providing effective accommodations allows students equal access to academic courses and activities. The presence of students with disabilities also contributes to the diversity of the student population.

What is a Mental Illness?

"Mental illness" refers to the collection of all diagnosable mental disorders causing severe disturbances in thinking, feeling, relating, and functional behaviors. It can result in a substantially diminished capacity to cope with the demands of daily life.

A mental illness is a hidden disability; it is rarely apparent to others. However, students with mental illness may experience symptoms that interfere with their educational goals and that create a "psychiatric disability." These symptoms may include, yet are not limited to:

heightened anxieties, fears, suspicions, or blaming others

marked personality change over time

confused or disorganized thinking; strange or grandiose ideas

difficulty concentrating, making decisions, or remembering things

extreme highs or lows in mood

denial of obvious problems and a strong resistance to offers of help

thinking or talking about suicide

Psychiatric Diagnoses

A student with a mental illness may have one or more of the following psychiatric diagnoses (American Psychiatric Association, 1994).

Depression. This is a mood disorder that can begin at any age. Major depression may be characterized by a depressed mood most of each day, a lack of pleasure in previously enjoyed activities, thoughts of suicide, insomnia, and consistent feelings of worthlessness or guilt.

Bipolar affective disorder (BAD, previously called manic depressive disorder). BAD is a mood disorder with revolving periods of mania and depression. In the manic phase, a person might experience inflated self-esteem, high work and creative productivity, and decreased need to sleep. In the depressed phase, the person would experience the symptoms of depression (see above).

Borderline personality disorder (BPD). BPD is a personality disorder which includes both mood disorder and thought disorder symptoms. This diagnosis has both biological and environmental determinants. Individuals diagnosed with BPD may have experienced childhood abuse and family dysfunction. They may experience mood fluctuations, insecurities and mistrust, distortion of perceptions, dissociations, difficulty with interpersonal relationships, and limited coping skills.

Schizophrenia. This is a mental disorder that can cause a person to experience difficulty with activities of daily living and possibly delusions, hallucinations, and paranoia. Schizophrenic individuals typically demonstrate concrete thought processing and appreciate structure and routines.

Anxiety disorders. These are mood disorders in which the individual responds to thoughts, situations, environments, or people with fear and anxiety. Anxiety symptoms can disrupt a person's ability to concentrate and focus on tasks at hand. Symptoms may be in response to real or imagined fears. Specific anxiety disorders include generalized anxiety disorder, obsessive-compulsive disorder (OCD), panic disorder, social and specific phobias, and post-traumatic stress disorder (PTSD).

Functional Limitations

The following functional limitations related to psychiatric disabilities may affect academic performance and may require accommodations (Center for Psychiatric Rehabilitation, 1997).

Difficulty with medication side effects: side-effects of psychiatric medications that affect academic performance include drowsiness, fatigue, dry mouth and thirst, blurred vision, hand tremors, slowed response time, and difficulty initiating interpersonal contact.

Screening out environmental stimuli: an inability to block out sounds, sights, or odors that interfere with focusing on tasks. Limited ability to tolerate noise and crowds.

Sustaining concentration: restlessness, shortened attention span, distraction, and difficulty understanding or remembering verbal directions.

Maintaining stamina: difficulty sustaining enough energy to spend a whole day on campus attending classes; combating drowsiness due to medications.

Handling time pressures and multiple tasks: difficulty managing assignments, prioritizing tasks, and meeting deadlines. Inability to participate in multi-task work.

Interacting with others: difficulty getting along, fitting in, contributing to group work, and reading social cues.

Fear of authority figures: difficulty approaching instructors or TAs.

Responding to negative feedback: difficulty understanding and correctly interpreting criticism or poor grades. May not be able to separate person from task (personalization or defensiveness due to low self-esteem).

Responding to change: difficulty coping with unexpected changes in coursework, such as changes in the assignments, due dates or instructors. Limited ability to tolerate interruptions.

Severe test anxiety: the individual is rendered emotionally and physically unable to take an exam.

Instructional Strategies

Students with a history of psychiatric disabilities can be intelligent, sensitive, creative, and interesting. You can employ strategies that will promote their success in your class. For example:

Address a variety of learning styles (e.g. auditory, visual, kinesthetic, experiential, or a combination of styles).

Incorporate experiential learning activities.

Be prepared to set behavioral expectations for all students in your class.

Embrace diversity to include people with psychiatric disabilities.

Accommodations

Some students with mental illness may require accommodations to allow them equal access to classes, programs, and coursework. An accommodation is the removal of a barrier to full participation and learning. The emphasis is on access, not outcome. This is done by providing the student with a disability equal access to the content and activities of a course, but not necessarily assuring their success.

Each student with a disability is encouraged to register with the office that supports students with disabilities in order to receive accommodations. Personnel from this office typically send instructors a letter documenting specific accommodations required for the student with the disability. It is the responsibility of the instructor to provide the accommodations. It is the student's responsibility to fulfill the academic requirements of the course. The best solutions result when the instructor, student, and disability support service professional work cooperatively. Meeting as a group may facilitate problem-solving alternatives. Respecting the privacy of the student by not discussing his or her disability or accommodations with others outside of this meeting is essential. Review accommodations periodically with the student to assess effectiveness and adjust to changing needs.

The following are typical classroom, exam, and assignment accommodations that may be recommended by the disability student service professional for a student with a psychiatric disability.

Classroom Accommodations

Preferential seating, especially near the door to allow leaving class for breaks.

Assigned classmate as volunteer assistant.

Beverages permitted in class.

Prearranged or frequent breaks.

Tape recorder use.

Notetaker or photocopy of another student's notes.

Early availability of syllabus and textbooks.

Availability of course materials (lectures, handouts) on disk.

Private feedback on academic performance.

Examination Accommodations

Exams in alternate format (e.g., from multiple choice to essay; oral, presentation, role-play, or portfolio).

Use of assistive computer software (e.g., Optical Character Recognition, allowing scanned text to be read aloud by the computer's sound card; or speech recognition for converting the spoken word to printed word on the computer screen).

Extended time for test taking.

Exams individually proctored, including in the hospital.

Exam in a separate, quiet, and non-distracting room.

Increased frequency of exams.

Assignment Accommodations

Substitute assignments in specific circumstances.

Advance notice of assignments.

Permission to submit assignments handwritten rather than typed.

Written assignments in lieu of oral presentations or vice versa.

Assignments completed in dramatic formats (e.g., demonstration, role-play, and sculpture).

Assignment assistance during hospitalization.

Extended time to complete assignments.

Not all requested accommodations are "reasonable." An accommodation is not reasonable if:

Making the accommodation or having the individual involved in the activity poses a direct threat to the health or safety of others.

Making the accommodation means making a substantial change in an essential element of the curriculum.

Making the accommodation would require a substantial alteration in the manner in which educational opportunities are provided, such as the course objectives being altered.

Making the accommodation would impose an undue financial or administrative burden to the institution.

References

American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed). Washington, DC: Author.

Center for Psychiatric Rehabilitation. (1997). How does mental illness affect the way I function at school? Boston University. www.bu.edu/cpr/jobschool/functed.htm.

Additional Resources

DO-IT has created a collection of videos that can be freely viewed at www.washington.edu/doit/videos/index.php. Of particular relevance are the following titles: Building the Team: Faculty, Staff and Students Working Together, Equal Access: Universal Design of Instruction, and Invisible Disabilities and Postsecondary Education. You may also find the following resources useful as you explore this topic further.

National Alliance on Mental Illness (NAMI)

About DO-IT

DO-IT (Disabilities, Opportunities, Internetworking, and Technology) serves to increase the successful participation of individuals with disabilities in challenging academic programs such as those in science, engineering, mathematics, and technology. Primary funding for DO-IT is provided by the National Science Foundation, the State of Washington, and the U.S. Department of Education. DO-IT is a collaboration of UW Information Technology and the Colleges of Engineering and Education at the University of Washington.

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Acknowledgment

This publication was developed under a grant from the U.S. Department of Education, #P33A990042. However, these contents do not necessarily represent the policy of the U.S. Department of Education, and you should not assume endorsement by the federal government.

Copyright © 2012, 2009, 2008, 2006, 2001, University of Washington. Permission is granted to copy these materials for educational, noncommercial purposes provided the source is acknowledged.

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By: Alfred Souma, Nancy Rickerson, and Sheryl Burgstahler

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Academic Accommodations for Students with Psychiatric Disabilities | DO-IT

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Achieving equal access through accommodations and universal design Tens of thousands of students enrolled in American postsecondary institutions report having a mental illness. Recent increases in the size of this group are due in part to improved medications that result in symptoms mild enough for…

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From Gale Reference Library

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From Association for Children’s Mental Health

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Problems at School | Association for Children’s Mental Health

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Learn how to navigate problems at school