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recognize and refer

https://www.nassp.org/wordpress/wp-content/uploads/2018/04/Mental_Health.pdf

http://theconversation.com/five-things-schools-can-do-to-help-pupils-mental-health-79376

https://www.edweek.org/ew/articles/2013/01/30/19murray.h32.html

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https://www.hhs.gov/ash/oah/adolescent-development/mental-health/adolescent-mental-health-basics

tania hart article

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time
solution:
-doesn't have to be super long as long as its every year
-during inservice, not separate

money
solution:
-can be taught by a trained guidance counselor

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One of the barriers described in the Hart article is that while many parents have a general understanding of the complexities and dynamics of their child’s mental health and disorder but feel helpless in fixing the problem, most teachers are oblivious to the mental health issues their students face. In order to combat this, it’s important to give teachers both specific tactics for ensuring a positive, safe school environment and knowledge to be able to recognize symptoms of low mental health in their students.

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Less than two weeks ago, Marjory Stoneman Douglas High School senior Emma Gonzalez delivered what amounts to a post-millennial rebuke to every preceding American generation for failing to protect her and her peers. She spoke out against our overly permissive gun laws, the corporate interests that maintain them and the cultural affiliations that make many of us reluctant to accept change.

As Gen-Xers, our thoughts went back to Columbine, our flashbulb memory of the first mass school shooting in our lifetimes. As we've been forced to bear witness over the years, we see similar circumstances playing out: a marginalized student (or former student) with a troubled past or a resentment commits a heinous act.

Lethal power means restriction matters. If 91 percent of suicide attempts with a firearm are fatal, but only 8 percent without a firearm are fatal, think of the lives saved and tragedies averted from implementing common-sense gun restrictions. Imagine the proportionate decrease for homicide attempts.

Yet time after time, we watch mass shootings lead to a call for government action, and time after time the government does nothing. This time, high school students who'd just survived a shooting at their own school boarded buses to Tallahassee and watched as their state legislature refused to reconsider a ban on assault rifles like the one that killed their friends a week before.

If we have taken anything away from Parkland, it's that we no longer have the luxury of delegating the care of our most marginalized students.

Mental health care access also matters. Governments should fund more robust school counseling programs so that students get care long before their feelings of despair and isolation metastasize into violence. But meeting that need will involve cumbersome debates, rebudgeting and hiring. All of that takes time.

Meanwhile, our efforts to address mental health in school have limitations. Researchers who study the impact of mental illness stigma have found that students identified as needing mental health services sometimes find that their friends then avoid them, their family members pity and distrust them, and their teachers fear them and underestimate their abilities.

So while we wait for governments to restrict access to guns and increase access to effective mental health care, what can teachers do?

If we have taken anything away from Parkland, it's that we no longer have the luxury of delegating the care of our most marginalized students to what passes for community mental health. Nor can we siphon off responsibility to providers in our schools - guidance counselors, psychologists, and social workers - or to contexts like advisory or health class that don't command the same respect or rigor from our students. Teachers might fear exploring mental health, a province we're told isn't ours. But apart from parents, who knows kids better than teachers?
RELATED: Teachers' Lounge: A student's obituary should never say 'gunned down while studying for chemistry'
No other profession is better placed to gain the trust of a student in crisis, or a student who might come forward about a struggling peer. Who is better placed than a teacher to organize a student's environment and be a source of consistent support? Our lives may depend on our willingness to brave the shoals of the distressed and the defeated, the socially ostracized and the academically remedial.

As teachers, we can decide to make school more than a place where students learn the skills to cleverly navigate the internet for the purpose of acquiring high-powered weapons. Or making homemade munitions, as in the case of the Columbine murderers. Even obtaining the capital, locating suppliers and identifying safe storage requires, in the darkest way, what we might call initiative, problem solving, creativity and attention to detail. When we teach such "21st century skills" and traditional academic knowledge, what are we helping students use it for?

Is the only purpose of school "to ensure that students graduating from high school are prepared to take credit bearing introductory courses in two- or four-year college programs or enter the workforce," or can school also become a place where students learn how they want to treat themselves, each other, and their world?

Gonzalez's speech was so moving ... because at the worst moment in her school's history, she took charge of her learning and her life.

Emma Gonzalez's speech was so moving not only because she had her facts correct and made sound arguments, but because at the worst moment in her school's history, she took charge of her learning and her life.

Maybe an important element of preventing violence and suicide is empowering all students to make their lives meaningful, in and beyond school. Maybe if students learn how to accept feelings of frustration, fear and embarrassment, they won't need to avoid those feelings by hurting themselves or someone else.

As teachers, we can ask ourselves these questions:

Who at school is empowered and why?

In what contexts at school are students choosing actions consistent with their values?

In what contexts are students struggling to find meaning and fulfillment?

How can we use our academic classes as opportunities for students to explore and enact their values?

Who is most marginalized, and how can we help them reconnect with their families, peers and teachers?

What further support do students need, and how can we help them get it?

So on March 14, when we walk out, we are putting legislators on notice that they'd better make restricting access to firearms their immediate priority. When we walk back in, we can step up to a role where we are choosing to measure ourselves not only by the academic and athletic achievements of students who already feel successful, but also by the extent to which all students turn school into a source of meaning and vitality.
The PBS NewsHour's Teachers' Lounge blog, written by teachers or school-related staff, gives the public a glimpse into how current events affect life inside schools. Sign up for the PBS NewsHour Education mailer here.

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Opinion: To prevent school shootings, can mental health be taught?

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Less than two weeks ago, Marjory Stoneman Douglas High School senior Emma Gonzalez delivered what amounts to a post-millennial rebuke to every preceding American generation for failing to protect her and her peers. She spoke out against our overly permissive gun laws, the corporate interests that maintain them and the cultural affiliations that make many of us reluctant to accept change.

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One out of every 4 or 5. That's how many students will display a significant mental health problem over the course of their lifetime.

Such students can be identified early with considerable accuracy if educators are given the right training and tools. Unfortunately, most schools rely on reactive methods, like office discipline referrals, to figure out which students need behavioral and mental health services.

Research shows this approach of waiting until students act out in school is inefficient and leads to as many as 80 percent of those with mental health needs to fall through the cracks.

Such concerns have heightened in the wake of the Parkland high school massacre. News reports indicate the alleged shooter exhibited a number of troubling behaviors, raising questions about his mental health status and whether more could have been done to help him sooner.

To address the issue of students falling through the cracks, more schools should adopt proactive, universal screening tools.

Universal screening typically occurs three times throughout the school year: fall, winter and spring. Screeners are brief assessments that take no more than a few minutes to complete. They include approximately 20 questions and are given to each student in the elementary classroom. These tools ask students to indicate things such as "I lose my temper" or whether they are "adaptable to change." The questions are purposefully broad and are meant to identify students who may be at risk for either internal problem behaviors, such as anxiety or depression, or external problem behaviors, such as aggression toward others. The screenings are scored and used to prioritize which students need intervention.

Screeners are typically administered without parental consent if they are embedded into the general school curriculum.

Research shows that screening tools can help educators identify students with mental health needs with far greater accuracy and speed, rather than waiting for a severe problem behavior, such as a school fight.

I developed one such tool - the Social, Academic and Emotional Behavior Risk Screener, or SAEBRS - with the help of several grants, including $1.4 million from the Institute for Educational Sciences in the U.S. Department of Education.

If society is serious about preventing severe mental and behavioral health problems, it must take a critical look at the current state of mental health supports in the nation's schools. Doing so will bring the value of screening tools into sharper focus.
School mental health stretched thin
First, let's consider the service provider side of the equation. The National Association of School Psychologists recommends a ratio of 1 school psychologist for every 500-700 students. However, the reality is that states on average have ratios of nearly twice that amount. Simply put, schools rarely have the staff necessary for comprehensive mental health services.

Second, only a small number of students who need mental health services will receive intervention in a timely manner. Due to the amount of time that teachers spend with students, teachers are the critical link to identify which students need help and to refer students to school psychologists, counselors and social workers. The question is: Do teachers know what to look for?
Silent issues overlooked
Consider a typical elementary classroom with 30 students. Approximately 6 students, on average, will have a critical mental and behavioral health problem such as anxiety or aggression, yet less than half will receive timely intervention. Who are those students? Typically those that exhibit more outward types of problems, such as aggression, problems paying attention and disruptive behavior.

Students with harder-to-see issues, such as withdrawal, anxiety and social isolation often get overlooked and rarely receive essential services. Teachers often lack the training or tools necessary to know which students may need help, beyond those that are disruptive to instruction.

These screenings are not part of the process for comprehensive special education evaluations, so the concerns about schools having to offer special education services as a result of the screening do not come into play.

While screening tools can help identify troubled students sooner, it is important not to oversell the usefulness of these tools. To be clear, there are no research-validated tools that can reliably identify which students may commit violent acts.
Toward universal screening
Currently, less than 15 percent of schools engage in some form of behavioral or mental health screening. However, more schools are adopting universal screening.

As the developer of a screening tool, I have seen rapid adoption of the tool over the last four years from two elementary schools in rural North Carolina to hundreds of schools across 28 states. As schools consider how best to meet the behavioral and mental health needs of their students, screening can provide crucial information to guide the way.
Nathaniel von der Embse is an Assistant Professor of School Psychology at the University of South Florida. This article was originally published on The Conversation. Read the original article here.

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Nathaniel von der Embse, The Conversation

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Opinion: Schools shouldn't wait for red flags to address student mental health needs

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One out of every 4 or 5. That's how many students will display a significant mental health problem over the course of their lifetime. Such students can be identified early with considerable accuracy if educators are given the right training and tools.

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As a clinical child psychologist and associate professor of social work, I'm concerned by the national discourse around mental health, violence and schools, as pundits offer misguided and simplistic solutions to the very complex issue of student mental health:

Arm the teachers. Install metal detectors. Practice lockdown procedures.

We can all agree that safety in schools is paramount, but by focusing on the intersection of violence and mental health, we are missing the point.

Our society is failing to effectively address the tremendous need for mental health supports for our children, my son included.
Related: Willing, able and forgotten
When I was growing up, springtime at school was reinvigorating: a time of warmer weather, spring break and even renewed enthusiasm for classes. Now that I'm a mother, each new season, or day for that matter, brings worry: worry that my teenage son won't make it out of bed and out the door in the morning; worry that if he does, he will be misunderstood in the classroom, the cafeteria or, worse, the band hall.

The band hall has long been his refuge, where he retreats to get lost in the comfort of music. But last semester, after a series of absences and missed assignments, he was temporarily suspended from playing in the high school band. His suspension was no surprise; it is the latest in a string of punishments by adults who do not understand his depression. And it is just one small example of how our society punishes and criminalizes, rather than prevents and treats, mental health problems.

"Our educational system punishes, suspends and expels children with mental disorders at double or more the rate of their peers. The disparity is largest for black and brown teenage boys ... "

One in five children has a debilitating mental illness, and exclusionary and punitive practices are the norm for dealing with their symptoms. Few educators would consider reprimanding a child to "just breathe" during an asthma attack, or sending a child to detention because he or she had a seizure and disrupted the class.

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Related: A new movement to treat troubled children as 'sad, not bad'
But according to the U.S. Department of Education, our educational system punishes, suspends and expels children with mental disorders at double or more the rate of their peers. The disparity is largest for black and brown teenage boys, who are shepherded out of school into the juvenile justice system as part of the well-documented school-to-prison pipeline. I often wonder whether my son would be among them if we lived in a different zip code or if his skin were the darker shade of some of his cousins'.

A few years ago, my son pushed into his brother as they passed in the school hallway, causing my younger son to stumble backwards. The incident was reported to the administration because of my older son's documented "emotional disturbance." Under the guise of safety, the school filed a police report alleging peer-to-peer assault and initiated a child welfare investigation for neglect and physical and emotional abuse. In disciplinary meetings, administrators wondered out loud whether a more restrictive environment would better meet his needs. With a strict warning, they simply suspended him. At age 12, my son became one of approximately three million public school students suspended from school each year.

Dozens of times since then, in instances big and small, I have seen how we misunderstand, exclude and punish students with mental health problems. I think of the 5-year-old who qualified for gifted education in his local magnet school but was denied admission because of his speech difficulties; of the high school student with autism spectrum disorder who was discouraged from taking an AP class he qualified for because his behavior might become challenging; of the college student who was failing all of her classes because she was homebound with debilitating panic attacks.

And I think of the countless parents who have told me, eyes cast down, about their child's mental health struggles. They know that empathy in our society is reserved for other illnesses. Their hushed tones are meant to protect their children and their family from stigma.
Related: STUDENT VOICE: Don't blame autism for the Florida school shooting
Rhetoric following the Parkland school shooting has deepened stigmatization. By labeling a teen with depression, ADHD and autism-spectrum disorder "sicko" and calling for troubled youth to be kept out of communities through institutionalization practices that have proven both ineffective and inhumane, President Donald Trump reinforced archaic notions of mental illness as a character flaw to be punished. And our collective silence only breeds misunderstandings of our children's symptoms and needs.

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So what if, instead, we were to speak up and call for better understanding and treatment of mental health disorders within our educational system? What if, in response, the educational system were to share the responsibility of meeting the mental health needs of our children?
Related: What happens when a regular high school decides no student is a lost cause?
Educators report that they have limited time and training to deal with mental health issues. Their focus, rightly, is to ensure that students acquire the requisite knowledge and skills in core academic subjects, an enormous and complicated undertaking in itself.

But to teach, educators must be able to engage their students, including the 20 percent who are too hyperactive, impulsive, depressed, panicked or distracted to listen. According to research, these children will be more likely to get poor grades, skip classes and drop out of school, especially when they have been suspended or expelled for misbehavior. The National Center for Education Statistics reports that just over half a million students drop out of high school each year, leading to a cascade of costly and negative consequences, including lower rates of employment, lower earnings when employed, and higher rates of both welfare and incarceration.
This story was produced by Dr. Esther Calzada is a clinical child psychologist, an associate professor of social work at The University of Texas at Austin and a fellow in the OpEd Project. Her program of research, focused on family and intergenerational processes and interventions, aims to reduce racial/ethnic disparities in mental health problems and academic achievement. The Hechinger Report, a nonprofit, independent news organization focused on inequality and innovation in education. Sign up for our newsletter.
We can invest in mental health services in schools instead. Well-developed, empirically validated, school-based treatments are available for childhood mental health disorders. They reflect decades of research showing that a supportive, inclusive and skills-building approach to dealing with mental health problems is most effective. In fact, the U.S. Department of Education's Office of Special Education Programs has long invested in the development, testing and implementation of programs to address mental health needs, including the widely recognized Positive Behavioral Interventions & Supports (PBIS). Researchers have estimated the cost of PBIS to be as high as $62 per student, compared with a cost of $163,340 per dropout. What will we choose to pay for?

This semester, my son has been allowed to play with the band again, but I struggle to find a sense of hope with this fresh start. I can't help but wonder when the next suspension will come. But in the meantime, I'm ready to drop my hushed tone. We can demand that others stop punishing our children for their illnesses. We can push for access to programs designed to support our children. We can stop the criminalization of mental health problems in schools.

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OPINION: We must stop the criminalization of mental illness in schools

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As a clinical child psychologist and associate professor of social work, I'm concerned by the national discourse around mental health, violence and schools, as pundits offer misguided and simplistic solutions to the very complex issue of student mental health: Arm the teachers. Install metal detectors. Practice lockdown procedures.