School- Based Adolescent Mental Health Programs. November/December 2. Issue. School- Based Adolescent Mental Health Programs By Terry Richardson, MS, LMHC, CMHS; Melissa Morrissette, LICSW, CDP, CMHS, MHP; and Laura Zucker, LICSW, CMHS, MHP Social Work Today. Vol. 2. 4A supplementary team of community mental health professionals integrated into school services is a plus for the early identification and treatment of adolescent mental health conditions. School-Based Mental Health Graduate Certificate Program Get Specialized Training To Provide School-Based Mental Health Services. Alliant offers a Graduate Certificate. School-based health centers are exactly what the name. About 20 percent receive funding through the HRSA Health Center Program. Even for professionals who work with adolescents and practically have seen it all, the number of youths with mental health challenges is simply staggering. One- half of all lifetime diagnosable mental health conditions begin by the age of 1. Kessler, Berglund, Demler, Jin, Merikangas, & Walters, 2. One in five adolescents in this country shows significant symptoms of emotional distress, with nearly 1. Knopf, Park, & Mulye, 2. The presence of mental illness in children and adolescents, if not properly diagnosed and treated, increases the likelihood of significant health issues for them as adults and greatly limits their ability to become productive members of society (Wu et al, 2. For adolescents, the first signs of mental illness or emotional distress can emerge in the school environment. While many schools have school psychologists, social workers, and/or counselors, progressive school districts recognize the value of a more comprehensive approach in which a supplementary team of community mental health professionals is integrated into the school service array. These services may range from intensive programs targeting underperforming schools or those designed to augment existing school health and wellness programs. Why It Makes Sense. From our experience, there are advantages of teaming with a comprehensive community mental health organization. Services are available to youths year- round, beyond the academic school year and during breaks when support for children and youths can be limited.
Community mental health clinicians, unlike their school counterparts, can see students even if they are suspended, not attending school, in detention, or in the hospital. They can support adolescents after hours through crisis and psychiatric services. Community mental health clinicians apply the latest evidence- based practices, including dialectical behavioral therapy, trauma- focused cognitive behavioral therapy, and functional family therapy. For many students, a key benefit is awareness. The presence of these services at school provides a level of access not typically available through the standard approach. School- based mental health programs, to be most effective, must be correctly constructed. While they may vary from school to school, there are some key characteristics consistent across all of them. School- based programs will not be effective unless there is collaboration and relationship building among parents, teachers, administrators, community mental health professionals, and students. An infrastructure, process, and clearly defined roles must be painstakingly developed to address the varying needs of the student body. And the program must have the right team members, who bring unique skill sets and experiences to the endeavor. School- Based Mental Health Programs Defined. What distinguishes a comprehensive school- based mental health program from what is commonly used in many schools today? Comprehensive school- based programs incorporate a team of behavioral health professionals from an outside organization, such as a community mental health provider, that partners with a school. This approach is effective because it enables specialists to quickly identify student issues and immediately triage care based on the severity of circumstances. Whether it is a minor emotional disturbance that requires basic support or a far more complicated mental health issue mandating a more intensive intervention, a comprehensive school- based approach enables a full range of options to schools that deploy them. Appropriate levels of care can then be structured based on severity of emotional/mental health issues. Team members from the community mental health organization can be activated when more intensive services are needed. School psychologists or social workers can provide wellness, education, and prevention programs. Concurrently, members of both teams consult at regular intervals and as needed so that the entire team is current and up- to- date. Key Elements School districts benefit from teaming with community mental health providers who have unique competencies, such as integrated substance abuse and mental health services for youths; family, individual, and group therapies; medication management; case management; and an orientation toward assertive community outreach principals. When complex interventions are needed, often under extreme crisis situations, schools will need to quickly mobilize a mental health team that brings a wide range of specialties to any situation. Team Blueprint What should an ideal treatment/intervention team look like? How many staff members should be accessible? How does a supplemental team interact with the on- site school staff? Given the wide range of issues that may emerge in a school setting, teams should be structured in such a way that expertise or practice areas can quickly be invoked when needed. While contracted staff are not always on site at the school, another advantage to engaging professionals from a community mental health provider is the fact that they can quickly assemble in the event they are needed. By far the most important member of the team is the . Some school- based programs may utilize a care coordinator from the community mental health organization. This individual is on site and dedicated to quickly assessing, triaging, and identifying needs that connect students and their families with appropriate service providers. Other schools with less intensive needs assign a member of the community mental health team to serve as the point person. Either way, this point of contact is crucial. The point person ensures optimal communication and quick mobilization. He or she collaborates with school nursing staff and administrators and deploys the services of the community mental health provider when needed. This person represents and has access to all the services that the agency provides, such as individual and group therapists, family counselors, chemical dependency advisors, experts in crisis management, and psychiatrists for medication management. These teams will play a role in developing care plans for students. Partnerships. Partnerships that are key to the success of a school- based program include a school district. Family members, of course, should not be overlooked, as they will play perhaps the most important role in outcomes for the adolescent, providing ongoing guidance during therapy, maintaining a nurturing and understanding environment in which adolescents can recover, and participating in family therapy. Community mental health organizations experienced in family settings will prove valuable here. Another place where community mental health organizations are indispensible is through established relationships with state agencies serving children. These include the juvenile rehabilitation administration and the department of children and family services. For youths with a history of being in . One of the most fruitful partnerships in this relationship is that of the school itself. School administrators, teachers, and medical staff are the foot soldiers of the program and, through their active collaboration with the community mental health organization, are the . Through frequent collaboration and interaction with community mental health agencies, school staff members become more adept at recognizing early warning signs and distinguishing nuanced behaviors. They even serve as mental health ambassadors of sorts, bringing much needed approachability and accessibility to the concept of mental health and the various services that might be available to students. Challenges. Most helping professionals would quickly sign up for a comprehensive school- based mental health program. Still, several challenges exist that must be considered when implementing such a program, including the following. Despite the incredible benefits and relative minimal costs of a school- based model, some funding mechanism is essential. Whether through Medicaid or private or foundation funding, it is unlikely that a comprehensive school- based mental health program can sustain itself without outside support. Territoriality may emerge. There may be the perception that you are there to make big changes. Some educators may not have been exposed to mental health programs, nor have they had training in the field. For this reason, mental health professionals must make themselves visible and be consistent and proactive in initiating meetings with key school staff, students, and parents when necessary. Another important factor is providing psych education to staff to help them understand mental health. The mental health professionals must take the time to educate the school about other services available through the agency. Inform school staff that functions such as psychiatric evaluation, medication management, group therapy, family therapy, case management, psychological evaluation, and crisis services can reduce their burden. It may take time, but a proactive, vigilant, and opportunistic approach to educating staff will pay off. Roles and Boundaries. Clarifying roles and setting clear boundaries as a school- based clinician is an important component to implementing agency/school counseling. Without it, there will be confusion and unreasonable expectations. Clearly, the first place to start in defining roles and setting boundaries will be through initial planning with school administrators and agency leadership.
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