Parents and Teachers as Allies

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• Parents and Teachers as Allies
• Partnering with Schools to Improve the Lives of
  Students
• Living with Mental Illnesses
• Darcy Gruttadaro, Director, NAMI National Child
  Adolescent Action Center
• Donna Pollard, Program Director Parents and
  Teachers as Allies Trainer, NAMI Orange County
• Donna Wallis, Executive Director Parents and
  Teachers as Allies Trainer, NAMI Orange County

2
The Vital Need for Early Identification of Mental
Illnesses

• The overwhelming majority of children and
  adolescents with mental illnesses fail to be
  identified and linked with services.
• There are often tragic and avoidable
  consequences.
• Many school professionals lack an understanding
  of early onset mental illnesses.

3
Research Supports Early Identification

• NIMH researchers found that half of all lifetime
  cases of mental illness begin by age 14, and that
  despite effective treatments, there are long
  delays sometimes decades between first onset
  of symptoms and when people seek and receive
  treatment. Untreated mental illnesses can lead to
  a more severe, more difficult to treat illness,
  and to the development of co-occurring mental
  illnesses.
• NIMH Funded Research, Released in June 2005.

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The Role of Schools in Early Identification

• NAMI recognized the tremendous value of having
  parents and school professionals working together
  as allies
• which led to the development of the Parents and
  Teachers as Allies publication in 1999 (updated
  in 2003).

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Parents and Teachers as Allies

• The PT as Allies publication covers the
  following
• Keys to early recognition and links to
  appropriate evaluation and services (teachers are
  never asked to diagnose children or to recommend
  medications)
• Understanding family reactions to mental
  illnesses and guidelines for helping families
• Navigating the referral process and linking to
  services as allies
• Strengthening the alliance between parents and
  school professionals and lists resources for both.

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President Bushs NFC Recommends Schools Play a
Bigger Role

• Goal 4 of President Bushs New Freedom Commission
  Report on Mental Health, issued in July 2003,
  calls for schools to play a larger role in the
  early identification of mental health treatment
  needs in children and in linking them to
  appropriate services.
• This is just what NAMIs PT as Allies program
  targets.

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The Words of the NFC

• The mission of public schools is to educate all
  students. However, children with serious
  emotional disturbances have the highest rates of
  school failure. Fifty percent of these students
  drop out of high school, compared to 30 of all
  students with disabilities. Schools are where
  children spend most of each day

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The Words of the NFC

• While schools are primarily concerned with
  education, mental health is essential to learning
  as well as to social and emotional development
  Schools must be partners in the mental health
  care of our children.
• NFC Report, 2003

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Why Schools

• Schools are in a unique and key position to
  identify mental health concerns early and to link
  students with appropriate services.
• Strong school mental health programs can help to
  address the needs of students, reduce unnecessary
  suffering, and help to ensure academic
  achievement.
• Goal 4 of The Presidents New Freedom Commission
  on Mental Health

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The Success of the Publication

• NAMI leaders recognized the value in sharing the
  publication with schools and began to use it to
  better inform school professionals about early
  onset mental illnesses.
• Innovative NAMI leaders in a number of states
  developed an in-service presentation program
  based on the publication.

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The Focus of NAMIs In-Service Program

• Helping schools to better understand the early
  warning signs of mental health treatment needs in
  students and how best to intervene so that youth
  with treatment needs are linked with services.

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The In-Service Early Pilot Program

• The In-Service presentation follows the content
  of the PT as Allies publication, with the lived
  experience representing a critical component.
• The In-Service presentation was launched in
  Orange County, FL (12th largest school district
  in the country) and has been delivered in
  multiple pilot sites in states around the
  country, including CA, IL, VA, WA, MN, CT, and
  others.

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The In-Service Early Pilot Program

• School professionals give extremely high grades
  to the early pilot program.
• School professionals often admit feeling ill
  equipped to address the needs of these students
  and how best to work with families.
• NAMI national received a four-year foundation
  grant to expand the early pilot program.

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Expansion of the Pilot Program

• The Pilot Program expansion targets public
  schools in urban, suburban, rural, and culturally
  diverse communities.
• NAMI continues to focus on cultural competence in
  the program. It will be available in Spanish in
  2007-08.

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Expansion of the Pilot Program

• The foundation grant has allowed NAMI to expand
  the scope and reach of the program.
• Two additional modules added
• Module to instruct grassroots family leaders
  about effective outreach to schools
• Module to include a presentation on early warning
  signs for parents and caregivers and effective
  outreach to families within the school community.

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Overview of Parents Teachers as Allies
In-Service Education Program

• Two-hour in-service education program.
• Most schools require school professionals to have
  in-service training/education.
• The Program includes a team of four presenters
  educator/family member, facilitator/F2F teacher,
  parent of a child, and consumer that had early
  onset MI.
• The Publication is provided to all participants.

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Content of the In-Service Program

• Welcome and Introductions
• Lead by Educator/Family Member
• Speaks from personal experience, warms up the
  room, connects with the audience as a credible
  education professional.
• Focuses on stigma and different perspectives we
  all have about MI.

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Some Suggestions for Welcome and Introductions

• Make the objectives for the presentation clear,
• Be sure to introduce NAMI to the audience.
• Provide NAMIs definition of mental illness
  Mental illnesses are medical conditions that
  disrupt a persons thinking, feeling, mood,
  ability to relate to others, and daily
  functioning. Just as diabetes is a disorder of
  the pancreas, mental illnesses are medical
  conditions that often result in a diminished
  capacity for coping with the ordinary demands of
  life.

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Content of the In-Service Program

• Early Warning Signs of Mental Illness
• Lead by Facilitator/Family Member
• Directs group to publication.
• Reviews the early warning signs.
• Reinforces that teachers are not diagnosticians
  but can certainly recognize early warning signs
  if they know what to look for.

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Suggestions

• We want the audience to become familiar with the
  monograph.
• We have asked members of the audience to read
  portions for a change of pace.
• Stress listening to families.

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Content of the In-Service Program

• Family Response Predictable Stages of Emotional
• Reactions Among Family Members
• Lead by Parent/Family Member
• Reviews stages from the publication (pg. 21-22).
• Parent recounts their personal journey with their
  child (infusing the lived experience).
• Talks about where things are now and steps a
  school took that were helpful.

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Content of the In-Service Program

• Living with Mental Illnesses A View from the
  Inside
• Lead by Consumer
• Consumer shares his/her experiences as a child
  living with mental illness.
• Focus is on the struggles, especially in school,
  teachers that helped, what was harmful, what was
  needed and how bad experiences can be turned
  around.
• Professionals are interested in knowing how to
  properly handle classroom circumstances that they
  have not been trained to address.

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Living with Mental Illness

• The consumer presentation captures the heart of
  the audience.
• Just having some understanding of the feelings a
  child is experiencing helps teachers cope with
  difficult behaviors.

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Content of the In-Service Program

• Group Discussion
• Lead by Educator/Family Member
• Everyone on the presenting team fields questions
  from in-service participants.
• Presenters are trained to know about the FAQ
  (differentiating between bad behavior and early
  warning signs, who do I refer a child to, isnt
  medicating a child controversial, how does all
  this help with classroom management, etc.)

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Content of the In-Service Program

• Closing
• Lead by Facilitator/Family Member
• Thanks participants and those who arranged the
  in-service training.
• Evaluations for program completed (satisfaction
  survey and pre- and post-test).
• We have found that school professionals want much
  more information (effective behavior
  interventions, classroom based EBPs, etc.).

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Effective Outreach to Schools

• Many schools have not engaged in the MH agenda
  yet and some resist it.
• It may not be a priority for schools.
• School professionals are stretched very thin.
• Many school-based MH professionals are
  over-extended, working at multiple schools with
  huge case loads and some fail to understand early
  onset MI.

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Outreach to Schools

• The key to success is to go in to schools knowing
  the challenges that they face.
• We see this task as akin to cultural and social
  anthropologists we put ourselves in their
  shoes.
• This program is a beginning to help schools
  understand the pressing need to recognize the
  early warning signs of mental illnesses and to
  link students with services.

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Outreach

• We know that there are many successful ways to
  conduct outreach with schools.
• An outreach strategy that works wonders in one
  district may not work at all in another.
• A thread of common importance establish a firm
  connection with the targeted school and build a
  relationship of trust.

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Outreach

• Some basic suggestions
• Start where you are most likely to succeed
  (capitalize on early success, the ripple effect
  and benefits of the grapevine).
• Find your strongest school-based allies.
• Find your strongest community allies (other
  advocacy groups, the PTA, etc.).

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Outreach

• The advantages and dangers of starting at the
  top.
• Craft your message carefully -- what matters most
  to this school?
• In our experience, school districts are hungry
  for this information but it can be difficult to
  make it a priority for them.

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How the Program Fits Within an Overall Advocacy
Agenda

• The education community is key to reaching the
  NAMI goal of reducing stigma and discrimination.
  Given the early onset of mental illness and the
  advantage of early identification we must find
  ways to reach educators.

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Our Orange County Experience

• Orange county is a large county with 31 school
  districts and 500,000 students.
• We have been providing lessons in education
  system.
• schools for 10 years.
• We have done some teacher in-services before the
  present PTasA program.
• We have made some friends in the county education
  department.

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The Snowball Effect

• Our first presentation after the our training in
• St. Louis was at the Orange County department of
  Education which was arranged by a NAMI member
  there. Personnel from the Orange county Health
  Care Agency attended.
• After that meeting five more presentations were
  scheduled.
• Because county personnel attended, we have been
  asked to present at the school nurse convention
  in August.

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The Snowball Effect, contd

• From the original five presentations, two more
  are scheduled for the future with a couple more
  possibilities.
• We have been asked to speak at two church groups,
  too.
• We did another presentation at OCDE in April.
• The more we do, the more we will be asked to do.

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Building Your Team

• Go for the gold!
• Find a well credentialed educator.
• The family member and consumer are key!
• Consumer presenters are the more difficult to
  find.
• The training day is from 8-5.
• We recommend training at least 3 teams.
• Make sure each team member understands the
  requirements.

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Securing Team Commitment

• On training day, determine the role of each
  participant.
• Stress the importance of meeting before a
  presentation to practice.
• Each participant needs to come to practice
  prepared.
• If there is not a program coordinator, one of the
  team members needs to be a leader.
• Our evaluations have been very motivating to our
  teams. (See handout)

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Training Opportunities

• Kingston Jr. High in Kingston WA needed a
  presentation for their faculty following two
  suicides. We were asked to do this and we asked
  to be able to train NAMI WA in the program. This
  was financed by a memorial fund for one of the
  victims.
• We have also gone to San Luis Obispo, CA to train
  folks there.
• This is an excellent program with the capability
  of helping in the prevention and early
  intervention of mental illness!

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Comment from Kingston, WA

• Email received from Eric Kvistad, father of
  student at Kingston Junior High
• I am the one who should be thanking you. This
  never would have been possible without you and
  Donna helping. My wife and I are gratified this
  subject has received so much attention in our
  local area. It may be the ray of hope that a
  troubled youth needs in order to get help.

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Next Steps

• Our first national train-the-trainers meeting for
  this program was held in March 2006 in St. Louis.
• NAMI and CHADD leaders from 14 states
  participated (CA, CT, FL, ID, IL, MD, TX, MN, MI,
  NC, OH, PA, TN, UT). Numerous schools in these
  states have received the PTasA Program and
  evaluations from these sites are currently being
  analyzed to create an evidence base for this
  Program.
• The expanded program will continue to be rolled
  out as additional states become trained during
  the next two years of the foundation grant.

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The Roll-Out

• Family advocacy leaders participating in the
  program are receiving ongoing technical
  assistance from the NAMI national office.
• This interaction between the field and NAMI
  national provides us with direct feedback on the
  programs effectiveness.
• The evaluation component of the program allows us
  to measure its ongoing success to help ensure
  continuous program improvement.
• NAMI continues to focus on cultural competence in
  the program. It will be available in Spanish in
  2007-08.

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NAMI Believes That

• together families, school professionals and
  mental health providers can make a tremendous
  difference in the lives of children and families.
• NAMI is pleased to see so many schools opening
  their doors to family advocates working to raise
  awareness about early onset mental illnesses.
• We look forward to continuing to build our
  partnerships and alliances with the school and
  mental health advocacy and provider communities.

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Contact Information

• Darcy Gruttadaro
• Director, NAMI Child Adolescent Action Center
• Phone [phone]
• Email darcy_at_nami.org
• Donna Pollard
• Program Director, NAMI Orange County
• Phone [phone]
• Email dpollard_at_namioc.org