Our Children Cant Wait Improving Services for Children and Adolescents with Mental Illness: Mental H

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Educator Roles in Promoting Mental Health and
School Success for PreK-12 Students
Carl E. Paternite, Ph.D. Center for School-Based
Mental Health Programs Department of
Psychology Miami University (Ohio) http//www.unit
s.muohio.edu/csbmhp Presented at Mental Health
Services and Schools Creating a Shared Vision
Ellicottville, NY August 19th, 2003
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Educator Roles in Promoting Mental Health and
School Success for PreK-12 Students

• Instructional Objectives For Presentation
• Increase participant awareness of the importance
  of
• educators in school-based mental health
  programming.
• Increase participant knowledge of effective
  approaches to
• enhance educator mental health professional
  collaboration.
• Increase knowledge of ways to infuse "mental
  health
• education" into the school milieu.

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Educator Roles in Promoting Mental Health and
School Success for PreK-12 Students

• Themes Addressed in Presentation
• Program development.
• Interdisciplinary collaboration and partnership.
• Prevention.
• Research, training and education.

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Mental Health Needs of Youth and Available
Services

• About 20 of children/adolescents (15 million),
  ages 9-17, have diagnosable mental health
  disorders (and many more are at risk or could
  benefit from help).
• Less than one-third of youth with diagnosable
  disorders receive any service, and, of those who
  do, less than half receive adequate treatment
  (even fewer at risk receive help).
• For the small percentage of youth who do receive
  service, most actually receive it within a school
  setting.
• These realities raise questions about the mental
  health fields over-reliance on clinic-based
  treatment, and have reinforced the importance of
  alternative models for mental health service
  especially expanded school-based programs.

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Leading Causes of Death in 15-19 Year Olds in
the United States in 2000 U N I T E D S T A
T E S, 2000
CAUSE OF DEATHS Accidents 6573 Homicide 1861 Sui
cide 1574 Cancer/Leukemia 759 Heart
Disease 372 Congenital Anomalies 213 Lung
Disease 151 Stroke 60 Diabetes 40 Blood
Poisoning 36 HIV 36
From Weist Adelsheim, 2003
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Report of Presidents New Freedom Commission on
Mental Healthhttp//www.mentalhealthcommission.go
v

• the mental health delivery system is fragmented
  and in disarrayleading to unnecessary and costly
  disability, homelessness, school failure and
  incarceration.
• Unmet needs and barriers to care include (among
• others)
• Fragmentation and gaps in care for children.
• Lack of national priority for mental health and
  suicide prevention.
• July, 2003

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Report of Presidents New Freedom Commission on
Mental Health Six Goals for a Transformed System

• Americans understand that mental health is
  essential to overall health.
• Mental health care is consumer and family driven.
• Disparities in mental health services are
  eliminated.
• Early mental health screening, assessment, and
  referral to services are common practice.
• Excellent mental health care is delivered and
  research is accelerated.
• Technology is used to access mental health care
  and information.
• July, 2003

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Four Recommendations Supporting Goal 4 Early
Mental Health Screening, Assessment, and Referral
to Services are Common Practice

• Promote the mental health of young children.
• Improve and expand school mental health programs.
• Screen for co-occurring mental and substance use
  disorders and link with integrated treatment
  strategies.
• Screen for mental disorders in primary health
  care, across the lifespan, and connect to
  treatment and supports.
• July, 2003

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Expanded School-Based Mental Health Programs

• National movement to place effective mental
  health programs in schools, serving youth in
  general and special ed.
• To promote the academic, behavioral, social,
  emotional, and contextual/systems well-being of
  youth, and to reduce mental health barriers to
  school success.
• Programs incorporate primary prevention and
  mental health promotion, secondary prevention,
  and intensive intervention,joining staff and
  resources from education and other community
  systems.
• Intent is to contribute to building capacity for
  a comprehensive, multifaceted, and integrated
  system of support and care.

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University of Maryland Center for School Mental
Health Assistance Mark Weist (http//csmha.umaryl
and.edu) ESBMH
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UCLA Center for Mental Health Assistance Howard
Adelman Linda Taylor (http//smhp.psych.ucla.edu
) Barriers to Learning (see handout)
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Interconnected Systems for Meeting the Needs of
All Students CONTINUUM OF SCHOOL AND COMMUNITY
PROGRAMS AND SERVICES (From Adelman Taylor,
http//smhp.psych.ucla.edu)
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Potential of Schools as Key Points of Engagement

• Opportunities to engage youth where they are.
• Unique opportunities for intensive, multifaceted
  approaches and are essential contexts for
  prevention and research activity.

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Schools The Most Universal Natural Setting

• Over 52 million youth attend 114,000 schools
• Over 6 million adults work in schools
• Combining students and staff, one-fifth of the
  U.S. population can be found in schools
• From Weist, 2003

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• Center for School-Based Mental Health Programs
  (at Miami University)
• Overarching Goals
• Build collaborative university-school district
  relationships to
• address the mental health needs of children
  and adolescents
• through multifaceted programming.
• Promote mental health and school success for
  youth through
• Primary prevention and mental health education
• Early direct intervention for identified at-risk
  children
• and adolescents, and treatment for those with
  severe/
• chronic mental health problems
• Action research, training, and consultation

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Center for School-Based Mental Health Programs
(at Miami University)

• Ohio Mental Health Network for School Success
• Six affiliate organizations working together in
  regional and state-wide activities (including
  Shared Agenda initiative)
• Butler County School-Based Mental Health Program
• School-based mental health promotion, prevention,
  intervention, and applied research activities.
• Addressing Barriers to Learning Program
• Annual conferences to initiate and sustain local,
  school-based projects that reduce mental health
  barriers to learning and enhance the development
  of healthy school communities.

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Center for School-Based Mental Health Programs
(at Miami University)

• Behavioral Health Advisor
• Mental health newsletter for elementary and
  secondary school educators, focusing on issues
  related to child mental health and school
  success.
• Evaluation of Alternative Education/ Discipline
  Programs
• Ongoing formative evaluation of 11 alternative
  programs in Butler County,OH.
• Mental Health for School Success
• Special project with Ohio Department of Education
  to promote mental health education integration.

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Center for School-Based Mental Health Programs
(at Miami University)Funding History (current
in bold)

• Butler County Mental Health Board
• The Health Foundation of Greater Cincinnati
• Ohio Department of Mental Health
• The Center for Learning Excellence
• Butler County Family and Children First Council
• Talawanda and New Miami School Districts
• Ohio Department of Education
• Miami University cost sharing

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School-Based Mental Health Partnerships Many
individuals have been instrumental to our
school-based mental health partnerships since
1998. To name just a few University-Based (3
universities, 5 academic divisions, 6
departments) Faculty/Staff Carl E. Paternite,
Karen Schilling, Julie Rubin, Denise Fox-Barber,
Amy Wilms, Betty Yung, David Andrews, Al Neff,
Diana Leigh, Alex Thomas, Randy Flora, Doris
Bergen, Valerie A. Ubbes, Raymond Witte, Joan
Fopma-Loy Psychology interns and graduate
assistants Lynne Knobloch, Becky Hutchison,
Sally Phillips, Leslie Baer, Linda Gal, Derek
Oliver, Mike Imhoff, Julie Cathey, Liz Morey,
Chris Dyszelski, Chris Mauro, Nancy Pike, Jessica
Donn, Sandra Kirchner, LaTasha Mack, Ann-Marie
Bixler, Jari Santana-Wynn, Jeanene Robinson,
Gloria Oliver, Francesca Dalumpines, Jamie
Williamson, Jill Thomas, Jennifer Malinosky,
Jason Kibby, Julia Pemberton, Ann Marie Lundberg,
Marc McLaughlin, Robin Graff-Reed, Melissa Maras,
Chris Reiger, Julie Swanson Community-Based Jo
hn Staup, Kay Rietz, Saundra Jenkins, Barbara
Perez, Susan Smith, Valerie Robinson, Jolynn
Hurwitz, Kate Keller, Terri Johnston, Charlie
Johnston, Kathy Oberlin, Ellen Anderson, Noelle
Duval, Linda Maxwell, Greg Foster, Teresa
Jullian-Goebel, Suzanne Robinson, Terre Garner,
Bryan Brown, Greg Rausch, Carolyn Jones, David
Turner School-Based Teacher consultants
Sherie Davis, Marilyn Elzey, Tom Orlow, Teresa
Abrams, Sarah Buck, Jim Carter, Julie Churchman,
Amy Gibson, Joy Boyle, Chris Carroll, Mary
Hessling, Joan Parks, Joanne Williamson, Jaimie
Pribble, Pam Termeer, Pat Stephens, Patricia
Scholl, Martha Slamer, David Wood, Susan Meyer,
Monna Even, Ginny Paternite, Connie Short, Terri
Hoffmann, Karen Shearer Guidance counselors,
school psychologists, school nurses, and
administrators Marianne Marconi, Sandy
Greenberg, Tom OReilly, Roberta Perlin, Betsy
Esber, MaryBeth Bergeron, Greg Rausch, Ann
Schmitt, Alice Bonar, Stephanie Johnson, Marcia
Schlichter, Susan Cobb, Phil Cagwin, Bob Bierly,
Martha Angello, Bill Miller, Bob Phelps, Dan
Milz, Dave Isaacs, Mark Mortine, Rhonda Bohannon,
Clint Moore, Cathy Keener, Mary Jane Roberts,
Jean Eagle, Alice Eby, Kathy Jonas, David
Greenburg, Candice McIntosh, Sharon Lytle, Terri
Fitton, Steve Swankhaus, Melissa Kessler, Mary
Jacobs .. Action-Project Teams Fourteen 2-4
person teams from ten schools in five school
districts, each with a university
faculty/graduate student liaison.
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The Ohio Mental Health Network for School Success

• Mission
• To help Ohios school districts, community-based
  agencies, and families work together to achieve
  improved educational and developmental outcomes
  for all children especially those at emotional
  or behavioral risk and those with mental health
  problems, including pupils participating in
  alternative education programs.

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The Ohio Mental Health Network for School Success

• Action Agenda
• Create awareness about the gap between childrens
  mental health needs and treatment resources,
  and encourage improved and expanded services
  (including new anti-stigma campaign).
• Encourage mental health agencies and school
  districts to adopt mission statements that
  address the importance of partnerships.
• Conduct surveys of mental health agencies and
  school districts to better define the mental
  health needs of children and to gather
  information about promising practices.

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The Ohio Mental Health Network for School Success

• Action Agenda (continued)
• Provide technical assistance to mental health
  agencies and school districts, to support
  adoption of evidence-based and promising
  practices, including improvement and expansion of
  school-based mental health services.
• Develop a guide for education and mental health
  professionals and families, for the development
  of productive partnerships.
• Assist in identification of sources of financial
  support for school-based mental health
  initiatives.
• Assist university-based professional preparation
  programs in psychology, social work, public
  health, and education, in developing
  inter-professional strategies and practices for
  addressing the mental health needs of school-age
  children.

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Policy Maker Partnership (PMP) at the National
Association of State Directors of Special
Education (NASDSE) and the National Association
of State Mental Health Program Directors (NASMHPD)
Concept Paper Mental Health, Schools and Families
Working Together for All Children and
Youth Toward A Shared Agenda (2002)
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Encourage state and local family and youth
organizations, mental health organizations,
education entities and schools across the nation
to enter new relationships to achieve positive
social, emotional and educational outcomes for
every child.
Purpose of the Concept Paper
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The concept paper is available online
atwww.nasdse.org/sharedagenda.pdfwww.ideapoli
cy.org/sharedagenda.pdfwww.nasmhpd.org
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Policy Maker Partnership (PMP) at the National
Association of State Directors of Special
Education (NASDSE) and the National Association
of State Mental Health Program Directors (NASMHPD)
Shared Agenda Seed Grant Awards to Six
States Missouri, Ohio, Oregon, South Carolina,
Texas, and Vermont
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Additional Funding for Ohios Shared Agenda
Initiative
Ohio Department of Mental Health Ohio Department
of Education Ohio Department of
Health and Numerous Additional State-level and
Regional Organizations
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Infrastructure for Ohios Shared Agenda
Initiative
The Shared Agenda seed grant is being implemented
in Ohio within the collaborative infrastructure
of the Mental Health Network
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Three Phases of Ohios Shared Agenda Initiative
Phase 1Statewide forum for leaders of mental
health, education, and family policymaking
organizations and child-serving systems (March 3,
2003) Phase 2Six regional forums for policy
implementers and consumer stakeholders
(April-May, 2003) Phase 3Legislative forum
involving key leadership of relevant house and
senate committees (October, 2003)
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Phase 1 and Phase 2Shared Agenda Forums
Logo Here

• Columbus, OH Statewide Forum, March 3, 2002
• Athens, OHSoutheast Wooster, OHNorth Central
• April 15, 2003 April 28,
  2003
• Columbus, OHCentral Bowling Green,
  OHNorthwest
• April 29, 2003 April 29,
  2003
• Cleveland, OHNortheast Hamilton, OHSouthwest
• May 5, 2003 May 5, 2003

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Strategies and Features of Various Shared Agenda
Forums

• Keynote presentations by national and state
  experts
• Mark Weist, Center for School MH Assistance, U.
  of Maryland
• Steve Adelsheim, New Mexico School MH Initiative
• Howard Adelman Linda Taylor, UCLA School MH
  Project
• Kimberly Hoagwood, Columbia University
• Howie Knoff, Project Achieve
• Joseph Johnson, Ohio Department of Education
• Eric Fingerhut, Ohio State Senator

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Strategies and Features of Various Shared Agenda
Forums

• Promising work in Ohio showcased
• Youth and parent testimony
• Cross-stakeholder panel discussions
• Facilitated discussion structured to create a
  collective
• vision, build a sense of mutual responsibility
  for reaching
• the vision, instill hope that systemic change is
  possible,
• and problem-solve regarding implementation
  issues
• Appreciative Inquiry model for promotion of
  systems-level change and transformation informed
  the process

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Outcomes and Recommendationsfrom Phases 1 and 2
of Ohios Shared Agenda Initiative

• Approximately 725 participants
• Report being compiled that will inform the Fall,
  2003 Shared Agenda Legislative Forum
• Through Legislative Forum raise public awareness
  and build advocacy for policy and fiscal support
  for better alignment for education and mental
  health in the next biennial budget process
• Website created to track and publicize Ohios
  Shared Agenda initiative (http//www.units.muohio.
  edu/csbmhp/sharedagenda.html)

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Ten Emerging Recommendationsfrom Phases 1 and 2
of Ohios Shared Agenda Initiative
Logo Here

• 1. Promote EFFECTIVE mental health and
  educational practices in schools
• 2. Increase family and community involvement in
  school mental health and educational programs
• 3. Actively solicit and appreciate student input
  in program planning and operation
• 4. Reduce stigma for children who need mental
  health
• services

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Ten Emerging Recommendations from Phases 1 and 2
of Ohios Shared Agenda Initiative (contd)
Logo Here

• 5. Maintain focus on all children, not just
  students in special education
• 6. Promote a better understanding of childrens
  mental health needs in schools
• 7. Expand cross-discipline training (preservice
  and inservice) for mental health/family-serving
  providers, educators and parents

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Ten Emerging Recommendations from Phases 1 and 2
of Ohios Shared Agenda Initiative (contd)
Logo Here

• 8. Work more effectively to reduce turf issues
  that interfere with childrens mental health
  service delivery and with mental health-education
  collaboration
• 9. Coordinate more effectively between
  state-level and regional/local efforts in the
  area of school mental health and in promotion of
  mental health and school success
• 10. Develop organizational structures (e.g.,
  501C3) that will promote strong coalitions and
  facilitate funding

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Creating and Maintaining Ongoing, Empowering
Dialogue with Educators

• Multi-level, formal and informal dialogue with
  policy makers, formulators, enforcers, and
  implementers.
• Programs for school board members and
  administrators.
• Newsletter for teachers.
• Website resources.
• Extensive contact time with educators in their
  school buildings.
• Joining the school community.
• Key opinion leaders.

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Assessing and Responding To Educator-Identified
Needs and Concerns

• Careful, detailed, local needs assessments from
  the perspective of educators, and a commitment to
  be responsive to identified needs.
• Results used in advocacy efforts and as
  guideposts for ongoing work.

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Perceived Problems And Teamwork Exercises
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Teacher Consultants

• Teacher consultants develop and implement special
  projects
• related to school-based mental health
  enhancement.
• Teacher consultants serve as liaisons to the
  schools in efforts to promote school-based
  mental health programming.
• Teacher consultants serve as informal
  advisers/mentors to
• school staff on matters related to
  social-emotional adjustment and learning needs of
  children and school/climate issues.

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Incentives For Teacher Consultants

• Leadership opportunity
• Training opportunity
• Academic credit
• Stipends (supplemental contracts)
• Empowerment
• Demystification

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• Addressing Barriers to Learning Annual
  Conference and Action Projects Program
• Goal
• Conduct annual conferences, to help initiate
  planned
• local public school-based projects that
  reduce mental
• health-related barriers to learning and
  enhance the

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• Objectives of Addressing Barriers to Learning
  Program
• Demonstrate, produce and assess school-based
  mental
• health practices (classroom-based,
  classroom-linked)
• that address barriers to desired academic
  outcomes
• and personal and social skill development.
• Put into continuing practice that which
  participants learn
• in conference activities and projects.
• Increase the effectiveness of school district
• collaboration and system support for
  school-based
• mental health practices.
• Disseminate findings.

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• Resources for Addressing Barriers to Learning
  Program
• Researchers and practitioners whose work on the
• conference theme evidences quality and the
  potential for
• successful application locally.
• Web-site support.
• Resource packets.
• Small grants to support action projects.
• Ongoing consultation with action teams with
  graduate
• students/faculty.

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• Conference Themes for Addressing Barriers to
  Learning Program
• 2000 Nonviolent Schools Building Programs
  That Work
• Consultants Betty Yung and
  Jeremy Shapiro
• 2001 School, Family, and Community
  Partnerships
• Consultants Marc Atkins and
  Scott Rankin
• 2002 School, Family, and Community
  Partnerships
• Consultants Program faculty

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• Addressing Barriers to Learning Current
  Elementary School Action Projects
• School-wide project focused on increasing
  students positive social skills, using monthly
• themes and activities (open house nights,
  assemblies, community speakers). Parent
• involvement in planning and implementation is
  emphasized.
• School-wide project focused on trait of the
  month themes (e.g., responsibility, caring)
• and activities (community service projects,
  fund raising for needy families, school-based
• counseling groups, after school activities,
  peer mediation program).
• School-wide attendance enhancement program,
  through improved monitoring, enhanced
• parental involvement with an after
  school/evening tutoring program linked to family
• dinner/activity events, and an attendance
  reward program.
• School-wide outreach program to families (The
  Road Show) taking school informational
• meetings into neighborhoods and communities,
  to overcome obstacle of the
• geographically large catchment area and to
  increase family sense of engagement with the
• school.

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• Addressing Barriers to Learning Current
  Elementary School Action Projects (contd)
• A violence reduction program, focused on
  development of resource materials and use of
• psychoeducational training in coping skills
  and strategies for at risk students.
• School-wide family engagement project
  emphasizing literacy, through school-based
• reading night dinner programs with
  storytellers and opportunities for families to
  read
• together.
• School-wide parent involvement and support
  program focused on attention to needs of
• families, efforts to increase positive
  attitudes toward learning, and enhancement of
  social
• skills of students, using community picnics
  and Parents on Board parenting classes.
• School-wide program focused on understanding and
  appreciating difference, tolerance,
• and conflict resolution skills, using
  curricula from the Center for Peace Education.

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• Addressing Barriers to Learning Current High
  School Action Projects
• Mentoring program focused on academic and
  personal success
• of students, including a strong community
  service component.
• Alternative high school service learning program
  incorporating
• intensive involvement with a senior citizens
  center and tutoring in
• an elementary school.

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• Addressing Barriers to Learning Training in the
  Project Evaluation Process
• Determine goals and objectives.
• Determine data needed to measure desired
  outcomes.
• Select measurement methods.
• Outline data collection plan.
• Collect data.
• Compile, analyze, interpret, and report results.
• Refine project based on findings.
• Note Dr. Doris Bergen (Miami University Center
  for Human Development, Learning, and
• Teaching) has provided ongoing technical
  assistance on the evaluation process.

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Addressing Barriers to LearningLevels of
Evaluation Evaluation expected on two or more
of the four levels Level 1 -- Records on
planned activities. Level 2 -- Self-report data
from participant groups on knowledge,
attitudes, behaviors. Level 3 -- Outcome data
on student effects (attendance, office
referrals, grades). Level 4 -- Systematic
observational data on behavior change
related to objectives of project. Note Dr.
Doris Bergen (Miami University Center for Human
Development, Learning, and Teaching) has provided
ongoing technical assistance on the evaluation
process.
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• Addressing Barriers to Learning Linking Project
  Objectives to Evaluation
• The Road Show
• Objectives
• Increase family involvement with school
• Increase student attendance
• Decrease discipline referrals
• Evaluation Plan
• Number of positive/negative calls to school
• Road show attendance rates and parent survey
• Attendance at parent conferences
• Student attendance rates
• Student discipline referrals

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Educators as Key Members of the Mental Health
Team

• Schools should not be held responsible for
  meeting every need of every student.
• However, schools must meet the challenge when the
  need directly affects learning and school
  success. (Carnegie Council Task Force on
  Education of Young Adolescents, 1989)
• There is clear and compelling evidence that there
  are strong positive associations between mental
  health and school success.

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Educators as Key Members of the Mental Health Team

• Children whose emotional, behavioral, or social
  difficulties are not addressed have a diminished
  capacity to learn and benefit from the school
  environment. In addition, children who develop
  disruptive behavior patterns can have a negative
  influence on the social and academic environment
  for other children. (Rones Hoagwood, 2000,
  p.236)
• Contemporary school reformand the associated
  high-stakes testing (including federal
  legislation signed in 2002)has not incorporated
  the Carnegie Council imperative. That is, recent
  reform has not adequately incorporated a focus on
  addressing barriers to development, learning, and
  teaching.

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Educators as Key Members of the Mental Health Team

• An Exercise
• How much time do you spend addressing the
  emotional,behavioral, and/or social difficulties
  of your students (minutes per hour)?

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Context Examples

• Senior high school with 880 students reported
  over 5,100 office discipline referrals in one
  academic year.

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What does this mean?

• 5100 referrals _at_ 10 minutes each
• 51,000 minutes or
• 850 hours or
• 141 6 hour days!

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Context Examples

• Middle school principal reports he must teach
  classes when teachers are absent, because
  substitute teachers refuse to work in a school
  that is unsafe and lacks discipline.

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Context Examples

• Middle school counselor spends nearly 15 of day
  counseling staff who feel helpless
  defenseless in their classrooms because of lack
  of discipline support.

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Context Examples

• Elementary school principal found that over 45
  of their behavioral incident reports were coming
  from the playground.

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Context Examples

• Three rival gangs are competing for four
  corners. Teachers actively avoid the area.
  Because of daily conflicts, vice principal has
  moved her desk to four corners to regain control.

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Context Examples

• Bus transportation company is threatening to
  w/draw their contract if students dont improve
  their behavior. Recently, security guards were
  hired to ride buses.

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Context Examples

• Elementary school principal reports that over
  100 of her office discipline referrals came from
  8.7 of her total school enrollment, 2.9 had 3
  or more.

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Whos problem is it?

• In one school year, Jason received 87 office
  discipline referrals.
• In one school year, a teacher processed 273
  behavior incident reports.

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Something to Think About

• Any student who is giving it bad to an educator
  is getting it at least as bad or worse from some
  important source in his life.
• (Mendler, 1997)

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Problem Behaviors

• Insubordination, noncompliance, defiance, late
  to class, nonattendance, truancy, fighting,
  aggression, inappropriate language, social
  withdrawal, excessive crying, stealing,
  vandalism, property destruction, tobacco, drugs,
  alcohol, unresponsive, not following directions,
  inappropriate use of school materials, weapons,
  harassment, unprepared to learn, parking lot
  violation, irresponsible, trespassing,
  disrespectful, disrupting teaching,
  uncooperative, violent behavior, disruptive,
  verbal abuse, physical abuse, dress code, other,
  etc., etc., etc.

• Exist in every school
• Vary in intensity
• Are associated w/ variety of contributing
  variables
• Are concern in every community

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Prioritizing Promotion of Healthy Development and
Problem Prevention

• School-based models should capitalize on schools
  unique opportunities to provide mental
  health-promoting activities.
• For example, recommended strategies for drop-out
  and violence prevention, including those for
  which the central role of educators is evident,
  can be promoted actively within an expanded
  school-based mental health program.

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Prioritizing Promotion of Healthy Development and
Problem Prevention

• For drop-out prevention, these include
• Early intervention.
• Mentoring and tutoring.
• Service learning.
• Conflict resolution and violence prevention
  curricula and training for students/staff.
• Alternative schooling.

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Some of What We Know About Youth ViolenceFrom
the Surgeon General (2001), U.S. Secret Service
(2000),CDC (2002), Mulvey Cauffman (2001)

• Violence is a serious public health problem.
• Violence is most often expressive/interpersonal,
  rather than primarily instrumental or
  psychopathological.
• About 30 to 40 percent of male and 15 to 30
  percent of female youth report having committed a
  serious violent offense by age 17.
• About 10 to15 percent of high school seniors
  report that they have committed an assault with
  injury in the past year a rate that has been
  rising since 1980.
• By self-report, about 30 percent of high school
  seniors have committed a violent act in the past
  year hit instructor or supervisor serious
  fight at school or work in group fight assault
  with injury used weapon (knife/gun/club) to get
  something from a person.
• Violent acts are committed much more frequently
  by male than by female youth. (see Miedzian, 1991)

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Some of What We Know About Youth Violence
(continued)

• 43 of male and 24 of female high school
  students report that they had been in a physical
  fight during the past school year. (CDC, 2002)
• No differences are evident by race for
  self-report of violent behavior.
• At school, highest victimization rates are among
  male students.
• Violent behavior seldom results from a single
  cause.
• School continues to be one of the safest places
  for our nations children.
• Serious acts of violence (e.g., shootings) at
  school are very rare.
• Targeted violence at school is not a new
  phenomenon.
• Most school shooters had a history of gun use and
  had access to them.
• In over 2/3 of school shooting cases, having been
  bullied played a role in the attack.

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For every complex problem there is a
simple solution that is wrong.
H.L.
Mencken
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A QUESTION WHAT ARE THE CAUSES OF VIOLENCE,
OTHER PROBLEM BEHAVIOR, AND DISCIPLINE PROBLEMS?
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Causes of Violence, Other Problem Behavior, and
Discipline Problems

• Out-of-School
• Society
• Media
• More children living in poverty
• Deterioration of family
• Difficult temperaments
• Less able to listen effectively and process
  verbal material, compared to children 20 30
  years ago

80
Violent Behavior (Resnick et al., 1997)

• Behaviors modeled by sports and television heroes
  desensitize students to violence and antisocial
  behaviors
• Strongest protective factors from antisocial
  behavior
• Strong emotional attachments to parents and
  teachers

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Aggressive and Rejected Children

• Thinking errors
• Attribute hostile intentions to accidental or
  ambiguous behavior
• Misinterpret important social cues
• Tease others but respond incompetently when
  provoked

83
Educators

• Thinking errors
• If punishment is severe enough, children will
  cease negative behavior
• Punishment is in the best interest of the child
• Well controlled classrooms must be quiet
  classrooms
• Control is like a behavioral ointment
• no control at home slather it on in school
• Prescribed discipline programs provide security
  for staff

84
Model Influences on Violent versus Non-Violent
Behavior (From Shapiro, 1999, Applewood Centers,
Inc., Cleveland, OH)
85
Some of What We Know AboutYouth Violence
PreventionFrom the Surgeon General (2001), U.S.
Secret Service (2000),CDC (2002), Mulvey
Cauffman (2001)

• Promoting healthy relationships and environments
  is more effective for reducing school violence
  than instituting punitive penalties.
• The best predictor of adolescent well-being is a
  feeling of connection to school. Students who
  feel close to others, fairly treated, and vested
  in school are less likely to engage in risky
  behaviors.
• A critical component of any effective school
  violence program is a school environment in which
  ongoing activities and problems of students are
  discussed, rather than tallied. Such an
  environment promotes ongoing risk management,
  which depends on the support and involvement of
  those closest to the indicators of trouble
  peers and teachers.

86
Violence PreventionWhat Doesnt WorkFrom the
Surgeon General (2001) and others

• Scare tactics. (e.g., Scared Straight)
• Deterrence programs shock incarceration, boot
  camps.
• Efforts focusing exclusively on providing
  education/information about drugs/violence and
  resistance. (DARE)
• Efforts focusing solely on self-esteem
  enhancement.
• Vocational counseling.
• Residential treatment.
• Traditional casework and clinic-based counseling.

87
Promoting Nonviolence An Example of a
Heuristic School-Based Framework

• Deutsch (1993) Educating for a peaceful world
• Four Key Components Including
• Cooperative Learning.
• Conflict Resolution Training.
• Use of Constructive Controversy in Teaching
  Subject
• Matters.
• Mediation in the Schools.

88
Prioritizing Promotion of Healthy Development and
Violence PreventionBest and Promising Practices

• Including
• Structured social skill development programs.
• Mentoring. (see Big Brothers/Sisters Garbarino,
  1999)
• Employment.
• Programs that foster school engagement,
  participation, and bonding.
• Promotion of developmental assets. (see Search
  Institute)
• A variety of approaches that engage parents and
  families. (e.g., parent
• training, MST, functional FT)
• Early childhood home visitation programs.
• Multi-faceted programs that combine several of
  the above.
• For good examples see Blueprint Programs.

89
Developmental Assets and Violence(1997 data,
www.search-institute.org)

• Approximately 100,000 6th-12th graders.
• Definition of violencethree or more acts of
  fighting, hitting, injuring a person, carrying a
  weapon, or threatening physical harm in the past
  12 months.
• 61 of youth with fewer than 11 of 40
  developmental assets were violent.
• 6 of youth with 31 or more of 40 developmental
  assets were violent.

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Positive Behavior Support(see www.pbis.org)

• PBS is a broad range of systemic individualized
  strategies for achieving important social
  learning outcomes while preventing problem
  behavior with all students.

92
Terminology

• Positive Behavior.
• Includes all skills that increase success in
  home, school and community settings.
• Supports.
• Methods to teach, strengthen, and expand positive
  behaviors.
• System change.

93
Discipline Defined

• The steps or actions, teachers, administrators,
  parents, and students follow to enhance student
  academic and social behavior success.
• Effective discipline is described as teaching
  students self-control.

94
Reactive Vs. Proactive

• Traditional approaches. (including aversive
  interventions)
• Address problem behaviors reactively
• Crisis driven
• PBS emphasizes proactive interventions.

95
Goals

• Improved quality of life for all relevant
  stakeholders. (the individual, family members,
  teachers, friends, employers, etc.)
• Problem behaviors become irrelevant, inefficient,
  and ineffective and are replaced by efficient and
  effective alternatives.

96
PBS Interventions

• Context driven.
• Addressing the functionality of the behavior
  problem.
• Acceptable to the individual, family and
  community.

97
PBS is a Problem-Solving Process

• Decisions are based upon functional behavioral
  assessment. (FBA)
• FBA directs intervention design.
• FBA establishes instructional targets for
  alternative skills
• FBA designates supports and context revisions
  required for maintenance of positive changes

98
Systems Change

• DEFINING FEATURE OF PBS
• Efforts focused on fixing problem contexts, not
  problem behavior.
• Successful outcomes can not depend solely on
  identifying ONE key critical intervention to
  fix the problem.

99
Components of School-Wide Systems

• Common philosophy.
• Positively stated rules. (3 or 4)
• Behavior expectations defined by context.
• Teaching behavior expectations in context.
• Reinforcement of expectations.
• Discouragement of violations.
• Monitor and evaluate effects.

100
Two Distinct Discipline Models

• Obedience Model
• Responsibility Model
• From Johnston (2003)

101
Obedience

• MAIN GOAL
• Student follows orders
• PRINCIPLE
• Do what the teacher wants
• INTERVENTION PUNISHMENT
• External locus of control
• Done to the student
• STUDENT LEARNS
• Dont get caught
• Its not my responsibility
• From Johnston (2003)

102
Responsibility

• MAIN GOAL
• To teach students to make good choices
• PRINCIPLE
• Learn from the outcomes of decisions
• INTERVENTION CONSEQUENCES
• Internal locus of control
• Natural or logical
• Done by the student
• STUDENT LEARNS
• I have more than one alternative
• I have power to choose
• I cause my own outcomes
• From Johnston (2003)

103
Science of behavior has taught us that students.

• Are NOT born with bad behaviors
• Do NOT learn when presented contingent aversive
  consequences
• Do learn better ways of behaving by being taught
  directly receiving positive feedback
• From Johnston (2003)

104
Teacher Behaviors That Contribute to Discipline
Problems

• Sitting at the desk most of the time, not moving
  or mingling with the students
• Using a low, unenthusiastic or uniteresting voice
  tone
• Becoming easily sidetracked by one students
  irrelevant question
• From Johnston (2003)

105
Teacher Behaviors That Contribute to Discipline
Problems

• Ignoring students interests and tying
  instruction solely to the textbook
• Repeating students answers too frequently
• Leaving concepts before they have been clarified
  and/or expecting independent work before
  understanding has been checked
• Not being prepared and leaving down time for
  students to fill
• From Johnston (2003)

106
Teacher Behaviors That Contribute to Discipline
Problems

• Poorly worded questions that cloud discussion or
  understanding
• Having questions/answers be directed solely
  between teacher and student
• Neglecting to tie content or learning to prior
  knowledge of students
• Using too much time to teach the lesson and not
  focusing on what is being learned
• From Johnston (2003)

107
Teacher Behaviors That Contribute to Reduction of
Discipline Problems

• Remove conditions that trigger maintain
  undesirable practices
• Increase conditions that trigger maintain
  desirable practices
• Remove aversives that inhibit desirable practices
• Establish environments routines that support
  continuum of PBS
• From Johnston (2003)

108
Promoting Nonviolence An Example of a Promising
Secondary Violence Prevention Program

• Positive Adolescent Choices Training (PACT)
• Developed by
• Betty R. Yung W. Rodney Hammond
• Components
• I. Violence-Risk Education
• II. Anger Management
• III. Social Skills

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PACT Components I and II

• Violence Risk Education
• Increase awareness of circumstances, risk
  factors, and consequences of violence.
• Anger Management
• Understand and normalize feelings of anger,
  recognize anger triggers, and manage anger
  constructively.

111
PACT Components III Social Skills

• Givin It
• Expressing criticism, disappointment, anger, or
  displeasure calmly and ventilating strong
• emotions constructively.
• Takin It
• Listening, understanding, and reacting
  appropriately to others criticism and anger.
• Workin It Out
• Listening, identifying problems and potential
• solutions, proposing alternatives when
• disagreements persist, and learning to
• compromise.

112
Closing Observations

• Clearly, intellectual, social, and emotional
  education go hand-in-hand, and all are linked to
  creating safe schools, building healthy
  character, and achieving academic success
• The proper aim of education is to promote
  significant learning. Significant learning
  entails development. Development means
  successively asking broader and deeper questions
  of the relationship between oneself and the
  world. This is as true for first graders as it is
  for graduate students, for fledgling artists as
  graying accountants.
• A good education ought to help people
  become more perceptive to and more discriminating
  about the world seeing, feeling, and
  understanding more, yet sorting the pertinent
  from the peripheral with ever finer touch,
  increasingly able to integrate what they see and
  to make meaning of it in ways that enhance their
  ability to go on growing. To imagine otherwise,
  to act as though learning were simply a matter of
  stacking facts on top of one another, makes as
  much sense as thinking one can learn a language
  by memorizing a dictionary. Ideas only come to
  life when they root in the mind of a learner.
  (Daloz, 1999, p. 243)

113
Closing Observations

• The need for increased attention to mental health
  promotion on behalf of youth, is quite clear
• We have a burgeoning field of developmental
  psychopathology but have a more diffuse body of
  research on the pathways whereby children and
  adolescents become motivated, directed, socially
  competent, compassionate, and psychologically
  vigorous adults. Corresponding to that, we have
  numerous research-based programs for youth aimed
  at curbing drug use, violence, suicide, teen
  pregnancy, and other problem behaviors, but lack
  a rigorous applied psychology of how to promote
  youth development.
• The place for such a field is apparent to
  anyone who has had contact with a cross section
  of American adolescents. (Larson, 2000, p. 170)

114
Closing Observations

• Certainly, educators are key partners in efforts
  to intervene with children in need and to promote
  development.
• In fact, through their day-to-day interactions
  with students, educators are the linchpins of
  school-based efforts to encourage healthy
  psychological development of youth.

115
This PowerPoint Presentation, with a reference
list for cited work, will be posted on the CSBMHP
website http//www.units.muohio.edu/csbmhp
116
Common Messages Across Initiatives

• It is important to build on the common goals of
  expanded school-based mental health programs and
  existing community and school initiatives. For
  example, in Ohio
• Shared Agenda Initiative
• Partnerships for Success
• Alternative Education Challenge Grant Program
• All share a common core focus on barriers to
  development, learning, and teaching.
• Identification of the common message across
  initiatives is extremely important for reducing
  the chances that what is being introduced by any
  one initiative will be marginalized by proponents
  of narrowly-focused school reform.

117
Strategies and Features of Various Shared Agenda
Forums

• Keynote presentations by national and state
  experts
• Mark Weist, Center for School MH Assistance, U.
  of Maryland
• Steve Adelsheim, New Mexico School MH Initiative
• Howard Adelman Linda Taylor, UCLA School MH
  Project
• Kimberly Hoagwood, Columbia University
• Howie Knoff, Project Achieve
• Joseph Johnson, Ohio Department of Education
• Eric Fingerhut, Ohio State Senator

118
Strategies and Features of Various Shared Agenda
Forums

• Promising work in Ohio showcased
• Youth and parent testimony
• Cross-stakeholder panel discussions
• Facilitated discussion structured to create a
  collective
• vision, build a sense of mutual responsibility
  for reaching
• the vision, instill hope that systemic change is
  possible,
• and problem-solve regarding implementation
  issues
• Appreciative Inquiry model for promotion of
  systems-level change and transformation informed
  the process

119
Proven, Successful Treatments Exist for Most
Disorders

• Treatment success rates
• 80 for major depression
• 65 for bipolar disorder
• 60 for schizophrenia
• 45 for heart disease

From Weist Adelsheim, 2003
120
Characteristics of Children Living in Poverty
(Ruby Payne, 1998)

• Laughs when disciplined or is disrespectful to
  the teacher
• Argues loudly with the teacher
• Responds angrily
• Uses inappropriate or vulgar comments
• Fights to survive or uses verbal abuse with other
  students

121
Characteristics of Children Living in Poverty
(Ruby Payne, 1998)

• Hands are always on someone else
• Cant follow directions
• Is extremely disorganized
• Talks incessantly
• Cheats or steal

122
Characteristics of Children Living in Poverty
(Ruby Payne, 1998)

• If one out of every four children under the age
  of 18 in the USA was living in poverty in 1996,
  25 or more of our students may exhibit these
  behaviors in the classroom.

123
Students cant learn when fearful of...

• Physical assault
• Assault to self-esteem
• Damages to personal property

124
and teachers cant teach!
125
Carly and Aidan
in their vehicles
126
Carly, Elmo and Aidan