Youth Mental Health First Aid: How Adults Can Help Youth in Need Hilva Chan and Monica Nepomuceno California Department of Education 1
What is YMHFA? Signs and Symptoms Risk and Protective Factors Fact and Fiction: Self Injury and Suicide Action Plan: ALGEE Free Trainings from Project Cal-Well 2
What is YMHFA? Australian based public education program Based on the concept of medical first aid Helps identify, understand, and respond to signs of mental distress or illness Eight-hour interactive course 3
Why Mental Health First Aid for Those who Work with Youth? Mental health problems are common Mental health problems often develop during adolescence Youth and young adults may experience mental health problems differently than adults Youth may not be well informed The sooner an individual gets help, the more likely they are to have a positive outcome Misunderstanding and discrimination are often associated with mental health problems Professional help is not always on hand 5
The Journey 5
What are Some of the Disorders we Might Hear About Among Youth? ADD/ADHD/ODD Anxiety Disorders Bipolar Disorder Depression Eating Disorders Psychosis Substance Use Disorders 6
35 Report of Chronic Sadness and Suicide Ideation by Student, 2013-15 CHKS 30 Percentage of students 25 20 15 10 25 19 19 32 34 5 0 Grade 7 Grade 9 Grade 11 Chronic Sadness Suicide Ideation During the past 12 months, did you ever feel so sad or hopeless almost every day for two weeks or more that you stopped doing some usual activities? During the past 12 months, did you ever seriously consider attempting suicide? 7
Adolescent Changes 8
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Signs & Symptoms: Physical Cardiovascular: pounding heart, chest pain, rapid heartbeat, blushing Respiratory: fast breathing, shortness of breath Neurological: dizziness, headache, sweating, tingling, numbness Gastrointestinal: choking, dry mouth, stomach pains, nausea, vomiting, diarrhea Musculoskeletal: muscle aches and pains, restlessness, tremors and shaking, inability to relax 10
Signs & Symptoms: Physical Hormonal: irregular menstrual cycle, loss of nocturnal emissions, loss of sexual desire Changes in normal patterns: overeating or not eating at all, sleeping much more or much less Appearance: Change in hygiene, unkempt Eyes bloodshot or glassy Weight gain or loss 11 19
Signs & Symptoms: Emotions Depressed mood and/or mood swings Unrealistic or excessive anxiety or guilt Excessive irritability or anger Lack of inhibition Lack of emotion or emotional response Helplessness or hopelessness Oversensitivity to comments/criticism Low self-esteem 20 12
Signs & Symptoms: Thoughts Frequent self-criticism or self-blame Pessimism Difficulty concentrating or remembering Indecisiveness or confusion Rigid thinking Racing thoughts Tendency to believe others see one in a negative light Altered sense of self Delusions or hallucinations Odd ideas; lack of insight Suspiciousness Thoughts of death and suicide 13
Signs & Symptoms: Behaviors Crying spells Withdrawal from others Neglect of responsibilities Loss of interest in personal appearance Loss of motivation Slow movement Use of drugs and alcohol Changes in energy level Obsessive or compulsive behavior Avoidance or phobic behavior Showing distress Talking rapidly 14
Typical Stages vs. Symptoms Examine the severity of the change Typical Adolescence Withdrawing from family to spend more time with friends Potential Warning Sign Withdrawing from friends, family and social activity Wanting more privacy Moving from childhood likes to teen pursuits Becoming secretive; need for privacy seems to be hiding something Losing interest in favorite activities and not replacing with other pursuits 15
Risk Factors Exposure to stressful life events/abuse/trauma Difficult or abusive childhood Ongoing stress and anxiety Medical conditions and hormonal changes Side effects of medication Illness that is life threatening, chronic, or associated with pain Brain injury Previous episode of a mental illness or another mental illness 16
Risk Factors Family history/genetics Learned behavior Chemical imbalance Substance misuse and sensitivity Seasonal changes Environmental factors 17
Protective Factors Healthy practices High self-esteem Good problem solving skills Feeling of control in their own life Spirituality Avoiding alcohol, tobacco and other drugs Consistent home/family routine Parental/familial support Monitoring of youth s activities 18
Protective Factors Regular school attendance and academic performance Having a good social support system Availability of constructive recreation Economic security Community bonding Feeling close to at least one adult 19
Self Injury Fact or Fiction? Self harm is a mental illness Self harm is more than just cutting, burning and things we can see Self harm can be a good thing Self harm is a failed suicide attempt 20
WHY? To manage painful feelings To show control of their body To end feelings of being detached from themselves To punish themselves To seek attention To avoid or combat suicidal thoughts 21
Suicide Fact or Fiction? If you ask a young person about his or her suicidal intentions, you will encourage the person to kill themselves A young person who attempts suicide will always be suicidal Suicide happens without warning Suicide occurs across all classes of young people 22
Warning Signs Talk about: Killing themselves. Having no reason to live. Being a burden to others. Feeling trapped. Unbearable pain. 23
Warning Signs Behavior (new or increased; after a recent loss or event) Increased use of alcohol or drugs. Looking for a way to kill themselves, such as searching online for materials or means. Acting recklessly. Withdrawing from activities. Isolating from family and friends. Sleeping too much or too little. Visiting or calling people to say goodbye. Giving away prized possessions. Aggression. 24
Warning Signs Moods Depression. Loss of interest. Rage. Irritability. Humiliation. Anxiety. 25
Get Help National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) My3 http://www.my3app.org/ Know the Signs www.suicideispreventable.org/ 26
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Leap of Faith 28
Passage of AB 2246 Mandates LEAs that serves pupils in grades 7 to 12 to adopt a board policy on pupil suicide prevention in the beginning of the 2017-18 school year Sign up for CDE AB 2246 implementation webinar Nov 29 29
Adopting Suicide Prevention Policies 30
Youth Mental Health First Aid Action Plan 5 Steps Assess for risk of suicide or harm Listen nonjudgmentally Give reassurance and information Encourage appropriate professional help Encourage self-help and other support strategies 31
Free Training through Project Cal-Well One of 20 states that received the NITT-AWARE-SEA grant Five year grant: 2014-19 Now is the Time: The President s plan to protect our children and our communities by reducing gun violence, released on January 16, 2013. 32
Project Cal-Well is a 5-year (2014-2019) Now Is The Time Project Advancing Wellness and Resilience Education grant funded by the Substance Abuse and Mental Health Services Administration. Through the California Department of Education, Project Cal-Well is implementing programs statewide and in partnership with ABC Unified School District, Garden Grove Unified School District, and San Diego County Office of Education. School Climate: Create school climates that promote healthy social-emotional development and well-being School-Based Services: Increase access to and availability of school-based mental health (SBMH) services for students and their families Community Partnerships: Build partnerships and crosssystem collaborations to promote youth well-being and access to community-based services Overall Mission: Increased awareness of and improved mental health and wellness of K-12 students. Goals Activities Outcomes Implement research-based school-wide interventions (i.e., PBIS, Restorative Practices, NAMI on Campus High School, Second Step, etc.) Provide professional development to district and school staff Build partnerships to expand SBMH interns/staff Provide SBMH services, including early intervention and treatment Provide family member/caretaker mental health awareness activities Improve tracking of referrals to SBMH services Enhance relationships with and improve tracking of referrals to community-based mental health organizations Participate in cross-system collaboration activities Provide professional development to community-based organizations and partners # Schools implementing SBMH interventions # Professional development opportunities Awareness of mental health and wellness among students and district and school staff # SBMH providers (i.e., school psychologists, school counselors, social workers, interns) # Students served by SBMH interventions and supports* # Students receiving SBMH services* # School-based and family counseling hours % Schools with waitlists for SBMH services % Students referred for and received communitybased mental health services* Student feelings of sadness, hopelessness, or suicidal ideation Student suspension rates YMHFA: Implement Youth Mental Health First Aid (YMHFA) trainings to school staff, community members and other professionals at the state and local levels Train instructors to provide YMHFA trainings Train participants to identify, understand, and respond to signs of student emotional distress and/or mental illness Train participants to engage in ALGEE: Assess for risk of suicide or self harm Listen non judgmentally Give reassurance and information Encourage appropriate professional help Encourage self-help # Individuals trained as YMHFA First Aiders and Instructors* Use of ALGEE by participants to support the mental health needs of youth Capacity throughout the state by partnering with existing YMHFA Instructors to deliver free trainings in their areas # School-aged youth referred to mental health services* 33 * Mandatory government reporting measures
Target Audience Non- mental health school staff administrators teachers, nurses, coaches, secretaries, registrars, lunch staff, bus drivers, campus monitors, yard supervisors, teacher s aids college/university interns parents youth employers, leaders of faith-based communities, law enforcement, and other youth-serving adults. 34
Request a Free Training One 8-hour day or two 4-hour days (consecutive) Be the host Recruit participants (up to 35) Provide light morning refreshments and/or coordinate lunch 35
Why YMHFA for your school/district? Training is FREE Training content support preparation of your Local Control and Accountability Plan Priority Area: Student Engagement and School Climate Training content supports PBIS/MTSS/SEL 36
Upcoming YMHFA trainings Nov 15: Glen COE Nov 30 Dec 1: National Conference on Catholic Youth Ministry Dec 5: Contra Costa COE Dec 14 15: Alameda COE Mar 8: Contra Costa COE 37
YMHFA@cde.ca.gov (916) 319-0208 or (916) 323-2212 38
Existing California Resources Student Mental Health Policy Workgroup 39
CDE Project Cal-Well Web page 40
Project Cal-Well Facebook Page https://www.facebook.com/projectcalwell 41
California Healthy Kids Survey Project Cal-Well Module 42
Directing Change Due March 1, 2017 Open to California youth ages 16-24 Student videos Suicide prevention Mental health Need Judges 43
NAMI on Campus High School Upcoming Workshops November 4 th San Diego County Office of Education November 5 th Kaiser Permanente Baldwin Park Medical Center January 13 th San Diego County Office of Education January 30th San Diego County Office of Education January 31st Garden Grove Unified School District https://www.youtube.com/watch?v =HYsS1_vcZr4 44
California Mental Health Advocates for Children and Youth 37 th Annual CMHACY Conference May 17-19, 2017 Asilomar Campgrounds Moving Beyond Coordination and Collaboration Strategies for Engagement Juvenile Justice Programs Access to Behavioral Health Services Affordable Care Act (Federal and State Reforms) Primary Care Health Reform California s Continuum of Care Reform Commercial Sexual Exploitation of Children Accountability - Transparency in Data and Outcomes Effective Practices Legislation, Propositions, Regulations, Policy issues Education Empowering Youth and Families for Self-Advocacy Attention to the Workforce 45
Join Our K-12 MH Listserv join-k12mh@mlist.cde.ca.gov Over 8,000 subscribed members Platform to reach educators, school, and community staff throughout the state 46
Hilva Chan Education Programs Consultant, CDE hchan@cde.ca. gov 916-319-0194 Monica Nepomuceno Education Programs Consultant, CDE mnepomuceno@ cde.ca.gov 916-323-2212 47