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Mental Health, Assets & Self Care

School Health Assistant Training

Linda Hummingbird, RN, B. Sc., NCSN

School Nurse/School Health Services Coordinator

Santa Fe Indian School

Santa Fe, NM

Rutgers University/Johnson & Johnson School Nurse Fellow

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Developmental Assets

Building Blocks of Healthy Development that Assist Children of all ages to grow up healthy, caring, and responsible

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External Internal

Support Empowerment Boundaries and

Expectations Constructive Use

of Time

Commitment to Learning

Social Competencies

Positive Values Positive Identity

Mental Health

“Successful performance of mental functions

Productive activities Fulfilling relationships with

others Ability to change and cope

with adversity

“Mental Health of Adolescents National Profile” National Adolescent Health Information Center ‘08

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Mental Illness Diagnosable mental disorders

characterized by alterations in thinking, mood, or behavior, (or a combination thereof) associated with distress or impaired functioning.

Mental Health of Adolescents National Profile National Adolescent Health Information Center

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Developmental Stages

0-1 year Develop basic trust Cry in rage until needs are met Cuddle, smile, make eye contact Cry for help: excessive crying,

sleep disturbance, feeding disorder, stranger anxiety, muscle rigidity

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Developmental Stages

1-3 years Autonomy Exploration (climbing, running) “Klingon” Develop comfort, pleasure,

safety seeking behaviors Hitting/biting for attention Language development Exploration of own body (Potty

Training) Occasional regression Play along with others w/o interaction

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4-5 years Independence Explore limits Imaginary companions Express aggression w/sibs or peers Body curiosity/sexual

differences/masturbation Bathroom talk Works w/others to plan, carry out

activities; shares toys

Developmental Stages

Developmental Stages 6-7 years Extremes of emotional response School phobia Quarrel w/parents, esp. mother (separation

anxiety or test parent/child relationship) Form multiple, relatively short term

relationships Sex play to satisfy curiosity about genitals Frequently initiate sib rivalry May resort to lying or stealing as coping

mechanism or sign of rebellion Able to play together w/ mutually agreed

upon rules

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Developmental Stages 7-9 years

More emotional balance Experience fear and rational concern

about possible world dangers: crime, violence, catastrophe

Develops interest in sex talk/sex jokes/ curious about mechanics of reproduction

Develops “crushes” Assume responsibility for actions Worry about academic performance Handles competitive play fairly well Assume more responsibility Fears being humiliated

Developmental stages

9 – 11 years Generally happy and content Rely more and more on peers for approval,

direction Develop more mature relationships w/sibs “Puppy love” “Best Friend” Show concern over issues of justice/fairness Worry about parents fighting, divorcing,

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Developmental Stages

11-13 years Moody/irritable Self-conscious about body image,

development, physical health, sexuality

Fear losing status w/peers Develop romantic relationships Close circle of friends for support Lose patience w/sibs, parents if

perceived as interfering w/personal, peer-related interactions

Developmental Stages 13 -19 years Crave personal freedom from parents

but still want and need their love Intense concern about understanding

why things are the way they are Experiment, test limits of pleasure &

pain; may be involved in thrill seeking, risky behaviors

May spend must time at home, sullen, withdrawn, isolated from family group, skip school, run away, treat all adults w/mistrust, disrespect, ignore household rules, “sex, drugs, and rock & roll”

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School Mental Health Concerns

“one in ten children/adolescents suffer from mental illness severe enough to cause some level of impairment”, but only one in five receives mental health services. Mental Health of Adolescents National Profile ‘08

A 2002 study revealed most youth receive mental health services through schools rather than through a PCP. For nearly half of all students with serious emotional disturbances, the school system was the sole provider of mental health services.

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Common Psychological Problems Depression Suicidal Tendencies Grief Substance Abuse Attention Deficit Disorders Eating Disorders

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Symptoms to Report to School Nurse Depressed/Irritable

mood for most of day Aggression toward

self/others Decreased

interest/pleasure in almost all activities

Significant weight/appetite increase or decrease

Sleep disorders

Slowed or hyperactive

body movements Fatigue/loss of energy Worthlessness or

unnecessary guilt Inability to concentrate Recurrent thoughts of

death, suicide

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The School Health Assistant’s Role Be Warm, ,Open, Compassionate and Supportive of

Student/Family Be Honest, but not Judgmental Provide Factual Information Treat Students/Parents with Respect Be Alert to Mood/Behavior Changes/Grades Know s/sxs of these most common disorders Be Aware There Often may be More Than One Mental

Illness Monitor the Student Frequently Avoid Being Confrontational Provide Positive Feedback Be Aware of Confidentiality Laws

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Health Assistant’s Role Be a Positive Role Model at all Times Practice What You Preach If You Know the Student’s Family, Work These Topics

into General Conversation Without Violating Student’s Right to Privacy

Advocate in your school/community for educational programs on these disorders and how they can interfere with the student’s ability to be successful in school

Find allies in your school/community willing to work to erase the stigma of mental/emotional/behavioral health disorders

Ask student how things are going in class and at home Realize that often in troubled homes, parents are

parenting the best they know how

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Resiliency and Strengths Youth can be extremely resilient Help them focus on talents

Art Music Sense of humor Positive personality traits

Treat them with fairness, consistency, and caring.

“You can’t educate a child who isn’t healthy, and you can’t keep a child healthy who isn’t educated.” Joycelyn Elders, M.D. , Former U.S. Surgeon General

Self Care

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Top Ten Stress Relievers

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1. Get Active 2. Meditate 3. Laugh 4. Connect 5. Assert Yourself 6. Breathing Exercises/Yoga 7. Sleep 8. Journal 9. Get Musical 10. Seek Counsel Mayo Clinic 9/2010

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Breathing Exercises

Sit straight in chair with hands in relaxed position in lap

Inhale slowly/deeply through nose, filling lungs completely; then exhale

Be aware of your posture Focus on any tense/painful areas and try

to relax them Continue breathing for at least 2 – 3

minutes

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Stretches

Eye Circles: open or closed, allow the eyes to slowly move a full circle. Repeat in opposite direction.

Shoulder Rolls: With arms hanging straight at sides, roll your shoulders in a complete circle front to back. Repeat in opposite direction.

Head Rolls: Allow head to gently roll in a complete circle. Repeat in opposite direction.

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Self-Massage

Temples/Forehead: Using three fingers massage in small circles around temples/across forehead.

Neck: With neck relaxed toward chest, use both hands and massage in small, firm circles from the base of the neck to head.

Shoulders: Sitting upright in a relaxed position, massage one shoulder at a time, using firm strokes to push muscles. Spend extra time on any tense or painful areas.

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Self Care/Stress Management Physical Activity Nutrition Hobbies Relaxation Therapy Deep Breathing Enjoy Life Spirituality

Our work can be stressful at times, yet it is very rewarding to be able to help a child, family, and/or community. We must remember to be good to ourselves, so that we can continue to be good to them.

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Children are 10% of our population; THEY

ARE 100% OF OUR FUTURE

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QUESTIONS?