The Essential Role of Classroom Teachers in Promoting Academic Success and

Social/Emotional Well Being

Robert BurkeRobert BurkeDepartment of Elementary EducationDepartment of Elementary Education

Ball State UniversityBall State University

Carl E. PaterniteCarl E. PaterniteCenter for School-Based Mental Health ProgramsCenter for School-Based Mental Health Programs

Department of PsychologyDepartment of PsychologyMiami UniversityMiami University

Presentation at the 5th Annual Conference on Curriculum and PedagogyPresentation at the 5th Annual Conference on Curriculum and PedagogyOctober 28, 2004October 28, 2004

The Essential Role of Classroom Teachers in Promoting Academic Success and

Social/Emotional Well Being

Instructional Focus:

Conceptual linkage between curriculum studies and the integration of mental health and education

Current status of child/adolescent mental health in the U.S.

Rationale for linking child/adolescent mental health with teacher education curriculum

Exemplars

Closure and conversation

The Crisis of Youth Mental HealthThe Crisis of Youth Mental Health

About 20% of youth, ages 9 to 17 (15 About 20% of youth, ages 9 to 17 (15 million), have diagnosable mental health million), have diagnosable mental health disorders, (and disorders, (and manymany more are at risk or more are at risk or could benefit from help)could benefit from help)

Between 9-13% of youth, ages 9-17 years, Between 9-13% of youth, ages 9-17 years, meet the federal (not special ed.) definition of meet the federal (not special ed.) definition of serious emotional disturbance (SED)serious emotional disturbance (SED)

The Crisis of Youth Mental HealthThe Crisis of Youth Mental Health

Less than 30% of youth with diagnosable Less than 30% of youth with diagnosable disorder receive any service, and, of those disorder receive any service, and, of those who do, less than half receive adequate Tx who do, less than half receive adequate Tx (even fewer at risk receive help)(even fewer at risk receive help)

For the small percentage of youth who do For the small percentage of youth who do receive service, most actually receive it receive service, most actually receive it within a school setting.within a school setting.

See HandoutSW Ohio Survey of Students

The Crisis of Youth Mental HealthThe Crisis of Youth Mental Health

These realities raise questions about the mental These realities raise questions about the mental health field’s insufficient attention to delivery of health field’s insufficient attention to delivery of ecologically sensitive and effective services;ecologically sensitive and effective services;

AndAnd they reinforce the importance of: they reinforce the importance of:– a community-based continuum of mental health a community-based continuum of mental health

supports,supports,

– commitment to a public health model of mental commitment to a public health model of mental health, andhealth, and

– expanded school mental health programs and expanded school mental health programs and services.services.

Schools: The Most Schools: The Most Universal Natural SettingUniversal Natural Setting

Over 52 million youth attend 114,000 Over 52 million youth attend 114,000 schoolsschoolsOver 6 million adults work in schoolsOver 6 million adults work in schoolsCombining students and staff, one-fifth of Combining students and staff, one-fifth of the U.S. population can be found in the U.S. population can be found in schoolsschools

From New Freedom Commission (2003)From New Freedom Commission (2003)

Why Put MH ServicesWhy Put MH Servicesin Schools?in Schools?

Access to youthAccess to youth

Clinical efficiency and productivityClinical efficiency and productivity

Reduced stigma; Increased youth/family comfortReduced stigma; Increased youth/family comfort

Outreach to youth with “internalizing” problemsOutreach to youth with “internalizing” problems

Enhanced ability to promote generalizationEnhanced ability to promote generalization

Enhanced capacity for prevention/MH promotionEnhanced capacity for prevention/MH promotion

Broadened roles for cliniciansBroadened roles for clinicians

Growing Focus on School-Based Growing Focus on School-Based Mental Health (SBMH)Mental Health (SBMH)

Federal investmentsFederal investments

U.S. Surgeon General Reports (1999, 2000)U.S. Surgeon General Reports (1999, 2000)

President’s New Freedom Commission on Mental President’s New Freedom Commission on Mental Health Report (2003)Health Report (2003)

American Academy of Pediatrics Policy Statement American Academy of Pediatrics Policy Statement on SBMH Services (2004)on SBMH Services (2004)

Progress in localities and states Progress in localities and states (e.g. Ohio’s Mental (e.g. Ohio’s Mental Health—Schools—Families Shared Agenda Initiative)Health—Schools—Families Shared Agenda Initiative)

““No Child Left Behind” MandateNo Child Left Behind” Mandate

Collaborative research-practice networksCollaborative research-practice networks

Report of President’s New Freedom Report of President’s New Freedom Commission on Mental HealthCommission on Mental Health

http://www.mentalhealthcommission.govhttp://www.mentalhealthcommission.gov

“…“…the mental health delivery system is fragmented and in the mental health delivery system is fragmented and in disarray…leading to unnecessary and costly disability, disarray…leading to unnecessary and costly disability, homelessness, school failure and incarceration.”homelessness, school failure and incarceration.”

Unmet needs and barriers to care include (amongUnmet needs and barriers to care include (amongothers):others):

Fragmentation and gaps in care for children.Fragmentation and gaps in care for children.Lack of national priority for mental health and suicide Lack of national priority for mental health and suicide prevention.prevention.

July, 2003July, 2003

New Freedom Commission on Mental HealthNew Freedom Commission on Mental Health

Goal 4: Early Mental Health Screening, Assessment, Goal 4: Early Mental Health Screening, Assessment, and Referral to Services are Common Practiceand Referral to Services are Common Practice

4.1 Promote the mental health of young children.

4.2 Improve and expand school mental health programs.4.2 Improve and expand school mental health programs.

4.3 Screen for co-occurring mental and substance use disorders and link with integrated treatment strategies.

4.4 Screen for mental disorders in primary health care, across the lifespan, and connect to treatment and supports.

New Freedom Commission on Mental HealthNew Freedom Commission on Mental Health

Critical importance of partnership with schoolsin mental health care:

“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 student drop out of high school, compared to 30 percent of all students with disabilities. “

“While schools are primarily concerned with education, mental health is essential to learning as well as to social and emotional development. Because of this important interplay between emotional health and school success, schools must be partners in the mental health care of our children.”

July, 2003, p. 58July, 2003, p. 58

School-Based Mental HealthSchool-Based Mental Health

Full array of mental health care for youth in special and regular Full array of mental health care for youth in special and regular educationeducation– Screening and assessmentScreening and assessment– TreatmentTreatment– Case managementCase management– Prevention (all levels)Prevention (all levels)– Mental health promotionMental health promotion

Related ServicesRelated Services– Classroom observationClassroom observation– ConsultationConsultation– Training with school staff, families, and community membersTraining with school staff, families, and community members– School wide initiatives (e.g., media, outreach, climate)School wide initiatives (e.g., media, outreach, climate)

SBMH AdvantagesSBMH AdvantagesMoves toward MH—Education systems Moves toward MH—Education systems integration, providing critical support to integration, providing critical support to education, and enhancing access to youth education, and enhancing access to youth for mental health carefor mental health care

Expands and connects education and Expands and connects education and mental health knowledge bases and mental health knowledge bases and promotes interdisciplinary collaborationpromotes interdisciplinary collaboration

Assists in the development and delivery of Assists in the development and delivery of a true system of carea true system of care

SBMH ImpactsSBMH ImpactsBased on an early and limited knowledge Based on an early and limited knowledge base, there is evidence that SBMH, when base, there is evidence that SBMH, when done welldone well– Assists in reaching underserved youthAssists in reaching underserved youth– Is associated with strong satisfaction by Is associated with strong satisfaction by

diverse stakeholder groupsdiverse stakeholder groups– Improves student outcomes (e.g., behavior, Improves student outcomes (e.g., behavior,

attendance)attendance)– Improves school outcomes (e.g., climate, Improves school outcomes (e.g., climate,

special education referrals)special education referrals)

In Schools With SBMHIn Schools With SBMH

The agenda to coordinate and provide a full range of The agenda to coordinate and provide a full range of programs and services remains large, and involves:programs and services remains large, and involves:

– Coordinating work of school-employed and community MH Coordinating work of school-employed and community MH personnelpersonnel

– Establishing mechanisms for identifying and referring youth in Establishing mechanisms for identifying and referring youth in need, ensuring service efficiency and avoiding service need, ensuring service efficiency and avoiding service duplicationduplication

– Ensuring that MH staff are well trained and supervisedEnsuring that MH staff are well trained and supervised

Schools are Usually Not Equipped Schools are Usually Not Equipped for SBMHfor SBMH

Norm of limited evaluation and Norm of limited evaluation and consultation services, primarily for youth in consultation services, primarily for youth in or being referred into special educationor being referred into special education

Generally poor quality of mental health Generally poor quality of mental health services for youth in special educationservices for youth in special education

School leaders may resist the mental School leaders may resist the mental health agendahealth agenda

Problems with School Systems Taking Problems with School Systems Taking on a Mental Health Agenda Aloneon a Mental Health Agenda Alone

Added responsibility, burden and costAdded responsibility, burden and cost

Less than optimal mental health resources Less than optimal mental health resources and expertiseand expertise

Bias of mental health work in relation to Bias of mental health work in relation to educational structures (e.g., connecting all educational structures (e.g., connecting all services to IDEA or 504)services to IDEA or 504)

In Schools Without SBMHIn Schools Without SBMH

Barriers to mental health care are more pronouncedBarriers to mental health care are more pronounced

There are pressures to increase referrals to special There are pressures to increase referrals to special education for students to receive MH careeducation for students to receive MH care

MH care within special education is generally very far from MH care within special education is generally very far from achieving principles associated with best practice, achieving principles associated with best practice, including:including:– short latency between referral and treatmentshort latency between referral and treatment– treatment by well trained providerstreatment by well trained providers– adequate duration of treatmentadequate duration of treatment– connection of treatment to quality improvement and connection of treatment to quality improvement and

empirically supported practiceempirically supported practice

In Addition to Parents, Teachers are on In Addition to Parents, Teachers are on the Mental Health “Front Line”the Mental Health “Front Line”

Yet, teachers/educators are very poorly trained Yet, teachers/educators are very poorly trained in problem recognition and mental health in problem recognition and mental health promotionpromotion

Significant need to enhance teacher/educator Significant need to enhance teacher/educator training based on analysis of issues confronted training based on analysis of issues confronted in the classroom/schoolin the classroom/school

Related significant need to enhance training of Related significant need to enhance training of mental health professionals to prepare them to mental health professionals to prepare them to engage with educators and function effectively engage with educators and function effectively in/with schoolsin/with schools

An ObservationAn Observation

Clearly, intellectual, social, and emotional education go hand-Clearly, intellectual, social, and emotional education go hand-in-hand, and all are linked to creating safe schools, building in-hand, and all are linked to creating safe schools, building healthy character, and achieving academic success:healthy character, and achieving academic success:

The proper aim of education is to promote significant learning. Significant The proper aim of education is to promote significant learning. Significant learning entails development. Development means successively asking broader learning entails development. Development means successively asking broader and deeper questions of the relationship between oneself and the world. This is 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 as true for first graders as it is for graduate students, for fledgling artists as graying accountants.graying accountants. A good education ought to help people become more perceptive to and A good education ought to help people become more perceptive to and more discriminating about the world: seeing, feeling, and understanding more, more discriminating about the world: seeing, feeling, and understanding more, yet sorting the pertinent from the peripheral with ever finer touch, increasingly 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 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 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 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 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)only come to life when they root in the mind of a learner. (Daloz, 1999, p. 243)

Learning is not a Learning is not a Spectators sportSpectators sport

~Donald Blocher~Donald Blocher

Those who have been required Those who have been required

to memorize the world as it is to memorize the world as it is

will never create the world will never create the world

as it might be.as it might be. ~Judith Groch~Judith Groch

Education is not Education is not the filling of a the filling of a pail, but the pail, but the lighting of a fire. lighting of a fire.

~William Butler Yeats~William Butler Yeats

Children must be taught Children must be taught

how to think, how to think, not what to think.not what to think.

~Margaret Mead~Margaret Mead

The art of teaching is The art of teaching is the art of assisting the art of assisting discovery.discovery.

~Mark Van Doren~Mark Van Doren

As knowledge As knowledge increases, increases,

wonder deepens.wonder deepens.

~Charles Morgan~Charles Morgan

If you can learn from If you can learn from hard knocks, you can hard knocks, you can also learn from soft also learn from soft

touches.touches.

~Carolyn Kenmore~Carolyn Kenmore

In education we are In education we are striving not to teach striving not to teach

youth to make a youth to make a living, but to make a living, but to make a

life.life.

~William Allen White~William Allen White

Public Policy Context:Public Policy Context:SBMH and the No Child Left Behind MandateSBMH and the No Child Left Behind Mandate

Two Important Interrelated Goals— Two Important Interrelated Goals— Achievement and WellbeingAchievement and Wellbeing

1) Achievement promotes wellbeing1) Achievement promotes wellbeing 2) Wellbeing promotes achievement2) Wellbeing promotes achievement

School accountabilities often acknowledge 1 butSchool accountabilities often acknowledge 1 but

fail to acknowledge 2fail to acknowledge 2

QuickTime™ and aTIFF (Uncompressed) decompressor

are needed to see this picture.

T: What materials are available to me to help these students?

A: Just use the old tests, have them review questions and answers.

T: Rather than just helping them memorize questions and answers I’d like to put some of this information in meaningful context so that they understand what it is they’re learning. Are there some additional materials available?

A: We don’t care about them learning. They don’t have to understand. They just have to pass the test.

Dialogue between a teacher and an administrator regarding a teacher’s request for resource materials for use with students who were being tutored because they

were struggling to pass the 9th grade proficiency test after several tries.

See Handout

Non-academic barriers to learning Non-academic barriers to learning exert a powerful negative influenceexert a powerful negative influence

EnvironmentalEnvironmental– Poor nutritionPoor nutrition– Family stressFamily stress– Family conflictFamily conflict– Peer influencesPeer influences– Exposure to violenceExposure to violence– Abuse, NeglectAbuse, Neglect– Poor school Poor school

environmentenvironment

PersonalPersonal– Attention difficultiesAttention difficulties– Behavioral problemsBehavioral problems– DepressionDepression– AnxietyAnxiety– Social problemsSocial problems– Trauma reactionsTrauma reactions

See Handout

A QUESTION:

WHAT ARE THE CAUSES OF VIOLENCE, OTHER PROBLEM BEHAVIOR,

AND DISCIPLINE PROBLEMS?

See Handout

Model: Influences on Violent versusNon-Violent Behavior

(From Shapiro, 1999, Applewood Centers, Inc., Cleveland, OH)

School Effectiveness in Promoting School Effectiveness in Promoting Achievement and the NCLB MandateAchievement and the NCLB Mandate

Least effective: Limited focus on academic and Least effective: Limited focus on academic and nonacademic barriersnonacademic barriers

More effective: Focus on academic barriersMore effective: Focus on academic barriers

Most effective: Integrated focus on academic Most effective: Integrated focus on academic andand nonacademic barriersnonacademic barriers

(CSMHA)(CSMHA)

Ohio’s Mental Health, Schools, and Families Shared Agenda Initiative

http://www.units.muohio.edu/csbmhp/sharedagenda.html

Phase 1—Statewide forum for leaders of mental health, education, and family policymaking organizations and child-serving systems(March 3, 2003)

Phase 2—Six regional forums for policy implementers and consumer stakeholders (April-May, 2003)

Phase 3—Legislative forum involving key leadership of relevant house and senate committees (October 9, 2003)

Phase 4—Ongoing policy/funding advocacy and technical assistance to promote attention to the crucial links between mental health and school success

See Handout

Guiding Principles for a Guiding Principles for a Mental Health,Schools, Mental Health,Schools,

Families Shared AgendaFamilies Shared Agenda

Mental health is crucial to school successMental health is crucial to school success

There are shared opportunities for mental There are shared opportunities for mental health, schools, students and families to work health, schools, students and families to work together more effectivelytogether more effectively

See HandoutSee Handout

Phase 4: An Immediate Legislative Outcome

Senate Bill 2Section 3319.61(E)

(effective June 9, 2004)

“The standards for educator professional development developed under division (A) (3)

of this section shall include standards that address the crucial link between academic

achievement and mental health issues.”

Mental Health and School Success Websites

National:National Association of State Directors of Special Education

(www.nasdse.org)

Center for School Mental Health Assistance (CSMHA, http://csmha.umaryland.edu)

Center for Mental Health in Schools(http://smhp.psych.ucla.edu)

Ohio:Center for School-Based Mental Health Programs

(http://www.units.muohio.edu/csbmhp)

Center for Learning Excellence, Alternative Education and Mental Health Projects(http://altedmh.osu.edu/omhn/omhn.htm)

Ohio’s Shared Agenda Initiative(http://www.units.muohio.edu/csbmhp/sharedagenda.html)

This PowerPoint Presentation is posted on the Center for School-Based Mental Health Programs website

http://www.units.muohio.edu/csbmhp/