Tag: behaviors

  • A Place Where Kids With the Toughest Behaviors Are Welcome and Can Heal – The 74

    A Place Where Kids With the Toughest Behaviors Are Welcome and Can Heal – The 74


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    Ann’s three young boys had been through a lot already. Her marriage to their father was marked by violence, and a divorce was followed by multiple violations of a protective order, she said. While their father sat in prison in North Dakota, she moved the family to the Twin Cities.

    But while the move gave them distance, it didn’t solve their problems, said Ann, who asked to be identified by her middle name to protect her children’s privacy. Her sons, especially the two youngest, suffered mental health issues including PTSD, ADHD and anxiety. Her middle son was diagnosed with disruptive mood dysregulation disorder, characterized by angry and sometimes violent outbursts.

    “I had 13 police calls within a nine-month period to my house,” Ann said. When a police officer handed her a domestic violence information card, she knew things had to change.

    Ann’s middle son had been enrolled in public school in a suburb of St. Paul, but after being removed from his mainstream classroom due to his behaviors, he wasn’t receiving the support he needed academically or emotionally.

    A social worker told her about Catholic Charities Children’s Day Treatment, located in Minneapolis Public Schools’ Wilder Complex and offering intensive supports to children in grades K-8 struggling with mental illness. Despite her nerves, Ann scheduled a visit. In one of her first interactions, an intake person said, “‘Because you’re here looking for help, you’re more advanced than most adults,’” Ann recalled. “I knew at that moment we were in the right place.”

    A trauma-informed approach for kids

    Jessica Dreischmeier, Catholic Charities Children’s Day Treatment Program director, said that her program is a good match for children like Ann’s sons. Staff not only understand the impact that early childhood trauma can have on mental health, but the program’s trauma-informed approach helps them make progress with kids deemed unfixable by other schools.

    “I would say a majority of the youth that come here for treatment have experienced some type of trauma,” Dreischmeier said. “We know that those symptoms can manifest themselves in a number of ways, including depression, aggression, anxiety, ADHD — and we have deep experience working with those kinds of kids.”

    With the right approach, she said, most kids can recover from mental illness.

    “One day might be hard, but over time we get there with pretty much everybody — which is awesome.”

    A long and loyal legacy

    Catholic Charities Children’s Day Treatment was founded in 1968 as an extension of St. Joseph’s Home for Children, founded in 1869 as a residential shelter for orphans. The day treatment program was created to provide an alternative option for children at St. Joseph’s who needed extra mental health support.

    St. Joseph’s Home closed in 2020, but the day treatment program continued. Enrollment is capped at 40 students who work with 17 full-time staff members. Students come from around the metro area but enroll in Minneapolis Public Schools through a partnership with the district. Mental health services are billed through health insurance.

    Many staff members have worked at the center for decades. Karen Johnson, a mental health practitioner who has been employed by the program for 24 years, said she feels a deep connection to the children in her care.

    “I should have retired five years ago,” Johnson said. “Each time I have that thought, another kid comes through the door, and  I’m like, ‘Now I have to stay until they finish the program.’ Then another kid comes.”

    A focus on parent connection and long-term success for kids

    According to the Minnesota Department of Human Services, there are 37 licensed mental health day treatment programs for children in the state. Still, Dreischmeier said that Catholic Charities’ program remains in high demand.

    “The need for mental health services for youth and children in Minnesota has been going up for a while,” she said, “but especially after Covid, it’s particularly evident.”

    A typical day for students includes two three-hour blocks – one for academics and the other for mental health therapy and treatment.

    Mental health support is delivered in individual and group settings with a focus on parent and guardian involvement, Dreischmeier said. Families are taught how to build strong connections with their child and to reinforce strategies they’re practicing at school.

    The kids work on setting goals for their life beyond the program. While students’ individual goals look different, the overall aim is a return to home life and a less restrictive school setting. “We’re hoping our intervention helps kids stay in their home and with their family and not have an out-of-home placement,” Dreischmeier said.

    ‘We’re not going to leave anybody behind.’

    For parents like Ann, the transition to day treatment often comes amid deep distrust of past educational settings. Families arrive feeling guarded, Dreischmeier said. They wonder: “‘Are you going to perceive my child as a problem?’ ‘Will you only see them for the behaviors they are having when they are having a hard time, or will you see my whole child?’”

    The kids often wonder the same thing, Johnson said. “A lot of these kids come here with no hope. They think, ‘People say I’m bad so I’m never going to be nothing.’ I try to change that narrative.”

    Dreischmeier said that her staff remains undaunted even by the students’ most challenging behaviors.

    “If something is hard, we’re going to all come together and work on it and talk about it,” she said. We’re going to move forward all together. We’re not going to leave anybody behind.”

    Academically, the aim is not just to keep students on track, but to move them ahead. In traditional school settings with larger class sizes and fewer supports, children with serious mental health issues are often separated from their peers and fall behind.

    Dreischmeier said things are run differently at Children’s Day Treatment, where the ratio of adults to students is much higher – often three adults to every six or seven students. “Students are really able to focus in and learn,” she said.

    On average, students participate in the program for a year to a year and a half, Dreischmeier said. Most then move back to their local community school. Some are recommended for further services, including residential and outpatient mental health programs.

    Surprised by hope

    After two years at Children’s Day Treatment, Ann’s middle son graduated  last year. Though he struggled in the beginning, she said, he eventually settled in and found success.

    “His graduation was the most incredible thing,” Ann recalled. “Staff said he’d emerged as a leader. We did not know that about my son. To hear his peers get up and give their testimonies about him – there was not a dry eye in the room.”

    Today, he’s enrolled at a school in her home district – something she never thought possible – where he continues to receive special education support. Ann’s youngest son enrolled at Children’s Day Treatment in the fall. She’s optimistic: “I’m just grateful for people like them who want to help children like mine.”

    This article first appeared on MinnPost and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.


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  • States balance supports and discipline to address troubling student behaviors

    States balance supports and discipline to address troubling student behaviors

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    In Arkansas, a $7 million program approved last year aims to support students’ mental health by restricting their cellphone use and using telehealth to connect more students to mental health providers.

    In Texas, a multiyear effort to study student mental and behavioral health yielded a host of recommendations, including putting Medicaid funds toward school-based mental health supports and better tracking of interventions.

    And in West Virginia, state education leaders and partnership organizations have amassed a trove of resource documents and built out training to help schools address student mental health challenges.

    All three states are working to proactively to respond to the student mental health crisis that worsened due to the COVID-19 pandemic. 

    All three states are also considering or expected to pass laws allowing schools to implement tougher discipline policies.

    Likewise, many states are tweaking their discipline policies at the same time they are putting more resources toward supporting students’ mental well-being.  

    Although school discipline and mental health supports are mostly addressed at the local level, state leadership is critical for setting expectations for accountability and requiring transparency in disciplinary actions, said Richard Welsh, founding director of the School Discipline Lab, a research center that shares information about school discipline.

    And states are using a variety of measures from proactively providing mental health supports to loosening restrictions for exclusionary discipline, said Welsh, who is also an associate professor of education and public policy at Vanderbilt University. 

    Post pandemic, “we did have an uptick in student misbehavior,” Welsh said. “But I think what also gets missing in that was we also had an uptick in student and teacher needs.” 

    The COVID factor

    Post-COVID, schools have reported a rise in unruly behaviors, including among young students. Some of the behaviors have been violent and have even injured teachers, leading them to turn away from the profession.

    Research published by the American Psychological Association last year found an increase in violence against K-12 educators over the past decade. After COVID restrictions ended in 2022, a survey of 11,814 school staff, including teachers and administrators, found that 2% to 56% of respondents reported physical violence at least once during the year, with rates varying by school staff role and aggressor. 

    Data also shows that student verbal abuse occurring at least once a week on average, doubled from 4.8% in the 2009-10 school year to 9.8% in 2019-20, according to APA.

    Students’ mental health needs increased during and after the pandemic, according to studies. Additional research showed that teachers, administrators and other school staff lacked resources to properly address students’ needs. 

    Some educators, parents and advocates worry that harsher student discipline policies will undermine evidenced-based practices for decreasing challenging behaviors and keeping students in school. They are also concerned that after several years of expanding positive behavior supports and restorative practices, a focus on stricter discipline policies will disproportionately affect students of color and those with disabilities. 

    The legislative activity at the state level is occurring at the same time President Donald Trump is calling for “reinstating common sense” to school discipline policies. An April executive order calls for the U.S. Department of Education to issue guidance to districts and states regarding their obligations under Title VI to protect students against racial discrimination in relation to the discipline of students. Title VI of the Civil Rights Act prohibits discrimination based on race, color or national origin in federally funded programs. 

    The Trump administration has called for the federal government to enact policies that are “colorblind,” not favoring one race over others.

    The order also directs the Education Department to submit a report by late August on the “status of discriminatory-equity-ideology-based school discipline and behavior modification techniques in American public education.” 

    Welsh predicts that the executive order will lead to more state activity addressing student behavior and a specific focus on the guidelines for administering punitive discipline. 

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  • More college students report history of suicidal behaviors

    More college students report history of suicidal behaviors

    Colleges and universities can support students with previous history of suicidal ideation or self-harm with long-term counseling or mental health support.

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    Over the past two decades, suicide rates in the U.S. have increased 37 percent, according to data from the Centers for Disease Control. Fifteen percent of all deaths by suicide are among individuals ages 10 to 24 years old, making it the second leading cause of death for this age group.

    This heightened risk has pushed colleges and universities to invest in preventative measures to address the complex issues that impact student well-being.

    A January report from Pennsylvania State University’s Center for Collegiate Mental Health (CCMH) finds that students with a history of suicidal or self-injurious behaviors report lower levels of distress after engaging with counseling center services, but they remain at higher levels of distress over all compared to their peers.

    Methodology

    The report includes data from the 2023–24 academic year, beginning July 2023 and closing June 2024. Data was collected from 213 college and university counseling centers, including 173,536 unique students seeking care, 4,954 clinicians and over 1.2 million appointments. The data is not representative of the general student population, only those accessing mental health services.

    By the numbers: The number of students reporting previous suicidal or self-injurious behavior (S/SIB) histories jumped four percentage points from 2010–11 to 2023–24, according to CCMH data.

    “While counseling centers have historically treated a considerable segment of students with heightened suicide risk, ongoing questions remain about the complexity of co-occurring problems experienced, the scope of services they utilize, and whether gaps in care exist,” according to the report.

    Compared to their peers without a history of S/SIB, these learners had higher levels of self-reported distress, particularly in symptoms of generalized anxiety, general distress and depression. They were also more likely to report a history of trauma or past hospitalization.

    Students had a higher likelihood of continuing to demonstrate self-injurious thoughts or behaviors, compared to other students, but the overall rates remained low, with only 3.3 percent of students with past S/SIB reporting it during college counseling.

    They were 14.3 times more likely to engage in self-injury and 11.6 times more likely to attempt suicide during treatment, and more than five times more likely to be admitted or referred to a hospital for a mental health concern. This, again, constituted a small number of students (around one in 180) but researchers noted the disproportionate likelihood of these critical case events.

    Ultimately, students with suicidal or self-injurious behavior history saw similar benefits from accessing services compared to their peers, with data showing less generalized distress or suicidal ideation among all learners between their first and final assessments. However, they still had greater levels of distress, even if slightly lower than initial intake, showing a need for additional resources, according to researchers.

    “The data show that students with a history of suicidal or self-injurious behaviors could benefit from access to longer-term and comprehensive care, including psychological treatment, psychiatric services and case management at counseling centers, as well as adjunctive support that contributes to an overall sense of well-being, such as access to disability services and financial aid programs,” said Brett Scofield, executive director for the CCMH, in a Jan. 28 press release.

    Future considerations: Researchers made note that while prior history of suicidal behaviors or self-harm are some of the risk factors for suicide, they are not the only ones, and counseling centers should note other behaviors that could point to suicidal ideation, such as substance use or social isolation.

    Additionally, some centers had higher rates of students at risk for suicide, ranging from 20 to 50 percent of clients, so examining local data to understand the need and application of data is critical, researchers wrote.

    The data also showed a gap in capacity to facilitate longer-term care, such as case management or psychiatric services available, which can place an additional burden on clinicians or require outsourcing for support, diluting overall quality of care at the center. “Therefore, it is imperative that colleges and universities invest in under-resourced counseling centers to ease the burden on counseling center staff and optimize treatment for students with heightened suicide risk,” according to the report.

    Investing in on-site psychological treatment or psychiatric care and finding creative solutions to work alongside outside partners can help deliver more holistic care.

    Other trends: In addition to exploring how college counseling centers can address suicidality in young people, CCMH researchers built on past data to illustrate some of the growing concerns for on-campus mental health service providers.

    • Rates of prior counseling and psychotropic medication usage grew year over year and are at the highest level since data was first collected in 2012. A 2023 TimelyCare survey found six in 10 college students had accessed mental health services prior to entering college, and CCMH data echoed this trend, with 63 percent of students entering with prior counseling history.
    • The number of clients reporting a history of trauma remains elevated, up eight percentage points compared to 2012, though down slightly year over year, at 45.5 percent, compared to last year’s 46.8 percent.
    • Anxiety is the most common presenting concern, with 64.4 percent of clients having anxiety, as assessed by clinicians.
    • In-person counseling services have rebounded since the start of the COVID-19 pandemic in 2020, with 63.7 percent of clients receiving exclusively in-person counseling and 13.5 percent receiving only video care.

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    If you or someone you know are in crisis or considering suicide and need help, call the 988 Suicide & Crisis Lifeline by dialing 9-8-8, or contact the Crisis Text Line by texting HOME to 741741.

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