Assessment Results
As a group, we interviewed multiple school social workers,
guidance counselors, teachers, and administrators from many different school
districts across the state, in addition to holding two focus groups of teenage
high school students at a residential treatment center in Spanish Fork. We
found great value in acquiring information from multiple sources and different
perspectives in order to create a more complete assessment of the situation.
Even with this variety of sources we were able to identify many common themes
and patterns.
From our interviews with school professionals, a common report
indicated a low level of mental health education and treatment currently
available to students. It was also reported that the constituency had minimal
interest in changing this unless they or their families specifically had been
affected by mental health problems at their school. This model of a reactive
versus proactive approach, coupled with the administration’s narrow focus on
student graduation and academic success, presents a difficult mold to break.
This seemed to be an underlying pattern in that health professionals are
competing with classroom time and as such, are hesitant to pull students away
from their academic studies.
Time limitations and lack of funding were also mentioned as common
barriers to intervening within the school systems. It was reported that many
school social workers and/or psychologists are required to work at multiple
locations within their school districts. In an interview with Jody Valantine, a
social worker at Pineview High School in St. George, UT, she mentioned that the
LCSW who provides counseling at her school is only available one day a week for
half of the day. This was a common report amongst other professionals as well,
who described being spread between upwards of 3-4 locations a week, making it
very difficult to be productive within each school setting. This problem is not
only present locally. According to the U.S. Department of Education Office for
Civil Rights, 1 in 5 high schools nationwide lack a school guidance counselor
to provide timely support to those seeking help (Teacher Equity, 2014). It is obviously
very costly for the districts to employ a full-time mental health professional
at each respective elementary, middle, and high school, and as such, this
remains a difficult issue to resolve.
Results from a facilitated dialogue of female high school students
at New Haven Residential Treatment Center in Spanish Fork, UT also reaffirmed
that access to mental health education and resources in public schools are
extremely limited. Although the teens interviewed were currently in a
residential setting, they were all attending mainstream public high schools
prior to their admission. The data we collected included the experiences of
students from various places across the nation and yet, the trends remained
similar. Students reported that social workers seemed mostly unavailable and/or
unapproachable due to limited exposure to the students in general. For students
who did receive some education about mental health issues, the exposure was
brief, usually in a health class setting. The overall focus seemed to be
learning the information rather than discussing its relevance in their lives.
Group discussions appeared to be discouraged and facilitated dialogues about
mental health issues within their classes were simply left out. Out of all of
the students surveyed, only one reported having adequate mental health
resources and education available to them in school.
Action Plan
The detailed plan for addressing this problem would ultimately
include several complicated steps that would involve both the high school
administration as well as local legislation. Ideal goals for addressing the
issue would include making changes to the school curriculum, incorporating more
mental health focus groups, greater access to social workers, and in general,
more facilitated discussions about depression and anxiety as they pertain to
the adolescent population.
As mentioned in our previous paper, 90 percent of adolescents and
young adults who die by suicide experience mental illness preceding death
(Brent, Perper, & Moritz, 1993). Even with this knowledge of the
commonality of mental illness, less than half of youth and young adult suicide
victims were in contact with any sort of mental health service in the year
preceding death (Renaud et al., 2014). For the purposes of this class, our plan
has followed a more simple process to address these dire statistics. This
process included the gathering of surveys, speaking with teachers and other
representatives in high school settings and researching already existing
programs such as Lifeline Utah and NAMI. We hope that by partnering with these
existing programs, we can better engage young people to ultimately prevent
teenage suicide in Utah. We also are looking into ways we can provide new
research that could help to facilitate a greater amount of awareness in the
high school systems as well as identify ways that mental health education could
be incorporated in the curriculum.
We have identified the Inclusive Program Development (Gamble,
2010) as the most appropriate social change model to achieve this desired
outcome. We arrived at this conclusion based on the focus of engaging the
beneficiaries in planning, implementing and managing this program that is
prevalent in the model. The primary constituency of the Inclusive Program Development
model is the agency board and administrators, as well as community
representatives. We want to spotlight the school administration as our primary
constituency as they are the power holders in the arena of public high schools.
If we are to facilitate any changes at all, it will be essential to collaborate
and ally with school administration including principals and superintendents in
addition to school counselors and social workers.
Another element of our project that leans heavily toward the Inclusive
Program Development model is the scope of concern being to develop a
service for a specific population. Increasing opportunities for high school
students to become more aware of mental health problems and concerns fits
perfectly within this model. As with any topic however, there is overlap to
other change models and Organizing Functional Communities is a close
fit. Gamble identifies advocacy for a particular issue or population as the
primary scope of concern for this model (Gamble, 2010). This easily coincides
with our primary goal to better serve the mental health needs of high school
students.
Another model that shares some overlapping attributes is the Coalitions
model. The common characteristic here is the focus on organizations and
citizens that have a stake in the particular issue. High school students
obviously have a stake in this as it relates to decreasing suicide and
increasing their own mental wellness. The school administration has a high
stake as well because the students well being is directly related to their
jobs. On a more sympathetic note, the administration would benefit along with the
community as a whole by a decrease in suicide incidents.
As we develop strategies for our group’s action plan, we desire to
meet the criteria for a good tactic. The criteria will involve a specific
demand, being educational (ideally engaging and fun), incorporating a larger
amount of individuals, and entailing pressure if “pretty please” is
unsuccessful (Schultz, Sandy, 2011). With the hope of making a request
rather than a demand, a potential strategy includes arranging a future meeting
with school personnel, PTA members, and student body officers. This meeting
would explore ways to address suicide, psychoeducation, stigma and promote
wellness through establishing an annual forum that could be implemented as
turnover occurs within the school system.
Practice-based experience has led us to believe that adolescents
have a tendency to inform a peer, rather than an adult, if they are having
suicidal thoughts. In researching evidence-based practices aimed at reducing
suicide incidences, trained school peer leaders were four times more likely to
refer a suicidal friend to an adult when compared to untrained peer leaders
(Wyman, Brown, LoMurray, Schmeeik-Cone, Petrova, Yu, Walsh, Tu, Wang, 2010).
This encouraging information reinforces the benefits of involvement of
student body officers and could be utilized when presenting to school
personnel. Educating constituents, student body officers, and other
selected peer leaders on the warning signs of suicide and mental illness stigma
barriers may be key in reducing suicide incidences.
When asked about ideas that could be helpful in addressing the
lack of mental health awareness and decreasing stigma, Jody Valantine, a school
social worker, made mention that television ads, YouTube and social media could
play a valuable role. In her experience, regardless of other obligations or
activities, students always seem to find time to spend watching television or
accessing social media. With a majority of adolescents accessing social media
on a daily basis, we believe this is a venue to be explored. Teens can
easily and quickly participate in the education process through posting,
liking, and sharing psychoeducational information. In a study, “social
media was seen as a useful means of delivering a range of suicide prevention
activities” (Robinson, Rodrigues, Fisher, Bailey, Herrman, p. 27 2015).
By May 8th, 2015, we hope to create a Facebook page designed to
cut down on the social stigma towards mental health issues, creating an area
where teens could access mental health information and crisis call lines. We
believe that by increasing media access to mental health topics, stigma could
decrease significantly. In addition, teens would have greater access to social
support and chat forums that would promote social awareness and discussion.
The role of program evaluation is critical to ensuring successful
and permanent change. It is mentioned in the article by Lawton, et al,
entitled Logic Models: A Tool for Designing and Monitoring Program
Evaluations that by utilizing logic models through the evaluation process,
we can be better prepared to present our findings and/or recommendations to the
stakeholders. Also, in regards to evaluation, Gamble reiterates the importance
of partnering with the organization/school to ensure their goals and objectives
are also being met (Gamble, 2010).
By gathering quantitative as well as qualitative data, we can
identify potential problems within our implementation process while also
accessing the outcome of our intervention. The qualitative manner in which our
action plan can be evaluated for effectiveness may include follow up
interviews, focus groups and/or surveys of future students regarding their
perceived level of mental health awareness. Also, following our Facebook page
and how many “likes” or shares we get may be an indicator of spreading
education. On a quantitative level, we would hope that there would be a
reduction in our state’s suicide rates and that this may also be an indicator
of our program’s effectiveness.
References
Brent, D., Perper, J., & Moritz, G. (1993).
Psychiatric risk factors for adolescent suicide: A case-control study. Journal
of the American Academy of Child and Adolescent Psychiatry, 32, 521-529.
Christiansen, B. (2014, March 1). Utah has
highest rate of mental illness in US. Daily Herald.
Civil Rights Data
Collection Data Snapshot: Teacher Equity. (2014, March). Retrieved from
Gamble, D., & Weil,
M. (2010). Conceptual frameworks and models for community practice. In
Community practice skills: Local to global
perspectives. New York: Columbia
University Press.
Lawton, B., Brandon, P. R., Cicchinelli, L.,
Kekahio, W., Regional Educational Laboratory Pacific, (., & National Center
for Education Evaluation and Regional Assistance, (2014). Logic Models: A Tool
for Designing and Monitoring Program Evaluations. REL 2014-007. Regional
Educational Laboratory Pacific
NAMI, Ranking America’s
Mental Health: An Analysis of Depression Across the States. (2007)
retrieved from http://www.nami.org/Content/Microsites150/NAMI_Pasco_County/Home
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Peter, W., Brown, H.,
LoMurray, M., Schmeeik-Cone, K., Petrova, M., Yu, Q., ... Wang, W.
(2010). An Outcome Evaluation of the Sources of
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High Schools. American Journal of Public Health,100(9), 9-9.
Renaud, J., Séguin, M., Lesage, A. D.,
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in Youth Suicide: A Study of Trajectories. Canadian Journal Of Psychiatry,
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Robinson, J., Rodrigues,
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Suicide Prevention: Findings from a Stakeholder
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