SCEP Assessment Results and Action Plan

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.

http://m.heraldextra.com/news/local/utah-has-highest-rate-of-mental-illness-in-us/article_053ef820-584d-5930-953e-c75548be7c5c.html?mobile_touch=true

Civil Rights Data Collection Data Snapshot: Teacher Equity. (2014, March). Retrieved from

http://ocrdata.ed.gov/Downloads/CRDC-Teacher-Equity-Snapshot.pdf

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 138/Whats_New121/Ranking_America_s_Mental_Health_FINAL.pdf

Peter, W., Brown, H., LoMurray, M., Schmeeik-Cone, K., Petrova, M., Yu, Q., ... Wang, W.

(2010). An Outcome Evaluation of the Sources of Strength Suicide Prevention Program Delivered by Adolescent Peer Leaders in High Schools. American Journal of Public Health,100(9), 9-9.

Renaud, J., Séguin, M., Lesage, A. D., Marquette, C., Choo, B., & Turecki, G. (2014). Service Use and Unmet Needs in Youth Suicide: A Study of Trajectories. Canadian Journal Of Psychiatry, 59(10), 523-530.

Robinson, J., Rodrigues, M., Fisher, S., Bailey, E., & Herrman, H. (2015). Social Media and

Suicide Prevention: Findings from a Stakeholder Survey. Shanghai Archives of Psychiatry,27(1), 27-35. Retrieved from Academic Search Premier.

Schultz, A., & Sandy, M. (2011). Tactics and Strategy. 258-279.

Valantine, J. (2015, February 8). Review on Mental Health Education for High School Students [Telephone interview].