The Other 60 Percent

A new tool in schools’ mental health tool box

Using Crayola markers set on each round table, small groups of adults from the Greeley area — school outreach workers, Boys and Girls Club staff and foster parents — created poster-sized pictures of what mental health problems look like. Glum stick figures sat under rain clouds, a face contorted from happy to sad and a placid face showed no outward signs of distress.

The pictures were just one of several hands-on activities sprinkled throughout a recent day-long training that aims to teach lay-people the signs of mental health or substance abuse problems in youth, and give them action steps to follow when they spot trouble.

Called Youth Mental Health First Aid, the training originated in Australia and was unveiled in Colorado last year. There is also an adult version of the training, introduced here in 2008, called Mental Health First Aid or MHFA.

Both are gaining momentum in what mental health advocates say is a welcome development in a state saddled with one of the highest suicide rates in the country and more than its fair share of school tragedies, including a deadly shooting at Centennial’s Arapahoe High School in December and a self-immolation at Westminster’s Standley Lake High School in January.

Olga Gonzalez, a community outreach worker who participated in the recent Greeley training, said she regularly fields questions from parents who are worried about their children but don’ t know where to turn. She recounted how one family she’d worked with discovered their son had started using drugs. Another learned that their son had stolen credit card information from a customer while manning the cash register at the family’s store.

“He has money in a savings account, you know. He just did it,” she said. “I wasn’t sure what kind of support he needs.”

Youth Mental Health First Aid aims to answer such questions for people who are not mental health professionals but who work closely with young people and their families. The target audience includes lay-people like teachers, coaches, guidance counselors, school nurses and even bus drivers.

Advocates for MHFA say Colorado now has one of the largest contingents of certified instructors—around 230 so far. In addition, it’s among only a handful of states to dedicate public funds to the trainings, with $750,000 appropriated for the program next year.

“We have been at the forefront of this since the beginning,” said Brian Turner, director of Mental Health First Aid Colorado at the Colorado Behavioral Healthcare Council.

Preparing first responders

The concept behind both versions of MHFA, much like medical first-aid, is to equip first responders with the know-how to address emerging mental health or addiction problems. The youth version is also meant to help distinguish between true mental health issues and the normal mood swings and behavior changes that characterize the life of a teenager.

But the training is hardly a technical lecture. It’s participant-friendly approach is evident in the hands-on activities, the video clips, the anecdote-peppered instruction and even the pile of bite-sized candy on each table. Originally, conceived as a two-day training, it has since changed to a one-day format.

“I think we try to make it accessible in a very non-threatening way,” said Pamela Collins Vaughn, one of the instructors at the Greeley training and quality assurance program director at North Range Behavioral Health.

The five action steps in Youth Mental Health First Aid.
The five action steps in Youth Mental Health First Aid.

Gonzalez, an outreach worker with Community Care Corps, said she learned about the training at a resource fair that she helped coordinate. Her work with families at two local middle schools, as well as in surrounding neighborhoods, made her want to refresh her knowledge on mental health issues.

While Gonzalez and other MHFA participants are certainly not charged with providing treatment, they do receive a customized local resource guide to help them connect youth with professional help when necessary.

In fact, encouraging youth to seek professional help is one of five action steps—condensed in the acronym ALGEE–outlined in the training. The other four include “Assess for suicide/self harm,” “Listen non-judgmentally,” “Give assurance/information,” and “Encourage self-help/other support.”

Turner said having concrete action steps is important because “there’s a big difference between learning about mental health and substance abuse problems and being able to do something about it.”

During the Greeley training, participants were asked to come up with gestures that would convey each of the five action steps. Soon, in an effort to commit the steps to memory, Vaughn and co-trainer Noelle Hause were leading the group in miming actions like non-judgmental head-nodding and reassuring arm-patting.

Reaching out to schools

While Turner said Youth Mental Health First Aid is not yet widely offered by school districts, there is growing interest. Among the districts that have offered it for at least some staff are Douglas County, Aurora, Thompson, and Weld County District 6.

Barb Becker, division director for community programs at the Arapahoe/Douglas Mental Health Network, said the one-day format make it a very doable training for educators.

One of the pictures made by participants at a recent Youth Mental Health First Aid training.
One of the pictures made by participants at a recent Youth Mental Health First Aid training.

“It just gives a really good overview,” she said, adding, “It takes away some of the stigma associated with mental health.”

While grants to offer Youth Mental Health First Aid are sometimes available and some mental health centers offer it for free, the price of the training can be a barrier for districts. Costs typically run at least $25 per person and can max out at $50 depending on facility and food costs.

While the new $750,000 in state funding will help with expansion, Turner said advocates are also investigating whether Medicaid reimbursements received by schools can help pay for the trainings. Currently, those reimbursements are used for all kinds of school health and wellness efforts, from paying school nurses to buying P.E. equipment.

If Youth Mental Health First Aid is widely adopted by schools, it will join a growing number of tools used to detect and combat mental health problems in students. Many schools already use suicide prevention curriculums, some are adding instruction on social emotional skills and a few conduct universal mental health screenings among students.

In addition, many schools regularly convene meetings to discuss and create plans for students who are showing signs of mental health or behavioral problem. Others publicize programs like Safe2Tell that allow students, parents or staff to anonymously report bullying or threats of school violence or suicide.

While Becker noted that middle-aged white men, not teens are actually at the highest risk for suicide in Colorado, she said it is still a problem among young people.

In 2010, Colorado had the seventh-highest  youth suicide rate among states and Washington, DC, with 16.7 deaths by suicide per 100,000 people in the 15-24 age group, according to data from the Centers for Disease Control and Prevention. In general, Colorado’s suicide rates are higher in rural and mountain communities than in urban areas. They are also higher among males than females.

Becker said there are a variety of reasons, including biological changes, peer conflicts and dating strife, that adolescents experience depression, which is a leading cause of suicide.

“It’s a hard time in life,” she said.

Ultimately, Turner hopes both versions of Mental Health First Aid will be widely available in all parts of Colorado. They won’t prevent all violent incidents, he said, but they might help. They can also aid in the healing process for communities that have suffered through fires, floods, droughts and other disasters.

#WontBeErased

Denver school board pledges to make sure LGBTQ students are ‘seen, accepted, and celebrated’

PHOTO: Andy Cross/The Denver Post
Ellie Ozbayrak, 4, sports rainbow wings at the annual PrideFest celebration at Civic Center Park June 18, 2016.

In response to reports that the Trump administration may seek to narrowly define gender as a condition determined by genitalia at birth, the Denver school board Thursday unanimously adopted a resolution in support of transgender students and staff members.

“The board, with its community members and partners, find this federal action to be cruel and harmful to our students and employees,” the resolution said. Denver Public Schools “will not allow our students, staff, and families to feel that they are being erased.”

The Trump administration has not yet made a final decision. But the threat of reversing actions taken under the Obama administration to recognize transgender Americans has prompted protests across the country, including a recent walkout at Denver’s North High School.

Several Denver students thanked the school board Thursday for the resolution, which says the board “wholeheartedly embraces DPS’s LGBTQ+ students, employees, and community members for the diversity they bring to our schools and workplaces, and strives to ensure that they are seen, accepted, and celebrated for who they truly are.”

“It is amazing to hear each and every single one of your ‘ayes,’” said a student named Skyler.

The resolution lists several ways the district supports transgender students and staff, including not requiring them “to undertake any expensive formal legal process to change their names in DPS student or personnel records” and honoring their pronoun preferences.

Read the entire resolution below.

making moves

In New York, a new focus on housing could also spur more diversity in schools

PHOTO: Christina Veiga/Chalkbeat
In 2016, the Community Education Council in Manhattan's District 3 approved a controversial school rezoning aimed in part at integrating schools.

On a recent morning in Brooklyn, principals, parents, and education leaders from across the state gathered to drill into the root causes of school segregation and develop plans to spur more diversity. Joining the discussion was someone unexpected: a representative from the state’s Fair and Equitable Housing Office.

“We want to see within your districts, what your challenges are, what your ideas are,” said Nadya Salcedo, the office’s director. “You can’t talk about integration and segregation without talking about housing.”

It is often taken as a given that schools are segregated because neighborhoods are. Yet the twin challenges of integrating where children live and learn are rarely tackled in tandem. In New York, two recent moves have the potential to address both.

The first: State education leaders who are working with local districts to craft school integration plans are also inviting housing officials to the table early on — and plan to include them throughout the process.

The second: In New York City, housing officials have launched a tiny pilot program to help low-income renters move into neighborhoods that offer more opportunities, defined partly by school performance. The initiative isn’t meant to tackle school segregation directly, but if it grows, it could result in more diverse classrooms.

Both are small and unconnected, involving officials from different agencies. Details about both the state and city efforts are scant, for now. But taken together, they suggest a new energy toward tackling housing issues that are often a barrier to more integrated schools.

“There have been some ripples of hope out there,” said Fred Freiberg, executive director of the Fair Housing Justice Center. “But we still have a long ways to go.”

The meeting in Brooklyn brought together school district leaders who have been armed with a state grant to help improve schools by integrating them. Now, housing officials have been looped into that work to brainstorm how to collaborate.

The housing department “is working to help desegregate communities,” spokeswoman Charni Sochet wrote in an email. “This includes working with our federal, State and local partners.”

Similarly, the city began its housing pilot this summer but didn’t share details until this week, when the Wall Street Journal profiled the program. The 45 families in the program’s first phase are getting assistance searching for a new home — including rent vouchers that are worth more in wealthier neighborhoods, financial counseling to help them afford a move, and support navigating the intimidating New York City housing market.

“The mayor’s education and housing plans take dead aim at achievement and economic gaps decades in the making,” Jaclyn Rothenberg, a city spokeswoman, wrote in an email. “All students benefit from diverse classrooms. Neighborhoods benefit from a diverse community.”

The pilot is striking given what Mayor Bill de Blasio has said about housing in the city in the past. When asked how he plans to tackle school segregation, he has often argued that the city’s power is limited because schools reflect entrenched housing patterns and private choices by families about where to live. “We cannot change the basic reality of housing in New York City,” he said in 2017.

Families with rental vouchers often find it difficult to move out of segregated neighborhoods where schools tend to struggle under the weight of concentrated poverty. The city’s pilot could tackle those issues.

“At least now I’ll have a chance to apply to some of these apartments,” one participant, the mother of a 10- and 12-year-old, told the Wall Street Journal. “I’m moving to a better school district, and nothing else matters.”

In places such as Baltimore, similar “mobility” programs have included a sharp focus on helping families move to areas with better schools, and making sure that students adjust well to their new classrooms. On a wide scale, such efforts could create more diverse neighborhoods and learning environments, since income tracks closely with race and ethnicity — and schools with high test scores are often filled with white students and those from more affluent families.

It could also have profound effects on how children perform academically and later in life. Moving to a neighborhood with lower poverty rates can boost college attendance and future earnings, according to some of the most influential research on the topic.

Montgomery County, Maryland offers another example, where the housing commission randomly assigned families to public housing instead of letting them choose where to live. There, children in public housing who went to “advantaged” schools in less impoverished neighborhoods did better in math and reading than their peers who lived in public housing but attended the district’s least-advantaged schools, according to a report by the Century Foundation, a progressive think tank.

That result hews to a growing body of research that has found that students benefit from attending schools that are integrated by race and socioeconomic class.

How the city implements its pilot will matter if students and schools are to benefit most. Although some studies have found that housing programs can improve affected students’ academic performance, the effect can be modest and vary greatly depending on where families relocate and which schools their children attend.

New York City presents some additional challenges. With a vast system of school choice and programs that selectively sort students based on their past academic performance, students and neighborhoods aren’t as closely linked here as they are in other cities.

Recent research found New York City schools might be slightly less segregated if students actually stayed in their neighborhood schools. And simply living near a school does not guarantee access in cases where competitive entrance criteria are used to admit students — a process called screening that critics say contributes to segregation. School attendance boundaries can also separate students by race and class even when they live side by side, a dynamic exemplified by recent rezoning battles on the Upper West Side and in gentrifying Brooklyn neighborhoods.

In New York, the scale of the challenge is huge: The city has one of the most segregated school systems in the country, an ignominious superlative that also applies to neighborhoods. The politics of unraveling these issues can be explosive. Many advocates for both fair housing and more diverse schools caution that policies should work both ways, giving low-income families and people of color the chance to leave under-resourced schools and neighborhoods, while also boosting investments in classrooms and communities that have been historically neglected.

“It shouldn’t be an either-or,” said Freiberg, the Fair Housing Justice Center director. “You’re going to have to do both.”

Though conversations seem to just be getting started, integration advocates and housing experts are heartened by the small steps already taken.

“This is a dream come true for people in the housing world,” said Vicki Been, a former city housing official who is now faculty director at the New York University Furman Center. “We have always been looking for ways to get families into neighborhoods that have better schools, lower crimes, better job opportunities.”

Reema Amin contributed reporting.