School Mental Health: The road ahead

Canada’s largest school board (Toronto District School Board, TDSB), recently made a major announcement that the entire workforce is to receive mental health training, as far down the line as the lunch lady. The four-year strategy will provide roughly 40,000 staff members with mental health training, focusing on promoting positive mental heath and wellness in schools, enhance the communication between school staff and parents and increase the number of anti-stigma programs by 50 percent, click here to learn more.

CBC News: More mental health training to help young Canadians

Kudos to TDSB for taking action on what we believe is vital to the health of our young people. This is a major step forward for both, the Province of Ontario and Canada.

We have recently collaborated with the Department of Education and the Teacher’s Plus Credit Union to implement a larger, but similar approach in Nova Scotia implementing our seminal resource Mental Health & High School Curriculum Guide, into each school board across the province. The approach included a two-day mental health literacy training on the Curriculum Guide as well as the ‘Go-To’ Teacher training model which focuses on improving educators’ knowledge. It has provided educators with the capacity to learn how to identify adolescents with mental health problems or disorders and how to link them with appropriate services for help.

Evidence-based results have demonstrated:

• A substantial improvement on knowledge regarding mental health and mental illnesses.
• Increased positive attitudes towards mental illness and people who live with them.
• Increased capacity to learn how to identify adolescents with mental health problems or disorders and how to link them with appropriate services for help

Dr. Stan Kutcher delivering school mental health training in Nova Scotia

The full 2013 Mental Health & High-School Curriculum report is available here.

The full ‘Go-To’ Teacher training report is available here. 

These developments have made Nova Scotia the first province to embed mental health literacy and full school identification, triage and support capabilities. The results provide sound evidence that the Mental Health Curriculum Guide training model and ‘Go-To’ Teacher Training are the model for other provinces to follow in addressing youth mental health literacy needs in Canada.

Teens are the least likely to seek out help for a mental illness or disorder further requiring the education of school staff and administration. In addition to the Guide, it’s important to provide a resource specific to those that continue to make the move at their final years of school over to colleges/universities and to fill this gap, Transitions has been made available both in the schools as well as in post-secondary intuitions. Transitions helps teens understand, self-help and assist others on various topics, ranging from different mental illnesses, finances, sexuality and much more. It’s availability as an App, an e-book, online and as a hard-copy makes it easily accessible for teens in the form and platform of their choice.

Once launched, the App was made available to 6000 post-secondary students across Nova Scotia immediately – not to mention the 3000 hard copies spread throughout the partner universities of the Stay Connected Mental Health Project.

While the initial focus was on Nova Scotia, it will be rolled out across Canada throughout 2014 with interest now coming in from the United States, United Kingdom, and as far as China for versions to be rolled out in those countries.

To learn more about Transitions, have a look at promotional video, 'Transitioning as a student.'

A comprehensive approach to dealing with Mental Health in the classroom is required and with the two strategies noted above we believe a true difference can be made at a critical point in the lives of the youth we hope to serve and protect.

For more information, please do not hesitate to get in touch with Faten Alshazly, the Advisor to the Sun Life Financial Chair in Adolescent Mental Health at info@teenmentalhealth.org.

Mitch Shea & Faten Alshazly

Academy in School Mental Health: Early-Bird Registration Date Extended!

There's still time to register for this year's Academy in School Mental Health. If fact we’ve extended the early bird rate until June 10!

Spend July 8-9 in Halifax learning and networking with experts in the field of youth mental health. You will gain a practical understanding of the most prevalent adolescent mental health disorders and learn effective tools and techniques that will assist you in the classroom.

"The 3rd annual Academy continues to get better every year as we build on from the last," says Dr. Stan Kutcher. "Each year we've seen great improvement in the workshop based in feedback and an increase in attendance."

The workshop welcomes a varying degree of professionals and parents, from educators, counsellors, principals, clinicians, advocates, parents and anyone else looking increase their mental health literacy and become better at what they do.

“The Academy strives to give attendees information that is current, cutting edge and contextualized to their area of work to help them do their job better,” says Kutcher.

For more on this and preview of the Academy, click here to view an interview with Dr. Kutcher.

Early bird registration is set at $250 until after June 10, after that registration increases to $300. Click here to register.

For up to date information on the Academy, visit our Academy webpage and follow the Academy on Twitter: @AcademyTMH.

Keynote Speakers and Breakout Session Contributors

This year's schedule has been completely revamped from previous years.

Keynote speakers have been arranged:

• Dr. Stan Kutcher - Youth Suicide: School Based Strategies


• Dr. Penny Corkum – Dealing with ADHD in the Classroom


• Barbara Kaiser – Bullying: What do we really know?


• Dr. Kathy Pajer - Self Harm

These sessions and many more will equip you with the tools you need to be more effective in your role.  Learn from and interact with the experts and participants!

Breakout session contributors include: Dr. Wade Junek, Dr. Sabina Abidi, Yifeng Wei,

Dr. Alexa Bagnell, Dr. Suzanne Zick, Trang Nguyen and IWK Teachers – Melanie Goodday and Julia Martino.

Check us out online!

Twitter: @TMentalHealth

Facebook: TeenMentalHealth.org

YouTube: TeenMentalHealth1

Young People and Concussions

Recently, Hockey Nova Scotia moved to decrease the probability of significant head injury in young people playing Canada’s game.  This type of regulatory progress is to be applauded and needs to be paired with increased educational activities designed to inform youth, parents, coaches, educators and health providers about concussions.  Even with the best available equipment and most appropriately designed rules pertaining to body contact in hockey and other sports, accidents can happen and brain injury can occur.  Everyone needs to be informed about the signs and symptoms of concussions and be aware that even a seemingly inconsequential “whack on the head” can lead to life altering concussion.

Benjamin Gray’s poignant story as reported by the Chronicle Herald (May 14, 2013), is an excellent example of how print media can participate in raising public awareness of this important issue, and Benjamin is to be applauded for his courage in sharing his personal and challenging journey with his brain injury.  His story is instructive while he describes a culture of personal and peer expectations to continue playing even when he knew he was not a 100 percent ready to return.  He shares his personal struggles with some of the negative emotional, cognitive and behavioral outcomes that could stem from concussions. He raises awareness that the path to recovery from a brain injury can be long, arduous and challenging for young people and their families alike.

His story also points to a very important lesson.  While we may not be able to prevent all concussions, we are able to properly react if a concussion happens.  This includes knowing about the signs and symptoms of concussion and what to do to help recover from the effects of the brain injury.  We now have a much better understanding of what needs to be done along the path of “return to play”.  And youth, parents, coaches, educators and health providers need to understand what to do and how to work collaboratively to ensure that young people do not return too quickly.

Less well appreciated is the importance of understanding the process of “return to learn”.  As Benjamin’s story illustrates, concussions can have significant and substantial negative impacts on a young person’s ability to successfully navigate the academic and social challenges at school.  We need to do a better job at educating young people, parents, coaches, educators and health providers at what to expect and how to help during the “return to learn journey”.

Recently, our team has created and made freely available information designed for youth and for parents, coaches and educators that help with understanding brain injury in young people and how to best ensure that return to play and return to learn are applied in the best interests of a healthy recovery.  Bringing together effective methods of preventing concussions and providing education about what can be done if a concussion does happen may help decrease the burden on young people, families and communities that brain injuries take.  Thank you Benjamin for helping us move in this direction.

Youth Brain Injury Guide: A guide to help youth understand the affects of brain injury

Brain Injury in Adolescence A guide for young people, coaches, educators and those that work with youth

- Stan

Mental Health Week Live Tweet Chat Recap: Engaging and Educating Through Social Media

During Mental Health Week, TeenMentalHealth.org and Dr. Kutcher took to social media to educate and create awareness around mental health. Engaging in a live Twitter tweet chat, the public were able to ask and elaborate on questions in relation to mental health.

The chat created a dialogue, fostering knowledge on hot topics in mental health.  “It provides the public with the opportunity to ask and engage, furthering their knowledge of what’s available locally and online,” says Dr. Kutcher.

Using the #TMHWeek tag, users were able to engage in the conversation, making it an effective way to spread knowledge and education.

CLICK HERE TO VIEW THE CONVERSATION 

For more information, visit TeenMentalHealth.org and follow us on Twitter @TMentalHealth

Rebecca Marino: Courageous Young Woman, Confusing CBC Story

Yesterday, CBC National carried an interview with Rebecca Marino, a young woman who has recently announced that she will be stepping away from a promising tennis career because of the toll that living with a Depression has taken on her. Click here to see the interview.

Kudos to her for being open and honest about the challenges she has faced.  As she put it, “I don’t have the passion I used to have”.  Depression is tough - it takes a toll on energy, on concentration, on experiencing pleasure and on many parts of life.  For some people who are caught in the jaws of Depression, just getting up every day and getting a small task accomplished is a success. 

And, let’s not underestimate the incredible toll that training to become an elite athlete can take on young people.  It’s tough!  The commitment has to be total, the stakes are high and the price of failure is also high.  It takes dedication and determination of a quantity and quality that most of us could not summon.  Elite athletes are amazing people and to be successful they need to be mentally and physically healthy.

So what did the CBC news story say?  On the website the story byline is: “Canadian admits social media comments took a toll.”  And what did the interviewer ask about – cyber bullying!  And what did Rebecca Marion say: “there were a lot of negative tweets along with a lot of positive tweets”…”this has not impacted my choice”.

Indeed, she was very clear.  She said that “depression has impacted my life and my career.”  That is the story – Depression, a mental illness has made it difficult for her to continue her career – to the point that she has decided to step away from that choice.  What if she had suffered a severe tear to her rotator cuff and could no longer swing her racket?  Likely the same outcome!  What if she had suffered a complex, multiple fracture of her tibia and fibula, so that she could no longer move rapidly across the tennis court?  Likely the same outcome!  But she suffered a perturbation of brain functioning called Depression and the CBC wants to make the reason cyber-bullying?

Am I missing something here?  Or is the media missing something here?  Is the point of the story supporting a promising young athlete dealing with a potentially career ending injury or is the point of the story to sensationalize cyber-bullying?  If Marino had suffered a shoulder or leg injury would the story be about cyber-bullying?  I doubt it.  Why is then a story that should be about Depression has become one about cyber-bullying? 

This story makes me wonder about a couple of things.  Are we seeing stigma against mental illness at play here?  Are we seeing a substantial lack of mental health literacy in media personnel here?  Are we seeing an attempt to “sell the news” instead of “reporting the news” here?  I don’t know.

But let’s not throw out the baby with the bathwater.  The Toronto Star also did a story on this.   Here the story is more balanced, more nuanced, yet even here the headlines focus on “cyber-bullying”.

Did Marino experience negative social media comments?  For sure she did.  Is that different than other elite athlete’s experiences? Maybe not.  Did they take a toll on her?  Likely.  Would she have been able to roll with the punches if she did not also have Depression?  Maybe – Depression takes a huge toll on a person’s ability to deal with negative events and negative experiences.  It makes you more vulnerable and may interfere with your usual ability to adapt to the “slings and arrows of outrageous fortune.” 

So now we have a better insight of the complexities of the issue.  Its really not about cyber-bullying – it’s about Depression and how it interferes with a person’s ability to adapt.  This does not mean that we can condone such negative electronic interactions.  As a society we need to learn to deal with the huge negativities that Twitter and Facebook and other social networking tools can create – especially to vulnerable people.  But let’s not forget Depression.  As far as I can tell, Marino’s career ending injury was a Depression, not Twitter.

- Dr. Stan Kutcher

My Wish for the New Year: More understanding less sanctimonious self – interest when it comes to talking about mental health in the public domain

So my New Year’s wish is that for 2013, the public discourse addressing mental health and mental disorders are civil, based on best available evidence, welcoming of all and not driven by sanctimonious self-interest.

The year that was 2012 saw lots of the opposite, to the above wish.  Two issues that stand out for me were: the reporting of youth suicide in the mainstream media & the NRA statements on school shootings following the Sandy Hook tragedy.

First, the mainstream media and youth suicide perturbations: The Amanda Todd suicide became a lightning rod for concerns about the responsibilities of media reporting related to youth suicide.  The relationship between suicide contagion in young people and sensational media reporting is well recognized and although good & useful guidelines for reporting on youth suicide in the media are well known, many of Canada’s mainstream media ignored these in their rush to titillate disguised as reporting.  Even the Globe and Mail, usually a vehicle of some considerate reflection jumped on the bandwagon in an editorial crying that the push to sell the story (in their argument, their need to keep the public informed about each emotionally driving tragic details of what happened) trumped the evidence to help keep vulnerable youth safer. 

To my mind, the mainstream media has a responsibility to keep the public informed.  It also has a responsibility to keep the public informed responsibly.  Young people contemplating taking their own lives are ambivalent during the period of intense emotional crisis that accompanies this consideration.  While in this vulnerable position, they can be pushed to choose life or they can be pushed to choose death.  We have noticed a substantive co-relation between the recent rise in suicide rates (after a decline for over 20 years) and the amount of sensationalized print and electronic media reporting of this issue.  I wonder if this is causally related.  Selling newspapers or advertisements for the newest blender, skin care product or automobile is, to my mind, not a reason for increasing the risk for choosing death by suicide for young people.

Second, the NRA pronouncements following the Sandy Hook tragedy:  Not only did their initial suggestions (turning America’s schools into armed camps) defy logic and any semblance of civil social organization, but their idiotic (and there is no nicer word for that) statement that there should not be a registry of guns but a registry of those who live with a mental illness is so absurd and so stupid and so dangerous that it gives me cold chills.  Just what other kinds of registries should there be?  Immigrants, people of color, people whose shoe size is between 6 and 7.5, and so on? Lets just register all those who live with a mental illness (that would be about 70 million Americans) so we can watch them like a good Big Brother.   Lets just register everyone and give guns to those whom we like and call them the “good guys” (those are the words the NRA used) and lets just allow them to shoot all the “bad guys” (those that we do not like).  What a solution!  So, why stop at guns?  Why not give all the “good guys” personal nuclear bombs and turn schools into chemical war factories.  Then the “good guys” will really be much better able to defend themselves.  After all, why use a semi-automatic/automatic weapon that can only kill 30 people at a time when you can use a nuclear bomb and get rid of millions.  Responsible gun ownership is one thing, killing humans is quite another.

So, that is my New Year’s wish.  Wonder if it will come true?

-Stan

Connecticut Tragedy: A reasonable vehicle for addressing mental health needs in young people?

Recent media coverage, sensationalistic and omnipresent as it is (and, by the way – has anyone noticed the correlation between frequency of school shootings and this type of media coverage?) has raised numerous issues about the relationship between the tragic story in Connecticut and youth mental health.  Largely the story line has gone something like this: oh my gosh, this young man had a psychiatric diagnosis; his mental illness likely made him act this way; why can’t our society do a better job of identifying youth who are likely to have this kind of negative impact; we need to fix our mental health services.

Have we ever wondered where that kind of story line takes us?  Does it take us to a rational and evidence based understanding of mental health and mental disorders?  Does it take us to a place where we can logically develop mental health care that meets the needs of young people and their families?  Does it provide reliable information about what a mental illness is and how a mental illness may or may not lead to specific behaviors and outcomes? OR – does this kind of knee-jerk reporting maybe increase the stigma associated with mental illness, lead to inaccurate understanding of what a mental disorder is and how that relates to specific kinds of behaviors and in both the long and short run, do a disservice to all those who are living with a mental disorder, their families and those who work to help them get well and stay well?

We know that easily accessible, responsive and best quality mental health care is not readily available for most young people who need it. We know that most young people with mild to moderate or non-complex mental disorders can be appropriately and effectively treated in primary care (click here to check out the child and youth mental health components.) We also know that it is the tiny minority of young people with a mental disorder who require intensive and high acuity mental health care.  And, we know that is only a tiny minority of those who may have a mental disorder of the type that leads to the tragedy recently played out in Sandy Hook.  So why is this event even considered to be the poster child for mental health reform?

I think we need to have many adult conversations that this tragic incident forces us to consider.  The most obvious one is that of: how to best deal with the killing capacity of the final common pathway – automatic/semi-automatic weapons and handguns.  The Dunblane school shootings in Scotland led to popular protest that led to changes in gun related legislation that has been associated with a substantial decrease in deaths of young people from shootings.  This is a no-brainer – or maybe this is the problem.

We also need to fix the mess that is mental health services for young people – everywhere.  Just because we live in Canada does not mean that we are doing what needs to be done – on the contrary.  But we don’t need to have a tragedy to address this reality, we need commitment from all of us and political will.

-Stan