William Dikel, M.D. - Blog

Student Surveys and Mental Health Risk Factors

6/30/2020

Photo courtesy of Wikimedia Commons, dotmatchbox at flickr / CC BY-SA (https://creativecommons.org/licenses/by-sa/2.0)

In my consultation to schools, I have found the Minnesota Student Survey to be a useful tool in identifying mental health risk factors. This is an anonymous survey that identifies areas of concern including a history of trauma, substance abuse, suicidal ideation and a history of suicide attempts. The anonymity of the survey encourages students’ willingness to share sensitive information. Unfortunately, the anonymity makes it difficult to identify students of concern.

I have found that the student survey data can be analyzed in an in-depth approach that identifies populations of at-risk students. By focusing on one item (e.g. a history of suicidal ideation) and then correlating this with another item (e.g. grades), significant information can be obtained. For example, one school district’s data indicated that, if a ninth-grade female student reported that she received mostly C grades, she had a 44% chance of also reporting suicidal ideation. Many school districts have school counselors meet with all of the students on their caseload at least once. Knowing that nearly half of the ninth-grade female students with C averages have suicidal ideation can help inform counselors regarding interventions. This is just one of many examples of two item correlations. Correlations can even be done with additional variables.

I would encourage your district to consider conducting in-depth analysis of Minnesota student survey data, in order to gain a better understanding of the mental health needs of your student population. For those of you who work in other states, there is a good chance that your state will have its own survey similar to the one that is used in Minnesota.

The Teacher's Guide to Student Mental Health: 2nd Edition published

2/10/2020

Student Mental Health: A Guide For Teachers, School and District Leaders, School Psychologists and Nurses, Social Workers, Counselors, and Parents. By William Dikel, MD.

I am happy to announce the publication of the second edition of my book, “The Teacher’s Guide to Student Mental Health.” I have added a large amount of material directed towards both educators and mental health professionals.

The new edition is now titled, “Student Mental Health: A Guide For Teachers, School and District Leaders, School Psychologists and Nurses, Social Workers, Counselors, and Parents.”

The book provides practical information, and outlines the nature of mental health disorders experienced by students. Student Mental Health: A Guide illustrates how these disorders manifest in the classroom, and describes what schools can do to successfully work with these students and their families.

My goal is to raise awareness regarding student mental health issues, and in so doing, to help these students become successful in school.

Including mental health in school district medical plans

8/28/2019

Including mental health in school district medical plans

School districts often have medical plans, e.g., protocols for addressing chronic medical illnesses such as diabetes, asthma or infectious disease. They tend to not have mental health plans for working with students who have mood disorders, anxiety disorders, ADHD, etc.

Given the nature and extent of mental health disorders experienced by students, and the effect that these have on their education, a mental health plan makes sense.

In this article, Creating a School District Mental Health Plan That Meets the Needs of Students Who Have Psychiatric Disorders, I lay out the essentials for creating a school district mental health plan, including roles and responsibilities, crisis intervention, educational planning, and other important considerations.

(Link: http://www.williamdikel.com/creating-a-school-district-mental-health-plan-that-meets-the-needs-of-students-who-have-psychiatric-disorders.html)

Improving outcomes for special educations students in the ED category

5/5/2019

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Special education students in the emotional disturbance category have the worst outcomes of all disability categories.

I wrote this paper with attorney Daniel Stewart. Together, we explored some of the reasons for these poor outcomes, from both a legal and psychiatric standpoint. We identified a number of issues related to policy choices, programmatic decisions, and results surrounding children eligible for special education.

Please read our article, "Emotional/Behavioral Disorders and Special Education: Recommendations for System Redesign of a Failed Category," for our detailed findings and recommendations regarding the ED category..

Second edition coming out

1/26/2019

I am pleased to announce that the second edition of my book, “The Teacher’s Guide to Student Mental Health,” will be published soon by W.W. Norton. As feedback from a variety of school professionals was overwhelmingly in favor of expanding the audience to other professionals, the book will have the new title, “Student Mental Health,” with additional title material indicating that is a guide for teachers, school and district leaders, school psychologists, social workers. counselors, parents and clinicians.

The book will have a significant amount of new information on topics, including:

evidence-based educational interventions for students who have emotional and/or behavioral problems
mental health related services on IEPs, drug use and special education
creating district mental health plans
how to handle mental health information in school files
implications of payer of last resort requirements and of the criteria for the emotional disorder category of special education
and much more.

The book’s purpose is to explain, in lay terms, the essential information regarding the educational needs of students who have mental health disorders. The goal is to make schools a supportive environment and to improve educational outcomes for this vulnerable population of students.

School Shootings and Mental Illness

3/2/2018

Once again, America is confronted with yet another horrific school shooting, and news media is filled with articles
about mental illness, violence, and what schools need to do.

My article, “School Shootings and Student Mental Health: What Lies Beneath the Tip of the Iceberg” puts the issue in perspective, and outlines practical steps that school districts can take to prevent violence while effectively addressing vulnerable students’ mental health needs.

Addressing the Core Issue in Children’s Mental Health: Early Intervention and Prevention

12/10/2017

Unfortunately, many (at least half!) of children and adolescents who have mental health disorders are never identified or treated. Those who do receive treatment are often years behind in necessary interventions. Although all children and adolescents who are on Medicaid are entitled to mental health screening, a variety of factors, including poor reimbursement to clinicians, results in lack of screening for many if not most. For those of you who are interested in better understanding mental health early intervention, please see my article, “Addressing the Core Issue in Children’s Mental Health: Early Intervention and Prevention.”

When Advocacy Isn’t Enough – Successful Mental Health Class Action Lawsuits

11/19/2017

I am a children’s mental health advocate as well as being a clinician and consultant. As an advocate, I have found that efforts of advocacy groups are not always successful, and that many children and adolescents do not receive the help to which they are entitled. Dan Stewart, supervising attorney at the Minnesota Disability Law Center and I compiled an overview of successful class action lawsuits that brought services to thousands of children and adolescents who otherwise would have gone unserved. The presentation provides information on the entitlement of EPSDT (Early, Periodic Screening, Diagnosis and Treatment) for youth on Medicaid: When Advocacy Isn’t Enough – Successful Mental Health Class Action Lawsuits.

How To Handle Mental Health Data in School Files

11/12/2017

In my consulting work with school districts around the country, I have found that many teachers and administrators do not fully understand how to handle mental health data in student school files. With increasing frequency, school districts are required to address complex issues that arise out of the mental health needs of students. In addressing these issues, school districts are faced with challenges related to gathering, receiving, maintaining, and disclosing mental health data on students. How to handle data that is sent to the school (e.g., mental health diagnostic and/or treatment records) and data that is generated by the school staff (e.g. counseling or school social work records) requires an accurate understanding of FERPA, HIPAA, and applicable state laws will help school districts avoid costly mistakes that could lead to litigation and liability. Michael Waldspurger, J.D. and I wrote this article as a resource to school districts.

How to Handle Mental Health Data In School Files

CASE/NASDSE Conferences in Milwaukee, Sept. 29-Oct. 1

9/25/2016

For those of you who will be attending the CASE/NASDSE conference next week in Milwaukee and/or the Center for School Mental Health conference September 29-Oct 1, I will be co-presenting with behavioral analyst Jan Ostrom on assessing, teaching and treating the delinquent, mentally ill student. We will be describing our Clinical-Behavioral Spectrum concepts as they relate to students who have both clinical and learned behavioral contributors to their difficulties. Hope to see you!