William Dikel, M.D.
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Student Mental Health and COVID-19: Challenges and Recommendations

10/1/2020

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COVID-19 has added a whole new dimension of challenges in addressing students’ mental health needs. In my latest article, I explore and outline some of these challenges and recommend a detailed expansion of Tier 1 services for students and staff, including a focus on lifestyle, self-mastery, mindfulness, and the cultivation of resilience. 

The 10-page paper, "
Optimizing the Effectiveness of Mental Health Support Staff in Your District" covers many relevant angles of the situation facing educators, counselors, and mental health professionals. I discuss the following and other concerns:
  • The roles of mental health support staff
  • The pyramid (Multi-Tiered System of Support or MTSS) model
  • Students' self-reported mental health disorders 
  • Efficiency of service provision
  • Elements of a school district mental health plan
I hope you find this information valuable to your school and school district. As always, I welcome your feedback!
Student Mental Health and COVID-19: Challenges and Recommendations
Student Mental Health and COVID-19: Challenges and Recommendations
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COVID-19 and School Openings

7/28/2020

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Picture
H.L. Mencken famously said, “For every complex problem, there is an answer that is clear, simple, and wrong.”  

This is especially true in discussions about COVID-19 and school openings. The best overview of this issue that I have found is Michael Osterholm’s Weekly COVID-19 podcasts from the University of Minnesota Center for Infectious Disease Research and Policy (CIDRAP):
 https://www.cidrap.umn.edu/covid-19/podcasts-webinars
Episodes 16 and 17 provide an in-depth analysis of this complex topic.  

I would highly recommend these podcasts to anyone who is seeking a thoughtful and thorough overview of the topic.

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Student Surveys and Mental Health Risk Factors

6/30/2020

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PicturePhoto 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.

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

2/10/2020

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PictureStudent 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.

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Including mental health in school district medical plans

8/28/2019

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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)


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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..
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Second edition coming out

1/26/2019

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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.
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School Shootings and Mental Illness

3/2/2018

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

12/10/2017

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

11/19/2017

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​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.
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    Dr. William Dikel is a board certified child, adolescent and adult psychiatrist who provides a wide variety of psychiatric consultation services.  He is based in Minneapolis, Minnesota, and provides consultation state-wide and nationally. 

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