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.”
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.
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
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!
Last week, I was delighted to receive a letter from American Academy of Child & Adolescent Psychiatry President Paramjit T. Joshi, MD. In the letter, Dr. Joshi informed me of my new status as recipient of the 2015 Sidney Berman Award for the School-Based Study and Treatment of Learning Disorders and Mental Illness.
According to Dr. Joshi's letter, "This award recognizes an individual or program that has shown outstanding achievement in the school-based study or delivery of intervention for learning disorders and mental illness."
I feel very honored to have been chosen to receive this award from AACAP. I am grateful to Dr. Joshi, Dr. Sheryl Kataoka, and other members of the Schools Committee of the American Academy of Child & Adolescent Psychiatry. This is a wonderful reason to visit San Antonio and I look forward to accepting the award there during the 62nd Annual AACAP Meeting, October 26-31. I hope to see you there!
I am excited to be leading a workshop at the MACMH 2015 Conference next week in Duluth. This is the 19th Child & Adolescent Mental Health Conference held by Minnesota Association for Children’s Mental Health, and it has become the largest children's mental health conference in the country. I'm honored to be participating as a speaker and look forward to seeing friends and colleagues at the DECC.
I'm leading a workshop there on Tuesday, April 28, on the subject of Creating a School District Mental Health Plan. The workshop is open to parents and professionals.
If you can't attend but are interested in student mental health and related subjects, feel free to read or download the slides for my talk, Creating a School District Mental Health Plan that Meets the Needs of Students who have Psychiatric Disorders, as well as other presentations and documents available in in the Articles & Papers section of the website.
When a student abuses drugs or alcohol, everything changes, including student mental health treatment.
Although many health and mental health disorders are potentially considered disabilities under special education law, substance use disorder (previously known as drug or alcohol abuse or dependence) is not. In fact, in some states, a student cannot qualify for the Emotional Disturbance category of special education if drug abuse is the primary cause of emotional or behavioral problems.
An article I co-wrote with school attorney Michael Waldspurger, and now available on the website, clarifies the relationship between substance use and special education law and addresses some of the legal issues that can arise when a special education student begins abusing chemicals. To learn more about this important student mental health issue, read Drugs and Disabilities: Conducting Special Education Evaluations of Students Who Abuse Drugs or Alcohol.
I recently added a new presentation to the website, Adopting Evidence-Based Teaching Methods for Students who have Emotional/Behavioral Problems. This is a PDF of a talk I first presented at the Education Minnesota 2014 conference. It provides an overview of teaching methods that result in improved academic performance and reduced behavioral difficulties.
Teachers need two kinds of information about children's mental health issues. First, they need to have an understanding of the different mental health disorders that affect children and adolescents and to understand how these disorders manifest within the classroom environment. Secondly, they need to know and utilize teaching methods that have been shown to be effective for individuals who have emotional and/or behavioral problems. This paper, in slide format, explains clear actions educators can take to improve the experience of students with emotional and behavioral problems.
I am happy to report that Choice Connect, a publication of the American Library Association, gave a “Highly recommended for all readership levels” review of my book, The Teacher’s Guide to Student Mental Health.
The reviewer wrote,
“The Teacher’s Guide to Student Mental Health is a practitioner-friendly resource that serves as a comprehensive road map for understanding school mental health and the implementation of evidence-based practices across classroom settings. A leading expert in his field, Dikel (child and adolescent psychiatrist) embeds years of clinical and field experiences into three distinct sections ('Why School Mental Health?' 'The Scope of Mental Health Disorders Affecting Children and Adolescents,' and 'A School’s Mental Health Framework') and strategically guides readers through the complexities of such timely topics. The wealth of knowledge captured in each section exemplifies the significance of school-based mental health service and support. This guide should be a permanent reference in the public and personal libraries of practitioners and parents who seek an extensive review of evidence-based techniques to effectively address factors associated with school mental health.”
I’m hoping that this book will find a wide audience of teachers, as well as school social workers, school psychologists, counselors, school nurses, principals, superintendents, school board members and directors of special education.
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.