One in five children ages 13-18 has or will have a serious mental illness. Suicide is the 3rd leading cause of death in youth ages 10-24. Can school-based mental health services help address this issue?
On May 8, 2018 in Olathe, KS, our panel of experts discussed current models for providing mental health care in schools, how these models could be changed to better serve students, the stigma of mental health services among students and educators, and possible ways forward in providing mental health services in schools.
Steven Arkin has been a staff neurologist at St. Luke’s Hospital Kansas City for 24 years. He is an associate professor in the University of Missouri Kansas City School of Medicine and is Co-founder of the SPEAK UP Foundation, an organization that advocates for mental health wellness in schools and communities. He attended Rush Medical College of Rush University in Chicago, interned at Northwestern University, and completed his residency at the University of Iowa. He and his wife Karen have two children.
Matt Arnet, LCPC, is the Clinical Director of Outpatient Services for KVC Kansas. As Clinical Director, he oversees the day-to-day operations of the outpatient therapists, medication management providers and master’s level psychologists for the Metro and East regions in Kansas.
Matt began working for KVC as a Therapeutic Case Manager in 2007. When the Outpatient department was formed in October of 2007, Matt was one of the initial eight in-home clinicians. He worked as the Intake Coordinator for the Independence, Missouri School-based Therapy Grant in 2010, before returning to Kansas Outpatient in 2011. In 2012, Matt was promoted to Outpatient Supervisor before being promoted to Outpatient Director in 2013.
In addition to duties with Outpatient, Matt is an internal consultant for Trauma Systems Therapy (TST), completing staffings for children in Family Preservation and Out-of-Home Care.
Matt received his Bachelors of Arts in Psychology from the University of Missouri-Columbia in 2001, and his Master’s in Counseling Psychology from Avila University in 2006.
“I love hearing my patients’ stories and becoming a part of their journey. Whether we have only a single encounter or build an ongoing therapeutic relationship, I honor the privilege to meet and know them.”
Alexander Gianikas is licensed by the state of Kansas. He earned a Master of Social Work from Loyola University in Chicago, Ill., and a Bachelor of Arts in Psychology from Florida State University in Tallahassee, Fla.
Mr. Gianikas has been practicing in the mental health field since 2009. He specializes in the treatment of minority and higher risk populations, LGBTQ issues, mood disorders, substance use and eating disorders.
He serves people of all ages at our Olathe Clinic.
Paul Giffin has served as a school counselor for 10 years at Santa Fe Trail Middle School in Olathe. Previously, he was a counselor at Atchison High School for 3 years and taught in the Kansas City, KS, School District for 10 years in both traditional and alternative settings.
He received a BA in Political Science from The University of the South and an MS in School Counseling from Emporia State University. He was recognized with an “Educator Excellence Award” from the Olathe Public School Foundation and “The Army of One Award” from the Leavenworth U.S. Army Recruiting Station.
He been married to his wife Maria for 23 years and has a 20 year old son Pierce, who attends KU and studies Physics and Mathematics.
Mental disorders are among the leading causes of disability in the United States. They include a broad range of social, psychological, behavioral and relationship disorders that may affect how an individual functions in his or her daily life and can lead to a range of outcomes that include disability, physical pain or even death.
Managing mental health in communities is important to maintaining a healthy and well-functioning society. Children and adolescents are susceptible to many of the same mental illnesses that affect adults. Scientists are discovering that changes in the body and brain leading to mental illness may start before any symptoms appear. Through greater understanding of when and how quickly specific areas of children’s brains develop, researchers are learning more about the early stages of a wide range of mental illnesses that appear later in life.
Young people are especially at risk for depression, obsessive-compulsive behaviors, phobias and substance abuse. Behavior disorders are another kind of mental disability that appear in childhood and adolescence. Even though health officials know how to treat — though not yet cure — most disorders, many children with mental illnesses do not get treatment. Without treatment, these children are at risk for falling behind in other areas of development.
Source: KC Health Matters, Health Care Foundation of Greater Kansas City (“Hospital Admission Rate for Mental Health Disorders” and “Number of Children Receiving Public SED Mental Health Services”)
Mental Health Stigma (source)Mental health stigma can be divided into two distinct types: social stigma is characterized by prejudicial attitudes and discriminating behavior directed towards individuals with mental health problems as a result of the psychiatric label they have been given. In contrast, perceived stigma or self-stigma is the internalizing by the mental health sufferer of their perceptions of discrimination, and perceived stigma can significantly affect feelings of shame and lead to poorer treatment outcomes.In a study done in 2010, 46% of adolescents described experiencing stigmatization by family members in the form of unwarranted assumptions (e.g. the sufferer was being manipulative), distrust, avoidance, pity and gossip. (source)
62% experienced stigma from peers which often led to friendship losses and social rejection.
35% reported stigma perpetrated by teachers and school staff, who expressed fear, dislike, avoidance, and under-estimation of abilities.
Missouri, 2015 Youth Risk Behavior Study (YRBS) (source)
Electronically bullied: 1,484
Bullied on school property: 1,477
Felt sad or hopeless: 1,477
Seriously considered attempting suicide: 1,471
Attempted suicide: 1,340
In 2014, 3,732 Jackson County children, 240 Cass County children, and 100 Lafayette County children ages 18 and younger received treatment through a division of the Missouri Department of Mental Health for serious emotional disturbances (SED) which include emotional, behavioral, or mental disorder that severely disrupts daily functioning in the home, school, or community. (source)
In Missouri, about 51,000 adolescents aged 12–17 (10.8% of all adolescents) per year in 2013–2014 had at least one MDE (major depressive episode). 39.7% of those adolescents received treatment and 60.3% did not. (source)
In Kansas, about 27,000 adolescents aged 12–17 (11.3% of all adolescents) per year in 2013–2014 had at least one MDE. 39.6% of those adolescents received treatment and 60.4% did not. (source)
As of December 2016, there were 97 geographical mental health professional shortage areas identified in Kansas.
In 2014, 19.6 percent of Kansans with disabilities did not visit a doctor due to cost.
In 2014, there was one behavioral health provider per 550 Kansans. (source, pg. 9)
[Chart 1 source: Survey participants were staff members of Children’s Mercy and parents. “Focus group participants noted several barriers that children and adolescents encounter relative to mental and emotional health in the community. Participants feel that mental health issues among children and adolescents are growing worse in the region.”]
Youth from low-income households are at increased risk for mental health disorders: (source)
21% of low-income children and youth ages 6 to 17 have mental health disorders.
57% of these low-income children and youth come from households with incomes at or below the federal poverty level.
Youth involved in the child welfare and juvenile justice systems are at even higher risk for having a mental health disorder:
50% of children and youth in the child welfare system have mental health disorders
67 to 70% of youth in the juvenile justice system have a diagnosable mental health disorder
The risk for mental health problems, especially traumatic stress, is greatly increased for children who are living in foster care as a result of abuse and neglect. Children often suffer from traumatic stress after experiencing or witnessing the injury or death of someone else, or otherwise feeling seriously threatened.
Youth of color experience disparities in prevalence and treatment for mental health issues:
88% of Latino children and youth have unmet mental health needs, compared to 77 percent for African-Americans and 76 percent for white children and youth.
31% of white children and youth receive mental health services compared to thirteen percent of children of color.
20% of female Latino high school students seriously considered attempting suicide and 15.4 percent made a suicide plan, compared to 16.1% of white female high school students who considered it and 12.3% who made a suicide plan.
In 2009, an estimated 70% of youth in the juvenile justice system had a diagnosable mental health disorder. (source)
More teenagers and young adults die from suicide than from cancer, heart disease, AIDS, birth defects, stroke, pneumonia, influenza, and chronic lung disease combined. (source)
Each day in the U.S. there are an average of over 3,470 suicide attempts by young people grades 9-12. (source)
In 2016, the highest U.S. suicide rate (15.17) was among Whites and the second highest rate (13.37) was among American Indians and Alaska Natives. Much lower and roughly similar rates were found among Asians and Pacific Islanders (6.62), and Black or African Americans (6.03). (source)
The suicide rate for girls ages 15 to 19 doubled from 2007 to 2015. (source)
Suicide is one of the leading causes of death for LGBTQ people aged 10-24. (source)
Suicide costs the U.S. $69 billion annually. (source)
In 2015, LGB students were 140% (12% v. 5%) more likely to not go to school at least one day during the 30 days prior to the survey because of safety concerns, compared with heterosexual students. While not a direct measure of school performance, absenteeism has been linked to low graduation rates, which can have lifelong consequences. (source)
LGB youth are at greater risk for depression, suicide, substance use, and sexual behaviors that can place them at increased risk for HIV and other sexually transmitted diseases (STDs).
Nearly one-third (29%) of LGB youth had attempted suicide at least once in the prior year compared to 6% of heterosexual youth.
In 2014, young gay and bisexual men accounted for 8 out of 10 HIV diagnoses among youth.
In 2017, 64.1% of youth with major depression did not receive any mental health treatment.
That means that 6 out of 10 young people who have depression and who are most at risk of suicidal thoughts, difficulty in school, and difficulty in relationships with others do not get the treatment needed to support them.
The state prevalence of untreated youth with depression ranges from 42.1% in New Hampshire lowest) to 77.0% in Arkansas (highest). (source)
50% of all lifetime cases of mental illness begin by age 14 and 75% by age 24. (source)
Approximately 50% of students age 14 and older with a mental illness drop out of high school. (source)
20% of youth ages 13-18 live with a mental health condition.
11% have a mood disorder.
10% have a behavior or conduct disorder.
8% have an anxiety disorder.
Suicide is the 3rd leading cause of death in youth ages 10-24. (source)
Expulsions in prekindergarten are almost twice as common — 89% higher — when classrooms don’t have regular access to a psychiatrist or psychologist. Only 23% of pre-K programs nationwide have on-site psychiatrists/psychologists or scheduled visits. (source)
Being at risk for mental health problems in first grade leads to a 5% drop in academic performance in just two years. (source)
The Substance Abuse and Mental Health Services Administration projects that 12,624 child and adolescent psychologists will be needed to meet demand by 2020, but a supply of only 8,312 is expected. (source)