Social Living, Mental Health and Our Teens

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May 16, 2018

PTSA-sponsored parent education event

Tonight’s Agenda

• Overview of Freshman Seminar: Ethnic Studies/Social Living
• Presenter: Courtney Anderson, BHS Teacher

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• Student Voices, Student Leaders
• Presenters: Ruby Spies, Ayyub Love, Kelly Perymon, Abby Steckel, Uliana Kovaleva

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• BHS Counseling Resources & Tips for Parents
• Presenter: Ms. Jasdeep Malhi, BHS Intervention Counselor

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• BHS Health Center: Working to Support BHS Students’ Mental Health
• Presenters: Efrain Michel & Zach Meredith, Behavioral Health Clinicians

Freshmen Seminar:

Ethnic Studies/

Social Living

Courtney Anderson

courtneyanderson@berkeley.net

What is Ethnic Studies/Social Living?

• Course developed and implemented schoolwide throughout SLCs for the last four years (though with different titles across SLCs)
• Universal 9th Grade Social Sciences course
• Freshman Seminar
• Two Unique Semesters

Units

Ethnic Studies

1. Culture and Identity
1. ENRICH
2. Race and Ethnicity
• Microaggressions
• Privilege
• Systemic v. Interpersonal
3. Immigration
• Historical and Current Policy

Social Living

1. Self-Care
2. Drugs and Alcohol
3. Sex, Sexuality, and Gender

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Yearlong Skills

1. Source Evaluation
1. How do we critique a source to understand its value and limitations?
2. Argumentative Writing
• TEAC (Topic Sentence - Evidence - Analysis - Concluding Statement)
3. Formal Discussions
• How do we engage with others in dialogue and not debate?
4. Presentations
• How do I present to and convince others of my ideas?

Assemblies and Presentations

Assemblies

1. SPARK
2. The Bigger Picture
3. ASB Speaker Series:
1. BHS Stop Harassing
2. Chicanx-Latinx United Voices (CLUV)
3. GSA
4. Muslim Student Association
5. Best Buddies

Class Presentations

1. Health Center
2. Restorative Justice Circles
3. SHIFT Peer Educators
4. GSA - LGBTQ
5. Marijuana and the Brain

Unit Overview: Self-Care

ESSENTIAL QUESTION: HOW DO WE CARE FOR OURSELVES AND OTHERS?

1. What is a Teenager?
2. What is stress/anxiety and how does it impact my body?
3. What is health? How can I care for my health (social, physical, and mental)?
4. In what ways does our health influence our decision-making, actions, and opportunities?
5. Sex Education
6. Health and Nutrition Education

ESSENTIAL SKILLS:

1. Creative Thinking and Writing
2. Self-Reflection

Unit Overview: Drugs and Alcohol

ESSENTIAL QUESTION: How do I practice harm reduction?

1. What is a drug?
2. How do drugs interact with the brain?
3. In what ways does our health influence our decision-making, actions, and opportunities (and vice versa)?

ESSENTIAL SKILLS:

1. Research
2. Presentations

Unit Overview: Sex, Sexuality, and Gender

ESSENTIAL QUESTION: To what extent does the media influence our understanding of SSG?

1. How do we define and describe sex, sexuality, and gender?
2. What does the media teach us about sexuality and gender?
3. In what ways are we “otherized” as a result of our identity?
4. What does a healthy relationship look like?

ESSENTIAL SKILLS:

1. Media Literacy
2. Research (First formal essay)
3. Discussion (Socratic Seminar)

Social Emotional Learning Standards

• Self-Awareness
• Reflect on own emotions, actions, and values
• Identify and practice self-care techniques and tools
• Self-Management
• Stress and anxiety management
• Time management and organization
• Social Awareness
• Empathize with others, especially from different cultures and backgrounds
• Relationship Skills
• Recognize and understand what a healthy relationship looks like
• Engage in and support community building within Hives
• Decision-Making
• Make informed choices regarding sex, drugs, and personal behaviors

Resources

1. Berkeley High School Health Center (H105)
1. Monday 10:00am – 4:00pm (closed 1:00pm-2:00pm for lunch)
2. Tuesday–Friday 8:30am-4pm (closed 12:15pm-1:15pm for lunch)
2. Google Classroom for Resources and Content
3. Oakland Teen App
• Healthy Oakland Teens connects Oakland, CA high school students to the closest teen clinics and school based health centers. Clinics and health centers provide free, youth-friendly STI and HIV testing, sexual assault care, mental health counseling and alcohol/substance use counseling services.

Where can we use more mental health support in ES/SL?

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• Ethnic Studies: Beginning of the year Intros
• Social Living: Self-Care Unit
• “De-Stress” Days
• Parent support
• How do parents learn about support mental health measures on campus?
• How do we support parents in supporting the mental health of our students?

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Clarifications/ Questions/Concerns?

Student Voices, Student Leaders

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• Ruby Spies
• Ayyub Love
• Kelly Perymon
• Abby Steckel
• Uliana Kovaleva

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Mental and Emotional Education Team

Peer Educators for Mental Health Equity

Abby Steckel

Background

• 20% of youth ages 13-18 live with a mental health disorder.

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• 50% of lifetime mental health issues begin by age 14.*

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• Limited mental health education at BHS.

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• Limited resources for drop in and ongoing counseling.

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• MEET is modeled off the successful SHIFT program.

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• Peer educators would serve as leaders in reducing stigma and breaking down barriers to service access.

*National Institute of Mental Health

Climate of Stigma and Isolation

• Of 242 BHS students surveyed, 60% reported having experienced mental or emotional health struggles at some point during high school.

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• 58% of those who self-identified mental health needs said they had not accessed care.

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• 75% of African American males with mental health needs did not access care.

Impact of Current Situation

• A survey of 148 students found that 52% missed one or more days of school due to mental health issues.

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• 32% self-medicated for stress, depression, anxiety, or another mental health disorder with marijuana, unprescribed adderall, alcohol, and other substances.

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• For students who already face educational barriers, struggles with mental health can contribute to the achievement gap.

Peers as a Resource

• Trainings such as Mental Health First Aid for Youth teach adults how to identify students in crisis and connect them to services.

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• BUSD offers no equivalent training for youth.

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• 51% of students surveyed said that a friend or other student would be their preferred resource if they were experiencing mental health difficulties.

BHS Health Needs Assessment

Background

• Joint effort by Alameda County and UCSF, completed August 2017.

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Selected Findings

• Services focused on intensive intervention and crisis response.
• Stakeholders unclear what services are available and/or how to access them.
• Cultural tensions in service provision.

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Recommendations

• Build trust among stakeholders and providers.
• Conduct regular outreach to increase awareness of available services.
• Create youth leadership and peer mentorship opportunities.

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MEET Program

• Cohort of peer educators execute two-day presentations focused on freshmen Social Living classes.

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• Presentations include an overview of mental health disorders and symptoms, coping skills, what to do if someone is in crisis, how to reduce stigma, and how to connect with existing resources.

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• A licensed clinician will prepare curriculum, teach peer educators, and provide support during presentations. They will also provide direct counseling.

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BHS Counseling Resources and Tips for Parents

Presented by: Ms. Jasdeep Malhi

Lead Intervention Counselor/ Coordinator

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Talking to your teens

• Trust
• Expectations
• Teacher Communication/Illuminate
• Quality Time
• Positive recognition/ earning rewards vs giving
• Attendance

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BHS Counselors

Universal 9th Grade/ Transition

• Hives, LEAP, Social Living/Coordination
• Two 9th grade counselors
• School Culture/ Link Crew
• Assemblies

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Counseling

AMPS- Dwayne Byndloss 510-644-8987

CAS- Juan Rodriguez 510-644-4579

AHA- Teri Goodman 510-644-6711

EL/ Newcomers- Teri Goodman 510-644-6711

AC Counselors

• A-Bel- Juan Rodriguez 510-644-4579
• Ben-Har- Maribel Quiroz 510-644-6193
• Has-Pe- Debra Clark 510-644-4572
• Ph-Z- Terrance Christianson- 510-644-4573

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More counseling...

BIHS-

Green House: Molly Offerman 510-644-6192

Blue House: Linh Le 510-644-6714

Purple House: Dwayne Byndloss 510-644-8987

9/10th College Adivsing: Brianna Brooks

Intervention Counselors:

Jasdeep Malhi- Intervention Coordinator/OCI 510-644-8984

Nashwa Emam- 10 the grade Intervention Counselor

David An- 9th grade Intervention Counselor

On Campus Intervention

Safety

• Reporting of bullying, harassment, lost/stolen items, conflict resolution
• Restorative Practice Coordinator: Eddie Estrada
• Director of OCI- David Luu
• ATOD Counseling- Kente Wiggins
• Intervention Counselor: Jasdeep Malhi

Discipline

• Student Referrals/ Lunch Detention
• Dean of Students Kiernan Rok- 510-644-6675
• School Safety Officers- Resource for counseling

Berkeley High School Health Center�Mental Health Services

Efrain Michel, LCSW, Behavioral Health Clinician II

Zach Meredith, LCSW, Sr. Behavioral Health Clinician

Presentation Outline

• Health Center Mission
• Services – Who, Where, What, How
• Referral and Assessment Process
• Stressors and Symptoms for Students
• How Parents Can Support Process
• Health Center Statistics
• Understanding Consent and Confidentiality
• Wrap Up

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Health Center Mission Statement

“The Berkeley High School Health Center empowers teens to take responsibility for their physical, emotional, and social health by engaging their strengths, experiences, and knowledge. The Health Center provides access to culturally appropriate care through a combination of direct services, partnerships, and referrals to community resources.”

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Health Center �Location, Contact and Hours

Room H105

(510) 644-6965

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Monday 10:00am-4:00pm (closed 1:00pm-2:00pm for lunch)

Tuesday-Friday 8:30am-4:00pm (closed 12:15pm-1:15pm for lunch)

Who are the Mental Health Staff at the Health Center for School Year 2018-2019?

• Efrain Michel, LCSW Behavioral Health Clinician II (on site)
• Zach Meredith, LCSW Sr Behavioral Health Clinician (on site)
• Fawn Downs, LCSW MH Program Supervisor (off site)

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• Graduate Interns:
• Elizabeth Magid
• Jenevieve Vartanian
• Ang Li
• Guan Jie Huang
• Nicholas Hodder-Hastorf

Languages Spoken by Mental Health Staff

• English
• Spanish
• Mandarin/Cantonese
• Vietnamese

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Core Values and Guiding Principles

• Cross-Culturally Responsive
• Collaborative and Co-Constructive
• Trauma-Informed
• Evidence-Informed
• Strengths-Based

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Mental Health Services �(Funded by Berkeley Mental Health)

Services Offered:

• Assessment/Triage
• Individual Counseling
• Group Counseling
• Family Counseling/Consultation
• Case Management
• Outreach/Class Presentations

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How to Access MH Services - Overview

1. Student/Referring Adult completes and submits Referral Form to Health Center
2. Licensed Clinician screens Referral Form and assesses level of risk
3. Clinician meets with and completes Initial Assessment with Student
4. Ongoing services are provided as needed

1. Completing/Submitting Referral Form

• Student fills out a “Self-Referral” form and drops it off at the Health Center. Mental Health Staff will then pull Student from class for assessment.
• Or student drops in at Health Center during school hours for assessment.
• Parent, teacher, peer, or school staff fills out a “Counseling Referral” form and drops it off at the Health Center. Mental Health Staff will then pull Student from class for assessment.
• Or parent, teacher, peer, or school staff escorts Student to the Health Center during school hours for assessment.

2. Referral Screening

• Each referral is screened by a licensed clinician and level of risk is determined based upon presenting concerns
• High risk student – same day assessment
• Moderate risk student – assessment within 2 working days
• Low risk student – assessment within 5 working days

3. Initial Assessment

• Student reviews and signs Consent to Services
• Clinician meets with and attends to Student’s concerns as well as what the Student hopes to get out of counseling
• Clinician completes Brief Assessment Form (BAF) – presenting problem, symptoms, personal and family history, risk factors, strengths, coping skills
• Clinician and Student co-construct plan for ongoing services

4. Ongoing Services

• Student typically receives three counseling sessions
• Parent(s)/Caregiver(s) contacted with student’s permission
• Student who presents with ongoing counseling needs and has Medi-Cal will be offered ongoing services at the Health Center or at Family, Youth, and Children’s Services (or at another local agency who accepts Medi-Cal as payment)
• Student who presents with ongoing counseling needs and has private insurance will be referred to their insurance for services

A Student may consider seeking out counseling services if they…

• … want a space that’s safe and confidential to talk (about anything)
• …are feeling overwhelmed, stressed out, or nervous about things going on in their life, or are just feeling down
• …have had a difficult thing happen to them or someone they know or love
• …are exploring/questioning an aspect of their identity
• …are experiencing any form of discrimination or harassment

Examples of Referral Concerns

• Self-Counseling Referral: “I am having really bad anxiety and I am feeling very uncomfortable;” “I am failing my classes;” “I don’t get along with my parents, I am stressed.”
• Counseling Referral: “Student often feels anxious; he is new to the school;” “Student’s father recently passed away and student needs someone to check in on him for support;” “Family is homeless; student comes to class late and seems distracted.”

Referral Forms

Common Stressors for Students

• Family Stressors
• Academic Stressors
• Peer/Social Stressors
• Identity-Related Stressors
• Trauma-Related Stressors

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• Substance-Related Stressors
• Medical Stressors
• Socioeconomic Stressors
• Grief/Loss Stressors
• Psychiatric Stressors

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Anxiety Symptoms

• Having extreme fear about a specific thing or situation, such as dogs, insects, or going to the doctor (phobias)
• Being very afraid of school and other places where there are people (social anxiety)
• Being very worried about the future and about bad things happening (general anxiety)
• Trouble sleeping
• Increased irritability and anger

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• Having repeated episodes of sudden, unexpected, intense fear that come with symptoms like heart pounding, having trouble breathing, or feeling dizzy, shaky, or sweaty (panic symptoms)
• Physical symptoms like fatigue, headaches, or stomach aches

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Depression Symptoms

• Feeling sad, hopeless, or irritable a lot of the time
• Not wanting to do or enjoy doing fun things
• Changes in eating patterns – eating a lot more or a lot less than usual
• Changes in sleep patterns – sleeping a lot more or a lot less than normal

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• Changes in energy – being tired and sluggish or tense and restless a lot of the time
• Having a hard time paying attention
• Feeling worthless, useless, or guilty
• Self-injury and self-destructive behavior

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Trauma-Related Symptoms

• Sometimes children who experience severe stress, such as from an injury, from the death or threatened death of a close family member or friend, or from violence, will be affected long-term. Symptoms include:
• Reliving the event over and over in thought or in play
• Nightmares and sleep problems
• Becoming very upset when something causes memories of the event(s)

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• Lack of positive emotions
• Intense ongoing fear or sadness
• Irritability and angry outbursts
• Easily startled
• Acting helpless, hopeless or withdrawn
• Denying the event(s) happened / feeling numb
• Avoiding places or people associated with the traumatic event(s)

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Suicide – Signs and Symptoms

• Talking about wanting to die or wanting to kill themselves
• Talking about feeling empty, hopeless, or having no reason to live
• Making a plan or looking for a way to kill themselves
• Talking about great guilt or shame
• Talking about feeling trapped or feeling that there are no solutions
• Feeling unbearable pain (emotional pain or physical pain)
• Talking about being a burden to others

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• Withdrawing from family and friends
• Changing eating and/or sleeping habits
• Showing rage or talking about seeking revenge
• Taking great risks that could lead to death
• Talking or thinking about death often
• Displaying extreme mood swings
• Giving away important possessions
• Saying goodbye to friends and family
• Putting affairs in order, making a will

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Health Center Risk Assessment Protocol

1. Licensed Clinician conducts Suicide Risk Assessment

2. Licensed Clinician notifies parent(s)/caregiver(s)

3. Referrals for additional services, if necessary

4. Process thoroughly documented

Suicide Prevention

If you know someone in crisis:

• Call the National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
• Call 911 or seek immediate help from a mental health provider
• Call Berkeley Mental Health Mobile Crisis: 510-981-5254
• Call Alameda County 24-Hour Crisis Line: 800-309-2131

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Number of Referrals from 09/01/17 through 12/31/17

• Total Number of Referrals: 93
• September: 23
• October: 31
• November: 16
• December: 23

Fall 2017 Referrals by Month and Grade

Reasons for Freshmen Referrals

Understanding Consent & Confidentiality

• Family Code § 6924 & Health and Safety Code § 12460
• Minors over 12 years old can seek out and consent to counseling services without parent consent if the health care provider believes that the minor is sufficiently “mature” to “participate intelligently” in the mental health treatment or counseling services.
• The health care provider is required to involve a parent or guardian in the minor’s treatment unless the health care provider decides that such involvement is inappropriate.
• Providers must consult with the minor before deciding whether to involve parents.
• This exception does not give providers a right to disclose medical records to parents without the minor’s signed authorization.

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Understanding Mandatory Reporting

Health care providers are expected to inform Child Protective Services (CPS) if they “reasonably suspect” any of the following:

• A physical injury inflicted on a child by another person other than by accidental means.
• The sexual abuse, assault, or exploitation of a child.
• The negligent treatment or maltreatment of a child by a person responsible for the child’s welfare under circumstances indicating harm or threatened harm to the child’s health or welfare. This is whether the harm or threatened harm is from acts or omissions on the part of the responsible person.
• The willful harming or endangerment of the person or health of a child, any cruel or inhumane corporal punishment or any injury resulting in a traumatic condition.

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Parent Consultation & Collaboration

• We are here to help!
• If you have any questions or concerns, please reach out to us!
• Call us at 510-644-6965 and ask to speak with a mental health clinician. If we are not immediately available, please leave a message with your name and contact info and we will follow up as soon as we can.
• You can also call Family, Youth, and Children’s Services at 510-981-5280 and ask to speak with the On Duty Clinician.

Resources

• Family, Youth, and Children’s Services: Alameda County Medi-Cal, sliding scales. Please call 510-981-5280 for intake appointment.
• Berkeley Youth Alternative: Alameda County Medi-Cal, Contra Costa Medi-Cal. Please call 510-845-9010 for intake appointment.
• Pacific Counseling Center: Alameda County Medi-Cal, sliding scales. Please call 510-548-8283 for intake appointment.
• Alameda County Access for all mental health services: 800-491-9099

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Contact Us

Efrain Michel, LCSW

(510) 644-4802

emichel@cityofberkeley.info

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Zach Meredith, LCSW

(510) 990-5271

zmeredith@cityofberkeley.info

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Fawn Downs, LCSW

(510) 981-5236

fdowns@cityofberkeley.info

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Sources

https://www.cdc.gov/childrensmentalhealth/depression.html

https://www.cdc.gov/childrensmentalhealth/ptsd.html

https://www.nimh.nih.gov/health/topics/suicide-prevention/index.shtml

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