1. TOM TORLAKSON State Superintendent of Public Instruction Youth Mental Health First Aid: How Adults Can Help Youth in Need Hilva Chan and Monica Nepomuceno, California Department of Education

2. TOM TORLAKSON State Superintendent of Public Instruction Agenda What is YMHFA? Signs and Symptoms Risk and Protective Factors Fact and Fiction: Self Injury and Suicide Action Plan: ALGEE Free Trainings from Project Cal-Well 2

3. TOM TORLAKSON State Superintendent of Public Instruction What is YMHFA? Australian based public education program Based on the concept of medical first aid Helps identify, understand, and respond to signs of mental distress or illness 3

4. TOM TORLAKSON State Superintendent of Public Instruction Youth Mental Health First Aid Course Length YMHFA is an 8-hour course (offered in one or two day sessions) Activities Discussion topics, exercises, and other activities keeps participants engaged and an opportunity to practice helping skills. Environment Two certified instructors lead each course and follow a national curriculum and teaching standards, while emphasizing hope for recovery. Classes usually consist of 30 people or less are offered in a respectful, comfortable environment. 4

5. TOM TORLAKSON State Superintendent of Public Instruction 5 Why Mental Health First Aid for Those who Work with Youth? Mental health problems are common Mental health problems often develop during adolescence Youth and young adults may experience mental health problems differently than adults Youth may not be well informed The sooner an individual gets help, the more likely they are to have a positive outcome Misunderstanding and discrimination are often associated with mental health problems Professional help is not always on hand

6. TOM TORLAKSON State Superintendent of Public Instruction What are Some of the Disorders we Might Hear About Among Youth? ADD/ADHD/ODD Anxiety Disorders Bipolar Disorder Depression Eating Disorders Psychosis Substance Use Disorders

7. TOM TORLAKSON State Superintendent of Public Instruction U.S. Youth with a Mental Disorder During Adolescence (Age 13-18) Prevalence (%) With severe impact (%) Anxiety disorders31.98.3 Behavior disorders19.19.6 Mood disorders14.311.2 Substance use disorders11.4 n/a Overall prevalence (with severe impact) 22.2

8. TOM TORLAKSON State Superintendent of Public Instruction 8 During the past 12 months, did you ever feel so sad or hopeless almost every day for two weeks or more that you stopped doing some usual activities? During the past 12 months, did you ever seriously consider attempting suicide?

9. TOM TORLAKSON State Superintendent of Public Instruction 9

10. Signs & Symptoms: Physical Cardiovascular: pounding heart, chest pain, rapid heartbeat, blushing Respiratory: fast breathing, shortness of breath Neurological: dizziness, headache, sweating, tingling, numbness Gastrointestinal: choking, dry mouth, stomach pains, nausea, vomiting, diarrhea Musculoskeletal: muscle aches and pains, restlessness, tremors and shaking, inability to relax

11. TOM TORLAKSON State Superintendent of Public Instruction 19 Signs & Symptoms: Physical Hormonal: irregular menstrual cycle, loss of nocturnal emissions, loss of sexual desire Changes in normal patterns: overeating or not eating at all, sleeping much more or much less Appearance: –Change in hygiene, unkempt –Eyes bloodshot or glassy –Weight gain or loss

12. TOM TORLAKSON State Superintendent of Public Instruction 20 Signs & Symptoms: Emotions Depressed mood and/or mood swings Unrealistic or excessive anxiety or guilt Excessive irritability or anger Lack of inhibition Lack of emotion or emotional response Helplessness or hopelessness Oversensitivity to comments/criticism Low self-esteem

13. TOM TORLAKSON State Superintendent of Public Instruction 1 Signs & Symptoms: Thoughts Frequent self-criticism or self-blame Pessimism Difficulty concentrating or remembering Indecisiveness or confusion Rigid thinking Racing thoughts Tendency to believe others see one in a negative light Altered sense of self Delusions or hallucinations Odd ideas; lack of insight Suspiciousness Thoughts of death and suicide

14. TOM TORLAKSON State Superintendent of Public Instruction Signs & Symptoms: Behaviors Crying spells Withdrawal from others Neglect of responsibilities Loss of interest in personal appearance Loss of motivation Slow movement Use of drugs and alcohol Changes in energy level Obsessive or compulsive behavior Avoidance or phobic behavior Showing distress Talking rapidly

15. TOM TORLAKSON State Superintendent of Public Instruction Typical Stages vs. Symptoms Examine the severity of the change Typical AdolescencePotential Warning Sign Withdrawing from family to spend more time with friends Withdrawing from friends, family and social activity Wanting more privacy Becoming secretive; need for privacy seems to be hiding something Moving from childhood likes to teen pursuits Losing interest in favorite activities and not replacing with other pursuits

16. TOM TORLAKSON State Superintendent of Public Instruction 25 Exposure to stressful life events/abuse/trauma Difficult or abusive childhood Ongoing stress and anxiety Medical conditions and hormonal changes Side effects of medication Illness that is life threatening, chronic, or associated with pain Brain injury Previous episode of a mental illness or another mental illness Risk Factors

17. TOM TORLAKSON State Superintendent of Public Instruction 26 Risk Factors Family history/genetics Learned behavior Chemical imbalance Substance misuse and sensitivity Seasonal changes Environmental factors

18. TOM TORLAKSON State Superintendent of Public Instruction 27 Protective Factors Healthy practices High self-esteem Good problem solving skills Feeling of control in their own life Spirituality Avoiding alcohol, tobacco and other drugs Consistent home/family routine Parental/familial support Monitoring of youth’s activities

19. TOM TORLAKSON State Superintendent of Public Instruction 28 Protective Factors Regular school attendance and academic performance Having a good social support system Availability of constructive recreation Economic security Community bonding Feeling close to at least one adult

20. TOM TORLAKSON State Superintendent of Public Instruction Self Injury Fact or Fiction? Self harm is a mental illness Self harm is more than just cutting, burning and things we can see Self harm can be a good thing Self harm is a failed suicide attempt 20

21. TOM TORLAKSON State Superintendent of Public Instruction WHY? To manage painful feelings To show control of their body To end feelings of being detached from themselves To punish themselves To seek attention To avoid or combat suicidal thoughts 21

22. TOM TORLAKSON State Superintendent of Public Instruction Suicide Fact or Fiction? If you ask a young person about his or her suicidal intentions, you will encourage the person to kill themselves A young person who attempts suicide will always be ‘suicidal’ Suicide happens without warning Suicide occurs across all classes of young people 22

23. TOM TORLAKSON State Superintendent of Public Instruction Warning Signs Talk about: Killing themselves. Having no reason to live. Being a burden to others. Feeling trapped. Unbearable pain. 23

24. TOM TORLAKSON State Superintendent of Public Instruction Warning Signs Behavior (new or increased; after a recent loss or event) Increased use of alcohol or drugs. Looking for a way to kill themselves, such as searching online for materials or means. Acting recklessly. Withdrawing from activities. Isolating from family and friends. Sleeping too much or too little. Visiting or calling people to say goodbye. Giving away prized possessions. Aggression. 24

25. TOM TORLAKSON State Superintendent of Public Instruction Warning Signs Moods Depression. Loss of interest. Rage. Irritability. Humiliation. Anxiety. 25

26. TOM TORLAKSON State Superintendent of Public Instruction Get Help National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) My3 http://www.my3app.org/http://www.my3app.org/ Know the Signs www.suicideispreventable.org/ www.suicideispreventable.org/ 26

27. TOM TORLAKSON State Superintendent of Public Instruction 29 Youth Mental Health First Aid Action Plan 5 Steps Assess for risk of suicide or harm Listen nonjudgmentally Give reassurance and information Encourage appropriate professional help Encourage self-help and other support strategies

28. TOM TORLAKSON State Superintendent of Public Instruction Free Training through Project Cal-Well One of 20 states that received the NITT-AWARE-SEA grant Five year grant: 2014-19 28 Now is the Time: The President’s plan to protect our children and our communities by reducing gun violence, released on January 16, 2013.

29. TOM TORLAKSON State Superintendent of Public Instruction Project Cal-Well Goals 1 Create safe and supportive school communities that promote mental health awareness, well-being, early identification, and early intervention of behavioral health issues 2 Increase access for and availability of school and community- based mental health services for students and their families within the Project Cal-Well LEAs 3 Promote positive school climate by utilizing research-based violence prevention and positive behavioral intervention programs in the Project Cal-Well LEAs 4 Implement YMHFA at both the state and community levels

30. TOM TORLAKSON State Superintendent of Public Instruction Requesting a Free Training administrators teachers, nurses, counselors coaches, secretaries, registrars, lunch staff, bus drivers, campus monitors, yard supervisors, teacher’s aids college/university interns parents youth employers, leaders of faith-based communities, law enforcement, and other youth-serving adults. 30 Host the training Recruit participants Target audience:

31. TOM TORLAKSON State Superintendent of Public Instruction Hosting a Free Training One 8-hour day or two 4-hour days (consecutive) Provide light morning refreshments and/or coordinate lunch 31

32. TOM TORLAKSON State Superintendent of Public Instruction Why YMHFA for your school/district? Training is FREE Training content support preparation of your Local Control and Accountability Plan— Priority Area: Student Engagement and School Climate Training content supports PBIS/MTSS/SEL 32

33. TOM TORLAKSON State Superintendent of Public Instruction 33 YMHFA Training Coordinator Monica Nepomuceno Education Programs Consultant, CDE 916-323-2212

34. TOM TORLAKSON State Superintendent of Public Instruction Existing California Resources

35. TOM TORLAKSON State Superintendent of Public Instruction 35 Cal-Well Project Director Hilva Chan Education Programs Consultant, CDE hchan@cde.ca.gov 916-319-0194 hchan@cde.ca.gov