Presentation on theme: "Mental Health and Wellness Program"— Presentation transcript:
1 Mental Health and Wellness Program Meeting the Policy and Requirement Handbook (PRH) Requirements for DocumentationValerie Cherry, PhD
2 Mental Health and Wellness Program Chapter 6.10, R3 General Emphasis(a)Assessment(b)Promotion, Prevention, and Education(c)Treatment(d).
3 Mental Health and Wellness Program (a) General EmphasisEarly identification and diagnosisBasic mental health careMental health promotion, prevention and educationEmployee assistance program approachShort-term counseling with focus on employabilityReferral to center support groupsCrisis interventionThe general emphasis of the mental health and wellness program shall be on the early identification and diagnosis of mental health problems, basic mental health care, and mental health promotion, prevention, and education designed to help students overcome barriers to employability.
5 Mental Health and Wellness Program Documentation (b) AssessmentSocial Intake FormMost recent was released via Information Notice November 16, 2012Bottom date - October 2012Review within 1 weekSigned by CMHCCompleted Copy or Original in SHRQuestion:Does the CMHC have to review and sign every SIF?YesNoReview of Social Intake Form (SIF) or intake assessment performed by counseling staff of students who indicate mental health history, current mental health problems, or who request to see the center mental health consultant within one week of arrival.
6 Mental Health and Wellness Program Documentation (b) Assessment Con’tAssessments and Recommendations for Referred StudentsWhat should the Intake include?Reason for ReferralPresenting ProblemMental Health HistoryChemical Health HistoryMental Status ExamBarriers to Employability and StrengthsDSM Diagnosis, if applicableEducation and RecommendationsReferral to Reasonable Accommodation CommitteeProvide student with MHCCMP Fact Sheets and note in SHRin progress note or on intake form.
7 Mental Health and Wellness Program Documentation (b) Assessment Con’tIntake Assessments should be placed in MH section of SHRProgress NoteMental Health Intake Forms (DRG)Provide student with Mental Health Chronic Care Management Plan (MHCCMP) Student Fact Sheets and note in SHRJob Corps Information Notice “Updated Chronic Care Management Plans”, dated April 10, 2014Flow Sheets for recording periodic monitoring visits for students with Schizophrenia, Bipolar Mood Disorder, and DepressionProvide student with MHCCMP Fact Sheets and note in SHRin progress note or on intake form.
8 Mental Health and Wellness Program Documentation (b) Assessment Con’tMSWR or Medical SeparationsProgress Note in MH sectionWhat should be included?Clinical justification for the separation due to health needs beyond what can be managed on center.Sometimes you may be asked for a recommendation on mode of transportation and if an escort is needed.Resource: Medical Transfer, Separation, and Referral; Management of Student Injury and Death Under FECA/OWCP TAGAdministrative Report of Functional EvaluationNotification of Medical Separation (Regional Office)Separation and Referral Instructions to Student/Parent/Legal Guardian
9 Mental Health and Wellness Program Documentation (c) Mental Health Promotion and Education1-hour CPP PresentationCurriculumStanding day of the week for new inputsCDP and CTP PresentationsMaintain a folder/binder, or computer file with days and topicsAnnual Center Wide ActivityMaintain a folder/binder or computer file with informationCDP and CTP Hints: For the CDP presentations, how should these be structured and are we expected to provide all of the activities in the curriculum? The CDP curriculum is a resource with various activities to support social emotional learning and it is probably not possible for you to conduct all of the activities for each cohort of students. Select activities from the curriculum and consider providing monthly presentations by trade or dorm for students or if at a large center quarterly. If counselors have active groups already set up for students you may be able to work with them and enhance the groups with activities from the CDP curriculum. Another idea is to integrate this presentation with the required Wellness Education class during CDP.What is the best way to do presentations during CTP? Some centers have what is called a "Career Readiness" group for students preparing to exit the program. If your center has this group, collaborate and provide activities from the CTP curriculum. If not, talk with your career transition counselor on center and see when would be a good time to set up a group for students preparing to exit where you can present an activity from the CTP curriculum.Question:Can any other staff help with the presentations? A. YesB. NoWe strongly recommend that the CMHC provide the CPP presentation to all new students. For CDP and CTP, if there is a counselor or intern who wants to assist with your supervision, that is not a problem. However, remember the requirement is for the MHWP and ultimately the responsibility of the CMHC.
10 Mental Health and Wellness Program Documentation (c) Mental Health Promotion and Education Con’tClinical Consultation with CD (monthly), Mgt. Staff, and HWMMinutesCoordination with other departmentsKeep file on specific trainings for Counselors and/or Residential Advisors.Include SGA, HEALs and other center departments with center wide activities and document in your file their participation in developing the activity.
11 Mental Health and Wellness Program Documentation (d) TreatmentShort term with employability focusDocument on progress note in MH section of the SHRHow do we document employability focus in a note?Sample Progress Notes in DRGMHCCMP Student Fact Sheet
12 Employability FocusStudent was referred by counselor for acting out behavior in the classroom. Student has history of anxiety and expressed feeling stressed out on center and difficulty with peers. Refer for medication evaluation and return in 1 week.Student was referred by counselor for acting out behavior in the classroom. Student has history of anxiety and expressed feeling stressed out on center and difficulty with peers. Introduced distress tolerance activity to increase awareness of feelings and how to express them in a more positive way. Student agrees to journal and will return in 1 week.
13 Sample Employability Progress Note S = Student reports having difficulty sleeping in the dorm along with feelings of sadness and disinterest in center activities over past two weeks. Student states he is becoming increasingly irritable during the day.O = Student was generally anxious throughout the session with a flat affect. At one point became tearful and slightly agitated. Able to verbalize how current symptoms could become barriers to employment if not resolved. Denied any suicidal thoughts or past suicidal behavior.A = Student has been on center for two months and is experiencing adjustment issues which may be triggering an episode of depression. Shows moderate level of motivation to address symptoms, identify, and remain in program.P = Schedule next appointment for 3:30pm to begin short-term cognitive behavior therapy to address symptoms on center and provide strategies on how to handle emotions on center and in future work environment. Gave student sleep hygiene brochure and instructed to return to wellness if problems do not get better before next appointment. Refer to Counselor’s adjustment group, alert RA and Counselor to watch for behavioral changes over the week and refer back to health and wellness, if needed. Lastly, student given mindfulness exercises to practice over next week.CMHC, Ph.D. # 1010
14 Sample Progress Note INTERVENTIONS FOR EMPLOYABILITY Indicate primary types of interventions utilized (Check all that apply). Describe in summary of session.Assess/Info GatherPsycho-educationMotivational InterviewingCrisis InterventionStress ManagementCBT/ACTEmpathic ExplorationSocial Skill TrainingDBT/MindfulnessDecision MakingPsychodynamic/RelationalOtherSUMMARY (Include how the session ties into employability or the work environment for the student)Session Phone contact Case Management/Consultation Other_______________________________________________________________________________________________________________________________________
15 Mental Health and Wellness Program Documentation (d) Treatment Con’tCollaboration with TEAPMinutes of meetingsCollaboration with CP - Psych MedsNote on chronological record or note in MH section of SHRStanding meeting with CP and/or Wellness staffCollaboration with Counseling staff in developing and/or leading psycho-educational groupsSchedule of groups on center provided by counselingIf you referred student to group, should be indicated in the SHR- MH sectionIf you are conducting a group, should be indicated in the SHRHINT: Chapter 2.8 Personal Development SkillR1. Conflict Resolution SkillsCenters shall provide each new student with instruction in basic conflict resolution techniques within the first 60 days of enrollment. At a minimum, instruction shall include:HINT: Chapter 2.4 Personal Counseling ServicesCenters shall provide intensive ongoing personal counseling services early within the first 60 days of the student’s stay on center. These services will continue as needed (see Chapter 3, Section 3.3, Personal and Career Counseling) throughout the student’s enrollment, with the following features:b. Ongoing structured, scheduled, and documented individual social development and adjustment counseling.c. Group support sessions designed to identify and address specific issues, such as abuse, relationships, child care, homesickness, language and cultural barriers, etc.d. Identification of students who need more intensive services and referral to such services.e. Intervention, implementation, and documentation of strategies to address personal issues, including mental health, medical issues, and English Language Learners.
16 Documentation of Case Conferences and CMHC Led Groups Pre-printed adhesive labels that allow enough space for brief sentence update. Signed and datedCase Management MeetingStudent continues to attend anger mgt. group and is doing well. No further MH services needed at this time.CMHC, PhDEmotional Regulation GroupStudent was active in group and participated in deep breathing exercise.CMHC, PhD.
17 Mental Health and Wellness Program Documentation (d) Treatment Con’tRegular case conferences between CMHC, Counselors, and other appropriate staff- Case ManagementDocumentation of Case Management and Feedback Form (DRG) in SHR in MH sectionProgress Note in MH sectionReferral to Off Center- Case ManagementRelease of Information to exchange updatesWork with Wellness staff to come up with system to document off center updates in the SHRWritten referral and feedback system- Case ManagementUse of Referral and Feedback Form (DRG)Provide feedback to the referral source at the bottom of form. Copy in SHRFollow-up on feedback at next case conference and document in SHRHINT: Include TEAP specialist in regular case conference meeting.
19 Care ManagementPRH requirement [PRH-6.10: R1, 4] states “students identified as having chronic health problems during the cursory or entrance physical shall be monitored as directed by the CP or other appropriate center health provider.”What CMHC tasks are considered care management?MHCCMP
20 Case ManagementPRH requirement [PRH 6.10 R3, d5] states “Information exchange through regular case conferences between the Center Mental Health Consultant, counselors, and other appropriate staff based on individual student needs.”Case management requires communication among staff, monitoring, and follow upWe do not recommend the use of CIS by CMHCS
22 Chapter 5 - Exhibit 5-4Centers shall include, at a minimum, the following:a. Five hours of annual training in adolescent growth and development for all staff. Topics could include effective communications, anger management, sexuality, suicide prevention, behavior management system, zero tolerance policy, appropriate staff/student boundaries, sexual assault prevention and response, sexual harassment and related social skills training, crisis intervention techniques, bullying prevention, violence prevention, and safety issues.New Staff OrientationCrisis Intervention training requirement (for 1st 90 Days and Yearly)
23 Best Practices that Make Assessors Happy! Document, Document, Document Smartly!Have documentation organized and available.Include discussions on how emotions and behaviors impact employability with students and document in progress notes.Include documentation in the file on students discussed and updated during meetings with counselors.Consistently provide information back to the referral source with a copy easily found in the SHR.Notation on Chronological Record in SHR“May 1, See Note in MH Section”
24 In A Nutshell SHR - MH Section Social Intake FormReferral and Feedback FormSpecifics for Referral SourceIntake AssessmentMHCCMPRACEmployability Progress NotesCase Management NotesOn and Off siteMed-Check in NotesGroup NotesMental Health Promotion and Education BinderCPP, CDP, and CTP Presentation InfoDocumentation of center wide activityDocumentation of any staff trainingsChronological RecordDocument dates students receive services with corresponding note in MH section.