Categories of Mental Disorders 1 Child and youth mental health problems can be classified into two broad categories: 1Internalizing problems  withdrawal  anxiety  fearfulness  depressed moods

Categories of Mental Disorders 2 2Externalizing problems  aggression  defiance  destructive behaviour

FUNCTIONS OF THE BRAIN Perception or Sensing Emotions Behavior Physical Functions Signaling (being responsive and reacting to the environment) Thinking or Cognition 3

Categories of Mental Disorders Mental Disorders are associated with the six primary domains of brain functioning: Thinking or Cognition e.g. Psychosis Perception or Sensing e.g. Pervasive Developmental Disorder, Autism Emotions e.g. Mood Disorders (depression), Bipolar Behaviour e.g. Attention Deficit Hyperactivity Disorder, Substance Abuse Physical Functions e.g. Eating Disorders Signaling (being responsive and reacting to the environment) e.g. Anxiety Disorders, Post Traumatic Stress Disorder 4

Categories of Mental Disorders This learning option will focus on the following: Signaling - especially as it relates to Anxiety Emotions - concentrating on Depression Thinking or Cognition - Psychosis Behaviour - focus on Substance Misuse, ADHD, Conduct Disorder Physical Functions – Eating Disorders Perception or Sensing (this category will not be covered as PDD and Autism are a separate learning option) 5

However… Mental disorders are never limited to only one brain function as several areas of functioning will be affected For example, depression is a mood disorder categorized within the domain of Emotion or Feeling but also includes symptoms from the domains of the Physical, Behaviour and Cognition It is estimated that 50% of children and youth experiencing a mental health disorder have two or more disorders at the same time Children and youth with multiple disorders are more vulnerable and treatment is more complicated 6

Onset The vast majority of mental disorders begin prior to age 25 years The bulk of disorders are diagnosed between ages 12 and 25 years Prior to age 5:  Pervasive Developmental Disorders, ADHD, Separation Anxiety Disorders Onset following puberty:  Depression, Obsessive Compulsive Disorder, Social Anxiety Disorder, Panic Disorder, Schizophrenia, Bipolar Disorder, Anorexia Nervosa, Substance Abuse, etc. 7

Prevalence Approximately 15% – 20% of children and young people (ages 1 – 25) will experience a mental disorder requiring professional intervention The most common disorders for children and youth are:  Anxiety Disorders  Behaviour Problems (including ADHD & conduct disorders)  Mood Disorders (e.g. depressive disorders)  Substance Misuse Problems Of all mental health problems affecting children and youth, the above disorders account for approximately 60% – 70% 8

Prevalence Research evidence has generally shown that concerning these most common disorders:  Rates of anxiety/depression disorders are higher for girls  Rates of behaviour problems are higher for boys  Boys and girls show equal rates of substance use disorders 9

Total in typical population:  Anxiety Disorders 10%  Depression 6%  ADHD 4%  Psychosis 1%  Anorexia Nervosa 0.2% All Disorders 15 – 20% Prevalence of Mental Disorders in Young People 10

Prevalence of Mental Disorders in Young People Translation to “average” classroom:  Anxiety Disorders 2 – 3 students  Depression 1 – 2 students  ADHD 1 student  Psychosis rare  Anorexia Nervosa very rare All Disorders 4 – 5 students 11

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Most young people with mental disorders will go on to be successful at school and live productive and positive lives when receiving proper treatments for their mental illness Some young people have severe and persistent mental disorders which respond poorly to current treatments (as in all other illnesses) and may require greater supports Mental illness does not respect any boundaries of race, class or geography Young People With Mental Disorders 13

Young people with mental illness are more likely to be victims not perpetrators of violence Young people with mental illnesses have difficulty accessing best possible care and face substantial stigma Early identification and provision of best evidence treatments have the opportunity to substantially improve outcomes Young People With Mental Disorders 14

Educational Implications for Students Students who have developmental, physical or learning problems are supported in developing social skills, self- awareness, self-control and self-esteem in order to succeed academically Students with mental health problems may have similar difficulty maintaining regular progress at school Students with severe mental health disorders often have difficulty developing skills at the same pace as other students and may need targeted or intensive support as outlined in an IEP 15

Observing Signs of Mental Health Problems Only physicians and psychologists are qualified to diagnose mental health problems School staff often are very helpful in observing aspects of behaviour that may not be as evident to a parent or mental health professional However, school staff need to avoid jumping to the conclusion that a student has a mental health disorder Rather, the objective recording of observations and an attempt to determine if the observed behaviours indicate that the student’s functioning is impaired is how we can be most helpful to parents or outside professionals who may be determining the presence of a diagnosis 16

Keys to Identification Is the student previously known to have had difficulty with mental distress? (or does a family member?) Has there been a recent significant change in mood, thinking or behavior? (change in baseline) Are the student’s problems causing distress to him/her or to others? 17

Keys to Identification Has there been a noticeable decrease in functioning: social, academic, other? Are there substantial changes in peer group participation or a significant change in peer group? Are parents or others raising concerns? 18

Difficultly Identifying in the School Setting It can be more difficult to differentiate “Distress” from “Disorder” in children and youth The “presentation” of the illness may be different at different times 19

Difficultly Identifying in the School Setting Sometimes the student is not well known to the staff member If a student is using drugs or alcohol the effects of those substances can interfere with identifying behaviours 20

Summative Assessment Refer to the handout, Summative Assessment Base your assignment on a student you currently work with, worked with in the past or a student whose condition you have familiarity with Using the Summative Assessment Rubric as your guide for the criteria by which your assignment will be graded, complete the assignment for submission by the date your instructor has specified Summative Assessment due last session 21

Know-Wonder-Learn Look at your K-W-L sheet and review your responses to the first two sections Correct any misconception that may have been recorded in the KNOW section Take a few minutes and complete the LEARN section, especially concerning how it relates to what you had written in the section for WONDER 22

Reflections for Next Day Think of the students you currently support, have in the past or know of from schools you have worked in and respond to the following:  How have students with mental disorders been identified?  What process is used to create a plan for supporting a student with a mental disorder?  What is your involvement in the process of supporting the student?  What support do you receive to prepare you for this task? 23