1. Colorado Department of Education Student Health Services Regional Nurse Specialists School Nurse E-Learning
Trainings
This presentation is part of a series of educational offerings for the school nurse that were adapted from trainings developed and presented by the Regional Nurse Specialists.
Please look at the “Introduction to E-Learning” found on the CDE School Nursing and Health web page.
If you have any comments or questions, please send an to:

2. All Hands on Deck Trainings
Contact Hours: You can receive contact hours for listening to this training and sending in the answers to the review questions in the training. Please go to the Answer Sheet for this training on the School Nursing and Health webpage. You can complete the answers as you listen to the training. You have to submit all the answers to get the contact hours.
All Hands on Deck
Module 1: 20 minutes
Module 2: 25 minutes
Module 3: 50 minutes
Module 4: 22 minutes
Total: 2.5 contact hours
Colorado Department of Education Student Health Services Regional Nurse Specialists School Nurse E-Learning
Trainings

3. The School Nurse’s Role in Behavioral and Mental Health
All Hands on Deck
The School Nurse’s Role in Behavioral and Mental Health
This program was adapted from the 2012 Presentation developed by the CDE Regional Nurse Specialists in conjunction with…
School
Nurse
Student
Success
Coordinated School Health
Journey to Mental Health

4. Module 1 Understanding the Scope of the Problem
Module 1 The Evidence
for School-Based Mental Health Services
The Scope of the Problem
Define behavioral health
Define mental health
What are some barriers to mental health treatment?
How do different culture view mental illness.
Identifying the scope of the problem.
Barriers to mental health interventions.
Mental health stigma and cultural influences

5. Scope of the Problem
Follow the Handout: Childhood Mental Health Issues Scope of the Problem Fact Sheet
Cradle to Jail (medical home)- add Mental Health Compliance Medications
Hand-out for nurses with STATS

6. Health Conditions per 100 US students
26.2% of US students have a mental or emotional disorder. Up from 22.2% in 2012
Most recent parent-reported prevalence of ADHD was 9.5%
The percentage of children with a parent-reported ADHD diagnosis increased by 22% between and 2007.

7. What is the Scope of the Problem?
1. The majority of major psychiatric illnesses begin in childhood.
About 20 percent of U.S. youth during their lifetime are affected by some type of mental disorder to an extent that they have difficulty functioning.

8. Underscoring the notion that mental disorders manifest early in life, the researchers also found that
symptoms of anxiety disorders tended to emerge by age 6,
behavior disorders by age 11,
mood disorders by age 13, and
substance use disorders by age 15.
*Scope of the Problem Fact Sheet
NIMH survey published in the Journal of the American Academy of Child and Adolescent Psychiatry, Oct 2010. 
From - Marianne Z. Wamboldt, M.D. Chair, TCH Department of Psychiatry and Behavioral Sciences

9. 2. 60% of families do not follow through on referrals for mental health services made by primary care physicians.
3. School‐related behavior and mental health problems affect every socioeconomic, racial, and age group.
4. For the majority, the only mental health services they receive is in the schools*
1Wissow et al.“A Common Factors Approach to Improving the Mental Health Capacity of Pediatric Primary Care” Adm Policy Ment Health (2008) 35:305–318
*Burns, G. et. al., Health Affairs, 1995

10. 5. Students with a Serious Emotional Disability have the poorest outcomes
Lowest grade point averages
Poorest attendance
Highest level of drop-out
Difficulty holding jobs after school
Youth Corrections – 59% of average daily population had moderate to severe mental health needs.
Colorado Connections for Healthy Schools ,February 8 ,2011
Barb Bieber, Colorado Department of Education
Denise McHugh, Center for Systems Integration
Amy Engelman, Colorado Department of Education

11. 6. Mental Health Intervention Is Important from a Student Perspective
Research* evidence that promoting social
And emotional skills plays a critical role in
improving academic performance:
10 % points higher on achievement tests
Better attendance
More constructive behavior, less disruptive
Like school more
Better grade point averages
“No Emotion Left Behind,” NYT, 2007
Academic success and social‐emotional competence are interdependent. A recent large scale review of 317 studies found that social emotional learning improved students’ achievement test scores by 11 to 17 percentile points.4 4 Payton, et.al. (2008):Collaborative for Academic, Social and Emotional Learning

12. Barriers to Mental Health Treatment

13. Barriers to involvement in child mental health interventions
Triple threat:
poverty
single parent status
stress
Concrete obstacles:
time
transportation,
child care
competing priorities
Attitudes about mental health, stigma
Previous negative experiences with mental health or institutions
Mental Health and Schools Supporting Collaborative Practice - Funding for the Mental Health and Schools Together - provided by The United States Department of Education Office of Safe and Drug-Free Schools

14. Barriers to involvement in child mental health interventions
Scarce mental health resources
Disparity in access to care for minorities
Geographical distribution of providers does not
equal demand across the state
PCP’s do not have necessary tools or training to
be effective.
The cost is increasing and the funding is low.
The Status of Mental Health Care in Colorado,
The Mental Health Funders Collaborative,
Oct Chartis interviews
Transportation
Stigma associated with mental illness and seeking care
Concerns about confidentiality – fear of exposure
Isolation

15. Mental Health Stigma

16. Cultural Influences

17. Review of Module #1
Number quiz:
Students with psychiatric or emotional disorders
A % B % C – 33%
Percentage of families that do not follow through with mental health referrals by their primary physician.
A. 20% B. 40% C. 60%
List quiz: Name 5 barriers to mental health interventions.
Thought question: It is easy to see how cultural influences can be a barrier to mental health intervention. Give an example of a cultural influence that is supportive of interventions.
(Answers available in a separate PowerPoint slide)

18. Resources:
Please check out all the resources on the Mental Health section of the Colorado Department of Education’s web page on “School Nursing and Health ” wellness/snh_healthissues