Tag: mental health
Self-Care Videos for Mindfulness – Families Series
Feel What You Feel
When emotions overwhelm us, we sometimes react in ways that we later regret. “Name it to Tame it” is a concept from neuroscientist Dan Siegel. It means that if we identify our emotions and work with them, instead of pushing them away, we are better equipped for self-control. This simple body sensing meditation creates a way to practice emotional self-awareness and build mental muscles for emotional regulation.
For more videos about mindfulness, please go to wapave.org Thanks for watching!
Take a Mindful Walk in Nature
Mindfulness can mean anything that helps you slow down and show up for what’s happening in a moment. This video demonstrates how to notice all of the body’s senses on a nature walk. Once it’s familiar, the concept could be useful in any environment, including indoors. Get creative and if it’s developmentally appropriate, you can encourage children to make up their own journey through their senses.
Get Calm by Getting Organized
When overwhelm is happening, it’s hard to imagine that getting organized will help. But here’s why it’s worth it: When you feel satisfied that you’ve done something, your brain releases happiness chemicals and hormones. This video provides information about how that works and how families can tap into happy by getting organized and taking time each day to celebrate everyone’s accomplishments.
How to Navigate School for Youth with Mental Health Concerns
Staff from PAVE’s Parent Training and Information (PTI) program provided a workshop as part of the statewide virtual conference hosted by NAMI Washington October 16, 2021.
This recorded training provides a general overview of student rights in education. Some information is specific to students impacted by mental health conditions.
The formal content begins about four minutes into the video and ends at about 46 minutes.
Here are a few examples of topics addressed:
- Does my student have the right to be evaluated for special education if they refuse to go to school because of anxiety?
- What accommodations are reasonable to ask for?
- What services might be possible for my student who struggles with emotional regulation?
- Can counseling be a related service?
- Are there protections for a student because of suicidal thoughts or attempts?
- What support is available for a student with a disability condition who isn’t prepared for adulthood because high school got interrupted by the pandemic?
Additional information about mental health education and services at school, the overall layout of youth behavioral health in Washington State, and where to find family support is included in a PAVE article: Mental Health Education and Support at School can be Critical.
To seek education, training, and support from the National Alliance on Mental illness, look for a virtual training or information about a local affiliate near you, listed on the NAMI WA website.
One place to access behavioral health services for children and youth anywhere in Washington is through the Seattle Children’s Hospital Mental Health Referral Service: 833-303-5437, Monday-Friday, 8 a.m. to 5 p.m.
Families and young people can reach out for individualized assistance from PAVE’s Parent Training and Information (PTI) staff at PAVE. Click Get Help or call 800-572-7368.
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How to Cultivate Resilience like a Starfish
Starfish are masters at letting turmoil wash around them. They are also excellent models of resilience. This short video uses imagery from the sea and provides a strategy to get grounded, steady the breath, and cultivate four key aspects of resilience: purpose, connection, adaptability, and hope.
Become present and let thinking float away as you treat yourself to this opportunity to take a few minutes to care for yourself.
Breathe Mindfully and Give Your Favorite Stuffy a Ride
Even young children can become grounded and calm if breathing with intention is fun and accessible to them. This short video features two young models showing how they give their stuffed animals a ride while they breathe into and out of their tummies.
Have your child choose a comfortable place to lie down and place their stuffed animal on their tummy. Help them to notice what it’s like to breathe and watch the stuffy go up and down. Ask them what it feels like to notice their breathing and their stuffy taking a ride.
Our five-year-old model says, “I loved it and felt like I could fall asleep.”
Mindfulness and Self-Care for Families During COVID-19 and Beyond
Webinars offer Parent Training to Support Behavior during Continuous Learning
While school facilities are closed because of COVID-19, families impacted by disability face complex challenges. For some, children’s difficult behaviors are a regular concern. According to the Centers for Disease Control and Prevention (CDC), stress and anxiety in children and youth may show up through unexpected or maladaptive behaviors. Those behaviors might get worse because of fear, isolation, and disrupted lives.
Meanwhile, some of the help that used to be there is gone. At school, students may have gotten 1:1 support or direct instruction to encourage behavioral skill-building. Those aspects of a special education program might be difficult or impossible to provide during social distancing.
While students are learning from home, parents can request individualized support from the school to support behavioral expectations, if behaviors have educational impact. Parent training can be a related service in a student’s Individualized Education Program (IEP). As always, family caregivers can request an IEP meeting to discuss options to support academic and behavioral goals and expectations.
If the student has a Behavioral Intervention Plan (BIP), that document might hold clues about strategies most likely to work. For more ideas about how to communicate with the school in reviewing a student’s program and perhaps also designing a temporary Continuous Learning Plan, parents can refer to PAVE’s article: IEP on Pause? How to Support Continuous Learning with School Buildings Closed.
To generally support caregivers in their various roles during COVID-19, Washington’s Office of Superintendent of Public Instruction (OSPI) offers a three-part webinar designed for families to help with behavior in continuous learning environments. The webinar has been recorded and uploaded to YouTube in sections, so families can access the content at their own pace.
The webinars are moderated by Lee Collyer, OSPI’s program supervisor for special education and student support. Collyer, a parent, describes his own challenges during the pandemic alongside ideas from research-based sources. Families are invited to send questions and comments to lee.collyer@k12.wa.us.
In various forums, Collyer has described his investment in fostering positive behavioral supports for students in order to reduce disciplinary actions. In a May 13, 2020, OSPI webinar about Mental Health and Safety, Collyer said, “My fear is that we’re going to try to discipline our way out of trauma.”
Following is a brief description of each segment of the three-part webinar series, with a link to each specific webinar. If you start with the first one, you will have the option to stay connected and flow through all three. Each segment is 20-25 minutes long, and the first one includes some background information about OSPI and Collyer’s role.
Supporting Positive Behavior in Continuous Learning Environments – Part One
Collyer begins the series by sharing OSPI’s official statements related to mission, vision and equity. He offers reassurance to parents that everyone is learning something brand new together, without time for proper training, and that “We should not let pressure from schools, teachers or school communities dictate what works for our family and what kind of learning we are prioritizing during this time.”
Collyer talks about the value of learning that is imbedded in everyday activities and part of family routines. He shares insights from psychiatrist Bruce Perry and psychologist Ross Greene, both widely regarded authors who apply their research to inform parents. Their names are linked here to practical articles about supporting positive behavior, and both are easily searchable to find additional materials.
The OSPI webinar includes signs of stress and anxiety to consider. Collyer recommends behavior solutions based on skill building: If children do not know how to do something (like behave), the answer is to teach, he points out, not punish. The segment ends by explaining how behavior serves a function and understanding that function is key to reducing escalations.
Supporting Positive Behavior in Continuous Learning Environments – Part Two
The second segment begins where the first leaves off, by discussing the functions of behavior and how to identify them and intervene early. Pre-teaching skills and reinforcing positive behaviors over negative ones in a 5:1 ratio is encouraged: For the best outcome, catch a child doing what is expected and provide encouragement five times more often than calling out an unexpected behavior.
The second segment also provides some specific strategies for home/school communications. Collyer describes the difference between a consequence and problem-solving and offers specific strategies for parent/child problem-solving.
Supporting Positive Behavior in Continuous Learning Environments – Part Three
The third segment begins with information about how a crisis might escalate and how reason and logic are compromised when fear and frustration highjack a person’s response system. Adults may need to consider their own escalation cycles and develop a personal plan for self-control to support children, Collyer says.
He describes how children might be uneven in their development of cognitive versus social-emotional skills and how that might create confusion about the best parenting strategy. How to set limits with considerations for trauma and ways to shift from negative to positive interventions are additional strategies provided in the final segment of this webinar series.
For additional resources from OSPI, visit the page for Special Education Guidance for COVID-19.
Stop and Settle with Five-Fingers Breath
Clear the Mind with a Beach Jar
Adolescent Health Care Act Provides Options for Families Seeking Mental Health and Substance Use Help for Young People Resistant to Treatment
A Brief Overview
- The Adolescent Behavioral Health Care Access Act, passed into law by the Washington Legislature in 2019, gives parents and providers more leverage in treating a young person who won’t or can’t independently seek medical help for mental illness and/or substance use disorder.
- The Washington State Health Care Authority (HCA) in March 2020 launched several website links with information about the new law, which includes an option for Family Initiated Treatment (FIT).
- The Washington State Hospital Association on July 9, 2019, provided a slide presentation describing the law’s history and its primary features.
- A place to connect with other families concerned about adolescent mental healthcare access in Washington State is a group called Youth Behavioral Healthcare Advocates (YBHA-WA) on Facebook. Included on the page are handouts that summarize key aspects of the new law.
Full Article
Getting mental health help for a youth in crisis can be complicated, frustrating and frightening.
Mental Health America ranks states based on the incidence of mental illness and access to services. The agency’s 2020 rankings list Washington in the 43rd position, based on various measures that indicate a higher prevalence of mental illness and lower rates of access to care.
Often a barrier to treatment is the youth, who may not be able to see a problem or want to get professional help. Parents often struggle to navigate systems that must balance a young person’s autonomy with concern that they may not be able to make good decisions because of their development, specific illness circumstances or symptoms that impact the brain.
In Washington State, the age of medical consent is 13. That means that a person 13-17 years old can independently seek medical treatment, without the consent or knowledge of parents.
Age of consent laws also have meant that Washington youth could say no to mental health or substance use treatment, regardless of whether parents and providers agreed that such treatment was necessary to protect the safety and well-being of the adolescent.
A law passed by the Washington legislature in 2019 gives parents and providers more leverage when a young person is struggling with a mental illness or substance use disorder and won’t independently engage with treatment. The law does not limit an adolescent’s ability to initiate treatment on their own.
A January 8, 2020, article in Crosscut profiles several families impacted by the new law. “Until the new law,” the article states, “parents often were shut out of their teenager’s care and treatment plans and couldn’t push a teen toward necessary outpatient or inpatient care without their consent.”
The Adolescent Behavioral Health Care Access Act enables parents/caregivers to bring a child for inpatient or outpatient treatment without requiring consent from the child, ages 13-17. The law includes elements introduced by the state Senate and House of Representatives, which originally titled the bill as HB 1874.
Passage of the law was a win for the Children’s Mental Health Work Group, which studied and reviewed recommendations from a stakeholder advisory group authorized by the 2018 legislature. The final version of the law included input from family members, youth, clinicians, hospital staff and many others who met dozens of times. A June 13, 2019, slide presentation available online provides additional history and detail about the work group and its recommendations: Family Initiated Treatment and Engaging Families in Treatment of Youth. The webinar with sound is available on YouTube.
The 2020 legislature is considering amendments to the law, and the Children’s Mental Health Work Group continues to meet to consider proposals to clarify provisions that relate to residential treatment and referrals for Wraparound with Intensive Services (WISe).
“Parent” is broadly defined
The 2019 law expands the definition of parent to include a wide range of family caregivers, guardians and others who have authority to initiate treatment. The Revised Code of Washington (RCW 9A.72.085) provides standards for “subscribing to an unsworn statement” that can apply to a caregiver initiating treatment.
Note that parents retain the right to make medical decisions for children younger than 13, and adults 18 and older are responsible for medical decision-making if there is no guardianship.
A substantive change with the 2019 law is that providers may share mental health information with parents without an adolescent’s consent, if the provider determines that information sharing with family is in the best interests of the adolescent patient. A list of information-sharing guidelines is included below.
How Family-Initiated Treatment Works
If a parent/caregiver believes that an adolescent requires mental health or substance use disorder treatment, the adult can escort the young person to an inpatient or outpatient treatment facility even if the adolescent doesn’t readily agree to go.
A provider will assess the adolescent and consider information from the family to determine whether treatment is medically necessary. An adolescent’s refusal to engage with the provider cannot be the sole basis for refusing to treat.
An inpatient facility can detain the adolescent under Family-Initiated Treatment (FIT) if medically necessary. Note: another option could be detention under the Involuntary Treatment Act (ITA), if the adolescent is determined to be gravely disabled or at imminent risk of self-harm or harm to others.
If medical necessity is found by an outpatient provider, a counselor is limited to 12 sessions over 3 months to attempt to work with the adolescent. If the young person still refuses to engage with treatment, then the period of Family-Initiated Treatment with that provider ends.
State laws continue to encourage autonomy for young people, but family engagement is encouraged. According to the Revised Code of Washington (RCW 71.34.010):
“Mental health and chemical dependency professionals shall guard against needless hospitalization and deprivations of liberty, enable treatment decisions to be made in response to clinical needs in accordance with sound professional judgment, and encourage the use of voluntary services. Mental health and chemical dependency professionals shall, whenever clinically appropriate, offer less restrictive alternatives to inpatient treatment. Additionally, all mental health care and treatment providers shall assure that minors’ parents are given an opportunity to participate in the treatment decisions for their minor children.”
Guidance for Information Sharing
Federal law, 42 CFR Part 2, restricts information sharing related to substance use, and clinicians cannot share that information without a patient’s written consent, regardless of whether the substance use co-occurs with mental illness.
Providers have discretion in determining what information about mental health diagnoses and treatment is clinically appropriate to share with parents of an adolescent 13-17. A provider retains discretion in withholding information from family/caregivers to protect an adolescent’s well-being. In general, the Adolescent Behavioral Healthcare Access Act encourages sharing information to support collaboration between the clinical setting and home. Specifically, providers and families are encouraged to discuss:
- Diagnosis
- Treatment Plan and Progress
- Recommended medications, including risks, benefits, side effects, typical efficacy, dosages and schedule
- Education about the child’s mental health condition
- Referrals to community resources
- Coaching on parenting or behavioral management strategies
- Crisis prevention planning and safety planning
Information about state laws related to Behavioral Health Services for Minors is available through the Washington State Legislature website under RCW 71.34.
Information about child and youth behavioral health services in Washington State is available from the Health Care Authority (HCA).
Developmental Screening (Birth to Three and Medically needed developmental screening)
What is Developmental Screening?
Developmental screening is the practice of systematically looking for and monitoring signs that a young child may be delayed in one or more areas of development. Screening is not meant to establish a diagnosis for the child, but rather to help professionals and families determine whether more in-depth assessment is the next step. By using a high-quality screening tool, professionals can screen children for delays accurately and cost-effectively.
Think about your child’s first months. The medical professionals set up regular “Well-child” appointments just to monitor how your child is doing. These “Well-child” visits allow doctors and nurses to have regular contact with children to keep track of the child’s health and development through periodic developmental screening. Developmental screening is a simple process that can have both informal and formal assessments. When using a tool that is more formal in nature, the short test can tell if a child is learning basic skills when he or she should, or if there are delays. Developmental screening can be done by other professionals in health care, community, or school settings.
We have heard many times over the years that a child’s greatest window for development is in the first five years of life. Eighty-five percent of the brain’s development occurs before age three, making the first years of life critical to a child’s future success. The research shows that early intervention greatly improves a child’s developmental and social skills. Early intervention services help children from birth through 3 years of ages. Services usually include the support of an early educator who works with the family, as well as therapy (if identified as a need) to help the child talk, walk, and interact with others.
It’s not uncommon for parents to become concerned when their little one doesn’t seem to be developing within the normal schedule of “baby” milestones. You may worry that he hasn’t rolled over yet, or that he isn’t doing what the neighbor’s child, who is about the same age is doing. There may be concerns about your baby sitting up or beginning to verbalize words and sounds.
While it’s true that children develop differently, at their own pace, and that the range of what’s “normal” development is quite broad, it’s hard not to worry and wonder. If you think that your child is not developing at the same pace or in the same way as most children his or her age, it is often a good idea to talk to your child’s pediatrician. Explain your concerns. Tell the doctor what you have observed with your child. The doctor or other professionals might ask you some questions they may also talk and play with your child to see how he or she plays, learns, speaks, behaves, and moves. A delay in any of these areas could be a sign of a problem.
You can also get in touch with your community’s lead agency for birth-to-three services, and ask for an evaluation to see if there are possible delays. Based on referrals from the Doctor and the evaluation provided by the early intervention team, your child may be eligible for early intervention services, which will be developed with you and will address your child’s special needs.
Screening is a simple process that can identify infants and young children who may be at risk for health, developmental, or social/emotional problems. It identifies children who may need a health assessment, diagnostic assessment, or educational evaluation. “Screening” means using a standardized instrument. This could include a parent questionnaire, observational process, or other form of measurement that has been validated by research to learn more about the child’s development. Using a standardized instrument is much more effective for identifying real concerns or delays than just using professional judgment or informal questions about the child’s development.
The screening process provides an opportunity for young children and their families to access a wide variety of services and early childhood programs. It also supports the parents’ understanding of their child’s health, development, and learning.
The developmental screening and evaluations can lead to the involvement of a Family Resource Coordinator who will walk with the family through those first three years. They do a family needs assessment, if the family wishes to have one done. This helps identify areas the needs and priorities of the child’s family. Family-directed services are meant to help family members understand the special needs of their child and how to enhance the child’s development.
The need to provide early intervention is significant. Many children with developmental delays are not being identified as early as possible. This can result in these children waiting to get the help they need to do well in social and educational settings until they are in a school or pre-school setting. Research has shown that in nearly one in six Washington kids has a developmental delay, but only 30% of these children are identified before starting kindergarten, when early support services are most effective. Additionally, research has also identified that in the United States, about 13% of children 3 to 17 years of age have developmental or behavioral disabilities. These can include autism, intellectual disabilities, and attention-deficit/hyperactivity disorder. Additionally, there are children who have delays in language, social skills, or other areas that affect school readiness. This same research found that many children with developmental disabilities weren’t identified before age 10. These types of delays have significant implications since by that age there are significant delays that might have been addressed earlier and provided opportunities for services and support that was missed.
Because of the rapid growth in a child’s first three years of life, early support and monitoring of child development is essential for these children to reach their full academic potential as well as social and personal success. In all cases, kids will experience greater success academically, socially, and personally if delays are caught early and kids and families get the support they need. Free developmental screening using the Ages and Stages Questionnaire-3 screening tool is one of the best ways to get more awareness of what can help your child. In addition to the Ages and Stages survey a terrific tool and support network has been established called “Within Reach”. The “WithinReach” website is committed to supporting optimal child development of all Washington families. Through the “WithinReach” Family Health Hotlineand Child Development program, families can access free developmental screening, connections to early learning and family support and referrals to early intervention for developmental delays.
If you would like a free developmental screening for your child or have concerns about your child’s development, it is as easy as calling their Family Health Hotline (800) 322-2588 or visiting their website at www.ParentHelp123.org.
Remember that as important as Developmental screening is as a part of early intervention, can go also be important in assuring that the needs of children of older ages also find success and resources. Developmental screening for older youth can include areas of the individual’s development in mental health, social and emotional needs, and communication needs, just to name a few. Developmental screening will help assure that the needs of the individual whether an infant or an older child, can be met, and how those needs can be met. As parents and family members we have a responsibility to help our children thrive and developmental screening can help us know which path to follow to make that happen.
Resources for this article:
http://www.cdc.gov/ncbddd/childdevelopment/screening.html
http://www.parentcenterhub.org/repository/ei-overview/
http://www.health.state.mn.us/divs/cfh/topic/devscreening/screening.cfm
http://agesandstages.com/research-results/why-screening-matters/developmental-screening/
http://www.cdc.gov/ncbddd/autism/index.htm
http://www.cdc.gov/ncbddd/actearly/pdf/parents_pdfs/intellectualdisability.pdf
http://www.cdc.gov/ncbddd/autism/index.htm
http://www.withinreachwa.org/what-we-do/healthy-families/child-development/
http://www.cdc.gov/ncbddd/childdevelopment/screening.html#references
Depression and the Autism Spectrum
It is a common misconception that people who have Asperger’s or Autism do not get depression.
In fact this is more common than you think!
Suicidal thoughts are ten times more likely in people with Asperger’s or in the Autism Spectrum. Survey data was used on 256 men and 118 women who were diagnosed:
66% reported suicidal thoughts
35% reported plans or attempts at suicide
31% reported depression
Depression can be caused by:
Social troubles because you do not seem to fit in
Guilt or regret over past actions/outbursts/meltdowns
Overwhelming feelings and thoughts
Anxiety and Panic Attacks
Miscommunications / Misunderstandings
Fatigue or Tiredness due either to the condition or to medications taken for the condition (e.g.: Ritalin)
Here are some comments people with Asperger’s have made:
(Comments have been made anonymously)
“I have been diagnosed with Asperger’s syndrome and depression.
My repeated obsessive thoughts turn into that sadness and also when someone gets frustrated with me like my parents. I don’t even know how I feel sometimes. When I can’t learn from my mistakes as fast as everyone else. I feel hopeless because it’s how I’m made to make mistakes over and over without ending.”
“I understand. Repeating the same mistake over and over…I would always forget to leave my coat in my locker at school (because of some rule) and 4 days out of 5 I would forget it. Consistently. And my repetitive obsessive thoughts also turn into sadness, but for me this occurs irrespectively of being yelled at.”
“I have Asperger’s and am high functioning to a degree. I also suffer from depression and anxiety which a lot stems to the fact my circle of friends has drastically dropped since my teenage years, I’m nearly 23 and I don’t go out like most people my age do. Mainly because I socially isolate myself. I find situations arise when I go out, for example…a club I used to go to has very loud bands on Friday nights, I can’t hear my thoughts it screws with my head. It depresses me because when I was younger I had loads of friends, now I’m a social outcast who feels nothing but bitterness and anger towards a lot of society. Al lot of my friends don’t want nothing to do with me anymore. Best friends have come and gone and now I feel alone. I live alone which doesn’t help and rely on Xbox live to chat to people. I just wish sometimes I wouldn’t come out with weird stuff. It freaks me out as well as it does to other people.”
The first step to helping, is by recognizing the signs:
A suicide attempt is rarely made all of a sudden. It is most common for individuals to shift between the stages on a continuum which range from thinking about suicide to committing suicide.
The stages can go back and forth and are not limited to:
Planning – for example, giving away possessions that were thought of as special to them.
Organizing means – a fascination with a certain weapon that they were not interested in before, for example.
Suicide attempt
Some may start in self harming behavior which can lead to death while the goal is not to actually die. This is because these individuals may not have actually thought of the consequences and finality of suicide.
Pay attention to:
Statements like “I would be better if I just died”
Threatening to commit suicide
If they are more withdrawn or depressed: not participating in their routine activities, they avoid communicating even more than usual.
Recognizing the signs is even harder when some people with Autism or Asperger’s cannot communicate the conventional way.
Here is how you can help someone who is depressed
People who consider suicide mostly need to know that others do care:
Even if you don’t talk, just being there helps
Let them know that most people think about suicide at one time or another, and thinking about suicide does not mean that things can’t get better.
Listen to what they are saying about themselves and their life
Avoid saying things like “you should be grateful to be alive!” or “You will be fine”
Tell them that you will always be willing to talk and there are others who care
Inspire them to make new friends or contact old friends or even call the Suicide Prevention Lifeline. https://www.suicidepreventionlifeline.org/– 1-800-273-8255. The Lifeline offers online chat, which is a good option when individuals are non-verbal or when social anxiety is high.
If you see that there is an imminent danger of the individual to commit suicide:
If it is an emergency, call 911
Contact outside help or make sure they contact their Doctor
Monitor their temperament and establish a follow up plan when there are changes – the plan can include calling the Doctor, making sure they call the National Suicide Prevention Lifeline – https://www.suicidepreventionlifeline.org/ or call 1-800-273-8255.
Make sure to remove any means that can facilitate suicide – prescription drugs, weapons, etc.
Most of all let them know that there are always people who are ready to help them. It is important for them to know that it’s ok to ask for help and let either family members, friends or professionals how they feel.
References:
Synapse, Reconnecting Lives, Fact Sheets: Depression, Suicide Risk and Autism
Retrieved from – http://www.autism-help.org/family-suicide-depression-autism.htm
Collingwood, J. Suicidal Thoughts 10 Times More Likely in Adults with Asperger’s.
Retrieved from http://psychcentral.com/news/2014/10/13/suicidal-thoughts-10-times-more-likely-in-
adults-with-aspergers/76016.html
Cassidy, S. et al. Suicidal ideation and suicide plans or attempts in adults with Asperger’s syndrome
Attending a specialist diagnostic clinic: a clinical cohort study. The Lancet Psychiatry, 25 June 2014 doi:
10.1016/S2215-0366(14)70248-2
Raja, M. Suicide risk in adults with Asperger’s syndrome. The Lancet Psychiatry, 25 June 2014
Doi:10.1016/S2215-0366(14)70257-3