Mental Health – Intervention program

Scope of the Problem

Mental health has always been seen as less important and not having any impact on physical health. It has been stated that poor mental health can be linked to a 67% increased risk of a heart attack and 50% increase risk of cancer and not to mention increased risk of substance abuse. Luckily, mental health has recently started to gain recognition in the eyes of public health. There have even been numerous interventions that target this issue in the adult population, but I believe that sometimes these mental health disorders take root in the early years of childhood especially during the early childhood to puberty. According to National Center for Children in Poverty, there are around one in five children who have a diagnosable mental health issue. The level of mental health declines as we transition into a low-income neighborhood. Having a mental health issues early in childhood can have significant impacts on the child’s school performance and can even lead to higher rates of school dropout. This is especially true of children that are in low income communities, it is said that around 21% of low income children ages 6 to 17 have mental health issues. This is a significant number and even though the state and national government provide aid to children of low income families through Child Health Insurance Plan (CHIP), mental wellbeing services are not covered under it. Being able to detect mental health disorders and providing proper treatment is key and contingent upon being able to identify symptoms of mental health disorders early on in these low-income children. This is why it is necessary to implement an intervention which will help to change the rates of diagnosis and treatment of mental health conditions by increasing awareness of mental health issues in the children at an early age.

Planning

            In this proposed intervention plan, behavioral and environmental changes will be implemented.  This allows us to ensure that the children are not only equipped with the tools to ensure they are mentally healthy, but also to ensure that they are in an environment that allows them to feel safe and be able to share issues that may be bothering them or putting their mental health at risk.

The stakeholders in this intervention would be the children, parents, and the school faculty. The children and parents are the primary stakeholders which I believe are directly affected. Getting the parents and the school faculty on board would require making them aware of the status of mental health in the nation, the toll that mental health has on children, the risks of not identifying symptoms, diagnosing, and treating mental health illnesses. With the school board it would also require us to illustrate to them that with a small amount of funding they would be making a huge impact on the children’s current and future mental health status. Obtaining information would be through the use student evaluations completed by their teachers.  These evaluations would be completed at different time intervals, one evaluation can be done before the workshop and another one month after the workshop. Through the use of these evaluations, we can get a better understanding of the behavioral changes that the students are undergoing since most of the time the children spend in a typical day would be with teachers. Another method we can utilize of obtaining information is to use focus groups of select students from different grade levels would be used to obtain additional information. Utilizing a focus group would help us gain a first-hand experience from the students on what they thought about the intervention and if their awareness about mental health was increased or not. This can also help us to improve the intervention based on the perception of the children.

The funding for this intervention would come from the individual school budgets if possible. If not, the funding can come from the City of New York budget. The program would be feasible in the long run because this program does not require too much funding. The only expenses that the school would be incurring would be to have a trained professional in mental health. If the schools possess a school psychologist or a psychiatrist, then we would be able to train them on how to hold this workshop for the children instead of having an outside professional come in and thereby lowering the cost of this intervention.

Development & Dissemination of the Intervention
            This intervention targets low-income children in Melrose neighborhood in the borough of Bronx.  This intervention consists of having a trained professional/guest lecturer that holds a mental health workshop for children at different grade levels. This workshop would take place at the beginning of the school year for a day or two in which the guest lecturer would spend a day in teaching the children. The level of information and workshop would be adjusted based on the age/grade level. The remaining day of the workshop would be dedicated to group and one on one activities which would encourage children to reflect upon the information they learned and how to apply the skills to maintain healthy mind set. In addition, the school can have teachers evaluate the students understanding of mental health. Another evaluation can be done a month later and based on the evaluations the teachers can create a lesson plan to reinforce the material again. In the after-workshop evaluation the teachers should be instructed to monitor the children’s progression and see if they are able to still recall the information about mental health and also observe if they are able to apply the skills they were taught and monitor and see if there have been any adverse changes in the children’s’ behavior. If the children are seen to be displaying mental health issues through the use of these evaluations, then the teacher can notify the parents and get the child counselor/school psychiatrist involved. They can also structure a plan in which the child is set up to see the school counselor in order to help them or the parents can choose to notify the child’s pediatrician if one is available.

The goal of this intervention is to increase awareness of basic mental health in children ages 6 to 12 years of age. By increasing awareness at a young age and methods on how to maintain healthy mental health, we would be providing these students with knowledge that they can utilize in the near future. In the long run this intervention can help to remove stigma around mental health as we educate the future adults at a young age. It also can help to decrease the incidence and prevalence of mental health illnesses that are common among teenagers such as depression, suicidal ideations, and anxiety. A secondary process through which we can help make an impact in the incidence and prevalence of mental disorders is to identify any early symptoms that children may be exhibiting throughout the year.

There would be some barriers to implementing this program such as:

– getting sufficient funding for the program,

– reluctant teachers

–  children that are not interested in learning

– skeptical parents

 – having the school board approve of this type of intervention

– teachers that have limited knowledge of mental health

Inputs that would be required to implement this intervention properly would be time, money, classroom space, and a trained professional.

Evaluation & Maintenance

The program would be evaluated from the forms filled out by teachers (described above) as well from the level of academic performance in the next few years and the level of drop out in high school. Teachers would fill out evaluations, one before the workshop to get a baseline and another evaluation a month after the workshop. If these evaluations are ineffective, then we can increase or decrease the frequency of the evaluation that the teachers would be filling out or even increase or decrease the time interval between the workshop and the evaluation period. We can also change up the workshop structure based on the feedback we get from the faculty in order to maximize the retention of information. Changing the structure could involve increasing the time allotted to teach the workshop to even increasing the frequency this workshop is held throughout the school year. Additionally, if the academic performance/dropout rates are not showing any significant changes then another approach might need to be taken in order to ensure that we are able to increase awareness as well helping to identify early symptoms of mental disorders.

            This program would need to be maintained over several years to help improve/maintain the children’s mental health. Additionally, since the cost of the workshop does not seem to take up too much of the school budget it does not seem too difficult to keep the program going for a few years in order to observe the larger impact that the program can have. The timeline of the program would involve the program to run for at least 3 to 4 years to be able to see some real short-term impact. In addition, once the program is seen making an impact in the lives of the children, it can be argued to the school boards about the benefits off putting the costs.

 

 

References:

http://www.nccp.org/publications/pub_929.html

https://www.ncbi.nlm.nih.gov/pubmed/15283617

http://www.nccp.org/publications/pub_687.html

http://www.mentalhealthamerica.net/issues/prevention-and-early-intervention-mental-health-early-childhood-puberty

http://www.campushealthandsafety.org/mentalhealth/consequences/

https://www.health.ny.gov/prevention/prevention_agenda/2013-2017/plan/mhsa/interventions.htm

https://www.wnyc.org/story/174508-blog-census-locates-citys-wealthiest-and-poorest-neighborhoods/

https://www.health.ny.gov/health_care/child_health_plus/what_benefits_can_you_get.htm