LEE ROBBINSEQUAL JUSTICE WORKS FELLOW

EQUIP FOR EQUALITYSPONSORED BY: THE CHICAGO BAR

FOUNDATION

Educational Services for Children with Mental Health Needs

Agenda

Introduction Landscape of children’s mental health in

IllinoisEFE’s Children’s Mental Health ProjectAdvocacy for children with mental health

needs Common issues Promising practices and legal tools

Questions

Michael

Michael* , a student with ADHD, was a seventh grader when he was expelled from his suburban school district for destroying a teacher’s pencil sharpener (she accused him of planning to use it as weapon). His IEP was also changed to indicate that the only environment where he could be educated was in a separate school for children with behavioral disabilities.

Equip for Equality learned that Michael’s school had expelled him in spite of finding that his behavior was solely related to his mental health issues, and had never updated his behavior plan prior to moving him to a segregated school.

Children’s Mental Health Project at EFE

Fellowship sponsor – the Chicago Bar FoundationHas sponsored 10 Equal Justice Works fellowships since 1999

o Fellowship organizer – Equal Justice WorksHelps launch the next generation of public interest lawyers

o Fellowship host organization – Equip for EqualityFederally mandated agency that protects the rights of people with disabilities in Illinois

Children’s Mental Health Project at EFE

1. Self Advocacy Assistance2. Direct Representation3. Community Outreach 4. Collaboration with Mental Health Providers

Focus on: Initial eligibility Students in need of intensive interventions School push-out

Children with Mental Health Needs in Illinois

It is estimated that nearly 175,000 children and adolescents in Illinois —7 percent of the

population under age 18 — have some sort of a serious emotional disorder

Only around 1 in 5 of these children receive needed community-based services

Illinois Department of Human Services, Illinois Mental Health Strategic Plan 2015-2018 (2013), available at: https://www.dhs.state.il.us/onenetlibrary/27897/documents/mental%20health/marysmith/strategicplan/mentalhealthservicesfiveyearstrategicplan2013.pdf

A word about trauma

Many children in our communities have experiences of trauma and adverse childhood experiences, whether through family issues, poverty, community-based violence, or some other source.

While not all children who have experiences of trauma will develop Post-traumatic Stress Disorder, trauma-exposed children are much more likely to develop mental health issues, and are an often overlooked cohort in the MI community.

SAMHSA, Tip 57: Trauma-Informed Care in Behavioral Health Services(2014), available at: http://store.samhsa.gov/shin/content//SMA144816/SMA14-4816.pdf

The State of Children’s Mental Health in Illinois

Budgetary Issues The mental health budget in Illinois has been cut by

approximately 30 % between fiscal years (FY) 2009 and FY 2015.

Barriers to Services Lack of community-based providers Community access to supports

Stigma Cost Confusion

NAMI Illinois, NAMI Illinois Action Agenda 2015 (2015), available at:http://www.namiillinois.org/advocacy.htm#Downloads and Fact Sheets

What do we mean by mental health issues?

“Serious changes in the way children typically learn, behave, or handle their emotions.”

Some examples: Attention-deficit/hyperactivity disorder (ADHD) Behavior Disorders Mood and anxiety disorders Tourette syndrome

Centers for Disease Control and Prevention, Children’s Mental Health (2015), available at:http://www.cdc.gov/ncbddd/childdevelopment/mentalhealth.html

EFE’s Children’s Mental Health Project2014-2015 Statistics

Since September 2014, EFE’s Children’s Mental Health Project has:

Provided legal assistance to over 100 families of children with mental health needs in Illinois by providing direct representation at school-based meetings, due process and school disciplinary proceedings, and federal court appeals

Provided training to over 500 parents, service providers, and advocates serving children with mental health needs

EFE’s Children’s Mental Health Project2014-2015 Statistics

Most served under IDEA eligibility categories of ED and Other Health Impairment (OHI)

Are facing school removal issue (disciplinary or special education placement change)

65% people of color

Most receiving 30 minutes or fewer of school social work services per week in school

Majority not receiving psychological services in school

Early Intervention Matters

Mental Heath America, Infographic Back to School Youth Mental Health 101 (2015), available at: http://www.mentalhealthamerica.net/conditions/infographic-back-school-youth-mental-health-101

Early Intervention Matters

Mental Health America, B4 Stage 4 Infographic (2015), available at: http://www.mentalhealthamerica.net/b4stage4

Early Intervention – the reality

Child Mind Institute, Children’s Mental Health Report (2015) available at: http://www.speakupforkids.org/ChildrensMentalHealthReport_052015.pdf

School-Based Mental Health Supports Matter

National Association of School Psychologists, School Psychologists: Qualified Mental Health Professionals Providing Child and Adolescent Mental and Behavioral Health Services (2015), available at http://www.nasponline.org/assets/Documents/Research%20and%20Policy/Position%20Statements/WP_Qualified_Mental_and_Behavioral_Health_Professionals.pdf

Most children with mental health needs are not receiving treatment. Of those who do receive assistance, the vast majority (70% to 80%) receive mental health services in schools.

Positive mental health outcomes are directly linked to student achievement, increases in graduation rates, and the prevention of risky behaviors, disciplinary incidents, and substance abuse.

Federal Laws Requiring Services for Students with MI in school

Individuals with Disabilities Education Act (IDEA)

Section 504 of the Rehabilitation Act

School-based services provide a critical opportunity for children’s mental health issues to be addressed as part of a child’s right to a free and appropriate public education

The promise of these laws is not being met in schools

Common Issues: School Push-Out

Least Restrictive Environment Federal law requires that students who receive special

education services and supports be educated with their nondisabled peers to the maximum extent appropriate

Students should only be moved to a segregated educational setting where they cannot be satisfactorily educated in a less restrictive environment even with supplementary aids and services

20 USC 1412(5)(B); 4 CFR 300.550-300.556.

LRE: The reality

CPS Percentage of TDS students

Students with other disabilities

17%

Students with ED

83%See Illinois State Board of Education, 2012-2013 Illinois Special Education Profile, City of Chicago SD 299, available at:http://webprod.isbe.net/LEAProfile/SearchCriteria1.aspx

LRE: The reality

In CPS, over 20% of students with ED are educated in a segregated setting

In other parts of the state, the numbers are even more disturbing: Examples:

Rockford SD 205 - 36.5% of students with ED in separate facility East St. Louis SD 189 – 52% of students with ED in separate facility Calumet City SD 155 – 42% of students with ED in separate facility Dolton – 42% of students with ED in separate facility

Many students are removed without ever having received appropriate interventions and supports to address their social emotional and behavioral needs in school

See Illinois State Board of Education, 2012-2013 Illinois Special Education Profile, available at:

http://webprod.isbe.net/LEAProfile/SearchCriteria1.aspx

Common Issues: School Push-Out

School Disciplinary Issues Students with emotional and behavioral issues are

disproportionately suspended and expelled from school

Federal special education protections for school disciplinary matters are not being implemented

The paradigm around school disciplinary practices has shifted from one of punitive to positive supports,

But practically, many students with mental health needs are not being provided individualized supports to address their issues prior to the point of crisis

Common Issues – School Push-Out

A particularly concerning trend is that mental health crisis services are being used as an end-run around providing proactive, appropriate special education supports.

Children in crisis are not being provided behavioral supports to de-escalate prior to crisis and removal from class

Children not actually in crisis are recommended for hospitalization

After hospitalization, poor coordination in school re-entry

Common Issues – Stigma and Perception

Even though we now know more than ever about the experience of children with mental health issues, many are viewed as “troublemakers” in school

The perception of children with mental health needs is that their behavior is a choice between right and wrong, rather than a manifestation of their disability requiring positive supports in school

Common Issues – Stigma and Perception

Quotes from IEPs of Children with MHN:

“A strength is he can be charming, if not he would stop coming to school altogether.” Student with Mood Disorder, Age 12

“He purposely engages in behavior to push away

adults.” Student with Emotional Disability, Age 12

“He is a continual disruption.” Student with PTSD, Age 8

Common Issues - Resources & Training

Many schools do not offer specific curricula or programs to specifically support children with mental health needs

Staff handling school disciplinary matters in schools often have limited training around addressing mental health issues

School social workers and psychologists are frequently housed at multiple schools, limiting their availability to address student issues.

Common Issues – siloed systems of support

Even where children with mental health needs are receiving outside supports to address their needs, services among providers and schools are often not coordinated.

After a psychiatric hospitalization, schools may not know that a child has been hospitalized, or take no steps after the hospitalization to revise the student’s school plan accordingly.

Legal Tools & Promising Practices

School Push-Out Solutions Children with mental health needs have a right to positive

interventions and supports where behavioral health concerns exist, even prior to a major behavioral incident occurring.

Students have a right to be educated in the least restrictive environment, and the IEP team must implement interventions to address the student’s needs prior to considering a more restrictive special education placement.

Students with disabilities have special protections in place under the law concerning school removal due to school disciplinary incidents. These steps must be followed when handling a student disciplinary issue in school.

Legal Tools & Promising Practices

So what do we advocate for instead of removal?

Functional Behavioral Analysis & Behavior Intervention Plan Can be particularly focused on trauma-specific needs,

sensory needs, safety planning, crisis planning Student does not yet need to have an IEP to have a BIP

Expert Consultation in the IEP Process Involve BCBAs Outside Providers – can provide consulting minutes as

part of IEP

Legal Tools & Promising Practices

So what do we advocate for instead of removal? (cont.)

Incorporate research-based social skills, trauma-focused, cognitive behavioral therapy-focused curricula into student’s school day

Increase social work and psychological services in school Minutes must be based on need, not resources

Train staff who work with children with mental health issues to address stigma, perceptions, and approach to behavioral interventions

Develop crisis plan as part of IEP process that is step-by-step and not punitive (i.e. police will be called when student is in crisis)

Legal Tools & Promising Practices

Tools for families: Request documentation from all disciplinary events that

occur at school

Encourage families NOT to pick up their child when school is requesting informal parent pick-up due to disciplinary issue and student is not being suspended

Request IEP meetings to discuss discrepancies between disciplinary reports and the behavior interventions required in the IEP or 504 Plan

Request an IEP meeting to discuss break-downs in crisis plan

Legal Tools & Promising Practices

Tools for families (cont.): Notify school of mental health hospitalizations

Using discretion, provide school with relevant information from outside providers and records to assist in school-based planning

Request documentation of all school disciplinary events

Garner community-based allies and supporters (social workers, hospital providers, etc.) who can assist with advocacy efforts at school and will be involved in the IEP process

Legal Tools & Promising Practices

Systemic lawsuits & advocacy efforts focused on children with mental health issues

Montgomery Public Schools – Bazelon Center

Trauma lawsuit – Compton

EPSDT lawsuits

ICG grant legislation

Michael

Today, Michael is a thriving in his current school, and is a star on his school’s baseball team. On weekends, he enjoys hanging out on his family’s Farm in Michigan.

EFE was able to advocate to have Michael’s illegal expulsionrescinded and placement changed back to his neighborhoodmiddle school. If his parents would not have advocated for hisrights, he would likely still be segregated from his peers,with an expulsion on his permanent record.