Stopping Schizophrenia in Its Tracks

Tuesday, October 28, 2014

Stopping Schizophrenia in Its Tracks

By Darcy Gruttadaro, Director, NAMI Child and Adolescent Action Center

http://blog.nami.org/2014/10/stopping-schizophrenia-in-its-tracks.html

For those experiencing psychosis, early identification and intervention matter—a lot. It lessens the long-term severity and often prevents psychosis from worsening. An effective early identification and intervention program should include the following coordinated array of services and supports:

·      Supported education and employment.
·      Cognitive behavioral therapy.
·      Peer support.
·      Family support and education.
·      Case management.
·      Community outreach.
·      Low dose antipsychotic medication.

These services work so well because they are offered together to provide the skills and support that youth and young adults need to get better. They also take into account the context of a young person’s life and the key role that peers and families play in recovery.

FEP (First Episode Psychosis) programs reduce costly hospitalizations and put youth and young adults with psychosis on an early path to recovery.

When you fund upstream interventions, you can prevent the tragedies associated with untreated mental illness: school failure, unemployment, hospitalizations, homelessness, jail and suicide. Investing in effective programs that intervene early produces far better outcomes for individuals, families and communities.

There are effective strategies available, so why aren’t more young people getting help? One of the main reasons is that these services and supports are simply not available in communities. However, there has been progress made recently that to help ensure the availability of these resources in more towns and cities across the U.S.

One significant event is that Congress has now required states to use 5 percent of their Mental Health Block Grant for First Episode Psychosis (FEP) programs. This means that states are obligated to set aside a certain amount of their federal funding to address the importance of early intervention.

How Is NAMI Helping

We recognize the urgency in expanding these programs. Our advocacy work and involvement in these programs is happening at all levels of the organization.

NAMI NYC Metro is partnering with OnTrackNY, an FEP program, in providing support groups and peer support for youth and young adults experiencing early psychosis. NAMI Connecticut is offering peer-run young adult support groups located close to FEP programs to make it easy for young adults to join. NAMI Minnesota has partnered with an FEP program and is creating education and support programs for youth experiencing early psychosis and their families.Oregon was an early adopter of these services and supports, having witnessed the success of these programs in Australia. Tamara Sale, the director of the Early Assessment and Support Alliance (EASA) in Oregon and a former long-time NAMI Oregon board member, shared how their program works successfully with youth and young adults experiencing early psychosis.

The EASA program recognizes that it can be difficult to engage youth and young adults experiencing early psychosis, so it uses strategic community approaches that meet young people where they are with messages of hope and relevance to their lives. They are flexible and persistent, even with youth and young adults that seem entirely uninterested in mental health care.

What You Can Do

FEP programs exist in a handful of communities and more must be done to spread these programs across the country. Here is how you can make sure that happens. Learn more about FEP programs. Understand why these programs are pivotal in creating better outcomes.Email or Tweet your Congressional members to thank them and to ask for their continued support of FEP programs.

Connect with your NAMI Affiliate in advocating at the state and federal levels for FEP programs so that youth and young adults experiencing early psychosis can access effective services and supports.

We can and must change the trajectory of people’s lives by intervening early with recovery-oriented and effective services. We simply cannot afford to wait.

Collaborating with students: Invite them to the IEP process

   

Collaborating with students: Invite them to the IEP process

Written by: Dr. Pamela Hill (http://exclusive.multibriefs.com/content/collaborating-with-students-invite-them-to-the-iep-process/education)

In the typical special education scenario, the special education team sets the goals for the student receiving an Individual Education Plan. However, at the age of 14 the student reaches the age of transition and begins to collaborate with the special education team to plan goals for his future.

The law intends that students can be involved with any transition decisions before age 14, which may include discussion of student goals and accommodations needed to be successful in school. But it is rare that a student attend his own IEP meeting before age 14, and there is little research to show that students are participating in developing their own IEP goals before age 14.

Does it really matter if the student participates in his IEP meeting before the law recommends he does? A poignant article written in 2006 called "Why is this cake on fire?" compared attending an IEP meeting to attending a child's own birthday party. The child was not invited year after year, and then when he finally was invited as a teenager he saw no reason to attend.

The meaning of the metaphor was clear. The child needs to attend — and be involved in a greater way — well before he is a teenager if we expect him to understand that the IEP is written as a plan for his success.

The crux of the IEP are the goals set to guide the student's educational process for one school year. There is plenty of support for students writing educational goals as a means for improving their own learning. Student-written goals can be a motivating factor for achievement in school and for attainment after school.

Wood, Karvonen, Test, Browder and Algozzine have delineated that students can begin to write simple goals with adult assistance at age 6. Beyond age eight they can set goals independently, determine actions and make changes to actions to meet the goals. Teaching students to write goals in the classroom can lead to a natural transition for teacher-student collaborative IEP goal development.

Discussion with students regarding their school goals will begin the process of looking to the future and then planning the steps to get there. Students can be taught that all types of goal development follow a simple pattern of questioning to guide decision-making.

·      What do you want to happen and why is it important?

·      By when do you want it to transpire?

·      What steps will be needed to make it measurable and successful?

·      How will you know when it is met?

Students need to develop goals that are realistic and achievable, and ones that are mastery-type goals. According to Alexandra Usher and Nancy Kober, mastery goals "involve demonstrating increased understanding, skills and content knowledge" which leads the student to "deeper cognitive processes, strategize more effectively, and more adaptable to changes."

Many students — especially those with learning disabilities — do not understand that a desired effect occurs by planning and negotiating the actions that lead to an outcome. Many think they have no control of their school accomplishments. However, students who develop and follow their own goals have an increased opportunity of developing positive motivation, self-efficacy and self-determination when meeting goals and experiencing success.

Once an educator makes the choice to include the student in the IEP process and not just "do it for them," she is making a choice that will influence the student for the future. The goals belong to the students, not the educators. It makes sense that the students take hold of the process early, and when they reach the age of transition they will already have a plan that has deep roots in success.