Meeting the New Mental Health Promotion and Education PRH Requirements

1. V Valerie Cherry, PhD Lead Mental Health Specialist Humanitas, Inc. Meeting the New Mental Health Promotion and Education PRH Requirements

2. In This Webinar • Participants will review the new PRH requirements for the Mental Health and Wellness Program. • Participants will be introduced to the specific templates and/or curriculums for the CPP, CDP, and CTP presentations for students. • Participants will be provided suggestions for annual center-wide activities.

3. You May Be Feeling…..

4. Overall Program Changes • PRH Chapter 6: 6.10, R3 • More emphasis on mental health promotion, prevention, and education for students and staff • Stronger integration with TEAP

5. New PRH Requirements • Six hours/100 students/week is the minimum required level of mental health coverage by a qualified licensed mental health professional. • 50 percent must be used for a combination of the following activities: mental health promotion, prevention, and education for students and staff; consultation to center director and staff; annual trainings; disability program support; or TEAP support.

6. New PRH Requirements • Assessment and recommendations for Job Corps applicants • Mental Health Promotion and Education

7. Promotion and Education • 6.10, R3(c) • 1-hour presentation on mental health promotion and education in CPP to include: • Description of the mental health and wellness program, what services are available, and how to make a self-referral. • Basic skills in identifying and responding to a mental health crisis. • Career Development and Transition Period presentations • One annual center-wide activities • Consultation with staff around prevention and education efforts • Coordination with other departments/programs

8. CPP Presentation Template • TIME FRAME • 30-60 minutes • GOALS • To provide students with an overview of the Mental Health and Wellness Program and the services available to them while in Job Corps. • To provide information on how to identify and respond to a mental health crisis. • MATERIALS • Handout or brochure that details services offered. (Center to create own)

9. What does it look like? • Part 1 • Introduction and overview of mental health and wellness services • Assessment, Promotion and Education, and Treatment • Part 2 • Identifying and Responding to a Mental Health Crisis • Preventing suicide and violence • How to help someone in crisis

10. Preventing Suicide • Provide general information on suicide. • Review warning signs of suicide and the importance of immediate intervention with key warning signs such as: threatening to hurt or kill self or talking about wanting to kill self; looking for ways to kill self; seeking access to pills, weapons, or other means of killing self; talking or writing about death, dying, or suicide.

11. Helping a Friend In Crisis • Discuss the importance we all play in helping people in crisis (e.g., most people in crisis do not seek help from professionals, but often provide warning signs to their friends and family). • Review the three steps of QPR: Question, Persuade, Refer ** • Question: Review examples of direct questions about suicide or violence (e.g., “You look pretty upset. Are you thinking about hurting yourself or someone else?”) • Persuade: Encourage students to listen to friends who share upsetting thoughts or display troubling, harmful, or dangerous behavior, and encourage them to seek help from their RA, counselor, instructor, HWC, or other trusted center staff member. • Refer: Provide students with on-center and off-center resources (including what to do if crisis occurs in the evening/night; ensure that students know how to immediately get help if needed). • Discuss how to handle a situation if a student will not seek help. ** For more information about QPR go to http://www.qprinstitute.com

12. I DON’T HAVE TIME! CPP POWERPOINT

13. CDP and CTP Presentations • More flexibility with these presentations in terms of format, topics and time allocated. Fit into existing center processes. Make it work for you and the students! • Health Education Classes • 90-Day Grad Program • CDP—Focus is on tying success in JC to managing emotions and behaviors which equals EMPLOYABILITY. • CTP—Focus is on helping students finish strong and using the CTP activities as a recipe for lifelong success and EMPLOYABILITY.

14. CDP Presentations Emotional and Social Well Being Curriculum • Goal: Teach students life skills including empathy, gratitude, dealing with conflict, assertiveness, and standing up for their friends. They contain discussion topics, classroom lessons, and worksheets. • Activities: Curriculum with discussion topics, classroom lessons and worksheets. • IMPORTANT: Consider the ethnic and cultural make-up of your center and adapt any activities to be sensitive and relevant for the group you serve. Special thanks to Dr. Lisa Adriance, CMHC, Cascades JCC Sonja Depratt, CMHC, Joliet JCC

15. Outline of CDP Curriculum • Activity 1: Gratitude • Activity 2: Emotional Awareness • Activity 3: Empathy • Activity 4: Standing Up for What’s Right • Activity 5: Dealing with Conflict and Confrontation • Activity 6: Assertiveness • Activity 7: Goal Setting

16. CTP Presentations Helping Students Finish Strong • Goal: Feelings of competence/success reinforced when students are reminded they have successfully completed the first three phases of JC. • Activities: • Brainstorm what factors helped with success in earlier phases including: • Personal/individual strengths: high motivation, focus on goals and better future, etc. • External structure and routine: waking up at set time, set daily schedule and expectations, etc. • Support/mentoring: helpful and supportive instructors, RAs, counselors, H&W staff • Access to care services: support with not using drugs/alcohol, medication compliance for mental health and/or health problems

17. CTP Activity Example I As a group, have students identify common challenges and worries they have during the CTP phase. What are the potential challenges they may have transitioning to work and leaving Job Corps? (List these on the whiteboard). If students have difficulty with this, it might be helpful to raise some of the following issues: • Access to healthcare (e.g., access to medication and medications) • Conflict with family members/challenges of moving back home (e.g., how to have adult relationships with parents) • Healthy living (e.g., eating well/regularly, access to gym/recreation/exercise, avoiding drugs/alcohol) • Developing healthy relationships, setting boundaries • Conflict with supervisors • Conflict with coworkers

18. CTP Activity Example II • Provide each student with a pen and one or two Overcoming Barriers • Ask students to take a few minutes to identify one or two challenges they feel they may have during CTP. Write each area on top of the Overcoming Barriers worksheet. • Provide an example of how to complete the Overcoming Barriers worksheet. • Allow ten minutes for students to complete their own Overcoming Barriers worksheet. Walk around and assist students as needed. If the group is cohesive and open with each other, students could complete this activity in pairs to assist each other.

19. CTP Discussion Topics • Conflict with parents, supervisors, peers • Assertive communication skills • Distress reduction strategies • Coping with different communication styles • Anger management • Sleep problems • Sleep hygiene/strategies to get to sleep and stay asleep • Issues with sleeping medication • Stress • Stress reduction strategies • Controlling responses to stress • Developing healthy relationships • Boundaries, relationship-building skills • Education regarding dating violence/healthy romantic relationships • Parenting Challenges • Parenting styles, behavior management • Access to healthcare • How to find/access health resources • Relapsing on drugs/alcohol • Access to resources, developing relapse prevention plan prior to leaving Job Corps • Housing/living resources • How to access resources in area • Returning to violent community • Realistic safety planning • Increasing mental health symptoms • Recognizing mental health problems • Continuing healthy behaviors initiated in Job Corps

20. More Promotion and Education • One center-wide activity annually • May is Mental Health Awareness Month • http://www.mentalhealthamerica.net/go/may • World Mental Health Day – October 10th • Outside speakers/activities • Joint participation in Health and Wellness Fair • Various contests (e.g., poster, rap, spoken word) – Partner with HEALs • Mental Health and TEAP presentations at assembly/business meeting • Mental Health and TEAP sponsored recreational activities • Your ideas about center-wide activities?

21. Supporting TEAP • In presentations to staff and students include information on the relationship between substance use and mental health. • In psycho-educational groups show students connections between substance use, mental health, and coping skills. • Include AOD information in center-wide activity. • Assist with relapse prevention programming for students with co-occurring disorders. • Other suggestions? • Proposed August Webinar on Co-occurring Disorders

22. MENTAL HEALTH AND WELLNESS PROGRAM COMMON REGIONAL OFFICE CENTER ASSESSMENT (Roca) CONCERNS AND SOLUTIONS

23. ROCA Concerns and Solutions • Information exchange through regular case conferences between the Center Mental Health Consultant, counselors, and other appropriate staff based on individual student needs not documented in SHR. • Form to document case management meetings for each student in the SHR • Take mental health meeting notes on paper with pre-typed headings (e.g., date of meeting, student name, and plan). These notes can then be photocopied, with one copy remaining as the meeting minutes, and the original section being placed in the relevant SHR. • Maintain one copy in counseling and cut/paste the other into individual SHRs. • Sample Form for Documentation of Case Management Meetings with Career Counselors.  

24. ROCA Concerns and Solutions • A written referral/feedback system is not established and/or feedback is not provided to the referral source and documented in the SHR • Referral/feedback form in the CMHC Desk Reference Guide (DRG) for information exchange between the CMHC, counselors, and health and wellness staff. • Success Management Plan in the CMHC DRG for providing information back to other referral sources (e.g., academics, trade), which includes only behavioral information. • The original with feedback should be in the SHR. A copy with the recommendations should be provided to the referral source. • Revised CMHC Referral and Feedback Form which does not include any diagnostic information and focuses on gathering information from staff and strategies for staff to use with students. (Thanks to Dr. Alec Mendelson, CMHC ,Tongue Point) Forms in the DRG can be modified to fit the needs of the center.

25. ROCA Concerns and Solutions • No or limited collaboration with counseling staff in developing and/or leading psycho-educational skill-building groups to promote wellness. • Relaxation training, anger management, mood regulation, assertiveness skills, handling relationships, sleep hygiene, etc. • CDS Curriculum • Other Ideas?

26. ROCA Concerns and Solutions • Students with MH disabilities not entered in the disability data • Psychotropic Medication = Disability Data (unless adjustment disorder). • May or may not have accommodation plan • Accommodations for students with MH disabilities not considered or documented. • All applicants with documented mental health disabilities should be interviewed (in person or by telephone) by the RAC (including, at a minimum, the CMHC and DC) during the application process.  Clinical notes from these interviews should be part of the applicant’s SHR (if enrolled) and should include either a statement that the applicant denied accommodations or refer the reader to the accommodation file for accepted accommodations. Applicant should be scheduled to see the CMHC upon arrival and a case management plan developed. • Proposed July Webinar on MH Accommodations for CMHCs

27. Common ROCA Observation • Charting does not reflect employability focus • How does the student’s current behavior impact being employed and what self help strategies or skills can you introduce to them and encourage them to practice. COPING STRATEGIES! • Anxiety – Mindfulness Meditation, Progressive Relaxation Training, Diet Choices • Anger – Thought Stopping, Emotion Regulation, Problem Solving • Mood Swings – Mood Charts, Exercise • Non-Suicidal Self Injury- Journaling, Self-soothing, Safe Alternatives

28. HELP PAYING FOR MEDS? • Partnership for Prescription Assistance– Many will get their medications free or nearly free. For more information, call 1-888-477-2669. https://www.pparx.org/ • Together Rx Access– Can help qualifying patients without prescription drug coverage save on hundreds of name-brand and generic products and connect patients to resources about coverage options.  For more information, call 1-800-444-4106 or visit http://www.togetherrxaccess.com. • RX Hope has program descriptions and downloadable applications for prescription assistance programs for specific medications including psychotropic medications. https://www.rxhope.com/ • Needy Meds – Find help with cost of medicines. http://www.needymeds.org/

29. Downloads Available Today • The PowerPoint • CPP Template • CPP PowerPoint • CDP/SEL Curriculum • CTP Curriculum • Documentation of Case Management Form • Revised Mental Health Referral and Feedback Form

30. MOVING FORWARD!