Mental Health in Schools Act

I read some really interesting news from the USA today. Mental Health in America reports that new legislation is being introduced by Rep. Grace Napolitano (D – Calif.) who is co-chair of the Congressional Mental Health Caucus: the Mental Health in Schools Act. 

As far as I can tell from the news reports, this Act will provide a means to address the mental health care needs of children and youth by providing funding for a variety of mental health related activities, including safe schools, early identification and referral to treatment. Kudos to Rep. Napolitano!

This is what I would like to see happen in Canada. First, wouldn't it be a neat idea if we had a mental health caucus in Parliament – non-partisan, committed to moving the mental health agenda forward.  When I become the federal MP for Halifax, I will work to establish this kind of structure. Second, this Act sounds like it may do some good. Although I do not know the details, it seems that it will provide funding to support evidence-based school mental health programs and improve case identification and linkages to mental health services. 

This almost sounds like the model that we developed a few years ago and have been piloting in Nova Scotia and elsewhere in Canada. This “Pathways to Care Model” has been described in various publications (including an upcoming entry in the McGill Education Journal) and an overview can be found on our website. If we can only improve the identification and referral to effective care pathway for young people, we would make great strides forward in improving youth mental health and advance economic, social, family, civic and personal success through secondary prevention following from effective treatment and follow-up. And our model adds even more – mental health literacy for students and teachers as well!

This to my mind is a good federal approach to mental health. It is focused on addressing a huge need, is grounded in best evidence and has the potential for amazing positive impact – both primary and secondary. What a difference to what is happening here in Canada!   In the area of mental health at least, we cannot keep having smug “we are so much better than the USA” self-congratulations.   Now that is a scary thought.

--Stan

Mental Health and Universities: the SFU innovation

Simon Frazer University (SFU) has taken an innovative first step in addressing mental health on campus. Launching their multifaceted program in concert with a national eating disorders awareness week SFU is putting into place a variety of mental health activities and infrastructures. These include programs that seem novel, some that we know may work and ofcourse some that may have little if any substantive impact. In one sense, this is an issue that has characterized many types of community-based mental health interventions as well as the development of mental health treatment facilities. Where numerous interventions are put into place together with the hoped for outcome of success but with little certainty in what components are necessary, which are useful and which are neither.

Regardless of this concern however, kudos to SFU for taking this initiative. Its about time. Our Transitions Program (of demonstrated effectiveness) and our staff (residence dons and faculty) mental health training programs can be used by post-secondary schools across Canada to effectively address mental health needs of students (see http://www.teenmentalhealth.org/). These however, need to be seamlessly linked to intervention and treatment programs for them to have the full range of positive effects needed. Improving mental health is an important goal but it must be linked to early identification and easily accessable effective treatments. Without that link, it is energy expanded for outcomes that are insufficent.

It is addressing this continuum that has been the focus of our work for the last three years. How do we go from mental health promotion (primarily through the enhancement of mental health literacy) all the way to support, intervention, treatment and continuity of holistic helping? 

What we have learned is that interventions must cross traditional silos of education and health providers. There are ways that we can do this and be successful. Part of the answer includes the enhancement of diagnostic and treatment competencies in primary care and reserving specialty mental health services for those students who require more intensive assistance. We are pleased that our first national program to address adolescent depression and suicide has now been made available through MD-CME at Memorial University. This web-based educational program provides both MainPro and MainCert credits. 

We are also working with groups in Nova Scotia, Ontario and British Columbia to pilot and evaluate a novel integrative model that spans the continuum from mental health promotion to care in high schools. Time and lots more work with many partners will help us better understand what needs to be there and how to make it available. Until then, many thanks to SFU for taking this important step. Look forward to seeing the results roll in.

--Stan