As family members, all of us would agree our children are complex. Instead of degrees behind their names, they often have multiple diagnoses and special education codes. They may have co-occurring substance abuse or developmental disabilities accompanying their mental health needs. The state of Maryland is beginning to look at the needs of children and youth with co-occurring disorders. As the mother of a child with mental health needs and developmental disabilities, it has always been a challenge to find services that address both disabilities; the same is true for youth with substance abuse and mental health issues.
Before the Coalition begins working on any initiative, we make it a practice to reach out to families and listen to their needs so we can bring the voices of many families to the table. We will be scheduling focus groups around the state to meet with families whose children have co-occurring disorders. We know the needs are great in this area and we are pleased that, at least, this is a start.
- Jane A. Walker
Executive Director
Important Legislation for Our Children
Annapolis is a busy place these days with the legislative session in full swing. There are two bills of particular interest to families caring for a child with mental health needs.
The first bill (House Bill 11/Senate Bill 204) changes the special education label for students coded 06, Emotional Disturbance. The bill, titled the "Student Stigma Act," would change the label from Emotional Disturbance to Emotional Disability, which is a less stigmatizing term conveying that mental health needs of children are a disability affecting the child's ability to learn. The bill would not change the eligibility criteria. Many families, youth and educators have told us the term Emotional Disturbance is degrading, and we hope this legislation will communicate a very different message about our children.
The second bill (House Bill 260/Senate Bill 504) requires schools to provide families with copies of documents five days in advance of the IEP meeting at which parents and school staff will be making education decisions based on those documents. Both federal and state laws support parent participation in meetings as partners with school staff; without the ability to prepare for meetings by reviewing documents ahead of time, as school staff are able to do, parents cannot effectively be partners in the special education process. At the hearing in the House for this bill, there was strong support from delegates, many of whom had been through the IEP process with their own children.
Both of these bills must make their way through the legislative process and, while passage of these bills looks hopeful, we will not know with certainty until they are voted on by the General Assembly in the next few weeks. Stay tuned!
Staying on Track in a Frozen World
Children with mental health and behavioral challenges thrive on routine. The recent major snowstorms have made life anything but orderly for children and their families across the state. In addition, February often ushers in the "winter blues," with its shorter hours of daylight and the natural inclination of people to spend more time at home and inside.
- So what can parents, guardians and caregivers do in this record-breaking winter to try to keep things "business as usual"? Here are a couple tips to help you through these cold, dark days:
- If your child takes medication, do your best to keep administering it on the usual schedule, even if it means waking your child up to take meds and then letting them go back to sleep.
- As much as possible, try to keep to regular bedtimes and wake times. It doesn't mean you still have to get up at 5:30 a.m. on days schools are closed, but do your best to keep to a regular schedule.
- Limit "electronic" babysitters as much as possible. Play outside in the snow, cook with your child, take a walk, play with the family pets or play cards, board games, etc. If possible and feasible, trade off play dates with other families to provide access to different games and give yourself a break.
- Older children might be able to use the time to keep up with studies, working on reports or long-range projects or even reading every day to keep in the habit.
- Older children can help out neighbors and the community by checking in with elderly and/or disabled neighbors, digging out those neighbors or the community, making and delivering food, etc.
Bullying Awareness
Schools are gaining a greater understanding of the growing need to stamp out bullying in all forms—not just in the classroom, lunchroom or playground, but also on such social media sites as MySpace, Facebook and texting, among others. And children with mental health issues can be particularly affected by such negative activity.
Bullying isn't just a responsibility of schools, however. Parents and the community at large have a role to play. Bullying prevention awareness efforts encourage communities nationwide to work together to increase awareness of the prevalence and impact of bullying on all children.
In Maryland, the 2007 iteration of the Maryland Youth Risk Behavioral Survey (YRBS), which was administered to students in selected high schools, indicated that more than 25 percent of the student respondents reported they had been harassed or bullied on school property during the previous 12 months. During the 2007–2008 school year, there were 118,834 suspensions/expulsions from school in Maryland 's 24 public school systems. Of these, 1,257 were for bullying, 1,103 were for harassment and 1,009 were for sexual harassment, representing a total of 3,369 suspensions/expulsions for these categories.
In response to those numbers, the Maryland State Department of Education in 2009 released its Model Policy to Address Bullying, Harassment and Intimidation. The complete policy and information regarding bullying can be found by clicking here.
Additional materials and information have been developed by PACER, a Minnesota center specializing in programs for children with special needs, which has a national program for bullying prevention. Families, students, schools, organizations and other groups can access activities and materials such as contests, toolkits and online bullying prevention training to help reduce bullying in schools, recreational programs and community organizations, by visiting www.pacer.org/bullying/bpaw/index.asp.
Finally, students and parents can access information on the federal government's Stop Bullying Now! Campaign by visiting http://stopbullyingnow.hrsa.gov.
Feds Issue Parity Rules
The U.S. Departments of Health and Human Services, Labor and Treasury issued new rules last month regarding parity for consumers enrolled in group health plans who need treatment for mental health or substance use disorders.
The rules follow up on the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, which prohibits discrimination and requires parity for treatment of physical, mental and substance use illnesses. That Act was a follow-up to an earlier law, the Mental Health Parity Act of 1996.
"Workers covered by group health plans who need mental health and substance abuse care deserve fair treatment," said Deputy Treasury Secretary Neal Wolin. "These rules expand on existing protections to ensure that people don't face unnecessary barriers to the treatment they need."
Under the new rules, group health insurance plans offered by employers with 50 or more workers are prohibited from restricting access to care by limiting benefits and requiring higher patient costs than those that apply to general medical or surgical benefits. In other words, plans must treat all disorders and illnesses equally in terms of out-of-pocket costs, benefit limits and such practices as prior authorization and utilization review.
The rules are effective for plan years beginning on or after July 1, 2010.
Responding to Child Sexual Abuse
An adult who hears a child tell of sexual abuse may feel uncomfortable and not know what to say or do. The American Academy of Child and Adolescent Psychiatry, through its Campaign for America 's Kids, provides the following guidelines:
- If a child even hints in a vague way that sexual abuse has occurred, encourage him or her to talk freely. Don't make judgmental comments.
- Show you understand and take seriously what the child is saying. Psychiatrists have found that children who are listened to and understood do much better in the long run than those who are not. The response to disclosure is critical to the child's ability to resolve the situation and heal from the trauma of sexual abuse.
- Assure the child they did the right thing in telling. A child who is close to the abuser may feel guilty about revealing the secret. A child may feel frightened if the abuser has threatened to harm the child or other family members as punishment for telling the secret.
- Tell the child he or she is not to blame. Most children attempting to make sense of the abuse will think they somehow caused it.
- Offer the child protection and promise you will take steps promptly to see the abuse stops.
Once the child is reassured, there are several action steps you can take:
- Report any suspicion of child abuse. If the abuse is within the family, report it to the local child protection agency. If it is outside the family, report it to the police. Individuals reporting in good faith are immune from prosecution.
- Parents should consult with their pediatrician or family physician, firstly to get a child's possible physical injuries treated and secondly to get a referral to a mental health professional for the child. Other family members who may be upset by the abuse also can get support.
Upcoming Events
6th Annual Child & Adolescent Mental Health Conference- "Clinical Updates: Highlighting Maryland’s Successes". March 23. Martin's West, Baltimore. Families are encouraged to apply. For more information contact: Joan Smith, Mental Hygiene Administration, 1-410-221-2529.
Online registration to come: http://trainingcenter.umaryland.edu
Webinar Wednesday Learning at Lunch Series—Ongoing. Innovations Institute hosts webinar seminars every second and fourth Wednesday of the month, covering such topics as early childhood mental health, trauma and the 1915 waiver. To join a webinar, click here. Enter your name and e-mail address, click "join now" and follow the instructions that appear on your screen. Note: You will need to install the webinar program if you have not already. Please leave 15 minutes to do so before the training.
Mental Health First Aid—Ongoing. Mental Health First Aid is a 12-hour training course offered by the Mental Health Association of Maryland designed to give members of the public key skills to help someone who is developing a mental health problem or experiencing a mental health crisis—to help the public identify, understand and respond to signs of mental illness. To find the dates and locations of classes, visit http://www.mhamd.org/mhfa/findclass.htm.
Special Needs Advocacy Training Institute: Everything an Advocate Needs to Know—Winter 2010 and Spring 2010. The Special Needs Advocacy and Montgomery College Workforce Development and Continuing Education present a four-session course on advocacy for parents, graduate students and professionals and school staff and administrators. Jan. 9 and 30, Feb. 20 and March 6; again on April 17, May 1, May 15 and June 5. Montgomery College Silver Spring/Takoma Park Campus, 7977 Georgia Ave., Silver Spring, Md. For more information and to register, visit http://specialneedsadvocacyinstitute.com/advocacy-training.html.
Family Resource Academy —Various dates, February–June, Saturday mornings, 9 a.m.–12:30 p.m. Villa Maria, 2300 Dulaney Valley Road , Timonium. Catholic Charities of Baltimore program to provide support to Baltimore County families raising a child with intensive behavioral health needs and who currently receive services from Catholic Charities Child & Family Services. Registration is required; the first workshop was scheduled for Feb. 13. For more information, contact Stephanie Maskovyak at 410.252.4700 ext. 265 or 410.628.0245, or e-mail smaskovy@cc-md.org.
From Surviving to Thriving—Various dates, February–June, Saturday afternoons, 12–3 p.m. Series of parent education/advocacy workshops for parents of children with disabilities (especially younger children). Sponsored by the Chesapeake Down Syndrome Parent Group. Dates are Feb. 20, March 20, April 10 and May 15. Presentation by Kathie Snow, author of Disability is Natural, planned for June. Towson Unitarian Universalist Church . Registration required; small fee; refunds possible if all five sessions are completed. For more information or to register, contact Claire Holmes at 410.372.0618 or cholmes@towson.edu.
High Noon WebCafé Webinar—March 18, 12–1 p.m. Maryland Coalition presents "Parenting a Child Who Has Intense Emotions Using DBT Skills," presented by Pat Harvey, LCSW-C. One-hour webinar discusses how Dialectical Behavior Therapy Skills can be used to help your child regulate emotional outbursts and aggressive behaviors. Registration is limited to 20, and pre-registration is required. Telephone conference call is available. For more information, contact Carol at callenza@mdcoalition.org.
Maryland Access to Justice Commission Listening Event—March 23, 3–5 p.m. Our Daily Bread, Baltimore . The commission is seeking opinions and feedback from citizens to help it make and implement recommendations to expand access to the state's civil justice system, including juvenile court. Register online at www.mdcourts.gov/mdatjc, and find directions as well. There is no cost to attend. Registration is required.
Maryland Access to Justice Commission Listening Event—April 20, 6–8 p.m. Maryland Court of Appeals, Annapolis. The commission is seeking opinions and feedback from citizens to help it make and implement recommendations to expand access to the state's civil justice system, including juvenile court. Register online at www.mdcourts.gov/mdatjc, and find directions as well. There is no cost to attend. Registration is required.
Mission Impossible? Addressing Behaviors in Challenging Children—May 4, 8:30 a.m.–4 p.m. Atlee Kepler Theater, Hagerstown Community College . Full-day course for those who live and work with children with challenging behaviors will present interventions, treatment approaches and practical strategies to help those living and working with children and adolescents who have been traumatized as a result of abuse, neglect, family violence and/or other major life experiences that have significantly disrupted their neurological, psychological and emotional development. Fee required; family rate available. For more information and reservations, call 301.790.2800, ext. 236, or visit www.hagerstowncc.edu/coned/seminars.
