Southern Reynolds County R-II School District Connecting Schools, Public Health, and Mental Health 1

Southern Reynolds County R-Southern Reynolds County R-II School DistrictII School District

Connecting Schools, Connecting Schools, Public Health, and Public Health, and

Mental HealthMental Health

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Our MissionOur Mission

To partner with key To partner with key community stakeholders to community stakeholders to

provide preventive and provide preventive and therapeutic health therapeutic health

(including mental) services (including mental) services to our students.to our students.

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School Health Advisory School Health Advisory Committee (SCHACs)Committee (SCHACs)

““provide visibility for school health provide visibility for school health within the school district and within the school district and community;community;

ensure that sufficient resources are ensure that sufficient resources are allocated to school health;allocated to school health;

intervene when individuals from intervene when individuals from within or without the school seek to within or without the school seek to eliminate or unfavorably alter the eliminate or unfavorably alter the school health program;school health program;

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facilitate understanding of schools facilitate understanding of schools and community segments;and community segments;

engage representatives from the engage representatives from the local business, media, religious, local business, media, religious, juvenile justice and medical juvenile justice and medical communitiescommunities

provide resources and linkage provide resources and linkage opportunities.”opportunities.”

School Health Advisory Council GuideSchool Health Advisory Council Guide MO Coordinated MO Coordinated School Health Coalition November 2008School Health Coalition November 2008 44

Our School Health Our School Health Advisory CommitteeAdvisory Committee

Created in 1999Created in 1999 Dedicated volunteers and school Dedicated volunteers and school

staffstaff Meet at least quarterlyMeet at least quarterly Also serves as the School Wellness Also serves as the School Wellness

CommitteeCommittee Also a Community 2000 CoalitionAlso a Community 2000 Coalition

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MembershipMembership

School Nurse (Chairperson, School Nurse (Chairperson, Secretary)Secretary)

Health Room Assistant (Mentor Health Room Assistant (Mentor for Team Spirit Club (students for Team Spirit Club (students provide alcohol and other drug provide alcohol and other drug use prevention programs) and use prevention programs) and Smokebusters Club (students Smokebusters Club (students advocate for tobacco abstinence)advocate for tobacco abstinence)

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Founders of PTOFounders of PTO Business OwnersBusiness Owners Elementary counselorElementary counselor High school counselorHigh school counselor Local health care providersLocal health care providers University of Missouri Extension University of Missouri Extension

(provide free educational (provide free educational presentations for students and presentations for students and staff)staff)

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Missouri State Legislative Missouri State Legislative RepresentativeRepresentative

Reynolds County Division of Family Reynolds County Division of Family Services DirectorServices Director

Reynolds County Health Department Reynolds County Health Department StaffStaff

Whole Health Outreach: a faith based Whole Health Outreach: a faith based not-for-profit organization-Resource not-for-profit organization-Resource Mothers, Family Enhancement, Mothers, Family Enhancement, Maternal-Child Visiting Nurse ProgramMaternal-Child Visiting Nurse Program

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Sexual Assault Education and Sexual Assault Education and Prevention Program Coordinator Prevention Program Coordinator and Educatorand Educator

Friends of Reynolds County: non-Friends of Reynolds County: non-profit 501 (3) (c) organization profit 501 (3) (c) organization that seeks private sector grant that seeks private sector grant funding for the local health funding for the local health department, due to shrinking department, due to shrinking governmental funding and ever-governmental funding and ever-increasing need for community increasing need for community services (school nurse serves as services (school nurse serves as secretary)secretary) 99

““Paint Me a Picture”Paint Me a Picture”

Geographically, Reynolds County is Geographically, Reynolds County is the 6the 6thth largest county in Missouri (811 largest county in Missouri (811 square miles) square miles)

Rural, farming, logging, manufacturingRural, farming, logging, manufacturing 51,000 acres are non-taxable and 51,000 acres are non-taxable and

non-inhabitable land, belonging to the non-inhabitable land, belonging to the Mark Twain Forest and the Missouri Mark Twain Forest and the Missouri Department of ConservationDepartment of Conservation

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The Data:The Data:

Reynolds County DemographicsReynolds County Demographics

Number of Residents 2000 2007Number of Residents 2000 2007 6689 64656689 6465

Kids CountKids Count (and following data)

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8.3

81

8

76

0

20

40

60

80

100

Percent

2000 2007Year

Population Density per Square Mile

ReynoldsCountyMissouri

1212

66 63

42 41

010203040506070

Percent

2005 2006

Year

Free and Reduced School Lunch Rate


1313

21

11

23

14

0

5

10

15

20

25

Percent

2002 2007

Year

Percentage of Poverty


1414

31

16

40

20

05

10152025303540

Percent

2002 2007

Year

Children in Poverty


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Self-Reported Mental Health Self-Reported Mental Health Status Behavioral Risk Factory Status Behavioral Risk Factory Survey Reynolds County 2005Survey Reynolds County 2005

28.61% 28.61%

reported that their mental reported that their mental health was not good for two health was not good for two or more of the past 30 daysor more of the past 30 days

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Behavioral Risk Factor Survey Behavioral Risk Factor Survey 20052005

Report of alcohol drinks on any Report of alcohol drinks on any occasion in the past 30 days:occasion in the past 30 days:

56.89% responded 1-2 drinks56.89% responded 1-2 drinks 15.52% reported 5 or more 15.52% reported 5 or more

drinksdrinks

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Acts of violence occurring Acts of violence occurring in the home are likely to in the home are likely to have profound long-term have profound long-term

effects on children effects on children exposed to the violence.exposed to the violence.

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17.36% reported “Yes”17.36% reported “Yes”

Has an intimate partner Has an intimate partner EVER THREATENED EVER THREATENED you with physical violence? you with physical violence?

This includes threatening to This includes threatening to hit, slap, push, kick or hit, slap, push, kick or physically hurt you in any way?physically hurt you in any way?

2005 Behavioral Risk Survey 2005 Behavioral Risk Survey 1919

18.58% said “Yes”18.58% said “Yes”

Has an intimate partner EVER Has an intimate partner EVER hit, slapped, pushed, kicked, hit, slapped, pushed, kicked,

or physically hurt you in any or physically hurt you in any way?way?

2005 Behavioral Risk Survey2005 Behavioral Risk Survey2020

Total Unintentional InjuriesTotal Unintentional Injuries

Age-Adjusted RateAge-Adjusted Rate Reynolds CountyReynolds County 91.0%91.0% MissouriMissouri 40.9%40.9%

Reynolds County Health Department Results and Priorities Reynolds County Health Department Results and Priorities 20052005

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Self-Inflicted InjuriesSelf-Inflicted Injuries

35-64 Year old Age Group35-64 Year old Age Group Reynolds CountyReynolds County 2.8%2.8% MissouriMissouri 0.4%0.4%

Reynolds County Health Department Results and Priorities Reynolds County Health Department Results and Priorities 20052005

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April 2006April 2006Grades 6-9Grades 6-9

“Smart Tracks”“Smart Tracks”Missouri Department of Missouri Department of

Elementary and Secondary Elementary and Secondary Education Education

Survey of Southern Survey of Southern Reynolds County R-II School Reynolds County R-II School

studentsstudents2323

Smart Track DataSmart Track Data

Only 68.2% of 8Only 68.2% of 8thth & 9 & 9thth grade grade students think taking 1 or 2 drinks students think taking 1 or 2 drinks daily poses a moderate to great risk daily poses a moderate to great risk of harm.of harm.

Only 73.34% of 6Only 73.34% of 6thth grade students grade students think taking 1 or 2 drinks daily poses think taking 1 or 2 drinks daily poses a moderate to great risk of harm.a moderate to great risk of harm.

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31.7% of 831.7% of 8thth & 9 & 9thth grade grade students personally know students personally know adults who use marijuana, adults who use marijuana, crack, cocaine, or other drugs crack, cocaine, or other drugs in the past year.in the past year.

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22.2% of 822.2% of 8thth & 9 & 9thth grade grade personally know adults personally know adults who sold or dealt drugs in who sold or dealt drugs in the past yearthe past year

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57.1% of 857.1% of 8thth & 9 & 9thth grade students grade students personally know adults who have personally know adults who have gotten drunk or high in the past year.gotten drunk or high in the past year.

20% of 620% of 6thth grade students personally grade students personally know adults who have gotten drunk know adults who have gotten drunk or high in the past year.or high in the past year.

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36.5% of 836.5% of 8thth & 9 & 9thth grade students grade students report that someone in their family report that someone in their family has had a severe drug or alcohol has had a severe drug or alcohol problem.problem.

10% of 610% of 6thth grade students report that grade students report that someone in their family has had a someone in their family has had a severe drug or alcohol problem.severe drug or alcohol problem.

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““A school cannot provide the A school cannot provide the best educational opportunities best educational opportunities for students unless the barriers for students unless the barriers to learning are addressed. to learning are addressed. Schools must create an Schools must create an environment that cultivates environment that cultivates student resiliency, shared student resiliency, shared support, caring for self and support, caring for self and others, and a sense of others, and a sense of community.”community.”

Promoting Mental Health in Missouri’s Children: A Guide for Schools, Promoting Mental Health in Missouri’s Children: A Guide for Schools, Families, and CommunitiesFamilies, and Communities, Missouri Coordinated School Health , Missouri Coordinated School Health Coalition 2008Coalition 2008

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InterventionsInterventions We wanted to be proactive and preventive We wanted to be proactive and preventive

in our approach.in our approach. In 2002, we began to partner with a local In 2002, we began to partner with a local

MA LPC in private practice.MA LPC in private practice. School Nurse serves as liaison between School Nurse serves as liaison between

student, parents, LPC, and schoolstudent, parents, LPC, and school LPC counsels students during school hours LPC counsels students during school hours

at a time approved by child’s teacherat a time approved by child’s teacher Our school nurse office/health room is the Our school nurse office/health room is the

site for student pick-up/drop off to protect site for student pick-up/drop off to protect confidentiality.confidentiality.

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Benefit: No missed appointmentsBenefit: No missed appointments Benefit: Does not interfere with Benefit: Does not interfere with

out-of school “family time”out-of school “family time” Benefit: Improved access to care: Benefit: Improved access to care:

LPC transports to and from her LPC transports to and from her office (with parental permission)office (with parental permission)

Benefit: Educational concerns are Benefit: Educational concerns are addressed—organizational skills, addressed—organizational skills, coping skills, behavior modificationcoping skills, behavior modification

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Benefit: No cost to school-LPC bills Benefit: No cost to school-LPC bills insurance (majority are medicaid insurance (majority are medicaid with no co-pay)with no co-pay)

Benefit: Consistent therapy in a Benefit: Consistent therapy in a long-term relationship with long-term relationship with presentation of preventive education presentation of preventive education as it becomes developmentally or as it becomes developmentally or situationally indicated.situationally indicated.

Currently, 16.6% of our elementary Currently, 16.6% of our elementary students receive preventive and students receive preventive and therapeutic counselingtherapeutic counseling

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““Students identified with Students identified with emotional disturbances are emotional disturbances are likely to display inappropriate likely to display inappropriate behaviors or suffer from behaviors or suffer from behavioral deficits, and, as a behavioral deficits, and, as a result, have significant result, have significant problems with school problems with school functioning and interpersonal functioning and interpersonal relationships.”relationships.”

Promoting Mental Health in Missouri’s Children: A Guide for Schools, Promoting Mental Health in Missouri’s Children: A Guide for Schools, Families and Communities:Families and Communities: Missouri Coordinated School Health Missouri Coordinated School Health Coalition 2008Coalition 2008 3333

Local Access to Mental Health Local Access to Mental Health CareCare

Nearest licensed psychologist is 60 Nearest licensed psychologist is 60 miles awaymiles away

Only one of our students sees a Only one of our students sees a licensed psychologist on a “regular” licensed psychologist on a “regular” basisbasis

Currently, three other LPC’s locally, Currently, three other LPC’s locally, one other provides services during one other provides services during school time. In previous years, there school time. In previous years, there were only 2 LPC’s locally. were only 2 LPC’s locally.

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Professional Development is Professional Development is KeyKey

November 18, 2005 November 18, 2005 MO Department of Health and Senior MO Department of Health and Senior

Services educational conference, presented Services educational conference, presented regionally in Missouri, “A Missouri Bright regionally in Missouri, “A Missouri Bright Futures Workshop”, planned by Marjorie Futures Workshop”, planned by Marjorie Cole, Missouri State School Nurse ConsultantCole, Missouri State School Nurse Consultant

Our school nurse, school counselors, and Our school nurse, school counselors, and local health department maternal child nurse local health department maternal child nurse attendedattended

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Participants received the Participants received the resource, resource, Bright Futures in Bright Futures in Practice: Mental HealthPractice: Mental Health, in , in addition to the wealth of addition to the wealth of information presented orally.information presented orally.

At our next SHAC meeting, At our next SHAC meeting, brainstorming session to address brainstorming session to address health (including mental) issues health (including mental) issues and create action plan for and create action plan for intervention.intervention.

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InterventionsInterventions

Spring 2007, 2008, 2009 Spring 2007, 2008, 2009 County Outreach Motivational EventCounty Outreach Motivational Event Offered to parents, grandparents, Offered to parents, grandparents,

other interested community membersother interested community members Educate and empower adults to Educate and empower adults to

promote safe and healthy behaviorspromote safe and healthy behaviors

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Free local offeringFree local offering Free child-care by high school Free child-care by high school

Child Development class Child Development class Chili-supper at $5 cost (a fund-Chili-supper at $5 cost (a fund-

raising event by high school raising event by high school club)club)

Participants select 2 break-out Participants select 2 break-out sessionssessions

All attend 2 keynote sessionsAll attend 2 keynote sessions3838

Keynote Sessions 2009Keynote Sessions 2009

““Underage Drinking: You Can Underage Drinking: You Can Prevent It When They are Under Prevent It When They are Under Your Influence”: Presenter-Your Influence”: Presenter-Director of Court Monitoring, Director of Court Monitoring, Mothers Against Drunk Driving Mothers Against Drunk Driving (MADD) Missouri(MADD) Missouri

““Prescription Drug Abuse”Prescription Drug Abuse”

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Break-Out Sessions 2009Break-Out Sessions 2009

““Handling Difficult Situations with Handling Difficult Situations with Your Child”: Presenter-Elementary Your Child”: Presenter-Elementary CounselorCounselor

““CSI: Creating Strong Individuals”: CSI: Creating Strong Individuals”: Presenter, Local LPCPresenter, Local LPC

““How Can I Help Kids/Teens Who Self How Can I Help Kids/Teens Who Self Harm?”: Presenter HS CounselorHarm?”: Presenter HS Counselor

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““Sexually Transmitted Infections Sexually Transmitted Infections (STI’s) What You Need to Know”: (STI’s) What You Need to Know”: Presenters-- Missouri DHSS STI Presenters-- Missouri DHSS STI Educator and local health Educator and local health department maternal child nursedepartment maternal child nurse

Also presented to high school Also presented to high school health classes that morning.health classes that morning.

Underage Drinking”: MADD: Also Underage Drinking”: MADD: Also presented to students grades 7-presented to students grades 7-12 that morning.12 that morning.

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““Working Together to End Dating Working Together to End Dating and Sexual Violence Through and Sexual Violence Through Education”: Education”:

Also presented in a series of Also presented in a series of lessons to middle and high lessons to middle and high school students in 14 schools in school students in 14 schools in five local counties since 2007 five local counties since 2007 through Friends of Reynolds through Friends of Reynolds County Grant via Missouri County Grant via Missouri Foundation for Health Funding Foundation for Health Funding

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Topics in previous years Topics in previous years includedincluded

Underage drinkingUnderage drinking GothicGothic Suicide PreventionSuicide Prevention Eating disordersEating disorders Nutrition and Physical ActivityNutrition and Physical Activity Substance Abuse preventionSubstance Abuse prevention

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2007 Elementary counselor 2007 Elementary counselor began presenting “Bright began presenting “Bright Futures”: My Healthy Family Futures”: My Healthy Family (includes mental health) to (includes mental health) to grades preschool-6grades preschool-6thth grade grade annually as part of classroom annually as part of classroom curriculumcurriculum

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2007 School Board approval for 2007 School Board approval for “Family Living” Class as mandatory for “Family Living” Class as mandatory for all 10all 10thth grade students grade students

Previously an elective classPreviously an elective class What makes a healthy, safe, family What makes a healthy, safe, family

unit? (includes mental health issues)unit? (includes mental health issues) Now alternates with state-mandated Now alternates with state-mandated

“Personal Finance” class for 10“Personal Finance” class for 10thth grade grade

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A Public Health Approach to A Public Health Approach to Mental HealthMental Health

Working Together . . Working Together . . . Working Smarter. Working Smarter

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Documents

Southern Reynolds County R-II School District Connecting Schools, Public Health, and Mental Health 1