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Mental Health Principles to Guide the 2002 Individuals with Disabilities Education Act Reauthorization

The Center for Mental Health Services indicates that 11% of children in the U.S. have a serious mental disturbance that is accompanied by significant impairment, in home, school, and/or social contexts.  Unlike outdated notions concerning children's mental health, it is now well recognized that these problems are not "just a stage" or simply a function of poor parenting or crowded classrooms, but are instead the result of a complex interplay of individual genetic, environmental, developmental, and physiological factors.  In any given year, it is estimated that one in five children and adolescents have a mental health disorder, yet fewer than 20% of these children receives needed treatment. The long-term consequences of untreated childhood disorders are costly, in both human and fiscal terms.

The Individuals with Disabilities Education Act (IDEA) assures eligible children with disabilities a free, appropriate public education.  It has several sections: Part B provides grants to states to implement services to preschool and school-aged children. Part C provides grants to states to implement statewide comprehensive systems of early intervention services for infants and toddlers with disabilities and their families. Part D provides grants to create and support the special education infrastructure through research, dissemination, applying research findings to instructional practice, parent training, and effective personnel preparation and technical assistance. Part B is permanently authorized.  Parts C and D are scheduled for reauthorization in 2002.

The mental health community hopes to build on efforts in the 1997 reauthorization that placed a greater focus on inclusion by providing appropriate services through positive behavioral intervention and support, rather than on exclusion through disciplinary action and cessation of services.  In addition, we seek to further family and youth involvement.  Schools should partner with both the student and the family with special needs to facilitate meaningful involvement in the Individualized Education Plan (IEP) process.  Increasing the knowledge of both the family and student concerning the IEP process will allow team members to work more effectively in designing the education plan for that student and allow for more successful outcomes.  Effective collaboration and partnership enable teachers, families and mental health professionals to have a better understanding of the needs of the child, as well as help reduce the stigma associated with these illnesses.

The following principles should guide the reauthorization of IDEA in order to protect children with emotional or behavioral disorders:

Guiding Principle

Children with emotional and behavioral disorders must receive an education that prepares them for optimal intellectual, occupational, and social functioning as adults.  Related services that further this goal are an essential component of the child's education.

Eligibility

Protect the existing eligibility of students with emotional or behavioral disturbances.  Of the challenges that continue to face special education regarding children with emotional and behavioral disorders, the problem of eligibility is one of the most pressing.  The current emotional disturbance eligibility definition is based on outdated concepts and has little or no empirical support.  The proposed emotional and behavioral disorders definition, on the other hand, has been a collaborative development of many professional and parent groups and draws on a sound empirical base.  Emotional or mental disorders often manifest themselves through overt behaviors; therefore, both the emotional and behavioral aspect of the disorder need to be addressed in a definition outlining eligibility for IDEA services.  As each state now reconsiders changing its existing terminology and definition in response to the 1997 IDEA reauthorization, which dropped the term "seriously" from the "serious emotional disturbance" definition, the emotional and behavioral disorders terminology and definition takes on added significance.

Effectiveness of Implementation

Create results-based, as opposed to process-based, performance measures.  Many of the reforms enacted in the last reauthorization aim at raising the outcome measures of special education including graduation, academic achievement, and attendance rates.  States are also required to develop performance goals and indicators that are aligned, to the maximum extent possible, with the State's general education performance goals and standards.  Nothing in IDEA precludes high standards and accountability.

Increasing access to related services is crucial to children with mental health needs.  Although required, psychological services and counseling are often not available to children in special education.  Addressing mental health and behavioral disorders aids in the removal of barriers to learning and enhances classroom management.  Current research demonstrates that when a comprehensive range of school and community-based services, including quality mental health services, is provided, students achieve superior outcomes and improved educational performance.  The lack of qualified providers, such as school social workers, school counselors, child and adolescent psychiatrists, school psychologists, and other qualified psychologists, must be addressed in order to provide these services most effectively.

Improve enforcement by local, state, and federal government.  The Department of Education must ensure that state special education programs comply with the IDEA.  To do this effectively, the Department must have adequate data regarding IDEA implementation to validate its monitoring and the capacity to sanction states when necessary.  Sanctions should be predictable and applied equally to all states and territories, based on student outcomes.  Compliance with the law's due process requirements is also essential for parents to ensure accountability for their children's educational programs.  Similarly, states have a duty to require local educational agencies to comply with the law, and need the same tools as federal enforcement agencies in order for true accountability to exist.

Improve training and professional development.  Too often school personnel have not received the necessary training in effective methods of educating students with emotional and behavioral disorders. A majority of students with emotional and behavioral disorders spend many of their school days in general education settings. For this reason, ensuring that general educators have the skills and the commitment to work effectively with students with emotional and behavioral disorders is paramount.  The presence of qualified personnel is critical to achieving positive student outcomes. A contributing factor to high dropout rates among students with emotional and behavioral disorders is the shortage of qualified personnel.  Recruitment and retention of qualified personnel is a critical component of educational accountability.

Transition planning and transition services must be included in a child's Individualized Education Plan.  Students must be assisted in the transition from school-based services to adult services, including vocational rehabilitation programs, higher education and employment. Helping a student plan and prepare for transition involves providing the student with a coordinated set of services that will help the student move from school services into a very different adult system.  The student should be involved in the development of any transition planning and the IEP should reflect the student's interests and allow for classes and training that will contribute to his or her success after leaving school.

Require schools to report on success of special education programs.  In order to be effective learning environments, schools need to be safe and orderly.  Creating a "school-wide IEP" for all children will help achieve this objective.  Efforts to achieve this goal must be based on an understanding of the nature of the child's disability and the effect of the disability on behavior.  School districts should be required to disclose their successes in special education and allow the Education Department to compile a national "best practices" document that could assist other school districts to replicate those successes.

Discipline

Ceasing educational and other services for students as a means of discipline violates the goal of "leaving no child behind." IDEA should continue to provide safeguards to ensure that children and adolescents with mental health related disorders who engage in misconduct are not deprived of educational services.  When education and services are denied, students are more likely to become involved in illegal activities.  School dropout rates and delinquency will increase and communities will be less safe. Furthermore, loss of progress due to lack of services is particularly difficult to recoup for students with emotional and behavioral disorders. Cessation of services should be prohibited because it is inappropriate and does not address the root of the problem.

Promote the use of positive behavioral supports. Positive behavior support is the application of positive behavioral interventions and systems to achieve positive change -- an approach that is proving both effective and practical in schools.  Positive behavioral support is the application of the science of behavior to achieve socially important change with an emphasis on behavior change that is durable, comprehensive, and linked to academic and social gains.  The development of positive behavioral interventions and plans is guided by a functional behavioral assessment that is a systematic way of identifying problem behaviors and the events that predict occurrence, non-occurrence, and maintenance of those behaviors.

All schools should establish and implement research-based, effective programs that prevent school disruption.  Classroom management strategies, such as a functional behavioral assessment, is an effective evidence-based program that improves the classroom environment and increases the capacity for student learning. Positive behavior intervention programs are another tool to address the emotional, behavioral and educational needs of students.  These programs are designed as a process that includes assessment of student needs to design effective interventions and supports that effectively result in improved classroom behavior and significantly reduce classroom disruption for teachers.  Professional development is critical to reduce the level of inappropriate disciplinary actions.

Prevention and Early Intervention

States must have the resources to effectively screen and identify all eligible children for developmentally appropriate progress to maximize their ability to enter school ready to learn.  Implementing the Surgeon General's recommendations to push for more prevention and early intervention services is fundamental to lowering future health care costs and preventing a life-long cycle of school failure, juvenile delinquency, substance abuse, and entrance into the criminal justice system.  Early intervention and preschool services must be available to all eligible children. Programs authorized by Part C and Section 619 of Part B allow states to create family-centered systems of services across multiple programs and funding streams to ensure that infants, toddlers and preschoolers are prepared for school and learning.

Focus on prevention and intervention whenever possible, using research-based practices.   Dissemination of effective research-based best practices to families and service providers must be a high priority.  School-wide programs for emotional and behavioral development and social learning should also be encouraged.  Positive behavioral supports and other interventions serve to improve classroom management, prevent negative behaviors, and focus all students on learning.  States also must ensure that sufficient supports are available to all children, especially in rural areas.  Finally, IDEA's early intervention and preschool programs should be available to all eligible children.   It is vital that the Congress substantially increase funding for the IDEA early intervention and preschool programs.  Additional resources should also be available so that all children suspected of having a disability can be screened in all areas of development.   Other state efforts should be enhanced to assure that no child is left behind.

Improve Quality of Special Education Services

Foster interagency collaboration to allow schools to make use of community resources.  With a startling 60 - 75 percent of young people in the juvenile justice system having a mental health disorder, special education should partner with the Department of Justice.  Given that many general health indicators at birth or in early childhood are precursors to disabilities later in life, a partnership with the Department of Health and Human Services (HHS) would also help children stave off complications related to their disability.  As HHS is the primary reservoir of preventive health services, it would be a lost opportunity for children with emotional and behavioral disorders not to receive the treatment they need.

Increase and encourage collaboration at the State and local level among government agencies that serve children.  Schools cannot do it alone.  Community services should be coordinated and information readily accessible to families regarding available community support and services.  Families that are eligible should be made aware of the range of medical and non-medical supports and services including wraparound services, as well as federal programs such as Head Start and Medicaid, including Early and Periodic Screening Diagnosis Treatment (EPSDT).  All agencies that serve children should have a coordinated approach and work to increase collaboration at both state and local levels to improve educational outcomes for children.

Endorsing Organizations:

American Academy of Child and Adolescent Psychiatry

American Counseling Association

American Psychiatric Association

American Psychological Association

Bazelon Center for Mental Health Law

Children & Adults with Attention-Deficit/Hyperactivity Disorder (CHADD)

Federation of Families for Children's Mental Health

National Alliance for the Mentally Ill

National Association of Protection and Advocacy Systems

National Association of School Psychologists

National Association of Social Workers

National Mental Health Association

School Social Work Association of America