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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 Unlike outdated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