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Miami-Dade Schools Adopt Foundation’s ‘Typical or Troubled?’ Program

Abstract

It’s not easy to assess whether teens need mental health care, but the Miami-Dade County public school system adopts an American Psychiatric Foundation program in an effort to get the answers.

The Miami-Dade County public school system has chosen the American Psychiatric Foundation (APF)’s “Typical or Troubled?” school mental health education program for use in all of the district’s public middle and high schools.

The program will train teachers, school psychologists, social workers, and guidance counselors on how to identify potential mental health problems and then refer students to mental health services as needed.

Photo: young students.

The Miami-Dade County school system—the fourth-largest school system in the country—has voted to implement the “Typical or Troubled?” program of the American Psychiatric Foundation. The program trains teachers and other school personnel to identify students who are at risk for mental health problems and refer students to appropriate mental health services.

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“If we are to seriously address the problem of mental illness, it will take the whole community linking hands and focusing on the teen years, when so many mental disorders first emerge,” said Miami-Dade Superintendent of Schools Alberto Carvalho. “The ‘Typical or Troubled?’ program is the best way we know of to do that.”

The program will begin with English and Spanish (“Típico o Problemático”) versions, and the school system is now preparing a Haitian Creole translation, as well.

The program also educates parents and other members of the public about mental illnesses and includes provisions for measuring outcomes.

“We chose ‘Typical or Troubled?’ because it had a solid research base and was pilot tested with diverse cultural groups,” said Ava Goldman, M.Ed., administrative director of exceptional student education and student support in the Miami-Dade system.

“We want to enlist all school personnel in becoming alert to early warning signs,” Goldman told Psychiatric News. “Often students who are withdrawn may make better connections with support staff at the school.”

The program has been used in more than 500 schools and school districts and has educated more than 40,000 teachers, coaches, administrators, and other school personnel across the country. The program trains school professionals to spot early warning signs and refer children who appear to be at risk to mental health professionals. The goal is to identify and treat mental health problems before they emerge as substance abuse, depression, or violence.

Miami-Dade will roll out the program in three phases, said Goldman. In March and April, the school district will start training personnel in 34 high schools with the greatest number of risk factors. The next phase will target middle-school counselors. Then all personnel will receive training during next fall’s professional development week at the start of the school year.

Teams of counselors are already in place in the Miami-Dade middle and high schools, with psychologists and social workers to back them up, so students can be referred for interventions within the schools or to community-based resources, Goldman said.

“The school is the perfect place to bring students, parents, teachers, and other school personnel together to ultimately connect those students who need help with support and treatment,” said Miami-Dade County Judge Steven Leifman, a member of the APF Board of Directors. “This program is a model program for every school community in our nation.” ■

More information about the “Typical or Troubled?” program is posted at http://www.psychfoundation.org/OurPrograms/TypicalorTroubled.aspx.

Ten Years of ‘Typical or Troubled?’

“Typical or Troubled?” began as a response to the Columbine High School shooting in 1999, said former APA President Richard Harding, M.D., a professor of clinical psychiatry at the University of South Carolina School of Medicine. Harding is a former president of the American Psychiatric Foundation (APF), the public education arm of APA, and is now its treasurer.

“We talked then about what we could do,” said Harding. “We thought that training the people who are around children day in and day out might be one preventive measure.”

The name came from a teacher who asked how to tell a “typical kid from a troubled one,” he said.

“Typical or Troubled?” collaborates with other national professional and advocacy organizations that play an important role in school-based mental health, including the American School Counselor Association and the School Social Work Association of America.

Program materials were developed with the help of high school personnel and have been reviewed for medical accuracy, said APF Executive Director Paul Burke. Psychiatrists and mental health professionals use a “train the trainer” approach to educate teachers, administrators, counselors, coaches, and school social workers.

“In addition, by also educating parents, ‘Typical or Troubled?’ can help them understand when their child is truly troubled and give them concrete strategies for how to get them the help they need,” said Burke.

In the next two years, “Typical or Troubled?” plans to expand its existing in-person training program with additional Web-based, video, mobile-app, and social-media approaches, he said. That continued growth is typical of the program’s history.

“Over the last decade, APA leaders—including Drs. Altha Stewart and Gabriella Cora—whether on the board of APF, staff members, or other partners—have worked to create, evaluate, expand, and financially support a program that serves thousands of educators and students in schools across the country,” said James H. Scully Jr., APA’s medical director and CEO and chair of the APF’s Board of Directors.