Kids, Poverty and Mental Health: How Hamilton schools reach kids

Meagan Coote thought she was coming down with something when she began feelingsick at school one day.She had just started grade nine and was feeling overwhelmed and a little nauseous butbrushed it off asback-to-school jitters.

After all, starting high school was a big step forher, since shed been used to small classesto accommodate her learning disability.Now her classes were twice the size.

As the days passed, she felt more and moreoverwhelmed until one morning she woke up and couldnt get out of bed. The crushingfeeling shed been experiencing had crashed down on her.

Her mother tried to coax her out by throwing open the curtains. Maybe some sunshinewill help, she said. Meagan implored her to close them. Even the bright lights were toomuch.

The more she tried getting out of bed, the more overwhelmed she felt.

Anxiety disorder

I was actually scared to leave my room, says Meaghan, 16.Her mother took time off work and did crafts with her in her bed. After several weeks,she called the school who sent a social worker over. Meagan was diagnosed as havinga profound social anxiety disorder.When I thought back, I realized Id experienced anxiety before, recalls Meagan.

I could never speak in public and I was always nervous about going into a classroomwith other students because they would pick on us because I was a little slow.

• Read Part 1 of Kids, Poverty and Mental Health

With the help of her social worker, Meagan began the slow recovery back.

"She started with small things, like having me open the curtains rather than sitting in thedark all day. After that, she got me to go out on the porch, says Meagan.

Transition help

After about a month, Meagan was able to leave her house. To help her transition backto school, her social worker enrolled her in a school-based anxiety treatment program calledChilled,run by the Hamilton-Wentworth District School Board.

Both the public school board and the Hamilton-WentworthCatholic District School Board have programs to help studentswho are experiencing mental health problems,because they recognize that missingschooling for extended periods can set students on a slippery slope.

They also recognize that a higher proportion of students with some type of mental healthproblem come from lower income neighbourhoods, a statistic confirmed by a 2008McMaster University study which showed that children and youth who live in povertyhave three times the rate of mental health problems than those from non-poor areas.

Much of that is related to poverty-related stressors as well as problems around accessing services. As David Hoy, manager of social work services for the Hamilton-Wentworth School Board, said, I think the type of (mental health) concerns are similar(as in non-poor areas) but the volume is higher and not just around mental health butaround area of needs.

Indeed, a report by the Hamilton-Wentworthcatholic board recognized thatchildren surrounded by poverty-related stressors, like unstable housing, can be moreprone to anxiety and depression because they internalize the stress around them.

Thats why many mental health school programs are located in areas where studentslive. School boards use data from the Early Development Instrument (EDI), a made-in-Hamilton tool that has been measuring school readiness in kindergarten students since2002.

EDI data has consistently shown that children in lower income neighbourhoods are athigher risk to falling behind in school. That datareleased to CBC Hamilton for the first time for this serieshas played a critical role in the decision-making of school boards, the city of Hamilton and agencies on locating of services ininner city and lower income neighbourhoods.

A prime example of that is the compendium of services located at Sir John A.Macdonald Secondary School, where close to 40 per cent of students come from lowincome homes.

The York Boulevard school has become the hub for several health and social programswhere a health clinic office in the school acts like a one-stop shopping centre. Studentscan see a nurse practitioner, public health nurse or social worker as well as an addictioncounselor from Alternatives for Youth and a traumacounsellor (for newimmigrant students).

Instead of having the student go to services, we have the services where the studentsare.- David Hoy, HWDSBmanager of social work services

Social workers do consultations, make referrals to other agencies, help with short terminterventions and assist with accessibility problems.

Basing those services in the school has proven to be effective because its the placechildren and youth spend most of their time.

Instead of having the student go to services, we have the services where the studentsare," said Hoy.

Kids can walk through the door with any issue, mental or physical, and get connectedto the most appropriate services. If its a newcomer suffering from PTSD (post traumaticstress syndrome) theres a program for that, and if its a student needing addictionservices, someone can connect them to it.

EDI MAPS:

CBC Hamiltonis revealing Hamilton'sEDI data for the first time. This mapshows the neighbour percentages for emotional vulnerablity, one of the five domains it measures.EDI data is used to help decide where social and mental health services are best located.

The public school board also began offering a cognitive behaviour-based program forthe most aggressive and disruptive children who are at-risk for subsequent substanceuse and delinquency.

Coping Power is being piloted in select schools and delivered to the whole class insome schools and in small groups with selected students at other schools.

We target kids who need the program, said Hoy, adding that some are located inschools in lower income neighbourhoods.

Poverty makes anything a bit of a challenge.

Three years ago, the province allocated $220 million to mental health initiatives, with aheavy emphasis to placing those services in the schools. Each school board is hiring amental health lead to help direct staff to effective evidence-based programs.

Weve embraced a view of mental health which is to understand that mental health is astate of balance.-Michele Bates, mental health lead for HWDSB

Michele Bates, was hired as mental health lead for theHWDSBlast year. He saidhelping students is also about offering preventive programs that encourage resiliency.

Weve embraced a view of mental health which is to understand that mental health is astate of balance, said Bates.

So while some of our social workers are focusing on kids who are experiencing mentalhealth problems, there are other efforts and energies within the school board trying tohelp them get healthy and stay healthy.

Positive Action is an example of that type of program. It teaches positive social andemotional skills to students and was implemented last year in certain Hamilton schoolsand will be taught in every school by next year.

Bates said social/emotional learning programs like Positive Action are evidence-basedand not only proven to promote good mental health in schools but have also shown tohelp with academic achievement.

Improving performance

One study of more than 200 schools showed that programs which nurtured a studentssocial and emotional skills improved student academic performance by 11 per cent.

So teachers who are using social-emotional learning programs are providing caringclassrooms that are emotionally and physically safe. Where students are treated withrespect, they get a better sense of belonging, said Bates.

Jackie Bajus, Superintendent at HWCSB, said theyreceived their share of the provincial funding for mental health programs last June sotheyre still deciding which programs to roll out.

Their longstanding program for students with mental health problems is Wilmas Place,an alternate learning environment that recently relocated from Main Street East to St.Columbia Elementary School.

The school is home to around 130 students, who also include teen moms, homelessyouth and those struggling with addiction. Students work on a variety of skills, includingcooking.

Bajus said they used EDI data to identify 12 high risk schools where students showedhigher vulnerability rates. The majority were located below the Mountain and in thedowntown core.

Smaller classes

Theboard recognizes that many of the students in those areas face challengesbecause of poverty and have set up various programs to buffer the negative impacts ofpoverty, including offering free bus tickets and breakfast programs.

They also created smaller class sizes for children who were having difficulty intraditional-sized classes. The results have been positive, especially at At St. AgnesCatholic Elementary School, which is located near Barton and Centennial streets, wherethey saw EQAO test scores go up.

Both boards admit theyre not able to meet the needs of all students who need help.As Bates said, thats simply not possible with a total of 29.1 social workers and 114schools.

Its not very many when you consider there are 51,000 students and when you think ofone in five kids having a mental health problem, thats over 10,000 students at any onetime who are in need of help, said Bates.