Outcome: Socially and Emotionally Healthy and Safe
% of children and youth who report being unhappy, depressed, anxious or stressed
18% of Austin ISD high school students and 11% of middle school students continue to miss school because they feel too sad or depressed to attend
Significance of Indicator: Depressed youth are more likely to engage in risk-taking behaviors, including drug use and risky sexual activity, attempt suicide, run away from home, and are less likely to succeed in school.
How we are doing on this Indicator:The only local data for this indicator is from the annual Austin ISD (AISD) Student Substance Use and Safety Survey: "How good is your ability to cope with stress and negative emotions?" and "During the last month, did you miss one or more school days due to any of the following reasons? Felt too sad or depressed to attend."
In 2014-2015, 18% of high school students and 11% of middle school students reported that they felt too sad or depressed to attend school for one or more days in the past month. The percentage is unchanged for high school students and decreased by 1% for middle school students.
In 2014-2015, 20% percent of middle school students in AISD reported that their ability to cope with stress or negative emotions was poor or very poor, a 3% increase from the year before. The rate for high school students increased from 19% to 23%.
what the data tell us
Percentage of Students in AISD Who Missed School Because They Felt Too Sad or Depressed to Attend
Definition: % of students reporting that they missed one or more school days during the last month because they "Felt too sad or depressed to attend."
Data Source: Austin Independent School District, Student Substance Use and Safety Surveys, 2010-2015
AISD Students Rating Their Ability to Cope with Stress and Negative Emotions
Definition: % of students responding to the following question: "How good is your ability to cope with stress and negative emotions?"
Data Source: Austin Independent School District, Student Substance Use and Safety Surveys, 2009-2015
Data Considerations: A high percentage of students responding to the survey report that they "don't know" how good their ability is to cope with stress and negative emotions. The data reported in this survey is not directly comparable to data reported for other demographic regions
The Story Behind the Indicator
National and State Data
National data from the Youth Risk Behavior Surveillance (YRBS, 2012) indicate that 28.5% of high school students felt sad or hopeless almost every day for 2 or more weeks in a row so that they stopped doing some usual activities in the 12 months before the survey. The rates differ significantly by gender: 36.9 % of girls and 22% of boys report feeling sad or hopeless.
Statewide data for Texas indicate 29.2% of high school students felt sad or depressed. The prevalence rate for Texas does not differ significantly from the national rate.
Therefore, we need to assume that the percentage of children in Austin ISD who are sad, happy, or depressed is likely higher than our limited local data indicates and we need to be cognizant of increased vulnerability among girls and specific risk groups.
Higher risk for adolescent depression occurs among the following groups:
- Females are more likely to develop adolescent depression than males (about 2 times more often)
- Children with a history of abuse/neglect, major family disruptions & instability (death, violence, abandonment)
- Children with health issues: long-term illness, obesity, poor nutrition, lack of health care access
- Children with a family history of depression, substance abuse & other major mental illness
- Teens victimized by bullying and harassment, including Lesbian, Gay, Bi-Sexual, and Transgender Youth.
- Central Texas is home to an estimated 110,000 youth 12 to 19 years old. As many as 11,000 of these middle and high school students and college freshmen are lesbian, gay, bisexual or transgender youth, and many thousands more are uncertain of and/or questioning their sexual orientation and gender identity. Among these are many youngsters whose families are unsupportive, who are literally kicked out of their homes, or must endure daily physical, verbal or emotional abuse from their parents, siblings and others in their households. According to considerable recent research, rates of homelessness, suicide, mental illness, substance use and abuse, and other adverse health and social outcomes are significantly elevated in LGBTQ youngsters (U.S. Census Bureau, 2006-2008 American Community Survey Three-Year Estimates).
Some Local Efforts to Improve this Indicator
- Mental Health America of Texas offers an online training program for high school educators that teaches them to recognize the common indicators of psychological distress and how to approach an at-risk student for referalls to the appropriate school support services. The training has been endorsed by the AISD Superintendent for high school teachers and a training for middle school teachers is in development.
- In 2012 Psychiatric Emergency Services, MCOT and AISD School Resource Officers trained together to better respond to mental and behavioral health crises on school campuses. AISD developed a Campus Reference Guide for Critical Incidence and provided Campus Administrator Training for Responding to students who report suicidal ideation or attempts.
- In collaboration with ATCIC, a select number of AISD employees, one of the Children’s/AISD Student Health Services Secondary School RNs, and one community partner (CIS) will be certified in Youth Mental Health First Aid (March 2014). These professionals in addition to identified Lone Star Circle of Care staff (3 AISD CRCRC Therapists) will comprise the “AISD Collaborative Training Team” with a focus on training AISD staff in YMHFA (8-hour training).
- The Trauma-Informed Care Consortium of Central Texas (TICC) was established in 2013 through the generous support of St. David’s Foundation. TICC, led by Austin Child Guidance Center, brings together professional organizations throughout the Austin community to address the trauma needs of children and families. TICC is made up of a variety of professionals and organizations in the Austin area that work with children – mental health clinicians, school personnel, medical/nursing professionals, occupational/physical therapists, law enforcement, and juvenile justice professionals. TICC’s mission is to create a comprehensive trauma-informed community for children, families, and providers through education, outreach and trainings.
- AISD is implementing Social and Emotional Learning with the goal of district-wide implementation by 2015-16. AISD is working through the Vertical Team approach to implement Social and Emotional Learning. A vertical team consists of a high school and all of its feeder schools. Two additional Vertical Teams will be selected for implementation each year. For the 2011-12 school year, the Crockett and Austin High Vertical teams were chosen. For the 2012-13 Eastside Memorial, McCallum and Travis Vertical Teams were added. Akins and part of LBJ Vertical Teams are starting in 2013-14. During 2013-14, SEL is being delivered to 73 schools serving 55 percent of the students in AISD. By 2015-16 the goal is to offer SEL in 120 schools serving all of the district's 87,000 students. . Elementary and Middle Schools implement curriculum for students from Second Step. Lessons are taught weekly and reinforced in all areas of the school. High Schools are using School Connect as their resource. In 5 high schools, a Methods for Academic and Personal Success (MAPS) class is being taught to Freshmen to develop SEL and study skills, supporting students as they make the transition to high school. SEL is implemented through explicit instruction, using district curriculum and resources, within a positive school climate.
- AISD students receive integrated health messaging through school health lessons. The focus of the AISD’s health education course is to educate students about health concepts through a comprehensive focus. The health course includes the topics: physical/social/mental health, environmental health, consumer health, disease prevention, human sexuality, parenting and paternity awareness, nutrition, alcohol, tobacco, drugs, healthy lifestyles, interpersonal skills, goal setting, decision-making, and CPR/first-aid/AED. Students receive information in health class, through CATCH, through physical education and other core subject areas such as science, math, social studies and language arts.
- Systematic and universal screening is not being implemented in Austin area schools. In 2012-13, AISD piloted a survey of elementary, middle and high school counselors to gather data on students with mental health needs who come to the attention of school staff. Although reporting from middle and high school campuses was inconsistent, the reported mental health needs of students were alarming. The following data include students from all grade levels: There were 521 reports of self-injurious behaviors, 188 reports of eating disorders, 498 reports of substance use, 658 reports of suicidal thoughts, 448 psychiatric crises, 236 students needing transition assistance following a psychiatric crisis, 60 suicide attempts, and 2 completed student suicides, and one teacher suicide.
- From September 2013 to January 2014 alone, Communities in Schools report 236 students disclosing suicidal ideations in elementary, middle and high schools served by the organization. Within that same time frame, AISD school counselors across all schools report 643 students disclosing suicidal ideations. While there may be duplication in these counts by CIS and AISD counselors, they nevertheless point to the magnitude of the problem.
- During the 2011-2012 school year, Austin ISD rolled out a web-based, integrated case management system, At the core of the Electronic Child Study Team (eCST) is a student dashboard that provides a user-friendly summary of key student data, a series of tabs that allow the user to drill down into specific data areas (e.g., attendance, assessments, enrollment history, discipline, etc.), templates for responding to the data, and a report generator that allows staff to create lists of students based on customizable sets of descriptive and risk-based search criteria. The tool is designed to house campus-created academic, behavior, attendance, and speech/language interventions; track how the district services students and their families; and progress monitor outcomes at student, campus, and district levels. The tool assists with advanced case management of individual and roster-based intervention plans (Austin ISD Connecting the Dots Initiative Update, 2013).
- AISD Child Study Teams coordinate services with community- and school-based providers including Communities in Schools, Lifeworks, ATCIC, and Campus Based Counseling Referral Centers.
- The Shared Psychiatric Services (a collaboration between Communities in Schools, SafePlace and Lifeworks funded by the St. David’s Foundation) have served 366 children and teens in 2011-12 with quality psychiatric services and provided coordination with school-based staff to develop more effective accommodations for students with significant mental health needs in the school environment. AISD’s Alternative Learning Center (ALC) and the Elementary Disciplinary Alternative Education Program (EDAEP) will soon be able to refer to LifeWorks’ Shared Psychiatric Services.
- AISD PD has identified a district mental health officer to consult with SROs and campus staff on mental and behavioral health needs of students with critical needs.
- Campus Based Counseling Referral Centers are a district initiative in AISD, which began with a pilot at Crockett High School in Spring 2012. In collaboration with AISD Comprehensive Health Services, Seton Healthcare, and Lone Star Circle of Care, CBCRCs currently operate on eight campuses: Akins HS, Austin HS, Bedichek MS (currently ATCIC, will transition to LSCC 2014), Burnet MS, Crockett HS, Dobie MS, Reagan HS, and Travis HS. In 2014 – ’15 – CBCRCs will are expected to expand to 14 additional campuses with plans to be on every middle and high school campus by 2016 (per principal agreement).
- Note: Other school districts in Travis County are also developing school-based health and mental health centers.
- For information about specific services available at a school, please consult YSM.
- Improve Screening: The Institute of Medicine and the National Research Council finds that 14 to 20 percent of youth experience mental, emotional, or behavioral disorders at any given time. The first symptoms of mental disorders occur 2 to 4 years before the onset of a full-blown disorder. This is an important window for screening and prevention services. Locally, primary care providers (Lone Star, CommUnityCare, Emergency Departments) are using Teen Screen, however, the program is not currently available for school districts. Another screening tool being adopted by the Texas Children Recovering from Trauma Initiative and by Travis County Health and Human Services is CANS (Child and Adolescent Needs and Strength). A screening tool for students should address Adverse Childhood Experiences, including family violence and abuse, peer and dating abuse, family history of mental or behavioral health issues, and severe or chronic illness.
- Improve the linkages and availability of adequate mental health services in this community: Investigators from Duke University (Archives of General Psychiatry, 2010) studied rates of recurrence or relapse in teens treated for depression and found that about half of the 196 adolescents in the study who recovered from major depression became depressed again within five years. The teens showed a high rate of response to treatment for their depression, with 96% recovering from the initial episode. But, regardless of what type of treatment they received—medication, cognitive behavior therapy or a combination of both—46% eventually relapsed. For reasons we don’t yet understand, girls were much more likely to suffer depression again than boys. While the findings were disconcerting, there were also positives. The overwhelming majority of youngsters did very well with treatment. A response rate of 96% is heartening and impressive. Treatment works — and a range of evidence-based treatments are effective — but only if teens get help when it’s needed. As we have seen with many adults, however, depression in adolescents is often a recurring and relapsing disorder, especially in people with more severe symptoms. This means that staying in contact with treatment professionals and checking to be sure depression hasn’t returned are important pathways to continued mental health.
Contributors for this indicator
The Child and Youth Mental Health Planning Partnership; compiled by Barbara Ball, SafePlace.