“Social status has impacted our perceptions of each other since the beginning of society.” with Alison G. Clark and Fotis Georgiadis

Social status has impacted our perceptions of each other since the beginning of society. Mental health problems affect entire families, and as a coping skill to protect their children from the shame of societal rejection, some parents deny the problem. In addition, the fear that “crazy” is contagious or dangerous has been an historical social […]

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Social status has impacted our perceptions of each other since the beginning of society. Mental health problems affect entire families, and as a coping skill to protect their children from the shame of societal rejection, some parents deny the problem. In addition, the fear that “crazy” is contagious or dangerous has been an historical social precedent, and it is only recently that mental illness has been considered a health condition which can be managed under the right level of care. What is considered normal behavior has become more skewed as well.

I had the pleasure to interview Alison G. Clark. Alison is a Nationally Certified School Psychologist and family wellness instructor dedicated to increasing high quality evidence-based instructional opportunities with evidence-based outcomes to youth in public schools by systemically implementing organizational changes relative to making multi-tiers of support sustainable in large school systems. Alison is the recipient of the 2016 Lifetime Achievement Award, bestowed by the Nevada Association of School Psychologists. She is a practicing school psychologist in inner-city, high poverty, and minority communities. Areas of expertise include mental health in schools, implementation science, family engagement, psycho-educational assessment, educational planning, positive behavioral instructional supports, behavior modification, instructional coaching, threat assessment, crisis counseling, and systems change. Alison is currently a co-founder of Healthy Minds, Safe Schools, working to bring a replicable and customizable mental health model to schools. Please visit Healthymindssafeschools.com for more information.

Thank you so much for joining us! Can you tell us the “backstory” about what brought you to this specific career path?

Early traumatic life experiences gave me a warped view of the world, but sharpened my edges for survival and adaptability. After my mother died tragically in a car accident that I barely survived, I grew up fast. The shock that comes from a “normal” safe life suddenly not being normal or safe anymore has never entirely escaped me. Understanding how fragile life is from a young age imprinted on me the vulnerabilities of being a child and put me on the path to being a fierce advocate for children.

I still have residual effects of traumatic brain injury: short-term and long-term memory gaps, forgetting names and faces of people I have met, attention problems, and poor impulse control. I intens[KD1] [AC2] [AC3] ely understand pain, loss, grief, confusion, and weakness, which makes me especially empathetic to children and sensitive to their needs. My father taught me and my brother survival skills through outdoor recreation, and when the going got tough we went out in the elements. I have been hunting, fishing, hiking, off-roading, and lost in the wilderness more times than I can count, and I think that connection to nature and thriving through unpredictable circumstances has trained me to be calm when in the middle of chaos. Understanding children in a moment of chaos and helping them gain insight into their own feelings, thinking, and behavior helps them become more resilient.

My job has required rapid adaptation to constantly evolving challenges in inner-city schools. Since Columbine, the need for on-site threat assessments and suicide protocols have been routine in my schools, and increasing. Lack of adequate resources and training in schools and scarce community supports to work with behaviorally and emotionally dysregulated children has reached epidemic status. Over the years, I have observed systems and people slow to respond to the escalating numbers and severity of students in need. I felt that some of the solutions to safety in schools needed to come from people who actually work in schools and know how to effectively change systems from the inside. Advocating for proactive evidence-based practices, changing school systems to detect students’ needs, and responding with the necessary intensity of intervention supports have been my main priorities. Healthy Minds, Safe Schools, was designed to reform school practices that specifically address the social, emotional, and behavioral health of students because growing emotionally and behaviorally healthy children should be a national priority.

According to Mental Health America’s report, over 44 million Americans have a mental health condition. Yet there’s still a stigma about mental illness. Can you share a few reasons you think this is so?

Social status has impacted our perceptions of each other since the beginning of society. Mental health problems affect entire families, and as a coping skill to protect their children from the shame of societal rejection, some parents deny the problem. In addition, the fear that “crazy” is contagious or dangerous has been an historical social precedent, and it is only recently that mental illness has been considered a health condition which can be managed under the right level of care. What is considered normal behavior has become more skewed as well.

Many parents [KD4] are not instilling personal and civic responsibility in their children, and educators are not equipped to teach behavior like they are to teach reading. Children should not be punished for difficulties learning to read, and they should not be punished for not knowing how to act appropriately [KD5] either; both require non-punitive remedial opportunities. Children who do not learn how to play well with others grow into adults who are unable to effectively resolve conflict in their lives, so we set kids up for failure in society by not teaching them effective interpersonal skills. It is easier to blame students for misbehavior than to fix institutionalized bias, rampant poverty, and lack of sufficient resources and funding for public schools. With the advent of social media, children have more “friends” online and fewer interpersonal social skills. They normalize being isolated for 12 hours a day playing violent video games and obsessing over Fortnite, instead of recognizing the health risks of living in a violent fantasy world. Parents and educators blame children for not having social skills, critical thinking skills, and resilience in the face of adversity, even when these values are not explicitly taught to children in school or modeled at home. Then children are blamed for inappropriate responses to situations they are unprepared to handle.

Mental illness is becoming more commonly identified and treated than ever before, but parents continue to blame themselves, blame each other, blame the schools, and blame their children for “making bad choices”, even when signs of mental illness are present. They refuse to put their children on medication or get family counseling due to fear of side effects and social stigma attached to mental health diagnoses. Parents have judged other parents since the beginning of parenthood, and the messages on Facebook and social media where parents portray the “perfect” life with “perfect” kids is probably one of the biggest illusions perpetuated among parents on social media. Parenting is not always easy, and if your child is the one who acts differently than expected, then it is more socially palatable to make excuses, blame the child and blame the system, than treat the problem. A compounding factor is that mental illness runs in families, and caregivers stepping up to care for mentally ill children of mentally ill parents are not prepared or supported to raise emotionally, behaviorally, and medically fragile children.

The stigma of mental illness is likely due to a lack of education and supports in the community, and lack of understanding that psychiatric disorders are neurological and should not be considered a source of shame. Caregivers refusing to treat their mentally ill children must be re-educated to not blame their children for abnormal organic brain differences and must be taught how to work with individuals who think and act differently. When caregivers understand that withholding medication from mentally ill children can be just as dangerous as withholding insulin from diabetics, they have taken a big step towards acceptance of long-term management of a serious health condition. Medication is not necessary in all cases of mental illness, of course, but is part of the bigger conversation of whole-child health care. I find that parents who admit that their children need psychiatric medication are more likely to feel that it is an admission of their failure as parents.

Can you tell our readers about how you are helping to de-stigmatize the focus on mental wellness?

My co-author and I recently wrote a book about implementation science and systems change in secondary schools (Multi-tiered systems of support in secondary schools: The definitive guide to effective implementation and quality control, Routledge Publishing, 2019), and our elementary schools version will be out early next year. It was our hope to deliver a “turn-key” implementation guide to successfully support and sustain academic and mental health school-based systems that strategically increase levels of support based on student needs. We designed school protocol that we hope every school adopts, to systematically address improving access to academic, behavioral and mental health services to meet the needs of all students.

Trying to understand student problems, and manipulate the systems that contribute to and maintain those problems, are the goals. In these challenging times of our culture, adults are grasping with understanding and adapting to life circumstances; yet the world is infinitely more confusing for our children, with the consequences more severe for mistakes. Students experience more adverse childhood events and trauma, but are treated with less empathy and are taught fewer coping strategies. Punishments for failing are harsher for students than ever before. As public schools have been forced into the accountability movement, focused more on passing standardized tests than measuring growth by any other developmental indicator, our students are being denied experiences to develop critical thinking skills, social problem solving skills, and civic responsibility. The relevance of public education is in crisis. We are not preparing our students how to thrive socially, emotionally or behaviorally in society, and many are barely learning how to survive.

Advocating for policy and practice of mandatory social-emotional-behavioral (SEB) instruction in preschool through twelfth grade will teach children early and often how to express themselves and negotiate difficult situations through cooperative learning, conflict resolution, and critical thinking skills. SEB screenings should happen several times a year because students do not stay stable over time. Students with at-risk indicators are supported and monitored closely. Students requiring active case management and triage are supported by mental health team providers trained to work in smart teams. At the state, district and school levels, it takes time to grow effective practices to address high quality universal SEB instruction, institute regular screenings and systems to identify and prioritize students’ needs, increase evidence-based remedial opportunities, and monitor and manage at-risk students in school, in addition to working closely with community wraparound services. The results of Healthy Minds, Safe Schools in elementary and secondary schools has been magical in decreasing student-to-student violence and office referrals for discipline.

Was there a story behind why you decided to launch this initiative?

In my experience, the need for an integrated school-based mental health model has been a long time coming. A defining moment came when communications between staff members broke down and systems failed a student who was a potential threat to my school community. Fortunately, the student did not follow through on the threats but it was sure a wake-up call for better communications and coordination to address school safety. The following school year we happened to have the highest rate of student suicidal ideations and attempts on one school campus I ever experienced. Yet, with defined school-based mental health systems in place, our team matched student needs magnificently and kept all students in crisis alive and working through their problems at school, home, and in the community. We were so efficient at identifying students in crisis that school police and local community mental health service providers complained to school district officials about our coordinated school-based efforts, reporting that we were overwhelming them with the number and severity of student referrals. It has been a wake-up call to the whole community for better coordination of school and community based mental health supports.

Mental health systems in schools are poorly understood and under-implemented. Obviously, if students do not feel safe in schools their capacity to learn is impacted. As the frequency and intensity of school violence have increased, school safety has grabbed the headlines as the most important factor on a school campus nowadays. School security must be addressed in terms of school site layout, restricted access to students, and safe schools trainings. However, what clearly keeps children most safe is a positive school culture with enforced anti-bullying policies, educators skilled in positive behavioral instructional supports, and defined multi-tiered systems of support in place for prevention, identification and remediation of students’ mental and behavioral health problems. We have defined school team functions, smart systems and programs, and processes to actively identify, support and manage high-risk students, increase inclusive family practices, promote collaboration with law enforcement, and improve resource mapping to provide access to community health and counseling services.

In your experience, what should a) individuals b) society, and c) the government do to better support people suffering from mental illness?

We can start with funding preschool for all children. Early childhood education is linked to positive educational outcomes for children later in life. We must teach students social-emotional-behavioral skills starting in preschool up through high school. Providing students with repeated opportunities to learn how to regulate their emotions throughout their school years will ensure ample exposure to social skills and problem solving. Banning corporal punishment in all schools across the country would eliminate the negative aftermath that abusive practices cause. Inflicting pain on a child is never a valid teaching method and causes permanent emotional harm to many children. Students of color and those with disabilities are disproportionately punished with harsher consequences, and it is a social justice issue to abolish corporal punishment in all schools.

Transforming schools into smart organizations where smart teams of highly trained individuals, working within and across teams, are actively solving problems for students to prepare them for success provides the most equitable practices within schools. Adequately funding education, paying teachers and educators a living wage, improving the ratios of school-based mental health professionals working in schools, and implementing multi-tiered systems of support for academic, behavioral and mental health practices in schools would make schools safer by investing in preventative care, timely remediation of academic and behavioral problems, and coordinated crisis response. Connecting community based health centers with schools to provide health and mental health services on school campuses reduces barriers to treatment, including transportation for families, improving access for students.

Individuals must start speaking up more about the need to improve mental health services in schools and the greater community through advocacy and policy. They can contact their local and state legislators urging them to increase funding and demand standards of school-based mental health systems, show up at committee meetings and hearings to voice concerns, write and submit statements at legislative committee meetings and hearings, call their elected representatives to voice concerns, vote for increased funding and services in schools and vote for those who support it, and run for office to lead efforts in policy and practice.

What are your 6 strategies you use to promote your own wellbeing and mental wellness? Can you please give a story or example for each?

  1. Turn off the electronics and give others my full attention when talking to them, especially my children. We are so attached to immediate communications, immediate news updates, and immediate gratification of instantly finding what we want on our electronic devices we forget to pay attention to actual people in our lives trying to interact with us. I know when I work too much or spend too much time online, I feel less connected to other people and less happy. Put down your cell phone and go play with your kids at the park, and talk to them the whole way there and back. You will all feel better.
  2. Get daily exercise. Endorphins are power players in feeling happiness, and my brain is happier when my body is moving. Exercise is one of the best anti-depressants and mood regulators there are, so get moving. And create healthy family habits by staying active together.
  3. Regularly staying in touch with my support group ensures that I have healthy lifelines. Whether you have close knit family or an assortment of friends, interacting with other people and showing them you care will make you feel a sense of belonging, which is a basic need, as much as food and shelter. Interacting with people you care about also increases those feel-good brain chemicals, like Serotonin and Dopamine.
  4. Go out into nature and marvel at the natural wonders of deserts, mountains, lakes, rivers, and skies. Appreciating animals, plants, sunsets, and the natural environment is stress relieving. Take your focus off yourself and other problems by going outside. Walking barefoot in the grass, gardening, and swimming will do, but if possible go a little outside your comfort zone and enjoy what you find.
  5. Meditation is highly relaxing and mind cleansing. I can meditate for several minutes in my office before a stressful meeting by focusing on my breath and nothing else. At night, relaxing in the hot tub, looking up at the stars, and quieting my mind allows me to process my feelings and experiences in a way that opens up spaces for creativity, understanding of different perspectives, and forgiveness.
  6. Having faith, expressing gratitude, and giving back to our community through charity gives me a sense of purpose, a belief that I am part of something greater, and always deep appreciation for my blessings, opportunities, and challenges.

What are your favorite books, podcasts, or resources that inspire you to be a mental health champion?

The Boy Who Was Raised as a Dog: And Other Stories from a Child Psychiatrist’s Notebook — What Traumatized Children Can Teach Us About Loss, Love, and Healing (Perry & Szalavitz, 2017).

Odd Girl Out, Revised and Updated: The Hidden Culture of Aggression in Girls (Simmons, 2011).

Freakonomics Radio

Better Life Lab

A Framework for Safe and Successful Schools: https://www.nasponline.org/resources-and-publications/resources/school-safety-and-crisis/a-framework-for-safe-and-successful-schools

Preventing Mass Violence Requires Access to Mental Health Services and Reduced Inappropriate Access to Firearms: https://www.nasponline.org/about-school-psychology/media-room/press-releases/preventing-mass-violence-requires-access-to-mental-health-services-and-reduced-inappropriate-access-to-firearms

Shortages in School Psychology Resource Guide: https://www.nasponline.org/resources-and-publications/resources/school-psychology/shortages-in-school-psychology-resource-guide

Behavioral and Mental Health: https://www.nasponline.org/resources-and-publications/resources/mental-health

Thank you so much for these insights! This was so inspiring!

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