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									Nashville Community Health Needs for
Children and Youth, 0-24

GOAL 6
Children and Youth are
Mentally Well
Participants of the 2006 Mayor’s Youth Summit
identified 3 strategies for the Mental Health
Subcommittee.
INITIAL FOCUS
• Promote awareness and a full range of mental health and
   substance abuse services along the continuum of care.
      Professional development across sectors.
      Community awareness and decreasing the stigma
      Increase early identification of student issue.
      Increase access to a full array of behavioral health services.

FUTURE FOCUS
• Provide mental health and substance abuse screening to all
  children and youth.
• Implement a treatment matching approach for children and youth
  who need services.

                                                2
Prevalence of Youth Mental Illness
• One in 5 youth suffer from mental health issues and
    1 in 10 from serious emotional disturbance.
•   Half of all mental illness begins by age 14.
•   Only about 20% of youths in need of services
    receive them.
•   Youth experiencing poverty and other negative
    environments are at higher risk for mental
    health issues.
•   More than half of youth experiencing mental illness
    also suffer from a substance use disorder.
•   Underage and excessive drinking has been noted to
    be the nation’s number one drug problem.

                             3
There are many factors that contribute to or
exacerbate behavioral health issues.
Biology                            Environment
• Genetics                         • Environmental toxins, such
• Chemical imbalances in the           as lead
  body                             •   Community violence
• Central nervous system           •   Child abuse and neglect
  damage                           •   Chronic poverty
                                   •   Loss of relationships
                                       through divorce, death, etc.
                                   • Peer pressure
                                   • Negative school cultures

                               4
Negative Consequences Associated
with Mental Illness
•   Bullying and violence
•   Substance use/abuse
•   Teen pregnancy and increased STDs
•   Academic failure and school dropout
•   Poorer physical health
•   Injuries and death
•   Suicide
•   Child abuse and neglect
•   Unemployment
                          5
Davidson County and MNPS Data
• Metro Nashville Public Schools (MNPS) includes over 72,000
  students and is the 49th largest in the nation.
• MNPS students are more often minorities:
      48% African American
      36% Caucasian
      12% Hispanic
      4% other
• MNPS’ ELL program has doubled in the past 5 years with
  over 7,000 students (10%).
• Over 60% of students receive free or
  reduced-price lunch.
• 65% of students graduated on-time in 2005-06. (an
  improvement of about 10% in 4 years).

                                6
Davidson County and MNPS Data
• Tennessee ranks 46th in the US in overall child
    well-being.
•   Davidson County has among highest rates in the state for
    high school dropout, suspensions, child abuse, economic
    deprivation, teen pregnancy & juvenile court referrals.
•   Truancy filings grew by 900% from 2000 to 2004.
•   School referrals to juvenile court tripled between
    2000 and 2004.
•   38% increase in dependency/neglect filings.
•   Increased referrals for alcohol and drug related charges.
•   2005 YRBS survey data show 25% of students drank before
    age 13 and 42% drank in the past 30 days.
                               7
School-Based Services in MNPS
• MNPS contracts with community agencies to support 14
  school-based mental health clinics, several Pre-K programs
  as well as therapy and case management programs.
• STARS provides prevention and early intervention services
  through student assistance programs in approximately 30
  middle and high schools.
• Several agencies such as Oasis, Centerstone, Domestic
  Violence Intervention Center, Vanderbilt, among others
  provide universal and indicated prevention services.
• MNPS provides services to students meeting eligibility for
  special education services
  (e.g., 504, IDEA).


                              8
Community-Based Services in
Davidson County
• Community mental health centers such as
    Centerstone, Vanderbilt, and Mental Health
    Cooperative Private agencies and counselors.
•   Oasis Center: Shelter and mental health counseling
•   Bradford, Cumberland Heights, and others targeting
    substance use issues.
•   Family and Children’s Services.
•   Tennessee Voices for Children: Respite services,
    parent support, and advocacy.
•   Services, outreach, and training through Metro Health
    Department as well as TN Department of Mental
    Health and Developmental Disabilities.

                             9
Current Service System Issues
•   Multiple barriers to accessing community-based services, e.g.:
        Capacity (waiting lists)
        Shortage of Child Psychiatrists
        Parental and youth engagement and voice
        Transportation
        Insurance and cost
        Stigma
        Culture and language
•   Few school-based intervention and treatment services.
•   Inadequate collaboration across youth-serving sectors, e.g., schools, mental
    health, juvenile justice.
•   Over reliance on inpatient care due to lack of community alternative to
    traditional outpatient counseling.
•   Inadequate behavioral health training for primary care providers.
•   Educators not trained or equipped to identify and adequately refer students
    with behavioral health issues.


                                              10
Anticipated Progress Over the Next
2-5 Years
• Advocacy for state and local policies mandating improvements in
  prevention, early intervention, and treatment services for youth.
• Increased collaboration across sectors.
    Subcommittee proposal for a DOE planning and infrastructure building grant for
     integrating schools and mental health systems.
    Plan to evaluate the network over time to assess impact of Alignment Nashville
     and similar community collaborations.
• Increased innovative effective school-based intervention and
  treatment services.
• Improved access to all types of services.
• More appropriate strength-based services based on individual and
  family needs.
• Innovative and more effective methods to effectively engage youth
  and their families and incorporate their viewpoints.


                                        11
References

•   Annie Casey Foundation, 2006.
•   Califano, 2003.
•   Costello et al., 2003.
•   DHHS, 1999.
•   Kataoka, Zhang & Wells, 2002.
•   Kessler et al., 2005.
•   TCCY, 2005.
•   TN Council of Juvenile & Family Court Judges, 2004.
•   US Public Health Service, 2000.
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