Action Research Paper (For Pro. Dan)
jhwiylolms38655
AssessingMentalIllnessinAdolescence.docxAssessing Mental Illness in Adolescence: Bullying & Suicide
Introduction
A mental disorder, also called a psychiatric disorder which is a mental or behavioral pattern that causes impairment of personal functioning and significant stress. Such factors may be consistent and persistent, remitting or may occur as a single episode entirely. Different disorders have different signs and symptoms and vary widely between specific disorders and are diagnosed by a mental health professional. Causes of mental illnesses are unclear. Mental disorders are usually defined by a combination of how a person behaves, feels, perceives, or thinks. Mental illness may be associated to particular regions of the brain that is often in a social context. Social norms, religious beliefs and cultural beliefs should be taken into consideration while making a diagnosis. Assessments are carried out by psychiatrists, psychologists, and clinical social workers by using various techniques and methods.
Mental health among adolescents is a very sensitive issue. This is so since these are some of the most tumultuous years of any individual and they need to be able to traverse these years in a safe mental environment. However, this is not always guaranteed in mainstream schools in America. American schools are becoming more and more unsafe due to the rise in bullying.
Bullying affects most middle aged teenagers because of its prevalence in schools. The World Health Organization describes bullying as a situation whereby a pupil or a group of pupils repeatedly tease, says or does things that are unpleasant or distasteful to another student. Some of the bullying tactics that the perpetrators often use on their fellow students include direct physical aggression such as pushing or hitting and subtle verbal tendencies such as name calling, spreading rumors, taking personal belongings or even making threats on the victims.
Bullying has three main characteristics that distinguish it from other forms of social interaction. First, bullying must have the element of intimidation. Thus, one needs to be intimidated through verbal intimidation, physical intimidation or social intimidation among others. Secondly, bullying must have a mismatched strength between the bully and the one being bullied. This can be a difference in physical size or capacity to fight as well as social status and social capacity. The final component that bullying requires is the unusual component. The conduct needs to go beyond what is considered to be normal for harmless social teasing (Arseneault et al, 2006). Bullies chose their victims based on different factors such as the differences that these students have from the others. This makes children with mental illness stand out as possible victims.
Bullying of children with mental illness increases their symptoms. Thus, a child who only had depression will start developing signs of anxiety or other psychotic disorders such as bipolar disorder. Therefore, it leads to a cycle where the students are bullied for having special mental needs which makes them even less capable and aggravates their symptoms. Bullying has also been proven to cause mental illness among children that would not have any mental illness issues otherwise. Since the events of the Columbine High School shooting in April, 1999, bullying has been heavily linked to the rate of violence within the school environment (Sutton, Smith, & Swettenham, 1999). This research will evaluate the theories that explain the causes of bullying in schools.
Although the Theory of Minds tries to explain the predictive behavior of bullying by analyzing the predictive behaviors learnt from the mass media, parental tendencies, and peer relationships. There is inconclusive literature on what really causes bullying among elementary school teenagers. In order to gain a deeper understanding on how bullying contributes to suicide and mental health problems our research will focus on understanding what causes bullying from a wide range of contributors such as the family background, the relationships between the teenagers themselves and the school environment (Luse, Mennecke, & Townsend, 2012). This research will focus more on teenage bullying and suicide ideation in relation to primary care givers such as parents and teachers.
One of the theories our research will use in the predicting of bullying among middle age teenagers is the family based pathways to suicidal ideation. The previous research has alluded that bullies are unable to understand the emotional states of others due to the insecure attachments with their parents. This perspective on school bullying is tries to explain how bullies are created using their family backgrounds. For instance, a child being raised in a highly stressful family environment, where there are high levels of crime and drug abuse will often portray these aggressive behaviors within the school environment. Other family stressors include divorce, or hard financial situations that force these kids into child labor and abuse.
The second theory that will be crucial in this research will be the peer based pathways to suicidal ideation. The function of relationships between middle aged teenagers and their peers is a crucial predictor to the amount of suicides among middle aged teenagers. The portion of students who experience prolonged victimization often require prolonged intervention programs and community support in order to bring them back on a positive mental health trajectory. World Health Organization (WHO) has recognized Bullying as a worldwide problem and in collaboration with UNAIDS, The United Nations Children’s Fund (UNICEF) and United Nations Educational Scientific and Cultural Organization (UNESCO) conducts continuous worldwide surveys among 13-15 years old children in order to evaluate the mental health behaviors among middle school-age students from all parts of the world including china. However, this tool is highly generalized and does not give an in depth understanding of the pathways to suicide ideation.
Bullying can be an extremely stressful situation for a young teenager. Doing a research on peer and parental pathways to teenage bullying and suicides will be instrumental in my profession as a counselor by providing a deeper understanding on Some of the Psychiatric assessment variables such as family background and teenage relationships. An effective Psychiatric evaluation is instrumental in the treatment of the root causes of bullying among teenagers. This requires an Understanding the behavioral tendencies of bullies and their victims as a way of reducing the level of depression and suicidal ideation among elementary and middle school teenagers.
While verbal bullying is the most common form of bullying among pupils in junior middle schools. Schools often focus more on physical forms of aggression thereby neglecting the relational forms of bullying such as Social exclusion because they are seen as the least forms of bullying. Direct physical aggression such as being Shoved around, locked in lockers or even being kicked are easy to recognize and deal with, which means the female counterparts are more likely to use other forms of psychological bullying in order to socially isolate their victims. Some of the subtle psychological bullying teenage girls use involves creating rumors about the victim, excluding them from social activities or completely ignoring them. These psychological stressors create general anxiety among the bullied students, truancy, dropping grades, substance abuse, loneliness and low self-worth. According to Kaltiala-Heino, et al, (1999) this form of Chronic bullying and victimization often leads to other societal problems such as school drop outs, a bad reputation, aggression and the carrying of weapons to school, gangs, delinquency. Many of these bullied pupils often lack the critical skills in conflict resolution and problem solving.
The introduction of counseling services to parents and students of bullied students will include parent teacher involvement as some of the ways the society can help build a supportive social environment in our schools. This strategy has been shown to tremendously improve the mental health of middle aged teenagers and how they are able to handle bullying in schools (Cheng, Newman, Qu, et.al., 2010). This research topic will be instrumental in developing intervention programs that create awareness and prevents suicide among middle aged students. This is because the tactics used in bullying changes with the invention of newer technologies such as the cell phones and social media platforms. It is therefore essential for me as a counselor to involve the pupils in the evaluation process of what they consider to be bullying or not.
Suicide is the second largest killer of adolescents in America. This is very worrying statistical information since suicides can be prevented with adequate care. The prevalence of suicide cases shows us that there is a need for action to increase the mental safety of schools in America. Bullying is an ever-growing problem in American schools with up to 7 out of 10 people who have gone through the American education system reporting some form of bullying during their studies (Fisher et al, 2012).
Bullying has grave effects on the mental health of developing children. Debate exists on the exact extent that bullying affects children with mental illnesses and those without mental illnesses. It was found out that bullying does indeed aggravate mental illness and it causes more cases of mental illnesses among bullying victims than non-bully victims. In the research, it is also important to note that many other factors can predispose one to mental health issues such as genetics as well as the home environment.
Thus, studies decided to analyze the effect that bullying had on the mental health of twins from age 11, 14 and 16. Twins chosen were both identical and non-identical. It was evident that even when genetic differences we're removed such is the case with identical twins that have similar genes. They also removed environmental constraints such as home environment by analyzing non-identical twins who do not have similar genes, but they have the same home environment.
In the findings, it was found out that the children who were exposed to bullying or those who reported bullying have twice the chances of developing mental health complications in the short term. Many of them reported higher feelings of anxiety and helplessness (Gould et al, 2018). However, by the time that these bullies are removed from their immediate environment, these children quickly recover. Such that, children who reported cases of bullying at age 11 reported these mental health symptoms at age 14. However, by age 16, most of these symptoms had disappeared. This shows us that there is indeed a link between mental health and bullying. Many of the victims of bullying and mental health conditions may successfully recover as the mind of the child is resilient (Gould et al, 2018). However, there are still some children who are not able to look beyond their mental illness which causes them to self-harm or commit suicide as a method of coping. Bullying and mental health issues in schools are gaining more attention as many children choose this detrimental path.
Methodology
No single factor causes mental disorders and therefore it is important where different content and issues are measured with methods from several sources. Given this fact, effects extend to multiple areas of a youth’s life and it is necessary to measure a wide range of personal and environmental factors. Substance use disorders need the need evaluation using multiple strategies and several sources of information (Winters, 1990). Thus, assessors should collect information through interview, observation, and specialized testing and attempt, with the adolescent's consent, to gather information from well-informed parents, other family members (e.g., siblings), and adults and peers important to the youth. The evaluation needs to be conducted according to federal laws and guidelines regarding child laws.
Procedure
Here are avenues that should be assessed to derive a picture of the adolescent’s problems
· History of use of substances, including:
1. over-the-counter and prescription drugs,
2. tobacco, and inhalants--the history notes age of first use;
3. treatment history;
4. and signs and symptoms of substance use disorders,
· Strengths and resources to build on,
· motivation for treatment
· Medical health history and physical examination on the patient such as, previous illnesses, nutritional status, medical trauma,
· Sexual history, which is, sexual activity, sexual abuse, sexually transmitted diseases (STDs), and HIV risk behaviors.
· Presence of attention deficit disorders, and influences of traumatic events such as physical or sexual abuse that bring up development issues of the adolescent.
· Mental health history focuses on history on suicidal attempts, bouts of anxiety, depression, behavioral disorders and also prior evaluation and treatment for them
· Family history includes history of the family’s substance abuse, mental, physical problems, chronic illnesses and their treatment, illegal activity, child management concerns and the family’s ethnic and socioeconomic background.
· School history that is academic and behavioral performance, and attendance problems.
· Vocational history whatever the adolescent is putting effort on, maybe voluntary work around.
· Peer relationships around himself which includes his interpersonal skills and neighborhood environment.
· Juvenile justice involvement and, including types and incidence of behavior toward that behavior.
· Social service agency program and child welfare agency involvement
· Leisure activities, including recreational activities, hobbies, and talents
Engrossment of Other sources
The adolescent's family is very important in the adolescent's growth out of the use of the substances. Hence, it is vital to form an alliance with the family to be involved the in the assessment process of the adolescent.
And during this period the family is abusing the adolescent at home, the family should be reprimanded about the matter. And one should be able to pursue more about the abuse from all sides that are the parents, abusing parent and even siblings or relatives. Certainly, the reports for the experts regarding evidence of abuse must be disclosed to each individual being interviewed on the matter.
This analysis should not be presented complete until there has been time to assess the family and others identified by the court as legal custodians who can speak for the adolescent. The analyst must determine who the family is, one who will represent the family and should be of legal custodian of the adolescent. The assessment of an entire family requires a specific set of skills and these assessments need people who are highly skilled and trained to interpret family dynamics, strengths, weaknesses, and social support systems. Assessors must also be able to identify key family structures and patterns in which the adolescent's substance use disorder is entangled.
It is also essential for the assessor to draw out previous treatment experiences, as well as previous attempts to address the substance use problem and assure the family's feelings about the adolescent. In this situation the family responses really matter in that you can determine whether the family wants to help the adolescent through the process and also the family can use that to judge the adolescent. Reason behind this is that the assessors determine how best to proceed in working with both the adolescent and family.
Of course, the absence of a family can be a barrier for adolescents seeking treatment of substance abuse. At-risk adolescents may be homeless or on the verge of homelessness. Potential assistance can be obtained by initiating procedures to help the adolescent achieve emancipation or become a temporary ward of the State. Other people related to the adolescent other than the family members include adult friends, surrogate parents advocates whereby they work hand in hand with the court officials, school related services, social services workers, treatment providers and the assessors. This system supports the information that the adolescent provides comprehensive assessment.
Analysis Plan
Assessment Instruments
Two methods are to be used during the assessment of adolescent substance use disorders:
1. Self-report questionnaires
2. Structured ad unstructured interviews
Laboratory testing can be done as a drug screening procedure and to identify exactly the amount of drugs is in the system as well as to identify which type of drug.
Use of well-structured questionnaire and interviews can give accurate and realistic understanding of the adolescent and the problems he/she is experiencing. Such information can provide findings and reports on the adolescent’s motivation and reason behind substance use and their level of desire to be helped from the treatment
Assumptions
Assumptions made in the assessment include:
1. That the comparison of mental illness as a form of physical illness as a means of validating the tangibility of adolescent mental health
2. The fact that environmental experiences that are stressful are embedded in the adolescent’s physical body leading to maladaptive reactions and responses to environmental stimuli.
3. The idea that the idea that isolated symptoms of mental health may on their own have negligible effect on the functioning of an adolescent but when multiple symptoms “pile-up” and accumulate the result can be seriously impaired functioning in the adolescent
4. Resiliency can be said and thought of a skill that an adolescent learns and applies to meet challenges
5. Adolescent mental illness is the product of two groups of influences: individual/genetic factors and environmental considerations
Limitations
1. If the adolescent lies and gives a false negative during their assessment hence hindering the effectiveness of treatment administered
2. Wrong diagnosis and false positives to adolescents who don’t actually have a mental disorder
3. Lack of appropriate care and treatment for certain disorders after diagnosis
4. Resistance to psychological assessment as some adolescents may refuse to be assessed when the health officer asks for consent
Delimitations
1. The adolescent is a minor and consent is required from both the adolescent and the parent/guardian
2. Privacy and confidentiality is maintained throughout the assessment
3. Transparency of tests administered and methods of acquiring data
4. Right to an informed decision regarding their diagnosis and way forward concerning their treatment.
Implications of the Improvement of Teaching Practice
Results speculated
Teachers are having a difficult time in identifying the different forms of bulling: According to Holt and Keyes (2004) Most of them are only able to identify the more egregious behaviors physical and verbal abuse. This is because many teachers do not possess the appropriate the knowledge or skills to recognize bullying behaviors among their students. Holt and Keyes (2004) report that “a greater proportion of studies have found that teachers report lower prevalence rates of bullying than students do” (p. 122), which likely indicates that students are aware of bullying to a much greater extent than teachers.
Less cases of bulling not been attended to: This is because, as stated earlier, only the most serious cases of physical and verbal abuse are dealt with. This leaves out the cases of name calling, spreading mean gossip, or intimidating looks as bullying which are also forms of bullying. In general, the understanding of teachers about the issue coincides with aspects identified in literature concerning the nature of aggression (physical, verbal and psychological), often understood as negative behaviors, intimidation, insults, harassment, exclusion and discrimination of all kinds. This causes the victim to experience feelings of inferiority. As a ripple effect, it contributes to the development of psychological and social disorders. Another essential characteristic linked to the definition is the existence of an imbalance of power between victims and aggressors.
Teachers’ training process is coupled with the lack of evocative and essential content for the practical application: The education system has heightened the topic of bullying and taken it to the agendas of discussion in schools, but not to properly equip the teachers to handle the situation properly when they occur in their classrooms. This presents the difficulty in identifying the aggression among the students, especially the more subtle and the complexity of violence situations. Experience alone in dealing with the situation is not enough if not entwined or associated with training and/or professional development that allows subsidizing consistent technical actions appropriate to the context and specificities of situations.
Various aspects of personal nature and the strain experienced at work also affect how teachers position themselves in face of violence: Reactionary measures taken most are reflections in the classroom and referrals to the school board. This leaves very little preventive measures in relation to bullying. Most effective preventive actions require using equally complex methods that reach the whole school and also from a preventive perspective, in a way that activities have indirect approaches, are focused on avoiding the problem and not restricted to post-fact measures.
Implications for Improving my Teaching Practice
Measures such as reserving time to discuss the topic and forms of prevention which comprises of establishing rules of behavior for the classroom and school spaces. It should be guided by the building of more positive models of social associations and interactions, can reframe the school and contribute to a secure environment as well as favor the culture of non-violence.
It is therefore important to inspire teachers to develop numerous strategies to respond to bullying, resorting to the ones in which the intensity depends on the chronicity and/or the nature of the victimization or intimidation. Simply, teachers can alter their interventions according to some variables, namely:
5. a) if that is the first time the violence occurred,
6. b) if it engaged other children
7. c) the nature of the aggression was physical, verbal or psychological.
8. Undoubtedly, training and support actions are needed in order to efficiently deal with bullying after its identification. This leaning can be done through various ways. First, informal mechanisms such as their own life experiences or the experiences of fellow mates and reading materials about the problem. Attending workshops and presentations dedicated to the subject can be a learning technique.
9. In formal capacity, teachers may gain knowledge through schools’ adoptions of bullying prevention programs. Most of these programs are go together with training aimed at helping teachers understand the problems of bullying and violence. Learning how to respond to instances of bullying and violence is one of the key strategies teachers can apply to curb the issue. This goes hand in hand with modifying their interactions with students, both the involved and uninvolved. Very often these programs promote policy development as well as realignment of the school’s and classroom code of conduct and behavior management systems. Teachers are called upon to teach students social skills that lessen the likelihood of interpersonal conflict. The most fascinating fact about these various programs is that they seldom address teachers’ classroom management practices and how they may contribute to the existence of bullying within the classroom.
References
Allen, K. P. (2010). Classroom management, bullying, and teacher practices. The Professional
Educator, 34(1), 1.
Bauman, S., & Del Rio, A. (2005). Knowledge and beliefs about bullying in schools: Comparing
pre-service teachers in the United States and the United Kingdom. School Psychology
International, 26(4), 428-442.
Cepeda, C., & Gotanco, L. (2017). Psychiatric interview of children and adolescents. Arlington, VA: American Psychiatric Association Publishing.
Cheng, Y., Newman, I. M., Qu, M., Mbulo, L., Chai, Y., Chen, Y., & Shell, D. F. (2010). Being
bullied and psychosocial adjustment among middle school students in China. Journal of School Health, 80(4), 193-199.
Fisher, H. L., Moffitt, T. E., Houts, R. M., Belsky, D. W., Arseneault, L., & Caspi, A. (2012). Bullying victimisation and risk of self harm in early adolescence: longitudinal cohort study. bmj, 344, e2683.
Gould, M. S., Lake, A. M., Kleinman, M., Galfalvy, H., Chowdhury, S., & Madnick, A. (2018). Exposure to suicide in high schools: impact on serious suicidal ideation/behavior, depression, maladaptive coping strategies, and attitudes toward help-seeking. International journal of environmental research and public health, 15(3), 455.
Hugh‐Jones, S., & Smith, P. K. (1999). Self‐reports of short‐and long‐term effects of bullying on
children who stammer. British Journal of Educational Psychology, 69(2), 141-158.
Kaltiala-Heino, R., Rimpelä, M., Marttunen, M., Rimpelä, A., & Rantanen, P. (1999). Bullying,
depression, and suicidal ideation in Finnish adolescents: school survey. Bmj, 319(7206), 348-351.
King, J. A., Ferris, C. F., & Lederhendler, I. I. (2003). Roots of mental illness in children. New York, NY: New York Academy of Sciences.
Luse, A., Mennecke, B. E., & Townsend, A. M. (2012). Selecting a research topic: A framework
for doctoral students. International Journal of Doctoral Studies, 7, 143.
Prinstein, M. J., Boergers, J., Spirito, A., Little, T. D., & Grapentine, W. L. (2000). Peer
functioning, family dysfunction, and psychological symptoms in a risk factor model for
adolescent inpatients' suicidal ideation severity. Journal of Clinical Child Psychology, 29(3), 392-405.
Sutton, J., Smith, P. K., & Swettenham, J. (1999). Social cognition and bullying: Social
inadequacy or skilled manipulation?. British Journal of Developmental Psychology, 17(3), 435-450.
Wolfe, D. A., & Mash, E. J. (2008). Behavioral and Emotional Disorders in Adolescents: Nature, Assessment, and Treatment. New York: Guilford Press.
