We began this interview with the intent of focusing, as we usually do, on one person’s research. However, this query soon became—like the collaborative work it highlights—a joint project involving James R. Koller and Karen Weston of the Department of Educational, School, and Counseling Psychology in the College of Education, two individuals working together to “think outside the box” by creating the Center for the Advancement of Mental Health Practices in the Schools, now affectionately called “the Center” by its members. “The Center was created in response to the rising number of students in need of mental health services today,” states its homepage. It was initiated “as a paradigm shift that recognizes prevention as a fundamental element in supporting our nation’s youth facing developmental challenges, psycho-social issues, and environmental stressors within the school system and community . . . with the whole thrust being a paradigmatic shift from mental illness to mental health.” Of course, “you’re never going to get away from mental illness,” admits Koller, “but instead of waiting until pathology occurs, the question posed to me was how we can do something different. How can we better prepare consumers at all levels to be better informed so that we can create a positive learning environment for each learner and increase her or his self-concept, while academic learning flourishes?”
The Center has been working with the School of Nursing and the College of Education at MU to provide mental health training for nurses, teachers, principals, and school counselors. Thanks to the collaboration with Vocational Rehabilitation, the Department of Health, the national centers on mental health, and other federal agencies, they have been able to do outreach, sharing, collaboration, and program development. “That’s the only way we’re going to be able to surmount some of these issues,” Koller remarks. “Without that collaboration, we would not be where we are today.”
Most of Jim Koller’s past research and practice as a licensed psychologist was directed toward pathology, that is, “abnormal behavior.” But he became disillusioned with the then-current state of affairs, realizing that “we have to do something different to stop the escalating incidence of mental illness vis-à-vis mental health problems in the country.” With the cooperation of the Missouri state legislature and the Department of Mental Health, the Center for the Advancement of Mental Health Practices in the Schools was conceived—“with the whole thrust being a paradigmatic shift from mental illness to mental health.”
“We are seeing an increasing number of suicides. We have one district [in Missouri] that has thus far this year had six adolescent suicides. It’s just devastating in that small school district. More and more school districts are having to grapple with this issue,” says Weston. How to respond to this problem involves some controversy about which is the best approach to suicide prevention. The Center has recently developed an online course on suicide prevention. They have also undertaken research with school leaders to understand their perceptions on suicide prevention. As Weston explains, “some people think if you talk about it in the schools that’s going to make kids more likely to attempt suicide, which is not true. It’s a huge misunderstanding that’s out there. There are some prevention programs that promote screening of kids to see whether they’re potentially at risk for harming themselves, and that’s highly controversial.” Naturally, suicide prevention relates to the Center’s work in schools as well, “because we want kids to have good coping skills so that they’re not thinking about taking their own lives.”
Weston’s personal vision for the Center is to change the way that schools operate so that there is better access to children’s mental health services. “In schools we can be academically oriented, which is important,” she says, “but we know that kids don’t do well in school if they’re not emotionally healthy. So it’s very important for their academic success as well as their long-term success in life that we start focusing on mental health promotion.” Happily, Weston reports that “the whole school mental health movement is really taking off,” but she also notes that “the needs are just profound in terms of the crisis in children’s mental health.” Whereas there are programs for childhood immunization, no such comparable program exists to address mental health – although mental health problems outnumber physical health problems. The Center’s premise is that “many of those mental health problems could be prevented if we take a more proactive approach. We’re going to have to wake up and start dealing with these issues.”
Through the Center, nurses are being trained to focus on mental health. “If we keep focused on looking at the whole person, continue to be as proactive as we can, we will be better off,” Koller says.
One of the Center’s new projects is funded through the Department of Health and Senior Services. This interdisciplinary effort is working across the state on community development, with a focus on children’s mental health.
Last July, the Center received a grant from the Missouri Foundation for Health. By holding focus groups with mental health professionals, the public schools, parents, child service workers, juvenile justice personnel, and so forth, they are seeking to address the question: “What could we do in schools and communities to help support healthy social and emotional development in children?”
Weston describes several of the Center’s current projects. For instance, one of them seeks “to integrate mental health systems with education systems,” starting with the Moberly Public Schools, and eventually applying the model elsewhere. For this purpose, they have begun an organization called the Moberly Community Coalition for Children and Families to address children’s mental health. “It’s been a fantastic learning experience,” observes Weston. “They have really built awareness in the community around the need to address children’s mental health and to promote mental health. We take a preventative approach, arguing that we should be paying attention to children’s social and emotional development, that we should be promoting mental health the same way we promote physical health.”
Koller offers more history on how the Center came to be, as well as on his teaching philosophy.
Koller observes that one of the biggest obstacles is getting people to do more than just nod and agree that mental health is important. “Of course, it’s important: but what are we willing to do to encourage it in our youth?” he asks. “We have to do something that’s more proactive than reactive. Mental illness is continuing unabated in our society in particular,” thanks in part to high levels of stress and the drive to succeed. He perceives this challenge as an ethical and moral responsibility: “When you have a chance to do something about it, when you have people who are willing to look outside the box at a different world, why not take it? At least you can’t be judged that you didn’t try.”
At the first and only sanctioned online-degree program with a focus on mental health issues in schools in the country, students can take individual courses based on their unique needs through continuing education, and even earn a degree at the Masters or Education Specialist level. Recognized as a national model, the Center’s online program focuses on evidence-based practice and on current, practical application-driven principles and tested theories; people working in the field can take coursework in areas with which they are being confronted professionally.
In its mission to convince lay people and the professional community about the importance of early intervention, the Center has encountered several obstacles. Trying to modify teacher certification requirements to include coursework in this area, for example, has been like “trying to teach an old dog a new trick,” Koller recounts. For one thing, people tend to think that mental illness problems and substance abuse don’t exist in their own community. “There is a naiveté that befits the general society as well as the professional ones. We really have to work on shaping and re-shaping the mentality towards mental health; it is a systemic problem that is going to take a long time.”
Béa Gallimore will return to Rwanda periodically to meet with the ABASA women, check on the projects that Step Up has spearheaded, and determine what further steps need to be taken to help these women become financially independent. Their next priority is to build a counseling center, which is becoming increasingly urgent as primary school children, who were not alive during the genocide, are showing signs of trauma. They may be withdrawn, have difficulty with attendance and learning, report nightmares and sleep disturbances, and show signs of anxiety and distress. From studies of the children of the Holocaust survivors, we know that symptoms of trauma may be transmitted down through the generations. Step Up’s mission of improving mental health availability, therefore, is of vital importance. To learn how you can help, go to http://www.stepuprwandawomen.org/.
Gallimore has merged her academic research with social activism. While her background in linguistic theory is useful in understanding certain linguistic phenomena, she acknowledges that “if I go speak about the semiotics of the language of the genocide, that’s something that academicians would understand, but it may not be useful for someone outside of the association.” Realizing this limitation, she founded Step Up! American Association for Rwandan Women, an organization that recognizes the reality that “the needs of the Rwandan women are enormous. Not only are there concerns for practical things such as jobs, food, and school supplies, but the mental health needs have largely remained unaddressed. Post-traumatic stress disorder, depression, and anxiety remain as an aftermath of the intense horror of the genocide.” Step Up has developed a number of projects to help redress these problems.