Occupational Therapy Training Program: School-based Mental Health Services for Youth
Early this morning I attended the "School-based Mental Health Services for the Adolescents within the Public Mental Health System" presented by Sarah Bream, MA, OTR/L, OTD, the division director of special services for groups with Los Angeles County's Occupational Therapy Training Program (OTTP).
Founded in 1975, OTTP is a nonprofit agency that provides mental-health services to at-risk youth and their families, predominantly in the South Los Angeles and South Bay areas.
Several students and a handful of mental health providers attended the session to learn more about how OTTP works with youth in need of school-based mental health services.
Bream shared that south LA-which has the highest unemployment rate in the state and accounts for 26% of the state's felonies-needs the most services. She went on to explain that the key role for OTs in this area is to help students get to school, to stay safe in school and to be motivated to learn and stay in school.
OTTP is supported and funded through the following:
Mental Health Services Act/Prop 63 (2004)-
MHSA is an asset to OTTP and provides the opportunity for the California Department of Mental Health (DMH) to "provide increased funding, personnel and other resources to support county mental health programs and monitor progress toward statewide goals for children, transition age youth, adults, older adults and families. The Act addresses a broad continuum of prevention, early intervention and service needs and the necessary infrastructure, technology and training elements that will effectively support this system." For more information, click here.
Early and Periodic Screening, Treatment, and Diagnosis:
EPSDT funds the OTTP program and "is for children and young people, under 21 years of age, who have full-scope Medi-Cal." For more information, click here.
Traditional key providers in the LA County Department of Mental Health (DMH) structure include licensed clinical social workers (LCSWs), psychiatrists, psychologists, and marriage & family therapists...not OTs.
Qualified Mental Health Providers (QMHP) act as diagnosticians in the state of CA and authorize the client care plan. These are LCSWs, psychologists, psychiatrists, and registered nurses...currently, OTs are not classified as QMHPs. (Lobbying for qualification continues.) Therefore, OT's care plans must be cosigned by a LCSW.
OTs are typically defined as mental health rehab specialists (MHRS), which requires:
- BA/BS degree + 4 yrs experience in a mental health setting as a specialist in the fields of physical restoration, social adjustment, or vocational adjustment
- MA/MS degree in social services field
OTs can:
- Initiate intakes
- Establish goals on care plan
- Provide OT intervention
- Provide case management
- Function as head of service over an EPSDT provider's contract
- Function as program head within DMH
OTTP school-based mental health services had 458 new admissions in 2007-2008 with a total of 1100 youth and families served yearly.
Bream shared the challenges that OTTP face:
Eligibility criteria (must be under Medi-Cal)
Indigent
Undocumented
- Travel
- Documentation
- Communication
Bream said that OTs can overcome these challenges by working as a collaborator with the following:
- youth and family
- teachers/administrators
- interdisciplinary team
- probation officer
- outside agency
- funding source
- county liaisons
OTTP addresses several needs among youth, including:
- safety from community violence
- freedom from abuse and domestic violence
- skills to succeed in school
- meaningful occupations to replace gang/criminal activity
- preparation for future employment
- coping skills
- self esteem
- respectful communication with authority figure
- anger management
- stress management
- opportunities to identify new interests
- opportunities to engage in occupation
- exposure to possibilities
- exposure to the bigger world
- ability to establish goals for the future
- transition to adulthood
Bream finished up her presentation by sharing case studies complete with videos of OTTP success stories. It was inspirational to watch the youth go from quiet, withdrawn students to confident, ambitious young adults through the incredible efforts of occupational therapists!
For more information on OTTP, call 310-323-6887.