Traumatic Loss Coalitions for Youth Program (TLC)

Traumatic Loss Coalitions for Youth Program (TLC)

State Report

October 2008

Mission

To accomplish our mission:

The TLC supports county coalitions bringing together educators, mental health providers, law enforcement personnel, members of community agencies and faith-based organizations to share knowledge, ideas, and experiences and create trauma response networks and lead response teams in each county.

Summary October 2007-September 2008

The Traumatic Loss Coalitions for Youth Program (TLC) continues to fulfill its dual mission of trauma response following critical incidents affecting school-age children as well as youth suicide prevention through its unique state-wide infrastructure. The CountyCoordinators are the conduit in each county and report to the Central Administrative Team who provides training, administrative support and technical assistance. This infrastructure enables those working in various settings with school-age youth to receive:

• An interactive State-wide Network
• Traumatic Loss Postvention Consultation and Response
• Resiliency Enhancement
• Professional Development
• State-wide Training and Conferences

Trauma Response

Providing a collaborative and coordinated mental health response to a global or community crisis affecting youth is an important mission of the Traumatic Loss Coalitions for Youth Program. To continue to fulfill this mission, the TLC has been working diligently on training school crisis teams and community mental health clinicians throughout the state. This year training was concentrated in the southern region of the state. To provide consistency in trauma response, the TLC has adopted the Post Traumatic Stress Management (PTSM) Modeloriginated by Robert D. Macy, PhD. This training has been offered in the past in the northern and central regions. The southern region training was held on January 23, 24, 25, 2008 at the CumberlandCountyCollege in Vineland.

There were 107individuals from the southern counties trained in the Certified PTSM3-Day Training this year. This number substantially exceeded the TLC’s Annex A target goal of 50 participants. In addition, 75 of those who received this certified training also received a One-Day Advanced Training in Suicide Protocol,and 70also received a One-Day Advanced Training in Homicide and Gang Violence Protocol. The number of attendees at the advanced trainings again exceeded the target goal of 50 participants. From September 2005 through September 2008, 409 individuals completed the Certified PTSM 3-day training. There were 243who attended the Advanced Training in Suicide Protocol and 207who attended the Advanced Training in Homicide and Gang Violence Protocol. These individuals are now part of the TLC’s State-wide Trauma Response Network (TRN).

The TLC Coordinators statewide have identified individuals from the above cadre of trainees to become part of their countyLead Response Teams (LRT). There are now 21counties with working LRTs,meeting the projected goal for this year. These LRTs are ready to assist schools and communities in the recovery stage following a critical incident. These teams can assist schools in several different ways: they can take the lead and provide a trauma response;they can work alongside the local crisis management teams;they can provide behind the scenes coaching on or off site, and they can provide care for the care givers by debriefing the crisis teams following a critical incident response. This year the LRTs provided 1,000hours of PTSM interventionin schools and communities. In addition, the TLC Central Administrative Team provided 30.5PTSM response hours, bringing the total to 1,030.5hoursof PTSM intervention to schools and communities in the past year. The Coordinators were personally involved in 498.5 of these hours demonstrating their commitment to trauma response and their willingness to work side by side with their teams. The interventions provided were varied depending on the need of the school or community. The interventions included planning and debriefing meetings with administration and faculty, stabilization and coping groups with youth, faculty, and parents, telephone consultation and support to school crisis teams, and individual psychological first aid with students, faculty and parents. There were 7,373 youth and adults who received PTSM intervention this year.

Feedback from affected schools, communities and families consistently reflects gratitude for the TLC’s assistance and highlights the knowledge, professionalism, and compassion of the responders. The following is an excerpt from a letter written by a principal following a coordinator’s response:“I want to thank you tremendously for the work you and your staff provided to our school community. I felt like my prayers were answered when you arrived. Your work with my faculty and students, as well as with the family minimized the feelings of guilt and despair. I thank you very much for this.”

The TLC Coordinators have been working diligently with their LRTs by involving them in periodic meetings that promote skill-building and self-care as well as creating a sense of trust and camaraderie in the group. These are vital elements in building and maintaining a well trained and healthy team. The Coordinators apprise the Central Administrative Team of the requests for LRT assistance and after gathering the pertinent information, they work together to develop the appropriate intervention. TLC Central Team remains available during the response to offer support and technical assistance. , Trauma responses are subsequently reviewed in the monthly regional Coordinator meetings where lessons learned are extracted and discussed, helping the Coordinators to continue to refine their skills. These measures ensure the tenets of the PTSM are adhered to in a consistent manner. The TLC Coordinators also follow up with the schools at 1 week, 1 month, 6 months and 1 year postvention to provide a continuity of care to the consultancies during these critical intervals.

In addition to receiving Certified PTSM3-Day and Advanced training, LRT members have been encouraged to become credentialed as Crisis Counselors through the New Jersey Division of Mental Health - Disaster and Terrorism Branch. The additional training provided by the Division enables them to participate in state-declared disasters if their services are requested.

Due to an increasing demand for services, the TLC Central Administrative Team has continued to offer postvention to families in the aftermath of a suicide loss and to families of first responders who have lost their lives in the line of duty. TLC works collaboratively with the New Jersey Chapter of the American Foundation for Suicide Prevention (AFSP), and the adults in these families are referred to the Survivor of Suicide Groups that are offered around the state. There were 12.5 hours of postvention to families provided through this outreach.

Youth Suicide Prevention

The TLC continues to be a leader in the provision of quality youth suicide prevention awareness and suicide assessment training programs.

Statewide Conferences

Clergy Suicide Awareness

The TLC in conjunction with the Diocese of Metuchen held a suicide awareness conference for catholic clergy entitled, Suicide: A Compassionate Approach to Intervention and Healing. Conference content included:

• Prayer Services, Rite of Christian Funerals, and planning Eulogies following a suicidal death
• Suicide awareness including mental health disorders that put individuals at greater risk of suicide
• Risk factors, protective factors and warning signs of suicide
• How to talk to a person at risk for suicide and increase the likelihood that they will receive life saving intervention
• Mental health referral protocol for a suicidal person
• Pastoral counseling with families in the aftermath of suicide

Two hundred attended including priests, deacons, religious, pastoral associates, chaplains, youth ministers, Lazarus ministers and bereavement group facilitators.

Trauma and Youth Conference

Robert Anda, MD, presented to 201 attendees on The Relationship of Adverse Childhood Experiences to Mental Health Disorders and Suicide in Youth. This well-received conference also included a panel discussion led by Dr. Anda, Theodore Petti, MD, Nadezhda Robinson, PhD, and Charles Goldstein, MSW.

Central Administrative Team State-Wide Initiatives

The TLC has continuedits efforts to assist schools in meeting the mandateof Assembly Bill 3931 requiring educators to receive two hours of suicide awareness training in their continuing education cycle every five years. This year alone, the TLC has conducted 26Suicide Awareness Training Workshops for Educators. This training includes information about the mental health disorders that put youth at greater risk of suicide, a description of suicide risk factors, protective factors, and warning signs as well as a discussion about school referral protocol for at-risk youth. This year 4,295educators were trained inthese workshops.

The TLC has continued in its efforts to improve the information and delivery of the Suicide Awareness Training for Educators by collaborating with the National Office of the American Foundation for Suicide Prevention. AFSP has agreed to fund the production of two training videos. One video is geared for middle and high school youth and focuses on clinical depression. The second video is focused on training educators to spot and refer youth at risk for mental health disorders and suicide. The video for youth is completed along with the training material. The TLC was asked by AFSP to assist with piloting this program in several New Jersey schools and this piece of the project is presently in discussion and will commence in January. Completion of the teacher training film and manual is scheduled for March 2009. TLC will assist in piloting this program for schools as well. Schools will be given these videos and the onsite or district licensed professionals throughout the state will have the ability to administer these trainings if they so choose.

George Scott, EdS, MFT, the Middlesex County TLC Coordinator, and Donna Amundson, LCSW, TLC’s Program Manager, have been conducting various trainings in the Chronological Assessment of Suicide Events (CASE) Approach. There were three regional trainings offered in March/April 2008. A total number of 373 individuals were trained with over 400 more that were closed out of the training. This training will be offered again regionally in 2009.

This training was also offered to screeners throughout the state through University Behavioral HealthCare’s (UBHC) Technical Assistance Center (TAC ). During this reporting year, 100 screeners received training. Also receiving CASE Model training were 52 UBHC supervisors.

The total number of individuals trained through all TLC Central Administrative Team’s Suicide Prevention initiatives statewide this year is 5,725, farexceeding our projected goal of 750. The annual suicide prevention conference that was previously held in May was rescheduled for November 2008 and will be covered in next year’s report.

Youth Suicide Prevention

TLCCoordinatorsCounty Initiatives

The TLC Coordinatorsalso personally provided or co-sponsored suicide preventionworkshops and trainings in their respective counties. This year 1,390 individuals were trained.

To date the combined suicide prevention efforts of TLC’s Central Team and Coordinators have enabled 21,843 individuals to receive life saving information.

TLC Coalition Meetings

The TLC Coordinators are mandated to provide three coalition meetings per year. The purpose of these meetings is to provide a forum in which school personnel, mental health professionals, law enforcement personnel, clergy and others who work with school-age youth can network, share information and ideas, receive training, and also review traumatic loss events that have occurred in their respective counties. Most coalitions have opted to meet more than three times a year and the mean number of meetings held is four. Several counties still meet once a month by popular demand. This indicates a continued need and interest in this type of collaboration among youth serving individuals and agencies. The coalition meetings include a one hour educational component. The topics are chosen by the coalition members and reflect the unique and diverse needs of the individuals and communities in the counties.

This year there were 1,542 individuals who attended coalition meetings, statewide. The largest number of attendees represented school districts and mental health agencies but also included juvenile justice, hospital professionals, private practice clinicians, law enforcement personnel, social service agency personnel, victim witness and college counseling center personnel.

There were 70 topics discussed in the educational component of the coalition meetings including Emergency Management, Grief,Mental Health Disorders in Youth, the Psychological Effects of Trauma, School Crisis Management, Substance Abuse, Suicide Prevention, and Violence in Schools.

Additional CountyTrainings

In addition to the suicide prevention trainings and the educational components of the county coalition meetings, the TLC Coordinators have also arranged other workshops and conferences in their counties. These programs included Strategies for Dealing with Crisis in the Schools, Self Care Coping, Bullying in the Schools, Co-Occurring Disorders Training, Working with the Red Cross in a Mental Health Response, Why Paper Cuts Hurt and Cutting Does Not and Managing Oppositional and Defiant Behaviors in Children and Adolescents. There were 2,467individuals trained in these county workshops and conferences in the past year.

Coordinator’sRegional and All County Meetings

There were six regional Coordinator meetings and two all county coordinator meetings held during this reporting period. The purpose of these meetings is to bring all 21 County Coordinators together to share information, network, problem solve, receive training, skill drilling and support, review critical incident responses, promote self-care and engender a camaraderie among these dedicated individuals who are doing this important and demanding work.

The December 2007 All County Coordinator meeting featured Dottie Ward-Wimmer, RN, LPC, PRT-S. The title of the presentation was, “How to Help Grieving Children”. All 21 coordinators were asked to bring one or two members of their LRTs to this presentation.

The second AllCounty meeting for this reporting period was held following the June 6 presentation by Robert Anda, M.D. on the ACE study (Adverse Childhood Experiences). An overview of the range of workshops and conferences provided by the TLC during the past schoolyear was presented. The coordinators gave a brief summation of their accomplishments of the past year and their goals for the new school year.

TLC Newsletter

The Newsletter is sent electronically to over 3,000 individuals. Each edition contains a column highlighting the activities of each county coalition, a list of the upcoming training initiatives, a listing of suicide prevention and traumatic stress resources, and a bibliography of pertinent books.

During the period of this report, the TLC published its Newsletter twice. In the Winter 2008 edition, coordinators were given the opportunity to thank their Lead Response Team members for caring and sharing their time responding to school incidents.

The Appreciation Letters column was introduced in the Summer 2008 Newsletter to highlight the efforts of the coordinators by printing “thank you” letters from administrators in their counties.

Website Project

The TLC website is continually updated with timely information and guidelines. The website also contains the CountyCoordinators contact information as well as upcoming conference and training brochures. Each TLC Newsletter is added to the website as an adobe file for ease in downloading.

This year several trainings contained an online registration form enabling interested individuals to streamline the registration process and receive confirmation electronically.

TLC Administrative Team Activities

The TLC Central Administrative Team has participated in several workshops and trainings in the past year to increase their knowledge and skill base in the areas of suicidology and trauma.

Donna Amundson spent a week in February 2008 training with Shawn Shea, MD, to begin her training and credentialing process as a macro trainer of the CASE approach.

Donna Amundson attended the American Association of Suicidology Conference in April 2008 as well as the Trauma Conference offered by the TraumaCenter in Boston in May 2008.

Donna Amundson continues to serve on the Governor’s Council on Youth Suicide Prevention as well as the NAMI Rutgers Advisory Board.

Nancy Baird, MA, presented a poster at the American Association of Suicidology Survivor Healing Conference in April 2008.

Dotty Rodrick continues to serve as a volunteer counselor on a 24 hour Crisis Hotline in OceanCounty.

TLC in the News

The TLC has enjoyed media coverage over the past year, bringing the program’s mission and activities to light.

The following is a list of publications in which TLC Central Administrative Team and Coordinators wereinterviewed or response acknowledged:

The Coast Star, 6/26/08

The Catholic Spirit, 5/15/08

The Catholic Spirit, 5/8/08

Sunday Star-Ledger, 11/11/07

This report is respectfully submitted by the Traumatic Loss Coalitions for Youth Program Central Administrative Team staff:

Donna Amundson, LCSW, Program Manager

Nancy Baird, MA, Resource Coordinator

Dotty Rodrick, Resource Coordinator

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