1	Is Your Teen Ready for Adult Life? Presented by: The Association for Children’s Mental Health
2	Association for Children’s Mental Health Mission Our mission is to promote the development of a system of care for the families of children with emotional, behavioral, or mental health disorders through community education and awareness, family support and involvement and the persistent pursuit of advocacy to improve the quality of life for Michigan’s families through: Community Education/Awareness Family Support Family Involvement Systems Change
3	What is Adult Life? Definition of Adult: a “grown up person” or, “fully grown animal” Cultural definition: Rite of Passage In America the rite of passage is often when you leave home to school or work and can live independently, be self-sufficient, financially stable and create a life for yourself with a limited amount of support from others Legal Definition: Age of Majority
4	What is Adult Life? Age of Majority Under Michigan state law when your child turns 18 they are considered a legally competent adult with full adult rights. He or she is presumed to be capable of making their own decisions. They can and will be held responsible for their actions. This applies equally with no distinctions or exceptions made for disability.
5	The 18^th Birthday The beginning of legal adulthood Represents self at IEPs Has medical privacy rights Must register for selective service (males) Must reapply for SSI/SSDI Must reapply for public mental health services Can register to vote
6	Is Your Teen Ready? Do they know how to: Get a class or work schedule changed Give notice to break a lease Get their medication adjusted Do they know what to do if: They get a ticket Their car breaks on the freeway Their heat doesn’t work They feel overwhelmingly sad or alone
7	Are you Ready? Identify your concerns/ fears Parent role shift Primary role~ ‘provider and protector’ to, Supporting role~ ‘mentor & advocate’ Learning to let go Start Gradually Seek a Support System
8	Central Concerns for Families Education planning Gainful employment and/or financial stability Independent living and/or living supports Safe/healthy relationships Healthcare
9	How Do We Get Ready? Natural Preparation: Adolescent Development: Nature Adolescence is a time to explore new life roles & identities The need to leave home and family is inherent to adolescence- It is natural! Risk taking is also an essential and natural component of adolescent development It is necessary for the development of social and personal competence; You must take risks in order to become independent Greater Independence = Greater risk
10	Is Your Teen Ready? Adolescent Brain Development The Brain Cognitive Functioning Emotions
11	Adolescent Development By late adolescence/ early adulthood the following changes are partially in place for some young adults: Physical & Sexual changes Capacity for Abstract thought Family influences are in balance with peers Transition to work, college, independent living. *It is important to remember that parts of the* brain are still developing until the mid- twenties.
12	Adolescents with SED May be still in the early or middle stages of early or middle adolescence characterized by: Emotional highs & lows = turbulent times Independent stage- testing limits, relying on peers Concrete thinkers- thoughts are in the here and now- not in the future or about things they do not have experience with Self Absorbed- this too is natural- they can be testy, challenge authority-after all the world does revolve around them
13	How Do We Get Ready? Environmental Preparation/ Nurture: Environmental Preparation: First, help ensure they complete high school Then, help them as they plan their future: Person Centered Planning Formal Transitional Planning Informal Parental Support
14	If Parental Support is Key What should I be Doing? Help them with Person Centered Planning: Identify how they envision their future Then help them identify their skills level Then help them come up with plan to acquire essential life skills
15	Why Finish High School? High school dropouts earn about $260,000 less over a lifetime than a high school graduate and pay about $60,000 less in taxes High school drop outs have a life expectance that is 9.2 years shorter than that of graduates A one-year increase in average years of schooling for dropouts correlates with reductions of almost 30% in murder and assault, 20% in car theft, 13% in arson, and 6% in burglary and larceny *October, 2005, Teachers College, Columbia University, Symposium on the “Social Costs of Inadequate Education”
16	What parents can do… Take an active role by… Working with the school to plan the supports & services that will lead to success Helping your child define her/his dreams, goals, and plans for life after high school Making sure the process starts early (well before the IDEA mandatory age of 16)
17	What is Transition? Movement, change, The act of passing from one state or place to the next, An event that involves transformation.
18	Educational Transition Broad definition: Formal process of cooperative planning that will assist students with disabilities to move from school into the adult world. Intent: Improve the likelihood that students will be successful and enjoy an improved quality of life when they exit the school system
19	School transition planning Options for completing high school Regular diploma completed in 4 years (at age 18) Regular diploma completed in more than 4 years (possibly with additional years in a location other than high school) GED Certificate of completion
20	Role of the IEP process Goal setting that makes sense for the student and their future Connection of transition goals to educational plans Monitoring of plan implementation Monitoring of actual progress
21	Transition Two Primary Themes 1.Start the process early Remember… Plan Ahead It wasn’t raining when Noah built the Ark…. Author unknown
22	Transition: The Concept
23	Educational Transition Requirement IDEA 2004 Ensure that all children with disabilities have available to them a free and appropriate public education that emphasizes special education and related services designed to meet their unique needs and prepare them for further education, employment and independent living (Section 601) Section 504 of the Federal Rehabilitation Act of 1973 Prohibits discrimination of students whose disabilities interfere with a major life function, who need accommodations in order to benefit from programs or activities. This is often used to provide educational accommodations for students who do not meet eligibility criteria for special education.
24	What does the law (IDEIA) say about Transition? §300.29-Definition of Transition Services Coordinated set of activities that: Designed within an results-oriented process, that is focused on improving the academic and functional achievement of the child with a disability to facilitate the child’s movement from school to post-school activities,
25	Including: Post-Secondary Education Vocational education Integrated employment (including supported employment) Continuing and adult education Adult services Independent living, or Community participation;
26	§300.29- Definition of Transition Services Based on the individual child’s needs, taking into account the child’s strengths, preferences, and interests; and Include: instruction, related services, community experiences, the development of employment and other post-school adult living objectives, and when appropriate, acquisition of daily living skills and functional vocational evaluation.
27	What does the law (IDEIA) say about Transition? Section 614 (VIII) beginning not later than the first IEP to be in effect when the child is 16, and updated annually thereafter- (aa) appropriate measurable postsecondary goals based on age appropriate transition assessments related to training, education, employment, and, where appropriate, independent living skills; (bb) the transition services (including courses of study) needed to assist the child in reaching those goals;
28	What Does The Law (IDEIA) Say About Transition? For a child whose eligibility terminates due to graduation from secondary school with a regular diploma or exceeding the age eligibility for FAPE under State law Section 614(c)(5)(B)(ii) SUMMARY OF PERFORMANCE A local education agency shall provide the child with a summary of the child’s academic achievement and functional performance, which shall include recommendations on how to assist the child in meeting the child’s postsecondary goals.
29	SOP Summary of Performance Don’t leave school without it…….
30	Summary of Performance A summary of the student’s academic achievement and functional performance that includes recommendations to assist the student in meeting his or her postsecondary goals
31	Example of Transition Goal/ Outcome A transition goal or outcome is a specific skill that can be learned and then demonstrated, that directly relates to a future adult life goal- (PACER) Example: Rachel will be able to explain her diagnosis to an employer and how it relates to supports or accommodations she may need on the job.
32	"Life is a series of..." Life is a series of lessons that must be lived to be understood. Ralph Waldo Emerson
33	Desired Transition Outcomes Are achieving life goals such as, I want to… Live in my own apartment with some friends Have a job as a graphic artist Have friends Get my driver’s license Go to Michigan State University Hang out with my friends
34	Desired Transition Outcomes Are Not achieving goals such as, I want to: Behave 80% of the time Reduce number of behavioral incidents Read at a fourth grade level Add and subtract numbers from 1-10 Appropriately identify money Remain focused and on task for fourteen minutes
35	Future Oriented Goals & Objectives Things to Consider: I want to live in my own place Consider: Will I be able to manage my money, get what I need and still pay my own bills? Will I need a roommate? What skills might I need to get along with a roommate and make this work? Can I keep track of and manage my own schedule including getting up on time for school, work or appointments? Do I know how to cook, clean, do laundry, and shop for groceries? Do I know what to do in the case of a crisis or emergency?
36	Future Oriented Goals & Objectives Things to Consider: I want to manage my own medications Consider: Do I know how and when to reach my physician? Do I have and can I keep track of my insurance card? Do I fully understand my diagnosis? Do I believe that my medicine helps manage my symptoms? Do I understand the risks if I stop taking my medication? Do I understand the side effects associated with my medication? Do I know how to renew a prescription? Do I know what to do if I feel my medication is no longer helping me or if I am experiencing new symptoms?
37	A ‘Good’ Transition Plan.. Addresses all of a young adult’s areas of need; while preparing them to independently live, work and play in their community of choice. Be Careful…To include all areas of need! Social, Emotional, Psychological and Sexual Development often get overlooked in the educational transition planning process. These developmental areas are where ‘our kids’ often struggle- be sure they are included as they are critical to success!
38	"Mental Health" Mental Health Transition Planning
39	Mental Health Code Regulatory Requirements Each Community Mental Health Service Provider shall participate in the development of school-to-community transition services for individuals with serious mental illness, serious emotional disturbance, or developmental disability. Planning and development shall be done in conjunction with the individual’s local school district or intermediate school district as appropriate, and Shall begin no later then the school year in which the individual student reaches 16 years of age, Services shall be individualized.
40	Eligibility Eligibility criteria for a Serious Emotional Disturbance (SED)*: A diagnosable mental, behavioral, or emotional disorder affecting a minor that Exists or has existed during the past year for a period of time sufficient to meet the diagnostic criteria specified in the most recent diagnostic statistical manual of mental disorders (DSM) The condition must result in a functional impairment that substantially interferes with or limits the minors role or functioning in: family, school, community activities Substance abuse disorder, a developmental disorder, and “V” codes in the DSM are included if they occur in conjunction with another diagnosable serious emotional disturbance.
41	Mental Health Programs Values & Essential Elements MDCH Contract Values governing public mental health services Recovery; Self Determination; Full community Inclusion; Person-Centered Planning; Essential Elements Early and active involvement with the schools; Participating in IEP Meetings and sharing information with schools; Providing information about CMHSP service populations; Using local councils and committees; Request information from schools; and Initiate transition planning
42	Mental Health Programs Values Mental Health Code Mental Health Code states that Transition Services must be based on values that reflect person-centered planning, and services that promote individuals to be: Empowered to exercise choice and control over all aspects of their lives; Involved in meaningful relationships with family and friends; Supported to live with family while children and independently as adults; Engaged in daily activities that are meaningful, such as school, work, social, recreational and volunteering; and Fully included in community life and activities.
43	Child vs Adult Mental Health Systems In the Adult Mental Health System: Eligibility criteria is narrower Services are more crisis based There is less of a continuum of services Adult services are less flexible than child services Lack of case management Young adults are in charge of navigating the system themselves Often because of stigma or other issues they may choose not to access services.
44	Transitioning from Child to Adult Mental Health Services It is very important to pre-plan for this transition: Make sure your teen understands what will be different Get therapists to make recommendations and communicate with adult providers Some areas have formal transition programs, some do not
45	Transition is Hard for Everyone It can be especially hard for teens with emotional, behavioral, or mental health issues. They have unique barriers to success Many of the deficits youth with SED have are critical components to successful navigation of the adult world.
46	Behavioral/Emotional & Cognitive Barriers to Success Mental Health Symptoms that make navigating adult life difficult: Overwhelming emotions Depression Anxiety and phobias Irritability & Restlessness Mood Swings Low self esteem Lack of motivation Memory problems, both short & long term Inability to cope with stressors Problems with judgment and perception Medication side effects Difficulty with concentration, organization and attention
47	If Parental Support is Key What should I be Doing? Help them with Person Centered Planning: Identify how they envision their future: What do they want to do? Who do they want to do it with? Where do they want to go? How would they like to live? Then help them identify: Skills they have, Skills they lack, What they need and natural supports they already have Community resources and how to access them. Then help them acquire essential life skills including: Self- Advocacy Problem Solving Social Skills
48	Life Domains to Consider During Transition Housing Basic Needs Daily Living Skills Employment Post-Secondary Education/ Vocational Training Transportation Health & Wellness Recreation Safety/Crisis Planning
49	Housing Things to Consider… Options: Independent Living Supported Housing
50	Housing Everyone has the right to safe and affordable housing. Individuals should have choice in their living situations There are options available if a person is unable to live independently at any point in time.
51	The Basics Needs Food Shelter Safety Money Employment SSI/SSDI Companionship Daily Living Skills Cooking Cleaning Laundry Utilities Money management
52	Employment Stepping stones to future employment: Work-based learning: volunteer and job shadowing experiences, internships, paid employment, small business experience Supports in the workplace including: Natural supports Formal supports
53	Laws Related to Employment American’s With Disabilities Act (ADA) Federal law passed in 1990 that prohibits discrimination against any person with a disability. This includes people who currently have mental health disorders as well as those who have fully recovered. The ADA covers employment, public services and accommodations. Section 504 of the Rehabilitation Act of 1973 Prohibits discrimination based on the basis of disability in any program that receives federal funding. MI Public Act 220 of 1979 Persons with Disabilities Civil Rights Act Covers employment, public accommodation & services, education and housing
54	Michigan Rehabilitation Services (MRS) The publicly funded state Vocational Rehabilitation Agency that provides direct and indirect services to youth with disabilities as they transition from school to work, in order to maximize their employability, independence and integration into the workplace and community
55	MRS (continued) Vocational rehabilitation (VR): a set of services offered to individuals with disabilities designed to enable participants to attain skills, resources, attitudes, and expectations needed to complete in the interview process, get a job, and keep a job.
56	Michigan Rehabilitation Services Examples of services provided: Job seeking & job keeping skills training Vocational & personal adjustment counseling Case management services Job design Skill training, on the job training, independent living and vocational or post-secondary training Examinations, to evaluate medical & psychiatric problems, treatment such as therapy surgery etc… Work tools, transportation to work, clothing, etc…
57	Keys to Success at Work Work Skill Sets Basic skills: Math, reading ,writing, etc.. Job specific skills, (will vary based on area of interest) Motor skills Customer service Computer skills Industrial Skills Office Skills Sales Advertising Management Business Ability to fix things or problems Etc…
58	Keys to Success at Work: Employment ‘soft skills’ It matters more how we act than what we can do… Work Behaviors/ Social Skills: Ability to dress appropriately, personal grooming punctuality, Ability to react appropriately to problem situations Ability to self-motivate, concentrate and stay on task Ability to remember and follow instructions and procedures, The ability to plan and organize your work Interpersonal skills: attitude, teamwork, cooperation and communication
59	Social Skills If your teen needs help with social skills in order to be successful in work or school… ASK FOR HELP! You can include social skills training as a part of your teen’s IEP and transition plan
60	Social Skill Instruction For the Workplace May Include: Small-talk and conversation instruction How to Give & Receive Feedback Voice- appropriate volume & tone Eye-contact Personal Space Issues Learning & Using People’s names Checking understanding & asking questions Building on others comments and ideas Initiating and responding to humor How to be supportive of co-workers and classmates Privacy & Appropriate Sharing of Personal Information
61	Keys to Success at Work Interpersonal Skills Attitude Cooperation Teamwork Communication Skills Self-Determination Skills Self-knowledge Self Direction Goal setting ability Decision making Self advocacy
62	Post-Secondary Education College Trade school Vocational Training Entrepreneurship
63	Before Selecting A College Consider: What support will they need? Will this college provide it? How do you access needed supports? Suggested Accommodations, (you may be asked to list them) Are there psychological or counseling services on campus? Is there a charge? Are there hospitals, substance abuse treatment centers, private therapy, etc.. available in the community? Do they have adequate disability resources? What is population of the student body/ class size? You can get a list of campuses that are NAMI affiliates- call 1-800-950-NAMI or E-mail request to info@nami.org.
64	College Accommodations Contact the Office of Disability Student Services at your school of interest. Inquire about accommodations & the process to access the supports you need Disability documentation- ask what is required Colleges will usually request an assessment that states that the student’s disability will persist over time and that they need accommodations in order to be a successful student. (An IEP is usually not acceptable)
65	Health & Wellness Physical health Mental health Substance Abuse Programs Family planning & parenting assistance Healthy lifestyle choices Nutrition Physical activity
66	Recreation More than just a good time- Recreation can be an important tool to create ties to the community and expand a young adult’s social network and natural support system.
67	Safety/Crisis Planning It is important for all young adults to understand how to protect their safety and well being. Young adults with emotional and behavioral disorders may need to have a to have a crisis plan in place. The nature and scope of the plan will be dependent upon the needs of each individual youth.
68	Prevention Planning Can be an important tool as you help your teen plan for independent living. Together Identify Problem Situations that may occur Then explore how they feel about the situation: what are their triggers? what do they need to feel safe if situation occurs? Discuss how making a prevention plan could help Figure out the skills they need to cope with situation, be sure to build on their strengths. Identify key supports, persons & coping strategies. Develop a prevention action plan. (H.B. Clark adapted 2001 from Michael Curtis & Phil Wells)
69	Help Them Acquire Coping Skills Help them to recognize their triggers both internal and external Help them find alternative responses Teach: Stress Management Avoidance strategies How & where to access needed supports Identify situations where emergency interventions absolutely need to be used and when they should not.
70	There will be Bumps in the Road.. Be Proactive: Know they will happen Prepare for them as best you can Assure yourself and your child you can go over the bump and move on.
71	What else can I do to help? Most importantly: Be supportive and positive- be sure they feel like you have the confidence that they can and will be successful- keep your expectations high You are their biggest fan- be sure they know it! Be available for support- but allow them to live their life- with all of its good, bad, glorious, and awful parts… It is truly the only way your child will become a successful and independent adult.
72	"The Passage From Childhood to..." The Passage From Childhood to Adulthood for All Of Us Involves the “Dignity Of Risk” – The Right to Make Mistakes and Learn From Them.
73	"I see children as kites" I see children as kites You spend a lifetime trying to get them off the ground. You run with them until you are both breathless. They crash, they hit the rooftop. You patch and you comfort. You adjust and you teach. You watch them lifted by the wind and assure them that someday they’ll fly. Finally they are airborne, and they need more string and you keep letting it out. But with each twist of the ball of twine there is a sadness that goes with the joy. The kite becomes more distant and you know that it won’t be long before the string will snap and the lifetime that holds you two together will no longer be the same. A child, as a kite, must be prepared to soar, as they are meant to soar, free and alone, to the greatest extent possible. And only then can we collectively say that we have done our job. Anonymous
74	Web Resources http://tip.fmhi.usf.edu Transition to Independence Process (TIP) Website http://ntacyt.fmhi.usf.edu National Technical Assistance Center for Youth Transition Website http://www.bipolarworld.net/job_schools/js27.htm Handling Your Psychiatric Disability at Work & School. http://www.acmh-mi.org ACMH Website
75	Resources For more information about transition services contact: Local ACMH office ACMH state office 1-888-226-4543 Your Local School or Intermediate School District Try your ISD’s Transition Services Coordinator Your local Community Mental Health Service Provider