Analysis of HB18: A Framework for Expanded School Mental Health

While this bill is characterized as just being a “framework” for school mental health, it actually makes fundamental changes in the focus of our schools.

1. This bill broadens the definition of mental illness, by calling it a “mental condition.” A mental condition is defined like this: (A) constitutes a mental illness, disease, or disorder, other than or in addition to epilepsy, substance abuse, or an intellectual disability; or (B) impairs a person ’s social, emotional, or educational functioning and increases the risk of developing a condition described by Paragraph (A).

We already have a problem “definition creep” in mental health. Each new edition of psychiatry’s Diagnostic and Statistical Manual (it’s catalogue of disorders) expands the list of disorders that psychiatrists can diagnose and bill for:

This sort of definition creep has no doubt contributed to overdiagnosis and over drugging of our society at large. Psychiatry’s Diagnostic and Statistical Manual lists “disorders.” (These are literally voted into existence, and there is considerable drug company influences on the panels that vote these disorders into existence) The DSM was first published in 1952 and had 128 diagnoses. The 5th edition of the DSM was published in 2013 and had 541 diagnoses.

This sort of definitional creep leads to things like: Reading disorder, math disorder, disorder of written expression, gaming disorder. While one would hope that these everyday problems would be managed academically or with parental discipline.

“Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure.”– Thomas Insel, Former Director– National Institute of Mental Health

– Thomas Insel, Former Director– National Institute of Mental Health

2. Positive behavior supports and interventions, grief and trauma-informed practices are among the practices that must be added to District Improvement Plans. These plans serve as guidance to districts for improving student performance. Implementation of Comprehensive School Counseling plan also incorporated. (page 2, line 33)

3. Continuing education for school principals must include evidence or researched based practices approved by the Commissioner of Education in consultation with the Health and Human Services Commission, on such things as how to effectively implement the Comprehensive School Counseling Program, mental health programs addressing a mental health condition. (page 4, line 10)

4. Continuing education for School Counselors must include: counseling students concerning mental health conditions and substance abuse, including through the use of grief-informed and trauma informed interventions and crisis management and suicide prevention strategies, and effective implementation of a comprehensive school counseling program. (page 4, beginning on line 57)

5. Staff development- includes recognizing students with mental health conditions, or at risk for suicide, how grief and trauma affect student learning and behavior and how evidence-based, grief-informed, and trauma-informed strategies support the academic success of students affected by grief and trauma (page 5, beginning on line 11)

6. Mental Health Education: (Page 6, beginning on line 54) (ii) mental health, including instruction about mental health conditions, substance abuse, skills to manage emotions, establishing and maintaining positive relationships, and responsible decision-making; science, risk factors, causes, dangers, consequences, signs, symptoms, and treatment substance abuse, including the use of illegal drugs, abuse of prescription drugs, abuse of alcohol such as by binge drinking or other excessive drinking resulting in [and] alcohol poisoning, inhaling solvents, and other forms of substance abuse. The agency shall compile a list of evidence-based substance abuse. (nobody knows causes, and the science isn’t settled)

7. Page 6, line 58- Local SHAC’s decide number of hours of MH and other health education K-12, as well as integrating the curriculum with health and mental health services provided at the campus, including by a private provider (page 7, line 24).

8. (8, beginning on line 55) Mandates the planning, establishment, and evaluation of a Comprehensive School Counseling Program.

9. Gives the school district the authority to contract with a non-physician mental health professional. This includes a masters level psych nurse. Can these prescribe? (page 9, beginning on line 10) Unlike other bills, this professional is not prohibited from treating individual children.

10. (Page 9, line 66)- expands who in the school can recommend a student be seen for a psych eval. It expands it to non-physician MH professionals hired by or under contract to the school. Nothing in this bill prevents the non-physician MH professional from also working for a psych hospital or other program that could benefit from such referrals. This makes clear that the district personnel can refer to the non-physician MH professional for evaluation.

11. (page 10, line 23, 24) Clarifies that MH and substance abuse services can be delivered by a school-based health center.

12. (Page 10, beginning on line 34) Changes consent requirements for school MH services. When original law was passed, it was amended to make it where a parent had to consent to each episode of MH services. Under this bill, the parent could consent to a series of treatments.

13. (page 10, beginning on line 64) Allows TEA and HHSC to come up with “guidelines” on how schools can partner with local mental health authorities or even private providers to increase student access to mental health services and how to make it billable under Medicaid.

14. (Page 34, beginning on line 6) HHSC MUST PROMOTE MH FIRST AID

Download PDF Version:

Leave a Reply

XHTML: You can use these tags: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>