A Phenomenon on Mental Health as a Challenge to Youth Development in Nigeria and Its Counselling Implications
Chapter One
AIMS AND OBJECTIVES OF THE STUDY
The major objectives of the study are to examine mental health as a challenge to youth development and its implications on counseling. Other specific objectives of the study include;
- To examine the state of mental health of youths.
- To determine the importance of youth development on nation building.
- To assess the benefit of counseling to youth development.
- To examine the factors affecting mental health of youths in Nigeria.
- To determine the impact of mental health on youth development and counseling.
CHAPTER TWO
LITERATURE REVIEW
Theoretical Framework
Gresham (2004) argues for the use of interventions to prevent behavior problems as opposed to those procedures that punish or try to avert the behavior. In other words, instead of addressing issues that have already surfaced, the goal of preventive interventions is to counteract risk factors and reinforce protective factors to disrupt an individual’s trajectory towards mental health dysfunction. Gresham discusses the town’s role in prevention and intervention specifically through his theory of town-based behavioral interventions. Towns are an important setting for child and youth behavioral interventions, since so many youths do not seek help outside of town. In addition, due to the amount of time youths spend in town, it becomes the ideal place for powerful youth mental health intervention.
Gresham (2004) suggests that interventions must be conceptualized based on intensity level and purpose, and that the goal is to match the intensity of the intervention with the intensity of the presenting problem behavior. Gresham outlines three levels of prevention. Primary (or universal) prevention seeks to prevent harm and is designed to affect all youths. These interventions can be delivered at a class-wide, town-wide or district-wide level, and seek to assist in the development and social development of youths by teaching development and prosocial skills. Secondary (or selected) intervention is designed for youths at risk of developing severe problems and therefore seeks to reverse harm. This level of intervention targets the 5-10% of youths who do not respond to the universal intervention, and therefore require more targeted interventions. The goal of selected interventions is to “provide youths with effective development and social-behavioral repertoires that will make them more responsive to universal interventions” (Gresham, 2004, p. 330). Tertiary (or intensive) interventions are reserved for the small percentage of youths who exhibit chronic difficulties and are responsible for most of the behavioral disruptions in town. These interventions attempt to reduce harm and decrease the frequency and intensity of the problem behaviors through intense, individualized, and comprehensive services.
In addition to these levels of intervention, Gresham also suggests the use of a Response to Intervention framework as a means of determining the level of intervention needed. “An RTI model uses a youth’s lack of response to an evidence-based intervention that is implemented with integrity as the basis for intensifying, modifying, or changing the intervention” (Gresham, 2004, p. 330). He argues that this approach allows for youths who are having difficulties to receive immediate assistance, as opposed to waiting for the issue to become more severe before interventions are implemented. Gresham believes that early intervention is critical. Early proactive involvement for all youths may reduce the need for more expensive and intensive treatment later in their development.
The incidence of mental health issues among youths is growing (Collishaw, Maughan, Goodman & Pickles, 2004), and it is widely known that untreated or undertreated mental health issues only get worse as time goes on (Repie, 2005). In a survey of educational professionals and families, Repie (2005) found that the cost of care, the quality of care and access to services were cited as the main complications. Therefore, individuals who do not receive care present very challenging and difficult problems for secondary towns to service. RTI is a useful theory for understanding how counselors support youths with mental health issues in their towns. This theory provides the guidance that towns need in order to be proactive, provide immediate assistance to those youths in need, and maximize general education’s overall effectiveness.
Towns are responsible for educating all youths, and typically their effectiveness is judged by their youths’ math and reading scores, as well as drop-out and graduation rates.
Youth success, though, is more than development success, and a town’s mission must be more than an instructional one. As Doll and Cummings (2008) assert, “life success is a product of social and emotional competence and personal ambition as much as development achievement and literacy” (p. 15). Therefore, just as towns are rethinking the way they traditionally offer development curricula and services, so too should they reframe the way they implement youth supports. Individual responsive services are not effective enough to address the rising number of mental health issues, nor can they adequately curtail the increase in the number of youths receiving special education services and its related costs (Martinez & Ellis, 2008). Instead, support services need to be part of a comprehensive, multifaceted, and cohesive framework.
Town administrators must ensure that every youth has an equal opportunity to succeed in town. In order to do so, they must put as much emphasis on social and emotional learning as they do on development learning. This literature review will discuss current trends in youth mental health, the historical and current perspective of town mental health, prevention science’s tiers of intervention, and explain the theory and model of Response to Intervention. In addition, this review will discuss how the Response to Intervention model can be implemented to address youths’ social and emotional needs, consider the benefits and challenges of implementing the
Response to Intervention framework, and examine how it fits into a comprehensive framework for addressing mental health issues. Finally, a review of the research regarding town mental health and counselors will be included.
CHAPTER THREE
METHODOLOGY
Every town was unique, and therefore has different needs and supports to offer youths. In addition, each youth presents a unique context within which counselors must create supports and a plan to assist them. This research was not intended to measure the effectiveness of specific interventions, but rather to explore what counselors are experiencing as they work with youths with mental health needs and what strategies they utilize. Therefore, this study sought to answer the following questions: What are the experiences of counselors who provide support to learners who struggle with mental health issues? In what ways do counselors perceive their roles as shifting as they work with these youths? Finally, how do guidance and counseling services and programs support the development achievement of youths struggling with mental health issues?
Since the primary interest of this research is the investigation of a particular phenomenon and sample’ experience with it, the researcher utilized an interpretive paradigm (Merriam, 2002). This paradigm does not see reality as being fixed and measurable, but rather as constantly in flux and different for each individual at different times (Burrell & Morgan, 1979). This paradigm helped the researcher understand the meaning the social world has for individuals (Merriam, 2002), and therefore explained the phenomenon through individual participant understanding, rather than through observer action (Burrell & Morgan, 1979). In addition, this paradigm is not concerned with conflict and change, but rather assumes that the social world is methodical and consistent in order to focus exclusively on the individual subjective experience (Burrell & Morgan, 1979).
Research Design
A qualitative design allowed individuals to tell their stories so others’ can learn the meaning the sample hold about the issue (Creswell, 2012). Also, a qualitative design assisted in giving a complex and detailed understanding of the issue at hand to make sense of a particular phenomenon (Merriam, 2002). Thus far, as identified in the literature review, the counselor’s perspective has been absent from the research. Since this study sought to understand what counselors are experiencing from their perspective, the sample’ voice was critical (Hoepfl, 1997). In addition, this study was not interested in determining how many counselors are using which interventions, but rather sought to describe their experience using interventions as they support youths with mental health issues. Rich description (Hoepfl, 1997), a characteristic of qualitative research, accounted for the nuances of individuals’ experiences in supporting youths in a way that quantitative research cannot. Therefore, the end product gives readers a better understanding of what counselors are experiencing in their jobs, and why they are or are not utilizing either tiers of intervention or Response to Intervention
Sample of study
For this research, I purposely selected three sample utilizing the criterion sampling strategy (Miles & Huberman, 1994), one in which sample were chosen based on predetermined criteria. Each participant had at least seven to ten years of experience in the town counseling field and work in suburban Lagos towns. The years of experience was key as youth mental health needs have increased exponentially in the past few years and documenting the counselor’s experience through this change was critical. Counselors new to the profession would not have this context. The sample were recruited from the researcher’s neighboring towns who participate in the Middlesex League Guidance Directors’
The sample for this study was small as the purpose of the study was to discover the story of what is going on in the field in detail. One limitation to the small sample size was that the results may not be generalizable to all counselors in suburban settings. In addition, while counselors represented towns with a range of median household incomes, all sample work in suburban towns. The restriction to suburban towns helped to focus the research, however, the results may not be helpful to counselors from urban or rural districts. Finally, choosing counselors with at least seven years’ experience was important to tell the story of what is going on and how the field has changed. However, a limitation was that some of these counselors may not have had the same education and training that newer counselors have in the field of counseling psychology, thereby limiting their capacity for self-efficacy in supporting these youths.
Population of study
The population was recruited from some mental health centers in Ikeja. I separated the sample into income categories and then I randomly selected one participant from each income category. The three chosen sample represented a substantial difference in income. In other words, I did not want the sample between tiers to only represent a few thousand dollars difference in income.
Information in the description of the study included why the site was chosen, what the researcher will accomplish during the study, how much time will be spent at the site, how the results will be used and reported, and what individuals at the site will gain from this research (Creswell, 2012). All results will be shared with the participating towns, as well as other interested towns, at the completion of the dissertation.
Once the principals gave me permission to conduct the research at their site, I asked the counselors to sign the consent form that included a full description of the research problem and purpose, as well as information about the time commitment, the data to be collected, potential disruptions, protection of confidentiality, and what the individual might gain from participating in the study (Appendix C). In addition, the consent form described the right of the participant to withdraw from the study at any time. Sample received a $25 gift certificate to Amazon at the conclusion of the interviews.
CHAPTER FOUR
PRESENTATION OF RESULTS
Findings
Transcripts were reviewed and initially coded prior to the next round of interviews being completed. After the completion of the third round of coding, codes were collapsed into five general categories: 1) role and responsibility of counselors, 2) experience with mental health issues, 3) Response to Intervention, 4) current supports and interventions, and 5) how to better support youths. Each category includes themes and subthemes, which describe the experience of these three counselors as it relates to their work supporting youths with mental health issues. In order to more fully explain the themes and sub-themes of these categories, excerpts from the interviews will be included.
CHAPTER FIVE
CONCLUSIONS AND RECOMMENDATION
Three significant conclusions were drawn from the research findings: a) in order to support all youths mental development, towns must support all youths emotionally; b) the model of town counseling services has not progressed as our knowledge of how to support youths has evolved; and c) programmatic interventions can work for general education youths when they are systematically need-based and focus on relationship building.
Recommendations for Future Research
The findings of this study identify the gap between literature and practice in supporting youth mental health needs in towns by highlighting the counselor experience. There are several areas where additional research is necessary in order to continue the conversation of town guidance services.
- This study only included three sample, which allowed for several interviews with each in order to reach a deeper level of understanding of their experiences. This would not have been achieved with more sample and fewer interviews with each. However, a small number of sample limits the generalizability of the counselor’s experience in supporting youths with mental health issues. Future research should focus on identifying the experience of counselors in different settings, including urban and rural towns, and sample should represent different states across the nation. Current literature and research continues to talk at counselors, however this future research will bring their voice to the forefront.
- One voice and perspective that was missing from this research is the district- and/or town-level administrator. This research highlighted differences between counselor and administrator perspectives on the role of the counselor in the town, and a lack of understanding about youth issues and their impact on town success. Future research should focus on youth mental health from the administrator’s perspective, and why service delivery is slow to change even though current research and literature advocate for it. Identifying why change is so difficult to achieve, and where ideas differ and overlap between administrators and counselors will be critical to future changes.
- Another area to focus on is towns that already utilize the Response to Intervention framework for mental health issues. This research can focus on the framework’s implementation in practice, and highlight some of the benefits and challenges associated with its usage. Moreover, questions surrounding its origins are significant – Who introduced the idea? How long did it take to implement? What steps did the town take to do so? What systemic changes were necessary to support this change, if any? Another option would be to conduct a case study or action research study to detail the framework’s implementation in one town. This research could highlight best practices and potentially lead to an implementation manual for towns to utilize as they move towards using this framework.
- Each participant indicated that in-town programmatic interventions will allow them to change the focus of their daily work to support all youths. One potential area of research is to interview counselors and administrators in towns that offer programs for youths. This research could focus on the programs they offer, what issues they address, and why these interventions work. With descriptions of the programs and their benefits and challenges, researchers could create a resource for other towns to utilize as they consider implementing programs. Sharing ideas, instead of reinventing the wheel, is always easier considering the restraints on administrators’ and counselors’ time.
- A final area of further research should be a quantitative analysis of implementing universal prevention and programmatic interventions. Special education costs are rising, which puts a strain on the rest of the district’s budget. This research could examine the cost analysis of hiring additional staff to run programs versus the cost of sending youths to out of district placement. Can more youths with significant issues be kept in-house with programmatic interventions, thereby saving the district money? With money being a significant factor in town counseling service delivery, this would give counselors and town-level administrators hard data to advocate for their budgetary needs with town committees.
Conclusion
As youth mental health issues continue to rise, towns will continue to be called upon to provide services to support their youths emotionally so that they can achieve mental development. This research highlights that even though current literature and research have proposed new ways of supporting this growing number of youths through proactive and systemic support, some town counseling departments continue to only be able to respond reactively to youth needs. The Response to Intervention framework offers one way for towns to address the social-emotional needs of their youths proactively, however, implementation will require substantial systemic change. Counselors and social-emotional learning must be given the same focus and support as teachers and development learning. If changing the system allows counselors to more effectively support and advocate for their youth, then it is imperative for town leaders to discuss how it can be realized in their towns. It is my hope that this research will be the first step in helping to create that change.
References
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