Haven and Hope

They did it. They faced some of the hardest obstacles imaginable, and they conquered them. They achieved academic milestones and planned for their futures, all while learning to build lasting relationships and coping with life’s uncertainties and challenges. They’re a little nervous about the next chapter, but ready or not... here it is!

This is a typical scenario for O-School Alumni. After several years of learning, healing, dreaming, and planning, most of our students leave the O-School and return home to be with their families or live independently while pursuing post-secondary education, joining the military, or completing secondary education without special education supports. With 90% of our high school graduates headed to college (two-year, four-year, and vocational programs) and 70% transitioning to less restrictive settings, we believe that our academic, clinical, and transition services help our students accumulate the coping and relational skills, exposure to real-world opportunities, knowledge, and life skills they need to navigate daily life after the O-School. We truly provide a safe haven and a path to hope for the young people who walk through the O-School’s yellow door.

What happens to our students once they leave the O-School? Will our alumni continue to use their strengths to achieve success? Do our alumni have the tangible resources needed to continue their unique paths to hope? Without the comfort and predictability of the O-School, are our alumni able to manage new stressors associated with employment, college, and relationships?

Research shows that these are important questions to ask because young people continue to need supports to safely navigate their own path to hope once they leave therapeutic day and residential treatment programs (e.g., Trout, Huscroft-D’Angelo, Epstein, & Kavan, 2014; Dougherty & Strod, 2014). According to the 2019 State of Mental Health in America report, which compares current mental health indicators to those reported in 2015, the adult population experienced an encouraging decrease in mental health problems and substance abuse, but major depressive episodes among young people increased from 8.66 percent to 12.63 percent (Hellebuyck, Halpern, Nyguyen, & Fritze, 2018). These are alarming numbers. Equally alarming is the reality that many young people return to communities with few supports (Trout, Huscroft-D’Angelo, Epstein, & Kavan, 2014; Hellebuyck, Halpern, Nyguyen, & Fritze, 2018).

Following up with our alumni helps us track and measure the impact of our efforts during treatment and make programmatic improvements. For instance, we recently added a Healthy Sexuality Program and a Transition Services Department in response to needs expressed by our alumni. Follow-up also helps us develop supports and serve as a bridge for our alumni after they return to their respective communities. In addition to annual pizza parties, alumni school visits, and connecting on social media, the O-School recently completed a six-year alumni follow-up project. This project surveyed 127 former students about their perspectives regarding the significance and benefits of the services they received while enrolled in the O-School and after being discharged, as well as any challenges faced. Six months after being discharged, alumni reported on a four-point scale that they were consistently able to maintain close relationships (M = 3.3, SD = 0.73) and that the O-School positively impacted their daily living habits (M = 3.2, SD = 0.95). These ratings were consistent when we followed up after one year, three years, and five years.

Alumni also shared the challenges they faced after leaving the O-School at one year, three years, and five years, including academic difficulties, bullying, balancing self-care (physical and mental health) and responsibilities, diminished coping skills, strained and/or unhealthy family relationships, and managing responsibilities such as work expectations, financial obligations, and living arrangements. Based on their reported challenges, research shows that rather than a loss of gains made during treatment, we are seeing a need for stronger ties between treatment provider, family, and community (Trout et al., 2014; Dougherty & Strod, 2014; Nayyar-Stone & Hatry, 2003). According to the Building Bridges Initiative (BBI), which is a national collaborative of residential providers, families, youth, advocates, community partners, and policymakers, with support from the Substance Abuse and Mental Health Services Administration (SAMHSA), following up on alumni plays a critical role in sustaining gains. In fact, follow-up is an organization’s contribution to the shared responsibility of sustaining positive outcomes, along with community partners and funding sources (Dougherty & Strod, 2014):

“Sustained positive outcomes are a shared responsibility of the residential provider, community partners, and the payers. Besides being a good business practice, follow-up is necessary to assess how youth and families are doing post discharge and what they may need in the way of additional community services and supports. The bridge between components of a residential and community-based system of services and supports, including schools, is essential, and it is incumbent on residential providers to ensure that the support is available to families and youth after returning to their communities. Routine follow-up protocols will allow residential providers to assess and improve their own performance.” (p. 6).

This is why our board, school leadership, transition services, and marketing departments are working together to strengthen and build sustainable community ties through creative partnerships with local businesses, the arts community, community organizations, school districts, and educational consultants. The O-School is also planning to launch a longitudinal student outcomes project that will insert conversations about follow-up into the admissions process. Informed by national measures (e.g., National Survey on Drug Use and Health and Behavioral Risk Factor Surveillance System), we plan to follow student progress from admission to three years after discharge to help us:

• Assess whether gains are maintained over time
• Identify what factors contribute to long-term success
• Motivate staff as they learn that former students are maintaining success
• Identify common post-discharge problems that could have implications for our programming
• Help alumni stay connected in case services or referrals are needed
• Go above and beyond accreditation and funder expectations
• Market our services

For more than 100 years, the O-School has provided excellent care and support to students with severe emotional challenges and high-functioning autism. We are proud of our legacy and the long-lasting connections we have with the students and families we have served over the years. As we fine-tune our follow-up efforts, we expect these connections to grow exponentially, allowing us to offer programming with greater efficiency and effectiveness. With students coming to us from around the globe, we believe our follow-up efforts will help us broaden the scope and geographic boundaries of the community.

Dr. Julia Wesley currently serves as Director of Research and Outcome Measurement for the O-School. To learn more about the O-School’s alumni follow-up project and other research activities, please contact Julia at jwesley@oschool.org. To learn more about the O-School’s residential and day programs, please visit our website. If you have a child or loved one who you believe would benefit from the O-School’s or Brooke Whitted Center’s services, please visit our contact page or call Director of Admissions Kristin Friesen at 773-420-2891.

References:

[1] O-School Student Exit Data (2019, October). Student discharge data between January 2017 and October 2019.

[2] Data in the State of Mental Health in America report are from national surveys, including the Substance Abuse and Mental Health Services Administration’s National Survey of Drug Use and Health (NSDUH) and the Center for Disease Control’s Behavior Risk Factor Surveillance System (BRFSS). Data were collected between 2011-2016.

Dougherty, R. H., & Strod, D. (2014, March). Building consensus on residential measures: Recommendations for outcome and performance measures. National Building Bridges Initiative. Retrieved September 11, 2019, from http://www.buildingbridges4youth.org/sites/default/files/BBI%20Building%20Consensus%20on%20Residential%20Measures%20-%20March%202014.pdf.

Hellebuyck, M., Halpern, M., Nyguyen, T., & Fritze, D. (2018). The state of mental health in America, 2019. Alexandria, VA: Mental Health America. Retrieved September 11, 2019, from https://www.mhanational.org/issues/state-mental-health-america.

Nayyar-Stone, R., & Hatry, H. P. (2003). Finding out what happens to former clients. Urban Institute: Series on Outcome Management for Nonprofit Organizations. Retrieved September 11, 2019, from https://www.urban.org/sites/default/files/publication/42746/310815-finding-out-what-happens-to-former-clients.pdf.

Trout, A. L., Huscroft-D’Angelo, J., Epstein, M. H., & Kavan, J. (2014). Identifying aftercare supports for out-of-home transitions: A descriptive analysis of youth perceptions and preparedness. The Journal of At-Risk Issues, 18(1), 11–17.

O-School Student Exit Data (2019, October). Student discharge data between January 2017 and October 2019.

Data in the State of Mental Health in America report are from national surveys, including the Substance Abuse and Mental Health Services Administration’s National Survey of Drug Use and Health (NSDUH) and the Center for Disease Control’s Behavior Risk Factor Surveillance System (BRFSS). Data were collected between 2011-2016.