Youth and Family F Youth and Family Focus Group-Parent/Caregiver

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Public Burden Statement: An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this project is 0930-XXXX. Public reporting burden for this collection of information is estimated to average 1.5 hours per respondent, per year, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to SAMHSA Reports Clearance Officer, 1 Choke Cherry Road, Room 2-1057, Rockville, Maryland, 20857.

Youth and Family Focus Group–Parent/Caregiver Version

Introduction

ICF is conducting an evaluation of the Advancing Wellness and Resilience in Education (AWARE) and Trauma-Informed Services in Schools (TISS) programs. The study is sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). As part of this study, we are inviting you to participate in a focus group for parents and caregivers of students at (name relevant school) so that we may gain a better understanding of the resources at your student’s school that help students feel safe and supported and that support them in overcoming challenges and feeling resilient. We are aiming to understand your perspectives about the availability of mental health programs, resources, and services in the school; access to those types of resources and services; and any recommendations you have to improve access to, or the quality of, mental health resources and services in schools. You have been asked to participate because you may have insight about the activities provided for all students through the (AWARE or TISS program, as relevant) or your student may have received other related services.

Before we begin, let me ask: Have you had a chance to review the material that was sent to you about the focus group? That material included a description of the study we are conducting and information about how the information you provide will be used and the privacy of your responses. (Note: the consent form and background information about the focus group will be sent to participants in advance.)

Let’s review the information in that material together now. Here are some things we want you to know about the focus group before agreeing to participate:

Purpose

We have invited students and parents or other caregivers from schools across the country to participate in focus groups like this one. The purpose of this focus group is to gather information about services at your student’s school. This is not an evaluation of you, your student, or the school. At the end of this study, we will prepare a report that summarizes the information we collected across participants.

Risk and Benefits

Participating in this focus group is unlikely to cause any problems for you in any way. Your answers will not give you any benefits or change any benefits that you currently may be receiving. Your input will be used to help improve mental health programs in schools.

Rights Regarding Decision to Participate

Your participation in this focus group is completely voluntary. You can choose not to answer any question for any reason. You may also choose to leave the focus group at any time, for any reason.

Compensation

If you agree to take part in this focus group, you will receive a $25 gift card at the end.

Privacy

We will keep your answers private, and we will not use your names when summarizing today’s discussion. We also ask that you do not talk about what is said in the focus group outside of this room in order to protect the privacy of others participating in today’s focus group.

Time and Recording

The focus group should take about 60-90 minutes. Your responses are extremely important to the success of the study. We value the information you share with us and want to make sure we capture all of it as accurately as possible. For that reason, we will be taking some notes and recording the discussion. If at any time you would like to tell us something in private, we can turn off the recorder.

Ground Rules

When you answer a question, please wait until the other person has finished speaking. We want to be sure that everyone who would like to speak has a chance to share their ideas.

Contact Information

If you have any concerns about your participation in this focus group or have any questions about the evaluation, please contact the project director, Colleen Murray, at [email protected].

Does anyone have any questions about the information we just covered or about the focus group in general?

Are you each willing to continue with the focus group? (Consent for each participant)

Are you willing to have the focus group recorded to ensure that we have an accurate record of the discussion?

Focus Group Questions

Opening Question

1. To get us started, please tell us your first name, and what grade your student is in.

Mental Health Literacy/Availability of Positive Health Supports (AWARE only)

2. Can you tell me a bit about how your student’s school creates an environment in which all students feel supported and safe? By “safe,” I mean without fear of physical or emotional harm. (Probe: list examples tailored to each school’s specific approach.)

How helpful is that approach?

What makes students feel safe at this school?

How do these supports (probe: refer to the specific supports under discussion) make all students feel included? For example: 1) students from different cultures or backgrounds or who grew up speaking a different language, including not English? 2) students who identify as LGBTQ+? This term includes lesbian, gay, bisexual, trans, queer, questioning, and more identities.

(Optional probe if needed to clarify or encourage discussion) What are some reasons students may not feel safe? (Probe: Bullying, peer influence, discrimination, home or community factors, unsupportive school administration, student-student conflicts or relationships? Student-teacher relationships?) How does the school help to address some of these issues?

3. What do you think are some of the biggest health challenges students (probe: at age of participants’ students) face today? When we say health or healthy, we are talking about being mentally, physically, and emotionally healthy. Another way to think about it might be health in mind, body, and soul. (Probe for substance use, violence-related behaviors, mental health-related behaviors)

1. In what ways does the school support student health?

4. What has your student learned about mental health at school this year? (Optional probes below)

Warning signs of suicide and how to get help? If yes, what are some examples of what they learned?

Causes of mental illness (such as depression, anxiety, or mood disorders)? If yes, what are some examples of what they learned?

• e.g., family history, stress, substance use

Symptoms of mental illness? If yes, what are some examples of what they learned?

• e.g., sadness, loss of interest, stress, restlessness, irritability

Things a person can do to improve their own mental health? If yes, what are some examples of what they learned?

• e.g., physical exercise, balanced diet, getting enough sleep, talking about problems

Things a person can do to help someone who is showing signs of mental illness? If yes, what are some examples of what they learned?

• e.g., offer to help, encourage him/her to get help from an adult at school, talk to an adult at school about it

5. How much do these activities and resources (probe: refer to resources under discussion and specific to the grantee context) help students from all different kinds of cultures and backgrounds? For example, are resources offered in more than one language?

   1. How much do these activities and resources (probe: refer to resources under discussion and specific to the grantee context) address the needs of students who identify as LGBTQ+?

6. How does the school keep you informed about the school’s efforts and activities designed to create an environment in which all students feel safe and supported?

For example, how does the school provide information for you about the school’s plans and activities to ensure students feel safe and supported? (e.g., materials, meetings, communications, etc.)

How does the school invite your opinions, input, and ideas on creating a positive, safe school environment?

Availability of Mental Health Services/Targeted or More Intensive

7. What types of support are available for students at the school who might need help with a personal problem?

For example, what about a school counselor? Teacher? Health center? School psychologist? Student support group?

8. How do these supports work for students from all cultures and backgrounds? ? For example, are resources or services (note: refer to services under discussion and specific to the grantee context) available in more than one language?

   1. To what extent do these supports address the needs of students who identify as LGBTQ+?

9. If your student needed help with a personal problem, do you feel it would be helpful to rely on the supports available at the school for assistance? Please explain.

10. How does the school keep you informed about services and supports available for students at the school who might need help with a personal problem?

How does the school invite your opinions, input, and ideas about services and supports that are needed?

Trauma-focused Services (TISS only)

11. Can you tell me a bit about the types of services available at the school for students who have had a traumatic experience? By “traumatic experience,” I mean an event or series of events that cause a lot of stress and may even make a student feel threatened about serious injury or death.

12. How does the school engage parents and caregivers and increase awareness about the impact of traumatic experiences on children and youth?

For example, how does the school provide information to you on this topic? (e.g., materials, meetings, communications, etc.)

Access to Services

13. How easy is it for students to get connected to supports or services provided through the school if they need them?

If a student had a personal problem, would they know what to do or who to talk to?

What challenges, if any, make it more difficult for students to get the services they need?

What makes it easier for students from different cultures—or who grew up speaking a different language including not English—to access the services they need? What makes it harder for such students to access services?

Experience with Services/Satisfaction

14. If you could change something about the services provided at the school, what would that be?

15. What could have made it easier to be connected to these services?

What other services would be helpful?

16. How satisfied do you feel overall with the services provided at your student’s school?

Perceptions: Outcomes

17. Do you think the services provided through the school make a difference in students’ lives?

Can you share an example?

18. Thank you so much for sharing your stories with us today. Is there anything that we missed?

Is there anything that you came wanting to say that you didn’t get a chance to?

Youth Resiliency and Outcomes Study Module (Option Year 3)

1. Next, we would like to talk specifically about student resiliency and coping skills. To what extent have the (insert resources specific to grant context) influenced your student’s resiliency and coping skills?

1. What are some practices or strategies that your student has learned from (insert resources specific to grant context) that have helped your student work through challenging situations?

2. Thinking about what we’ve talked about today about the work the school does to support student mental health, what else, if anything, do you think the school can do to help students feel healthy and safe and supported at school?

How can the school ensure that parents and caregivers are informed, included, and engaged in efforts to create a safe and supportive school environment?

Closing

Again, thanks to everyone for participating in this discussion. If you have any additional information for me to consider or if you have questions about the progress of this study or the information that was gathered, please do not hesitate to contact us. We have provided contact information in the materials you were forwarded before this discussion (refer group to materials provided in advance), and we can provide any of those materials or information again now.

Also, I want to check in with everyone now that the focus group is completed and let you know that if answering any of these questions or participating in the group has made you want to talk to someone about your feelings and experiences, there are many excellent resources available to you. We are also providing each of you with a list of resources that offer counseling and support here in [CITY] that may be useful to you. Please come talk to me or [NAME - OTHER ICF STAFF] if you would like any additional information or have questions or if we can help connect you with someone to support you right now.

Note: After the focus group is completed, the moderator will send the participant a thank you communication and a $25 gift card for their participation.

Youth and Family Focus Group—Debrief and Crisis Protocol

Questions included in the Youth and Family Focus Group are unlikely to cause distress. However, the ICF team will closely monitor the group for signs of distress and pause the focus group if necessary to support individual participants in suspending or ending their participation in the focus group if feeling distressed. As part of the introduction and informed consent procedures in advance of the focus group, the moderator will review the following information with youth participants: “Participating in this focus group is unlikely to cause any problems for you in any way. If answering any of these questions makes you want to talk to someone about your feelings and experiences, you can talk to a school counselor or teacher. If talking to someone at school is not the best plan for you, you should talk to a grown-up you trust, such as a parent or family friend.”

Following the focus group, the ICF moderator will note, “I want to check in with everyone now that the focus group is completed and remind you that if answering any of these questions or participating in the group has made you want to talk to someone about your feelings and experiences, there are many excellent resources available to you. (Youth version only: For example, you can talk to a school counselor, teacher, or other trusted adult such as a parent or family friend). We are also providing each of you with a list of resources that offer counseling and support here in [CITY] that may be useful to you. Please come talk to me or [NAME - OTHER ICF STAFF] if you would like any additional information or have questions or if we can help connect you with someone to support you right now.”

The ICF team will provide a list of resources offering behavioral health counseling and support for each focus group participant. ICF will tailor the list of resources for local sites once the participating sites are selected. For example, a sample list of resources developed for a site in Milwaukee is included below. In the case of participants who appear distressed following the focus group, the ICF team will approach the participant privately and offer support including asking, “Can I help connect you with someone to support you right now?” (Whitney and Evered, 2022) The team will support the participant in connecting directly with a school counselor, teacher, or other trusted adult such as a parent or family friend and/or with local behavioral health counseling services.

Sample List of Resources

Milwaukee School System-Specific Resources

• School Social Worker/Psychologist

• You can reach out to your school social worker/psychologist for support. Your school social worker/psychologist can help you with any type of issues, including things related to your experiences at school or at home. They can also connect you to other resources for additional support.

• Name: [INSERT SCHOOL NAME}

• Contact information: [INSERT CONTACT INFO]

• Department of Gender & Identity Inclusion (GII) Case Management

• GII is an MPS department that supports students and their families. GII can work with you and/or your family to understand your needs and connect you to appropriate resources.

• Website: https://mps.milwaukee.k12.wi.us/en/District/About-MPS/Departments/Office-of-School-Administration/Gender-and-Identity-Inclusion.htm

• Froedtert Inclusion Health Clinics

• Provide medical care to meet the health care needs of the LGBTQ community. 

• Website: https://www.froedtert.com/locations/clinic/inclusion-health-clinic-sargeant-health-center

• Call: 414-805-2018

• PRISM Program

• A mental wellness resource for LGBTQ+ youth in Wisconsin. The PRISM Program is a team of queer and/or trans Certified Peer Specialists trained to use their lived experiences with mental health and substance use struggles to support others in their recovery journey. You can call or text their number for support between 10am-10pm Sunday-Friday or 12pm-10pm Saturday.

• Website: https://www.mhawisconsin.org/prism

• Call or text: 414-336-7974

• Brady East STD Clinic (B.E.S.T.D Clinic)

• Provides high quality sexual health services to all in an affirming environment and at no cost.

• Website: https://www.bestd.org/

• Call: 414-272-2144

• Diverse and Resilient

• Works to achieve health equity and improve the safety and well-being of LGBTQ people and communities in Wisconsin.

• Website: https://www.diverseandresilient.org/

• Call: 414-390-0444

• The Milwaukee LGBT Community Center

• Offers services to meet the needs of LGBT youth, adults, and their allies in the Greater Milwaukee area.

• Website: https://www.mkelgbt.org/

• Call: 414-271-2656

• Courage House MKE

• Wisconsin’s first home for displaced LGBTQ+ youth who have suffered mental or physical abuse, have no means to support themselves, and/or need a place to temporarily call home.

• Website: https://www.couragemke.org/

• Call: 414-240-2882

• Children’s Hospital Gender Health Clinic

• A multidisciplinary clinic focused on children and youth seeking assistance with gender identity development and transition concerns. Staff meet with new patients through age 16 on an individual basis for comprehensive evaluations, mental health consultations and education. Services also include puberty-suppressing hormone therapy, gender-affirming hormone therapy, surgical treatments, and speech/voice training. The clinic can also provide children and adolescents with connections to other resources and support within Children’s Wisconsin and the community.

• Website: https://childrenswi.org/medical-care/endocrine/gender-health-clinic

• Call: 877-607-5280

• FORGE

• Reduces the impact of trauma on trans/non-binary survivors and communities by empowering service providers, advocating for systems reform, and connecting survivors to healing possibilities. FORGE strives to create a world where ALL voices, people and bodies are valued, respected, honored, and celebrated; where every individual feels safe, supported, respected, and empowered.

• Website: https://forge-forward.org/

• Call: 414-559-2123

• Pathways Counseling

• State certified, outpatient mental health clinic. Pathways provides many LGBTQ+ mental health services. Individual, couple, family, and group therapy options are available.

• Website: https://www.pathwayscounseling.com/

• Call: 262-641-9790

• Hmong American Women’s Association

• Organizes Southeast Asian women, girls, Queer and Trans people to champion gender justice and collective liberation.

• Website: https://www.hawamke.org/

• Call: 414-930-9352

National Resources

• The Trevor Project

• Offers information and support to LGBTQ+ young people. The Trevor Project is available 24/7 every day of the year. You can contact them by call, text, or online chat.

• Website/online chat: https://www.thetrevorproject.org/get-help/

• Text: text “START” to 678-678

• Call: 1-866-488-7386

• 988 Suicide & Crisis Lifeline

• The Lifeline provides 24/7 free and confidential support for people in distress. You can contact them by call, text, or online chat.

• Chat: https://988lifeline.org/chat/

• Call or text: 988

• Website: https://988lifeline.org/help-yourself/

Reference

Whitney, C., & Evered, J. A. (2022). The Qualitative Research Distress Protocol: A Participant-Centered Tool for Navigating Distress During Data Collection. International Journal of Qualitative Methods, 21. https://doi.org/10.1177/16094069221110317.

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