In stressful moments, it always helps to have someone by your side. When it comes to providing mental health services, school districts could use some extra support, too.
In California, experts agree the pandemic has exacerbated already deep-rooted mental health challenges for students. An August report from the Little Hoover Commission, a state independent oversight agency, called the pandemic a “perfect storm of stress, anxiety and trauma,” and a survey conducted by United Way of Greater Los Angeles this summer found that 42 percent of students listed mental wellness as a top priority and more than half expressed some level of worry about their mental health. About one third of students of color said they did not have an adult at school with whom they could safely share their feelings.
With an influx of federal pandemic relief funding and potential money from the state budget surplus, many districts in California find themselves flush with more resources for mental health services than they’ve had in years. But that funding is running up against a familiar problem: staffing shortages. In this case, there may not be enough trained school mental health professionals to go around. To fill the gap, some districts are partnering with community organizations to bring essential services to struggling students using human infrastructure that already exists.
“Lots of people in California are facing a tsunami of mental health needs. And yet, there's not enough professionals and paraprofessionals to really address the need,” says Christine Stoner-Mertz, CEO of California Alliance, a network that supports and advocates on behalf of “member” community organizations providing child and family services across the state. “Many of our members have, given the workforce challenges, really tried to expand and increase… partnerships with schools.”
Surging Mental Health Needs
Student mental health was especially vulnerable under the pandemic because remote learning hindered traditional school-based services, says Allison Becwar, chief program officer of youth-focused community organization, Lincoln Families. She notes that mental health referrals to school counselors dropped largely because teachers couldn’t easily monitor their students’ well-being through a screen.
Today, elementary students are taking longer to transition back into school routines, she says, and among older students, fighting and self harm have increased.
Robin Detterman, executive director of Seneca Family of Agencies, a community organization providing mental health, education and juvenile justice services across California and Washington state, has seen the same trend. At a school in East Oakland where Seneca conducted a screening of 200 fourth graders for a new trauma support group, Detterman expected to register a handful of participants. She was shocked to find that about 60 percent of those students met the criteria for having experienced trauma and needing more intensive support.
“When you look at that being the basis of what is happening in school, the way that we have traditionally approached mental health as an add-on doesn’t work anymore,” she says.
Spectrum of Services
Partnering with community organizations is one way school districts can meet this heightened need, says Stoner-Mertz, especially because it allows teachers and staff to access a wider array of services, from crisis-level counseling by outside therapists, to regular monitoring and check-ins by lower-level workers from both schools and partner groups. “Everyone is going to need a different level [of support],” she says.
Since the onset of the pandemic, Seneca has been adapting their school-based services with that directive in mind. In some cases, they provide coaches who serve as coordinators for teachers and students in schools and in others they send service providers like therapists and behavioral health aids directly into classrooms.
Seneca is also part of a state-wide movement known as CalAIM which advocates, in part, for more comprehensive coverage under the state’s Medicaid program, so that even basic services for families—like grocery deliveries and housing resources—can be considered part of mental health support.
“In the past year and a half, a lot of our focus hasn't been particularly on what you might think of as ‘therapy,’” says Detterman. Instead, she says their work has been integrated across the entire school, and now extends to families’ day-to-day needs. “Which of course are the foundation for all kinds of wellness, and particularly emotional wellness.”
Providing comprehensive support to students also means that struggling kids can be identified and referred to counselors or non-emergency mental health programming, or simply sought out for regular informal check-ins, before they reach a crisis, she says. Under a traditional school counseling model, and because of state Medicaid policies, students and families who can’t afford outside mental health treatment often have to wait to receive a diagnosis or until their needs become dire before qualifying for any school-based services. “That doesn’t happen for families of means,” she says.
Shifting the Workload
This integrated approach can also lower the strain on mental health professionals with the highest level of training by transferring some of the workload to less specialized—but more available—teachers and counselors.
“One of the things that we’ve been talking about is… interventions that maybe don't require somebody that has a license or a master's degree, but that you could train to at least identify some of the key issues,” says Becwar, from Lincoln Families.
In elementary schools, her organization supplies intervention specialists, who typically don’t hold advanced degrees, to deliver lower-level services to students referred by school leaders. The organization also offers a number of other services including group therapy, newsletters to teachers helping them identify toxic stress in students and themselves, and arts-based therapy programs.
One such arts initiative launched this fall to meet persistent, but not yet crisis-level, mental health needs among students at Fred T. Korematsu Discovery Academy and Esperanza Elementary School, within Oakland Unified. There, students use feathers, wire and other materials to create their own allies, known as “Worry Warriors.” The characters, based on Guatemalan worry dolls, help kids talk through anxiety and uncertainty with trained clinicians.
The Worry Warrior project employs clinicians from Lincoln trained by Francine Ostrem, a clinical manager at the organization. She had originally designed the arts-based therapeutic program for a variety of students, including those with life-threatening medical conditions, but converted it for students with COVID-related stress this fall.
“This isn’t arts and crafts,” says Ostrem. “This is saying to a child, ‘We take you seriously, we see you… and we want to know what you're thinking and feeling.’”
That statement has a powerful impact. When even a few students can access more comprehensive mental health resources, an entire school can benefit, says Becwar.
“More kids are getting some short term interventions,” she says. “And that’s going to have an impact on the entire school culture because then we also have more kids who are self aware, more kids who have words to describe what they're going through and more tools in their toolkit to work through their pain and grief.”
