Welcome to our podcast, Conversations About Student Mental Health. I’m Chris Leonard, clinical social worker, working with adolescents for over 25 years. The purpose of this podcast is to talk with school administrators, educators, clinicians, and parents, to open a dialogue that will help the growing number of students struggling with mental illness.
In this first episode, I’m going to set the stage by sharing some advice about the role of the school in addressing student mental health. Let’s start by addressing any possible doubts or concerns people might have about the school’s involvement with student mental health. Not everyone believes that the school really should have a role in addressing student mental health issues.
After all, schools have so much to do already. Schools are charged with meeting or exceeding standardized testing benchmarks, ensuring that students acquire the academic, technological, and soft skills needed for college, and they have to make sure that teachers have the requisite knowledge and skills to properly prepare students. These are just a few of the things that schools have to do. And schools have to do all of this on increasingly tight budgets.
So some really would hold to this idea that schools should not be getting involved with student mental health. There’s not the capacity, there’s not the time; and capacity and time are issues, and I will get to those. But the truth is, when it comes to getting involved with student mental health, schools really don’t have a choice. Districts are obligated to address any student issues that interfere with the student’s ability to access their education.
So although it can be a fine line for districts, in addressing student mental health needs, it’s something that they have to do. The way that school districts address these issues, should be educationally based. No one’s suggesting that a school should become a clinic. And in fact, and this is another piece I’ll get to, bringing in a mental health provider can actually help your school maintain the separation between your school and the mental health services.
But some leaders may have another hesitation, they may say, “OK, fine, yeah that sounds like a great idea, bringing in a provider, but if I do that, isn’t that going to highlight that I’ve got a mental health issue in my school, and won’t that bring stigma to the school and to our town?”
Well, the truth is, yes, there is some stigma, there’s a great deal of stigma associated with mental health issues. And that is something that does need to be addressed. We know, but we’re educators, right? So who’s better placed than we are to address stigma? To educate students, to educate parents about the importance of mental health, mental health hygiene? We teach kids about all sorts of physical hygiene, why not teach them about mental health hygiene, taking care of oneself?
We also know, and I can’t underscore this enough, how prevalent mental health issues are among students today. We’re all familiar with the studies that suggest that more than 1 in 5 adolescents between 13 and 18 will experience a severe mental health disorder at some point. We also know that between 13 and 20 % of students nationwide will be affected to at least some degree. So we already know, we’ve got students in our schools who need the mental health intervention.
Another objection people may raise, is they may say, “Wait a minute, I’ve got professionals in place, I’ve got a social worker, I’ve got a psychologist, they’re really good, they know what they’re doing. Why can’t I just address these issues with the staff I already have in place?” Well, the answer to that concern is if schools were able to do this effectively, they’d already be doing it effectively. The depth of the mental health issues that we are seeing in students today goes beyond the training for school counselors, school psychologists, and school social workers.
For instance, school psychologists, they’re really highly trained. They receive extensive training in assessments that identify students’ strengths and weaknesses, learning styles, academic potential, and yes, some socio-emotional issues that may be interfering. But their training, even their full year internship, takes place in a school. In contrast, mental health providers receive their trainings in clinics, where they’re much more likely to not only see but work with students who’ve experienced trauma or suffer from severe anxiety, depression and similar disorders.
So the training that mental health professionals receive is really specific to the depth of the issues that we’re starting to see in schools. And although our school professionals are highly trained, they’re trained to handle the educational side, to manage that, and to really work with a typically developing child. So this is where the mental health provider can come in and fill the gap, to ensure that students are getting the support they need from professionals specifically trained to provide that help.
So let’s assume that we get that right team in place, let’s assume that we make the bold step and we create that partnership. What are our challenges now? I think it really comes down to two things, time and training. You know, the district staff, as we’ve said, they have that educationally based training, and they’re not equipped to deal with the students who are presenting with severe mental health issues. Teachers in particular have not received mental health training in their teacher training programs. These are the professionals who are dealing with the students every single day. Also, as I said earlier, the school district doesn’t have the time to have their staff deal with these issues, which in some case, can be really quite extraordinary mental health issues.
So you really can’t take the time out of the school day when you have so many educational tasks and functions to perform, to really address the issues at hand with any depth or effectiveness. So what is effective? You know, how can we address these intense needs that are students are presenting with? Here’s where I can’t emphasize enough the value of a partnership with a mental health provider. It enables you to build capacity for all of your staff. If we think about this in terms of the New Jersey tiered system of supports, the way you can envision it is that you can train all of your staff in those universal design or tier 1 interventions. So, this might be a positive behavioral intervention support program, that teachers and staff can be trained in to work with all students. That gives you that positive school climate and culture. And then, with a partnership with a mental health provider, that mental health provider can provide additional training to the school counselors, school psychologists, school social workers, and the provider can provide support to the people who will be providing individual and group counseling sessions.
So that’s where the direct service comes in, that direct service through individual and group counseling, that’s your tier 3 level of support, for the students who need the more intensive group, individual, or family counseling. It’s important to note that, you know, these students are the students who in the past, just had to be sent out, automatically to therapeutic placements. So, overall, your partnership, will help with the complete development of your tier intervention program, which includes building the capacity of your staff.
So that mental health professional isn’t just a resource for your students, that right professional is resource for your staff as well. And this can really help your staff increase their readiness, their effectiveness with the students. You know, we also know, from talking with teachers in various places, what I hear is teachers get really anxious about what they’re dealing with. You know, what do we do? And teachers care deeply, they want to know what’s the right thing to do, how should I respond? What’s the best way that I can help?
So when you build this capacity for your staff, you’re creating tools for the teachers, you’re giving them tools in their toolboxes to help the students. And that’s what you’re trying to do with teachers all the time, whether it’s reading strategies or whether it’s writing strategies, or you know, whatever strategies there are that are emerging in the field, you’re always trying to keep your teachers in touch with best practices. It’s important to start to think about mental health capacity as a best practice. It’s not an option, it’s really something that we need to be providing.
So a challenge is, and a challenge for districts is always, “OK, let’s assume that we build this program, there are students who still need to be sent out, or out of district placement, right? So how do we make the distinction between the students who can be served in district, and those who really need out of district placement?” Well, when you’ve created that effective tiered intervention program, and you’ve partnered with an effective provider, this whole question about who stays and who needs to go out, is actually relatively simple. Districts who’ve created that effective tiered intervention program, they know that the students have gone through the tiered intervention model, everybody’s getting the tier 1 supports, some are getting the tier 2 supports, the students really in need are getting the tier 3 supports. When a student is still not successful when they’re receiving the tier 3 supports, that’s how you know they need a more intensive program. That’s when you know they need that out of district placement, that higher level of care.
So when you have that tiered intervention program in place, with the partner, that really helps you make effective placement decisions really determining what is the least restrictive environment for each student. And this way, you’re not leaving these decisions up to your individual case managers, this enables you to have consistency across the board in terms of which students are being sent out to therapeutic placements. And the other thing is, when you put this kind of structure in place, this is another cool thing, if you put this kind of structure in place, it gives you this opportunity for really intensive data collection to determine which students need a higher level of care. You can look at grades, attendance, disciplinary reports. This helps to make your school superintendent and your board of education more comfortable in knowing that you’re doing everything that you can to educate the student in the least restrictive environment, and that your decisions are not random. So when that student is really improving through your tier 3 intervention that you’re providing, that student can remain. When you’re providing tier 3 intervention and you’re still seeing problems with attendance, still seeing that student in the nurse’s office, you’re still seeing that student not making improvements, then you know they need a higher level of care.
So let’s review what we’ve done so far. We’ve talked about the importance of being proactively prepared to respond rather than being reactive. We’ve highlighted the advantages of partnering with an expert, rather than just relying on your own staff or even hiring your own counselor. We’ve talked about the importance of setting up tiered interventions, and about how having the partner can help you provide those tiered interventions much more effectively. We’ve touched on the value of data collection and how this informs the decisions about student needs and placement. We’ve talked about setting up positive behavioral interventions. In a nutshell, we’ve really tried to provide you today, with a vision for how partnering with a mental health provider can really help you build your capacity as a professional community, as a school.
So what have we not addressed yet? Money! We know that districts are operating under really tight financial budgets. And they have to stay within a 2% cap. So I think it’s important to understand that when you provide these services within your district, it’s a best practice for your students, but also in the long run, it’s going to save you money. For each student that you send to a therapeutic out of district placement, the tuition cost is probably around $70,000, and now you’re paying another $20,000 for transportation. So for each individual student that you’re sending out, it’s close to $90,000. So providing with that mental health provider, enables you to create a bridge for students that you want to return to district. Some students may only need to be out of district for 1 or 2 years, but if you don’t have a program in place for them to come back to, very often they’re not successful. So if you have these programs in place, that makes it so you have a landing pad for your kids to come back to. And you actually have the opportunity to save money rather than spend more money. So this idea that, building a program in district is more expensive, that’s actually not correct. It’s really best for your students, it’s really best for your district, and it’s really best for your budget.
But the truly visionary educational leaders do this proactively. You know, when you’re going to create this program, rather than say to yourself, “Oh, well I’ll fund this program by bringing students back to district” It’s actually more effective to look at the students that you can successfully keep in district, and look at the capacity that you’re building with your staff, including teachers, your psychologist, your counselors, and the support that you are also providing for your building administrators. We know that students with mental health issues take a tremendous amount of time for the administrators, because some of them are suffering from anxiety and depression. They’re not coming to school, their attendance rates are down, and so are the graduation rates. These are all things that administrators are responsible for. So this is another piece that you need to pay close attention to.
It looks as if we’re about out of time for today, I hope that I provided you with some compelling reasons why schools really need to proactively engage in supporting student mental health. That’s it for our show today, thanks so much for listening, I hope you found today’s topic valuable, and that you will join for future conversations about student mental health.
Christopher J. Leonard, MSW, LCSW, M.ED.
Chris Leonard is Director of Operations for Sage Thrive and the Sage Day Schools. He is an experienced teacher, school administrator, social worker and psychotherapist with over 30 years of experience working with children, adolescents, and families. Mr. Leonard is married with two daughters and enjoys distance running, mountain and road biking, hiking, and the outdoors.