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#JamesDonaldson on #MentalHealth – #Washington #Students Are Facing A #MentalHealthCrisis. Here’s Why #Schools Are On The Front Lines.

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(Gabriel Campanario / The Seattle Times)

By Hannah Furfaro

#Education Lab is a #SeattleTimes project that spotlights promising approaches to persistent challenges in public education. The #SeattleFoundation serves as fiscal sponsor for Education Lab, which is supported by grants from the #Bill&MelindaGatesFoundation, #Amazon and City University of Seattle. Learn more about Ed Lab

It’s Jan. 26, a Tuesday. But it could be any day, really, since #schools closed a year ago. 

After Porter’s online classes end around noon, he closes his computer and turns to the glow of his cellphone, where he kills the rest of the day watching videos on Netflix or YouTube. His bedroom lights are off, blinds closed against the afternoon sun.

“You wake up, go to pointless #school, spend hours working for nothing, just to get an A, and then go to sleep, and repeat that,” said Porter, a Seattle high #school #student who often shows up late for class or zones out during virtual lessons. “I don’t even know what the days are. Everything is just blurry.”

Porter’s younger sister Grace, a middle schooler, was at first motivated to get ahead, recording classes and rewatching them to make sure she didn’t miss anything. 

But around the winter holidays, her panic attacks began.

Grace and Porter didn’t struggle with #mentalhealthconcerns before #schools closed, but their new angst and sense of #hopelessness reflect what many other #students say they’re coping with during the #pandemic. It’s a trend that cuts across generational lines but has hit #young #people particularly hard. 

Among #children, serious #mentalhealthissues are leading to emergency room visits, a sign that #youth aren’t receiving help through usual channels, such as #schools. 

In #Seattle, a typical night at #SeattleChildren’shospital now includes admitting one to two #children who have attempted #suicide. Each week, the hospital’s emergency department sees about 170 #children and #adolescents for psychiatric emergencies — up from 50 a week before the #pandemicNationally, emergency visits for #mentalhealthissues jumped by 31% among 12- to 17-year-olds during the #pandemic.

Even before #COVID-19, #children and #teens were reporting increasing incidence of #hopelessness, #anxiety and suicidal thoughts; these concerns disproportionately affect #studentsofcolor, who are also less likely to report that they have an adult supporting them or that they are hopeful about the future. #Isolation during a year away from #school, on top of other stressors such as the national reckoning over racial justice, are compounding. 

#JamesDonaldson notes:

Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.

Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.

Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle

A few #children with #mentalhealthconditions say they’ve gotten better during #school closures, but anecdotally, many others are worsening, including those with disabilities. Youth like Grace and Porter, who were active in sports, the arts and with their friends pre-#pandemic, are experiencing new and troubling symptoms, although they have not been diagnosed with a specific #mentalhealthcondition. (The Seattle Times is using different names for the siblings to protect their privacy.)

Last month, Gov. Jay Inslee declared a #youth #mentalhealthcrisis and, in a move that acknowledges the critical role #schools play in #children’s #mentalhealth, mandated that school buildings reopen to all grades by April 19. In two weeks, Porter and Grace should be back in classrooms.

But simply returning to school buildings won’t reverse the cascading effects of a year in #isolation, experts say. And many #students will return to a system ill-equipped to support them. In #Washington, #schools employ 1,100-1,200 school #psychologists, or one for every 1,000 #students, according to the state’s association for #school #psychologists, far below national recommendations of one to 500-700 #students.  

“There’s not enough #mentalhealthproviders [in #schools nationwide] and this is, again, before #COVID-19,” said Hesham Hamoda, staff psychiatrist at Boston Children’s Hospital. “Imagine how wide the gap is now, as really every child is impacted in some way.”

#Washington #schools don’t do a good job of handling everyday #mentalhealthissues, such as #stress or #anxiety, even in the best of times. And they’re part of a strained #mentalhealth system: In 2020, #Washington came in at No. 43 on a national youth #mentalhealth ranking from #MentalHealth America. 

“There are lots of other states that are doing a better job at this,” said Camille Goldy, director of student supports at the Washington Office of Superintendent for Public Instruction. For instance, she said, some states use Medicaid to pay for #mentalhealthservices at #schools — a way to fill gaps left by limited education funding. In Washington, the practice isn’t widespread.

Remote learning has made it even harder to identify #students who need help. Many #students, like Porter, became invisible to supportive #adults when they kept their cameras off. 

#Mentalhealthcare access and quality are at least partly determined by ZIP code because of the way #schools are funded here. The funding structure gives districts leeway to decide how many #mentalhealthprofessionals to hire, or whether to pay for other supports such as #suicideprevention programs or school-based health centers.

For example, #SeattlePublicSchools formed partnerships with the #KingCounty health department and local health providers to create school-based health centers that are staffed by #mentalhealthprofessionals and sit on school grounds. But some districts struggle to pay for a single #school #psychologist.  

A handful of solutions are beginning to emerge.

Federal stimulus funding may prompt some #schools to hire additional #mentalhealth staff, although the dollars are temporary. In his 2021-23 budget, Inslee proposed $400 million that districts could use, at least in part, to support #student well-being; the overall biennial budget for schools is about $26 billion.

In #Washington during the #pandemic, #school #mentalhealth training programs went virtual and reached more #school staff — and expanded to #parents and caregivers, a new study shows. Community-based organizations have shifted gears to target youth #mentalhealth needs and partner with school districts. And a group of researchers are focusing on equipping #teachers to notice and intervene when #students need help.

At a moment of extreme disruption, Hamoda said, the way #mentalhealth supports are delivered in #schools “really needs disruptive innovations.”

New concerns

For Porter, the textures of daily life have flattened, its colors dulled. 

He has a close-knit group of friends, is on the football team and plays video games. Before the #pandemic, he’d spend his afternoons at friends’ houses or at the gym. But with #school still closed, he hasn’t seen friends nearly as often. “It’s made me feel really lonely,” he said. “There’s not many people I can rely on.”

Grace, his sister, says she’s noticed her brother’s mood sour as the months have worn on. 

Her own emotions have oscillated between sadness, frustration and grief, she says. Around Christmas, with #stress bubbling over and after her family made the decision to celebrate without extended family, Grace had a few panic attacks. Like her brother, she often finds herself scrolling for an escape on Netflix.

She takes long walks with her dad at night to “just let it out.” “I would just start crying, and I would just walk with him and talk about everything and why I’m feeling like that,” she said. 

These feelings are a marked change for Grace, who used to spend her time playing basketball and soccer and attending choir practice. 

Researchers and education officials are just beginning to collect data on how significantly the #pandemic has affected the well-being of Washington #children. #UniversityofWashington psychiatry and #behavioral sciences professor Jason Kilmer is currently teaming up with the state’s health care authority and its education and health departments to ask more than 57,000 #students questions such as “have you felt depressed or sad most days, even if you felt OK sometimes?”

The survey analysis is expected to be done before the end of the #school year, said Kilmer, who is leading the work.

Why schools?

Young people face big barriers to getting #mentalhealthcare. They don’t have agency over most parts of their lives, and can’t make decisions about buying health insurance, or whether to live in a community where care is accessible. #Students may also face transportation challenges or discrimination.

In Washington, many #school districts try to fill these gaps. At the most basic level, #schools use so-called “social emotional learning” curricula, which gives all learners a broad set of tools to manage their emotions, cope with challenges and learn to be empathetic. The state also provides limited funding for #school districts to hire #school counselors, social workers and #psychologists. 

Many experts and educators agree that it makes sense for #schools to provide support since #children who are well are more likely to succeed academically. #Children also spend so many hours of their days in class that it makes sense for #schools to provide #mentalhealthcare; research shows that if #students receive #mentalhealthcare, it’s most likely happening at #school

In fact, there’s so much research that experts have a good handle on what gold-standard school #mentalhealth programs should look like. Ideally, they say, schools would offer several “tiers” of support, ranging from schoolwide social emotional curricula or mentorship programs to more targeted interventions, such as cognitive #behavior therapy. States would set up professional development programs and a statewide #mentalhealth monitoring system, to track trends or quickly identify districts where #suicide rates are increasing. 

But there’s a vast gap between best practice and reality.

“We have decades and decades of research showing the things that can be effective in #schools,” said Aaron Lyon, co-director of the #UniversityofWashington’s SMART Center, which studies school-based #mentalhealth. “The extent to which that has been codified in legislation or paid for or funded is much more limited.” 

Jill Locke, left, and Aaron Lyon are co-directors of the UW SMART Center.  They are part of a team of researchers innovating to help schools implement evidence-based mental health practices. (Dean Rutz / The Seattle Times)
Jill Locke, left, and Aaron Lyon are co-directors of the UW SMART Center. They are part of a team of researchers innovating to help #schools implement evidence-based #mentalhealth practices.

Last legislative session, lawmakers introduced a bill that would have boosted funding and reduced the ratio of #students to #mentalhealth staff — but the proposal didn’t make it out of committee.

Another complicating factor: There’s a shortage of the most highly trained #mentalhealth staff — school #psychologists — in #Washington, said Alex Franks-Thomas, president of the #WashingtonState Association of #School #Psychologists. This limits the staff’s work to evaluating students who need learning accommodations rather than serving #students like Grace and Porter, who have more generalized concerns, like #anxiety or #depression.

“The general practice is, as long as you get all your special education stuff done, if you have extra time to work with general education #students … then that’s great,” Franks-Thomas said. “We … can’t have a more expanded role because there aren’t enough of us.

Meeting needs

Students seek help for many reasons: relationship troubles and #school stresses, as well as family responsibilities or tragedies. Trauma is also a serious concern, especially in places that have faced systematic oppression, such as low-income neighborhoods and #communitiesofcolor. 

The #pandemic has exacerbated these concerns. And for #students without access to school buildings, “there’s no relief from that,” said Sean Goode, executive director of King County-based nonprofit Choose 180. 

“Young people don’t have any place to go to get away, to reset, to experience something different.”

Goode’s organization has traditionally worked to decriminalize #youth #behavior and reduce #school expulsions. But during the #pandemic, Choose 180 pivoted to focus more on #mentalhealth, partnering with eight #schools in the Highline #School District and working with #students who aren’t engaging with online learning. Goode said that the “most difficult resource” to connect #students with are #mentalhealthprofessionals.

Because of this, the organization decided to hire a #behavioralhealth specialist. Grassroots partnerships are part of a broader array of creative strategies to get #students help during the #pandemic. 

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#Mentalhealth resources for young people

Some ideas suddenly became more scalable during school closures — for example, training programs for #teachers and #mentalhealth staff went online, increasing participation dramatically. 

UW researchers are also working with Hamoda, the Boston Children’s psychiatrist, on a study to scale up #mentalhealthservices by using digital tools to help #teachers better identify #students’ needs. That’s particularly important since it can take years for #children to get a diagnosis and treatment.

Getting #teachers and paraeducators involved “reduces the time for us to wait for a #mentalhealthprofessional to go in,” said Jill Locke, co-director of UW’s SMART Center. 

When Grace and Porter return to school, they’ll have tons of changes to get used to. For one, they’ll have to get to know their #teachers — nearly all of whom they’ve never met in person. 

Porter hopes his relationships with #teachers who have reached out to help will strengthen. But he’s bracing himself against more disappointment, knowing school will be far from normal. 

Grace is luckier. At least a few #teachers have noticed when she feels down. One day, when Grace was taking a Spanish test, she got sidetracked on a question that asked what was different now than before the #pandemic. 

“I wrote something about it being sad and not feeling as comfortable or free,” she said. A few days later, her teacher asked her to stay after virtual class. “She checked in and she wanted to make sure I was OK,” Grace said. “It was nice to know she was really reading my stuff.”

How to find help

If you are experiencing suicidal thoughts or have concerns about someone else who may be, call the #NationalSuicidePreventionLifeline at 1-800-273-TALK (8255). You will be routed to a local crisis center where professionals can talk you through a risk assessment and provide resources in your community. https://suicidepreventionlifeline.org/

Photo by Pragyan Bezbaruah on Pexels.com
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