Schools facing mental health challenge

MARSHALL — The statistics on children’s mental health are startling — 1 in 7 U.S. children aged 2 to 8 years old has a diagnosed mental, behavioral or developmental disorder. One in 4 children are affected by an anxiety disorder, though 80 percent are never treated, according to the Center for Disease Control.

At the Marshall Public School board meeting recently, three school counselors recently shared those statistics and revealed how mental health issues often affect students in school.

Our purpose is just to really bring awareness to children’s mental health in your schools,” Jennifer Hey said. “We want to let you know that mental health is near and dear to our hearts and it’s also something that’s in the news more and more often. So we’re going to bring to your attention, some those national statistics that are very important, but we want to drill down to our local statistics as well.”

Hey referenced a presentation from two years ago, noting that “things have really changed” since then.

“(According to National Alliance on Mental Illness), 1 in 5 children ages 13-18 have or will have a serious mental illness,” she said. “What we’re seeing in schools is anxiety — general anxiety and separation anxiety — depression and then toward the top of that tier is mood disorders as well.”

Counselor Abigail Lecy wasn’t able to be in attendance, so Hey shared how the national statistics translate in regard to students at the Park Side Elementary level.

“With the statistics being 1 in 7 children, that would be 75 students at Park Side who would be dealing with a mental health crisis,” Hey said. “With the national anxiety statistics at 1 in 4, that would be 134 students dealing with anxiety.”

Hey said Lecy and her team completed more than 30 mandated reports to the county during the 2017-18 school year.

“She does see a continued need for early behavior interventions — as early as preschool and kindergarten,” Hey said. “She definitely believes that coping skills are necessary for kids to be successful in the classrooms, so early intervention is key.”

Along with Hey, Krista Bjella serves as a school counselor at Marshall Middle School.

“We recognize that these mental health challenges face our students and how that affects them here in school,” Bjella said. “Seventy-five percent of social phobia manifests by age 15 and 75 percent of separation anxiety disorders manifest by age 10, so what we see in school with those students are attendance issues. And as you know, research shows that when students struggle with attendance, their achievement drops.”

Bjella added anxiety disorders can make students two times more likely to drop out or fail at school. “It just goes right back to that attendance piece,” she said. “The more they’re out of school, the harder school gets, the less achievement they have, the more it affects their anxiety — it just really starts to spiral for them.”

Hey said in relation to national statistics, it’s possible that 140 students at MMS have a diagnosable mental health issue. If 1 in 4 are known to have anxiety, that means 175 middle school students would be affected. According to Child Mind Report, 2016, 75 percent of attention deficit hyperactivity disorder (ADHD) manifests by age 8 and that oppositional defiant disorder manifests by age 14.

“With the oppositional defiant disorder, we start to see increases in classroom disruption,” Bjella said. “It doesn’t just disrupt their learning either. It can disrupt learning for others as well. With ADHD, we see challenges with focus as well as executive functioning development delays. So students aren’t able to do some of the common things that maybe others can in terms of managing multiple tasks and organizing themselves. We see an increased need some of those areas and we’re having to teach those skills or reinforce those skills.”

Bjella shared that there were 11 hospitalizations in a behavioral health unit for students at MMS during the 2016-17 school year. There have been six so far this year, she said.

“It used to be about a 5- to 7-day placement, so they’d be out of school 5-7 days,” she said. “We’re seeing those placements longer now, so it’s 10- to 14-days out. We’re also seeing them placed further away. So it used to be we’d work with Avera Behavioral Health in Sioux Falls (South Dakota) — and we have a great relationship with them — but now we’re seeing students placed as far away as Fargo (North Dakota), Rochester and Fergus Falls, which creates some challenges in terms of parents being to go and visit those students and get them their homework when they’re gone. We work hard to try and get it to them, but we are seeing a change in where those placements are happening, and it’s oftentimes because beds are full.”

Similar to the upward trend nationally, the counselors said they are seeing children’s mental health needs increasing at the local level.

“In terms of mandated reports (at MMS), last we had 35 for the whole year,” Bjella said. “This year, we’re up to 45 already. Students’ basic needs aren’t always being met, and as we know with Maslow’s hierarchy of needs, if their basic needs aren’t being met yet, learning is difficult. So we work really hard to connect them with support and services.”

A new statistic being kept this year is students involved with a county worker — anything from a child protection worker, probation officer, child welfare officer, circle coordinator or children’s mental health professional.

“We have about 70 students involved with a county worker,” Bjella said. “So they’re getting some supports, which is good. The county is able to provide some supports to those students.”

Mental health partners

MPS has several partners who help provide mental health services to students. Greater Minnesota Family Services has a presence in each of the district buildings and currently serves 159 students — 39 at Park Side, 13 at West Side, 45 at MMS, 27 at MATEC and 35 at MHS. Unfortunately, 14 additional students are currently on the waiting list — including students at every facility.

“In all of our buildings, when there are openings for Greater Minnesota services, they fill very quickly and there’s almost always a waiting list of students who are wanting or needing services,” said Kristina Tauchen, school counselor at Marshall High School and MATEC. “Most therapists have a cap on how many clients or how many families they can reach. Once they reach that limit, they wait list begins.”

While the in-house support works extremely well for most students, the counselors said they never hesitate to refer students to outside resources, especially when its deemed a high crisis. In addition to multiple independent therapist, other agencies MPS works with include Avera Behavioral Health in both Marshall and Sioux Falls, Western Mental Health, Southwest Minnesota Health and Human Services Children’s Mental Health and Open Door Dental.

“There’s a lot of phenomenal agencies in the community we partner with, so our students receive support in a variety of different areas.” Tauchen said.

Bjella shared other points that can potentially make a positive difference. “Really educating our frontline staff — every teacher, every bus driver, every custodian and so on — on how to recognize that atypical behavior, that behavior that doesn’t fit with a typical teenager or child, is important,” she said. “We can teach them what that behavior might look like and how to recognize those warning signs and red flags, so we can get those students connected with services.”

Skills can also be taught to students in the classroom, in small groups or individually. Collaboration with school nurses it also vital.

“Every one of us works closely with the school nurses because we recognize that those mental health challenges can come out in physical ways,” Bjella said. “Kids don’t understand why their tummy hurts or why they have a headache, so they’re frequenting the nurse. As we start to uncover those patterns, we start to understand better, that maybe this isn’t about a stomach issue, it’s more of a mental health need.”

Continued education on trends and interventions for social workers and counselors is another component in the effort to be as proactive as possible, as is continued access to qualified professional services for students and collaboration with parents and families. “Probably one of the most important is collaborating with parents and families by educating them and connecting them to the supports and services that they might need to help their student,” Bjella said.

Enhancing the situation

One of the things school counselors and social workers strive to do is to remove some of the stigma surrounding mental health.

“We try to enhance the awareness of mental health in our school and aim to remove shame and stigma of asking for help,” Tauchen said. “Sometimes students are having issues and don’t know how to describe it or they’re worried about what their friends or family are going to say, so just trying to remove some of that stigma, that it’s OK to ask for help.”

The school professionals are also trained to recognize warning signs, such as sudden changes in grades, attendance or disciplinary issues or noticeable problems at home. They also provide individual focus to students regarding issues surrounding their mental health, academic well-being and social and emotional needs.

“We work with students to come up with plans that work for them,” Tauchen said. “What we definitely see at the high school level is that when students have higher mental health needs, that’s the priority. And their school responsibilities aren’t going to fall into place until they’ve taken care of that anxiety, depression or other things that are going on. So we help them really navigate that and come up with an individual plan.”

Bjella said she believes the county has changed its mindset and approach over time as well.

“They’re really looking to connect and intervene earlier with the families and provide more support services versus letting things spiral to get to the court system,” she said. “I see less court than I used to, even five years ago.”

Board chair Jeff Chapman asked the counselors if the students in the district were getting enough mental health help.

“In a perfect world, we always want to do more,” Bjella said. “We want to be proactive. We want to connect with as many kids as possible with the services they need. That early intervention piece is critical. So the earlier we can get them those supports, the better. But we also recognize those supports are needed throughout.”

With appropriate identification, evaluation and treatment, children and adolescents living with mental illness can achieve success in family life, school and at work, according to the Minnesota Department of Human Services, though the overwhelming majority of children with mental disorders fail to be identified and lack access to treatment and support.

Tauchen said MATEC has a higher than average number of students with a mental health diagnosis, though that isn’t unusual for an alternative school.

“Many of them also have multiple adverse childhood experiences (ACES), which are things like abuse or neglect, divorce, witnessing domestic violence, parental alcohol or drug abuse issues, and having multiple ACES can lead to delayed development, mental health concerns, behavioral concerns, things like that,” she said. “So their chronological age might be 15, but because of the delayed development, a student might be more developmentally like an 11- or 12-year-old, so that can lead to some learning and behavioral issues, things like that.”

Gov. Mark Dayton and former Lt. Gov. Tina Smith worked with the state legislature and announced in November 2016 that a $12 million investment for school supports had been secured to improve the state’ low student-to-counselor ratio.

Marshall Public Schools was one of 77 in the state to receive new resources — in the form of additional school counselors, school psychologists, social workers, chemical dependency counselors or school nurses. Lecy’s position at Park Side — previously held by Deann Reese — is funded through that investment.

While the state average is one counselor to every 792 students, MPS is more aligned with what the American School Counselor Association recommends, which is one to every 250 students. The district currently employees 12 counselors and two social workers.

With heavy loads to carry and seemingly having the weight of the world on their shoulders — as every student life could be considered at risk — the counselors are quick to accept help from others, even from the students themselves. National statistics say that 1 in 12 teens attempt suicide each year.

“At the high school level, our students are excellent about coming in and saying they’re worried because their friend texted them or their friends posted something on Facebook,” Tauchen said. “We wouldn’t know otherwise. We’re not Facebook friends with the students, so we don’t see their messages.”

A student might think their friend will be mad, but that’s much better than the alternative. In general, they’re excellent about recognizing when something is wrong and then telling somebody about it.”

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