Students across the country have stepped into their classrooms, filled with excitement to start a new year. In many cases, though, students also bring physical, social, and emotional concerns.
For some students, these concerns are normal back-to-school jitters that will not affect their schoolwork. For others, these worries profoundly detract from their ability to learn.
One in five children in the United States has a diagnosable mental health disorder, but only 21 percent of those children needing mental health services receive care.
Consider these comments from a parent of a young girl in south Georgia, where the poverty rate is high and high school graduation rates are low compared to the national average:
“She is continually talking about killing herself and she tells me that I don’t understand,” said the parent of a 12-year-old girl who has been seeing a therapist at a public middle school. “She tells me that ‘my therapist understands me and I can talk to her.’ She can see the school therapist whenever she needs to do so. This not only provides her the support that she needs to stay in school but it reassures me that whenever she has suicidal thoughts, help is nearby. The therapist has helped us find a group for family therapy and has met with us at home, too.”
This 12-year-old is not alone. According to school therapist Samantha Boatwright, self-harming behaviors and suicidal thoughts are just two of the concerns often shared with her by the youth and families that she supports in her position at a public middle school in south Georgia.
While some may argue the job of schools is to focus solely on academics, it is difficult to ignore the issues that may impair a child’s ability to focus, engage, and learn.
Children with emotional disturbance drop out of high school at high rates and have higher rates of absenteeism and suspension or expulsion than their peers. In addition, racial, ethnic and socioeconomic disparities in children’s mental health status and care still exist.
As director and researcher, respectively, at The Center of Excellence for Children’s Behavioral Health at Georgia State University, we have extensively studied these issues and examined potential ways to address them. We know this is a serious public health problem that affects the children involved, their families and society as a whole. We are supporting solutions by partnering with state agencies to promote optimal care for youth with behavioral health difficulties.
Increasing access through school-based mental health
School-based mental health programs were first introduced in the 1980s. According to the most recent data, over one-third of school districts in the U.S. used school or district staff and over one fourth used outside agencies to provide mental health services in the schools.
Recently, there has been increased interest and momentum in integrating behavioral health services into the school environment due to several factors. Recent federal legislation targets access to mental health services, and there have been education reforms focused on outcomes, early intervention, and flexible learning supports.
The Affordable Care Act has been a boost, allocating funding to support improved and expanded services at school-based health centers and community-school health partnerships.
Evidence from existing state programs shows school-based mental health initiatives increase access to needed mental health services and promote earlier identification of and intervention for mental health needs of individual students . Additionally, these programs foster a better school climate with increased attendance and academic performance, and fewer discipline referrals and classroom disruptions.
Helping nearly 1,000 students a month
In Georgia, the Office of Children, Young Adults and Families (CYF) in the state’s Department of Behavioral Health and Developmental Disabilities initiated and funded the Georgia Apex Program, during the 2015-2016 school year to increase school-based mental health services.
The intent, according to CYF Director Danté McKay, is “to provide early detection of mental health needs, increase access to services, and spark increased collaboration between community mental health service providers and schools.”
In its first year the school-based mental health program provided more than $9.5 million in state grants to embed therapists from 29 community service provider agencies into schools across the state. The goal was to promote universal prevention and to provide early intervention and services for at-risk students and their families.
Preliminary results from the first year of the Georgia Apex Program show the program served an average of 951 students each month over the school year. It also provided services to more than 2,400 first-time recipients referred to school-based mental health services.
Providers began serving 104 schools in August, 2015 and eventually served 136 schools by May, 2016.
There were challenges, such as space and family engagement. There were also successes, such as expansion of access and enhanced partnerships between providers and schools. These findings mirror those from school-based mental health programs implemented in other parts of the country.
There are notable examples of individual student successes, including at-risk students graduating high school, better school attendance, fewer discipline referrals, and improved grades among program participants.
But, like most new endeavors, support for the program must be built. Initially, increasing awareness and obtaining buy-in from local school officials is critical, as is engaging families because a lack of parental involvement can delay or prevent students from receiving services.
However, with reports of early success, more Georgia schools are requesting therapists and provider agencies plan to increase the number of participating schools during the 2016-2017 school year.
Developing community partnerships key
To make sure all children learn and progress, schools must address the developmental and mental health needs of children. This is particularly true for those at high risk, including children living in areas of high poverty or grappling with community violence.
This places greater demands on K-12 schools. Therefore, schools weave together a basket of resources from the school district and broader community to ensure students who need additional supports receive these services.
Yet, mental health concerns are often overlooked and under-resourced. In some communities, this is simply because of the lack of available resources. However, other barriers exist for families seeking mental health supports including shortages of mental health providers, financial challenges, transportation, scheduling, and stigma-related concerns. Providing mental health services within the school setting can help to address some of these challenges.
Ann DiGirolamo, Director, Center of Excellence for Children's Behavioral Health, Georgia Health Policy Center, Georgia State University and Deana Farmer, Senior Research Associate, Georgia Health Policy Center, Georgia State University
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