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COVID has taken its toll on student mental health. What are districts doing to help?

News Tribune - 9/24/2021

Sep. 24—School districts across Pierce County have prioritized mental and behavioral health resources for students returning to the classroom after a year and a half away.

Some have doubled down on counseling programs, while others have outsourced to telehealth companies to give students a safe place to talk.

Remote learning has taken a toll on students across the state.

The Washington state Department of Health reported in July that suicide ideation, suspected suicide attempts and suspected drug overdoses have increased in 2021 compared to the same week in 2020 and 2019.

From April 2020 to April 2021, the state agency has seen about a 75 percent increase in youth inpatient community hospital discharges for mental, behavioral and neurodevelopmental disorders.

Experts like Ashley Mangum, a program manager of Pediatric Mental Health with Mary Bridge Children's Hospital, said the pandemic has highlighted struggles many students face.

There has been an increase in the severity of mental and behavioral health cases. The state program Wraparound with Intensive Services helps connect Medicaid-eligible youth with "intensive mental health care." Mangum said Pierce County saw a waiting list for the service for the first time in "quite some time."

Learning from home also made it difficult for teachers and counselors to recognize when a student needed help, Mangum said.

"Our kids lost a lot of access to their community support and natural support that really would help identify how they're coping with things," she said.

Even upon returning to the classroom, there have been more student referrals than years before the coronvirus pandemic. Mangum said many students have had anxiety about the return, and some are experiencing grief and loss of a family member due to the coronavirus.

Some local school districts have added mental and behavioral health services to address the need, from additional counselors to new staffing to contracting with mental health services.

Health and education experts have stressed that this year will be an unusual one, and that students feeling anxiety about the changes is expected and normal.

In a public discussion with health officials about mental health and returning to school on Aug. 19, state Superintendent Chris Reykdal said students haven't had the same level of face-to-face social engagement in school for more than a year because of COVID-19 impacts.

"They're going to be tired," Rekydal said.

During the same discussion in August, Dr. John Dunn, medical director for preventative care with Kaiser Permanente, said that parents should keep an open line of communication with teachers and watch for any significant changes in their children's eating and sleeping habits, or any unusual drops in grades.

"This school year is not going to be anything like (students) have been through — there are going to be a lot of new things in place, there are going to be new expectations even in familiar surroundings," Dunn said.

Washington state funds districts based on the number of students they have, which includes counselor funding, but the funding is not required to be specifically used on counseling services. For example, Tacoma Public Schools uses more than what the state provides for counseling services for counselors from local levy and federal funding.

Most of the time, school counselors are not deeply trained in mental health, Rekydal said.

"So if there is an opportunity to have the counselor pull the student in, they'll have initial evaluation screening, ask them questions and relationship building, and if they see something there that causes them to say, 'Let's bring more expertise,' that's when, if the school system has it — either the building, or the district or a community-based partner — they might bring in someone who is a licensed mental health expert," Reykdal said in August.

More resources on the way

Locally, districts are pouring dollars into mental health support this school year for their students.

In Tacoma Public Schools, Pierce County's largest district with nearly 30,000 students, as much as $1.3 million new funding has been earmarked to use on counseling support for this coming year. The extra funding is from the Elementary and Secondary School Emergency Relief III (ESSER III) fund, passed by Congress in the American Rescue Plan Act earlier this year.

Currently, Tacoma employs about 100 school counselors. The new funding will add three new elementary school counselors and three new secondary school counselors.

"We know that schools need it, especially right now," said district spokesperson Nora Doyle.

Doyle said that the pandemic emphasized the importance of social-emotional learning (SEL), which aims to help students succeed not just academically, but mentally as well. Tacoma is also in the middle of developing SEL curriculum for secondary students across the district that was started prior to the pandemic.

The curriculum is already in place for elementary-aged students, taking time out of a student's day to address how they're feeling. At Tacoma'sLister Elementary, for example, classrooms start their day with a "morning social" for teachers to help gauge the moods of their students.

"The exact time may vary, but all elementary schools have SEL on their master schedule," Doyle said. "Some days may be a lesson from the curriculum and other days may be a class circle during that time to build relationships and discuss the SEL lesson from a prior day."

The Puyallup School District is launching a new districtwide telehealth program next month through Hazel Health. All 23,000 students will be able to sign-up for an assessment and be scheduled within three to four days, district communications director Sarah Gillispie said. Services in Spanish will also be available.

"That is quite a bit different than what families have experienced in our local community when they tried to find a service provider on their own. We've heard that they're getting told anywhere from three to five months to sign up in the waiting list," Gillispie said.

The district signed a one-year contract with Hazel Health for up to $330,000 and providing up to six visits per student before insurance is billed.

The district's director of Social Emotional Wellness, Michele Bledsoe, said the district has always offered help to students in need of mental and behavioral health resources, but the pandemic has shown the need for more.

Puyallup and Bethel have implemented the Multi-Tiered System of Supports (MTSS) program. Bledsoe said the first tier addresses 80 percent of students, meeting mental and emotional needs through rapport with teachers and staff. Another tier of 10 to 15 percent of students relies on a more individualized focus, through counselor sessions with support groups for students struggling with friendships or repercussions of divorces. The final tier includes about 1 percent of students, who Bledsoe said need a "special plan" with district staff and health care providers to help students achieve academically.

In a 2020 survey of families and staff asking what the district should focus more resources on, 85 percent of respondents said they wanted additional mental health support for students.

Last year, the district partnered with Woodcreek Healthcare at Mary Bridge Children's Hospital to provide a therapist for Emerald Ridge High and Glacier View Junior High students.

Asked how frequently students used the program, Gillispie said, "utilization of the Woodcreek pilot program at ERHS/GVJS has been hard to gauge given the impact of COVID in schools the last year and half."

The new telehealth program will help more students across more schools, Gillispie said.

The increase in services is expected to help all students in need.

"For some families, accessing quality mental health services has been an issue for a number of years, and for some families, this is a new issue because of things that they faced during the pandemic," Bledsoe said.

The Bethel School District, which enrolls 20,000 students, has been with SEL curriculum prior to the pandemic, but this year formed a new team to specifically address the social and emotional well-being of students.

The group started this year determining what mental health resources already exist in each school and how it can help support them by meeting with school principals and other leadership. The MTSS team also will work to partner with community-wide behavioral and mental health supports.

Even before the COVID-19 pandemic, students in the Bethel School District expressed the need for help. According to a Healthy Youth Survey conducted by the district annually, more than 50 percent of eighth, 10th and 12th graders reported they felt "nervous, anxious and on edge."

"We're getting a lot of students coming in with anxiety, being able to have the stamina to be in school all day and follow routines," said Elissa Dornan, director of behavioral health for Bethel's MTSS team.

Bethel also uses electronic surveys as an initial indicator into how their students are feeling. These surveys can be sent to students on their district-issued iPads. Starting this year, Bethel added daily check-ins for students.

There's still more to do, Dornan said. The MTSS team is working on finding ways to create more access to mental health resources at the school level.

"Our goal is to embed more mental health services in each of our schools," Dornan said.

Clover Park School District did not respond to requests for comment.

Mangum recommends families looking for help reach out to Kids' Mental Health Pierce County, school districts, and 2-1-1 to be connected to resources.

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