(Ed.: Content warning: discussion of suicide, heavy content)
Suicide is the second leading cause of death in Washington state for people ages 15 to 19z
About 40% of 10th graders reported feeling sad or hopeless, and 21% had attempted to die by suicide according to the 2021 Healthy Youth Survey. Similar numbers are found in grades eight and 12.
So what can be done to address the crisis?
In Whatcom County, Health and Community Services (HCS) is partnering with the county’s seven school districts to expand resources to address the youth mental health crisis being felt nationwide and locally.
Funding, additional counselors and the potential of telehealth services are all parts of the county-district partnership to ensure youth are living safe and healthy lives.
Not out of nowhere
Diana Gruman, director of the counseling training clinic at Western Washington University, said the mental health crisis seen today throughout the nation, including local communities, did not appear out of nowhere.
“It is important to note that the surge in mental health concerns in youth was rising much before the pandemic,” she said; the pandemic exacerbated existing mental health concerns that were surging 10 years before.
The root causes of these declines in mental health are unknown, Gruman said.
Whatever the cause, the issue continues to permeate local schools.
County funding at Meridian
A behavioral health sales tax supports services throughout Whatcom County, with the revenue generated expected to reach over $9 million by the end of 2023. These funds are available to Whatcom schools for mental health services, supporting interlocal agreements signed by the seven school districts.
Joe Fuller, program specialist for HCS, said this partnership between the county and schools is important because schools are hubs for our communities where children spend the majority of their time.
The Meridian School District filled a mental health coordinator position during the 2021–22 school year. Aaron Jacoby, director of Special Services, said the goal is to build and support the structures and systems to support the social-emotional needs of students, staff and families. The position also serves as a resource for families who are struggling to access behavioral health resources elsewhere.
Laura Lupo, Meridian’s mental health coordinator, has been working to create systems for teachers to make referrals and acts as a bridge between staff, families, community partnerships and students.
“This year, I feel like the supports have increased quite a bit,” Lupo said.
Jacoby agreed, saying this is one of the first times their school district has been able to have an individual dedicated to full-time support related to mental health. Previously Meridian Middle School had no mental health counselors.
Jacoby attributes some of these challenges to inadequate access to mental health professionals. He said historically society has placed a lower value on supporting mental and behavioral health needs.
John Dunne, a retired child psychiatrist, said when he started practicing in 1977 the need and demand for services were lower than what we see today.
“There’s been an increasing frequency of anxiety, of depression and of ADHD and autism spectrum disorders,” he said.
Dunne also said training systems have not kept pace with the times in terms of their turnover of students heading into the field. He noted that in the mid-’70s two child psychologists would graduate out of the University of Washington-based training program each year. The number is now up to five — still not enough.
“We should be churning out 10 new child psychiatrists every year,” Dunne said, asserting that the program is not keeping pace with either the growth of population or the need.
Jacoby said some soul-searching will need to be done in the larger society to meet kids where they are and to keep moving forward productively.
The Meridian School District is looking to hire another mental health counselor in the middle school, but that person is not yet on the job. Jacoby said what they can provide right now is continued collaboration between districts and educating staff on how to best support students’ mental and behavioral health needs.
There have been discussions of implementing telehealth services in schools — allowing students to call in when they need support. Lupo said these plans and agreements are in the development stages.
On San Juan and in Bellingham
Beck Bell said via email that the San Juan Island School District has always required support and instruction in health, social skills, emotional skills and understanding when and how to make healthy choices.
Bell, the district Special Services director, said the San Juan Island School District continues to have many partnerships to support children with all kinds of needs, including with San Juan County which provides grant opportunities to support mental health services within the schools.
Mild mental health needs may need general intervention like classroom social skills instruction or a check-in with a school counselor. If families decide to seek support through private providers to address more serious needs, the school district will work with the district’s special services team, including nursing services and contract medical providers, to see what next steps need to be taken at school.
The Bellingham School District has been a model for surrounding school districts in relation to mental and behavioral health.
Keith Schacht, director of teaching and learning for the Bellingham School District, said their schools have been addressing student mental health over the last eight to nine years.
“We used to not have school counselors full-time in each of our schools,” he said. “We have increased the number of counselors from three to four at the high schools. Each of our elementary schools has counselors … working out of their building.”
Jay Jordan, assistant superintendent for the Bellingham School District, said the district has had over many years a strong investment in counselors being in all schools. The funding and support they are receiving through the interlocal agreement will allow them to hire two additional mental health specialists which will give schools more internal capacity.
Mental health specialists work with school counselors and act as temporary mental health service providers until students can get connected with outside providers. They also aid with the referral process.
“What we’re talking about is a system that is changing the barrier to access clinical health,” Jordan said.
Services have existed, but it was a matter of where students could receive those services he said. Bellingham, being a larger district, had more latitude with personnel, hiring and providing access to students more quickly.
Dana Smith, assistant director of communications, said campus and partner counselors come into the schools, while also offering spaces for children to attend telehealth appointments.
“It’s like we can host a little satellite mental health clinic in a number of buildings,” she said.
The Bellingham School District will be opening a school-based health center that will be operating out of Options High School. The center will serve the whole district and be a designated space, in addition to having mental health care providers, to allow kids to get the help they need.
“That is on the horizon,” Smith said. “Part of the reason for that mental health focus for the health center is [because] that’s what students told us they needed the most.”
Continuum of care
School districts are working to add more mental health counselors and other resources to aid students feeling the adverse effects of poor mental health. Even so, Gruman said, adding a single mental health provider will not solve the problem.
“There’s a misconception that when we talk about treatment of mental health, we think only about one-on-one intensive treatment,” she said. “A better approach, a more effective approach, is to consider the continuum of care that begins with prevention strategies and small-group intervention. We know this is more efficient and more developmental.”
A more-preventive care model would be more efficient to implement in school districts, Gruman said.
There is a push to hire people who can treat high needs or crisis cases, but this does not address the needs of students going through elementary school and middle school who have heightened risk factors, she said.
Gruman pointed out that school counselors are trained to work throughout the whole system — to collaborate with educators, parents and community members to create environments and teach skills that prevent full-blown mental health problems from blooming.
Effective care, Gruman said, looks at a continuum where younger students are receiving the tools needed to create a solid foundation early on and to continue to build those skills and techniques.
“It might have taken our society a while to figure out that this is important,” Jacoby said. “[But] I think people are there, at least in the schools, [who] understand it; and they are all in on collaborating to help support kids. That’s definitely something that’s encouraging.”
— Reported by Aria Nguyen
“Some progress but gaps remain in mental health care for Whatcom adolescents,” Salish Current, Aug. 2022
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