Across the board, local school administrators are reporting an increase in student referrals for mental health and/or counseling services this school year. Even with multiple programs in place to identify students in crisis, finding outside providers in rural Susquehanna County is an obstacle.
According to Maryann Colbert, Director of the Lackawanna-Susquehanna BH/ID/EI program, all six school districts in the county now have school based behavioral health (CSBBH) teams in place. The teams offer the districts training and support, she said. “They can be a support to a district when children are experiencing a crisis situation,” Colbert said. The teams can determine if a referral is needed or can help determine what is happening with the student and connect the child with appropriate resources.
The CSBBH team provides are higher level of care than a school Student Assistance Program (SAP) team. SAP is a team process in schools used to mobilize resources and designed to assist in identifying issues including alcohol, tobacco, other drugs, and mental health issues which pose a barrier to a student’s success, according to the PA Dept. of Education website.
“There are still many problems to solve on the path of how to enhance what we are doing for rural communities and school districts,” Colbert said.
Increase in student mental health needs
Montrose Area Superintendent Chris McComb said that mental health and counseling referrals have been “on the rise for the past several years, and the pandemic certainly has not helped.”
The same holds true at Blue Ridge, according to Superintendent Matt Button, but he added, “It’s hard to quantify because (the need for services) comes and goes based on student request/crises.”
Elk Lake principals are also seeing an increase. “I would say that we are at least doubled if not tripled the amount of referrals,” said one principal. “We’ve also experienced a significant increase in the amount of students we have had to send for crisis evaluations.”
Colbert said, “Social isolation (from the pandemic) has had a tremendous impact especially among adolescents. They have not had consistent interaction with peers, we know that kids have been really impacted by this.
In Montrose Area, McComb said students are “absolutely” experiencing issues either directly or indirectly related to the pandemic. But other school administrators are seeing mental health issues arise from all areas, “pandemic and non-pandemic-related,” offered Susquehanna Superintendent Bronson Stone.
Button noted an increase in students needing mental health support since the pandemic began but added, “It is difficult to say whether or not it is directly or even indirectly correlated,” he said. “We have a significant number of students whose families are struggling financially, emotionally and logistically (housing/jobs).”
“(It’s) hard to say with accuracy if these issues are directly related to the pandemic but it’s fair to say the pandemic hasn’t helped,” offered one of the Elk Lake principals. “Some issues that we would suggest are directly linked to the pandemic- would be an impact on communication among students and their ability to connect with peers within the school setting. Students who may have already been struggling to maintain friendships are now experiencing a lapse in time where they are unable to connect with peers that they would normally see daily. They are also unable to have interactions with school staff members or counselors which may have been helpful resources for them.”
The other principal said the pandemic has amplified needs. He said, “The correlation I see has been the need for appropriate social skills, conflict resolution, increased social media/technology concerns, and an increase in self-esteem needs. Isolation has been very concerning for many of my students who have had to quarantine.”
School Programs & Services
All the districts have several programs in place to help identify at-risk students.
At Blue Ridge, the district uses both the Child Find (IDEA) and the SAP (Student Assistance Program) processes. We have a full-time contracted social worker in the MS/HS and a CSBBH (School-Based Behavioral Health) program in the elementary school.
Susquehanna Community has a mental health screener that is utilized in addition to the SAP referral system.
McComb said, “We have a number of ways to identify students in order to get them help.” The Montrose Area elementary schools utilize screeners and child study teams to identify at-risk students. The high school primarily uses its SAP team. “But we have also been able to get students assistance through the Safe to Say system,” he noted.
For a number of years, the Montrose Area elementary schools have had community based mental health services and, this past year, those services were expanded to the high school.
Montrose Area Jr-Sr High School has employed a crisis counselor for the past several years, and – a few years ago – partnered with Friendship House for a crisis counselor to work with elementary emotional support and autistic support students, according to McComb.
“This past year, we actually hired that person as a district employee due to the increased need,” he said.
In addition to SAP, Elk Lake has a multi-step tiered system in place, starting with trauma informed trainings for staff members that students interact with on a daily basis. Teachers have had some training on what to look for and how to identify certain behaviors. The district has five counselors, of which one is a crisis counselor. More intensive services – such as CSBBH – is also available. A trauma therapist comes to the schools to see specific students and two other counselors also come to the schools each week.
“Once a student is referred to the SAP team the team collects data and decides which resources would best fit the needs of the referred student,” said the principal.
Access to Services
“Susquehanna county isn’t a hotbed for mental health help for the community,” said one Elk Lake principal. “Oftentimes there is a several months wait list to get appointments or proper medication.”
There has been talk in the district about a “case worker” to act as the tie between school and home situations. “Having another person to invest in our families and help us at the school would be a huge help. Funding and resources seem to be a stumbling block for this,” he said.
“Access to services has historically been an issue in rural communities. Over the past several years this has become increasingly more difficult. Probably the biggest challenge is finding access to mental health services outside of the school, like partial programs. They are virtually non-existent,” said McComb. “It becomes extremely frustrating to identify a need only to be told ‘sorry, there are no programs available.’”
Stone echoed fellow administrators, “Providers are in scarce supply. However, the (Susquehanna Community) district did form a partnership this year that resulted in an additional counselor in the district one day per week. The district has received approval on a grant that will provide an extra counselor each day next school year to support students in both schools.”
“Unfortunately, referring to outside services is not always simple,” adds an Elk Lake principal. “Our county is large and many of our families work either 2nd or 3rd shift or may share a vehicle with their spouse. Transportation is tough – how can we make those connections to outside services if transportation is unavailable and additional time?”
He continued, “A caseworker would be fantastic to work in the areas of need holistically for the student/families of our school. Sometimes the help isn’t always mental health rooted (maybe housing, food, basic living securities) but does contribute to mental health.”
Colbert said, “We’re not putting heads in the sand when comes to these issues. We’re having the conversations about mental health needs in our communities – what are the strengths and barriers. Those conversations are occurring at frequency much greater than pre-pandemic.”
She said Lackawanna-Susquehanna BH/ID/EI is working with school districts to develop a suicide and violence risk assessment form. The form would be filled out with a crisis referral and will loop back after the crisis intervention with a safety plan put into effect.
The agency is also connected two-year pilot program from Drexel University, bhworks, with funding provided through the Pennsylvania Garrett Lee Smith Youth Suicide Prevention Grant. Bhworks is software that a teacher or mental health professional can use to screen students in seven minutes and determine the appropriate steps. The program produces monthly data. “We will actually know, this many are depressed, or anxious,” Colbert said.
“A lot of times – in our work – we use anecdotal information. This tool will give us real data,” she said. The data may confirm “what we’re doing is working,” as well as “where we need to guide our efforts, where we need more attention.”
RESOURCES & HOTLINES
Safe2Say Something: 1-844-saf2say
Scranton Counseling Center Mental Health Crisis: 570-278-6822; 1-800-348-6100
Advocacy Alliance Warm Line: 6-10 p.m. daily: 1-866-8114
National Suicide Prevention Lifeline: 800-273- TALK (8255)
National Alliance on Mental Illness (NAMI): nami.org; 800-950-6264 or text 741741 for free, confidential crisis counseling
Women’s Resource Center: 1-800-257-5765; 570-278-1800
Essential Community Services: Dial 211