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School districts challenged to meet student mental health needs

Hamilton Journal News (OH) - 3/29/2014

March 29--BUTLER COUNTY -- Demand in mental health services for children has dramatically increased, and school districts across the county are opening their doors to outside counseling agencies to meet the need.

"The demand continues to grow," said Kimball Stricklin, chief executive officer at Butler Behavioral Health Services. "There's been a lot more sensitivity over the last two to three years on mental health illnesses in schools, and tragedies that have made people more cognizant."

The rate of students served through Butler Behavioral's school-based program has jumped 166 percent in just a three-year period -- from 120 students in 2011 to nearly 320 this year. The agency has seven therapists for school-based counseling in 41 schools across six county districts, according to Stricklin.

"The schools carry a big responsibility," Stricklin said. "Schools are asked to do an awful lot of things they aren't equipped to do or equipped to do as well as they'd like."

At least 1,000 students across Butler County are receiving mental health services, according to mental health providers. Most districts were unable to provide figures for the number of students getting school-based services.

The Ohio Department of Education doesn't track the number of students receiving mental health services, either inside or outside of the school day, said spokesman John Charlton.

"It's acknowledged in Ohio and across the nation, there's a need for mental health services," Charlton said. "There never seems to be enough services to go around or meet the needs."

At St. Aloysius Cambridge in Hamilton, the agency started a school-based counseling program six years ago, said Christina Baker, director of child programming. Baker said about 350 students across eight districts are served by counselors from St Aloysius. Those districts are Hamilton, Fairfield, Ross, Talawanda, Lakota, Madison, Monroe and Edgewood.

The agency also has 50 students enrolled in its partial hospitalization program that includes a half-day of counseling and a half-day of learning.

Community Behavioral Health, with locations in Hamilton and Middletown, serves about 70 students through one-on-one and group counseling in schools. The Counseling Source in Blue Ash serves another 200 to 300 students locally.

These agencies are a handful of the nearly 20 mental health providers in Greater Cincinnati that provide mental health services in Butler County schools. Officials said allowing access during the school day helps remove many barriers, including transportation and busy schedules for parents.

Services are offered to all students from kindergarten through 12th grade, and they must have either Medicaid or private insurance for school-based therapy.

The only cost to districts related to mental health services are the salaries of positions such as nurse, school counselor and school psychologist, officials said.

As well, seven of the 10 districts utilize a total of 16 liaisons from the Butler County Success Program -- through Butler County Educational Service Center -- to bridge the gap for families between the health provider and school district.

The program launched in 2005, and districts pay $25,000 per liaison per year, said Cari Wynne, supervisor of Butler County Success.

"The liaisons have the relationship with families and can encourage and help families come to the decision their child could benefit from treatment," Wynne said.

The Butler County liaisons serve 403 students -- an increase of 205 percent from the 132 students served in 2008, according to Wynne.

School and counseling officials said it's a true "team effort" to provide the student with the help they need in order to turn focus back onto classroom learning.

"We're all on the same team, sitting around the table, problem solving and planning for the student," said Deborah Turner, student services coordinator for Middletown City Schools.

Within Hamilton City Schools, 18 mental health agencies are used to meet the demand for mental health services, said Mindy Fischer, director of pupil personnel. Depending on the needs of each individual school, counselors come for a half-day or up to two days per week for private sessions with students.

"We're opening up our doors to so many agencies, saying 'come help,'" Fischer said. "This has been a big year for us."

Fischer said it's important for any child, or adult, to have their basic needs met, including mental health, before they can learn and grasp new materials. She said a safe, stable environment is needed for the student to learn coping skills and strategies.

Fischer said she notices a spike in the number of students needing the services once they hit third grade.

"Around third grade the curriculum is getting hard and the gap widens between typical behavior and those with mental health behaviors," Fischer said.

At Edgewood City Schools, the district started partnering with Butler Behavioral Health and Community Behavioral Health last October to increase its mental health services of individual and group meetings, said Michael Imhoff, school psychologist at the high school.

For the past four years, the district has had about 15 students receive school-based counseling from St. Aloysius.

Imhoff said the district makes up to five referrals each week to mental health providers. He said issues range from depression and anxiety to drug abuse and cutting.

"Jails are becoming the new mental health clinics for adults, and schools are becoming the new mental health clinics for minors," Imhoff said.

Mara Krall, school counselor at New Miami Middle and High schools, said when she meets with students it's for issues including bullying, not getting along with their peers or difficulties at home.

"The family unit is changing pretty consistently with divorce, parents incarcerated and living with grandparents," Krall said. "The hardest obstacle is the intake process and parental involvement."

Since 2006, the New Miami district of 730 students uses school-based counselors from three outside agencies. Krall said about 12 students in the middle and high schools get school-based services, with another 20 in the middle of the referral process.

Krall said after a student is referred for services, she will meet with them to determine their scope of need, for either weekly therapy sessions or something more involved. Krall said she's looking for signs and symptoms of a more serious issue, such as self-harming and expressing suicidal ideation.

"Students need that social, emotional support before they can learn," Krall said.

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