Students with problems show need for in-school mental health services

Nov. 10--Dana vaguely recalls being in grade school when her South Buffalo house burned down. Pictures, pets -- everything was gone. Then came the series of hotel rooms and apartments and family money troubles.

Many of her closest friends were experiencing traumas of their own, and she seemed to absorb all of their anxiety, as well.

By the time she was in high school, Dana was constipated and throwing up blood. She was plagued by worries and couldn't sleep at night.

Two years ago, she picked up a steak knife and started slicing the inside of her left arm. It was a shallow cut, one of many she would make over the coming months. The first time, she told her mother about it and promised not to do it again. But of course, she did.

"I thought about going deeper, hitting a vein," Dana said, "but I never did."

She did enough, however, to ultimately land her a week's stay in the hospital under suicide watch last year.

Dana's story isn't unusual. According to a high school survey conducted last year of roughly 5,500 students in the Buffalo Public Schools, there has been a rise in suicide attempts that required medical treatment, as well as increases in self-reported heroin use, rape and heavy smoking.

Not all high-risk behaviors are climbing in the district. Some, like alcohol use, are showing consistent declines.

But the rising percentage of students reporting symptoms of depression, suicide risk and other mental health problems is clear.

Nearly 14 percent of all students reported suicidal thoughts. Of that number 10 percent -- 416 -- reported attempting suicide in the previous 12 months.

More than 3 percent -- 145 kids -- reported hurting themselves badly enough to require hospitalization.

Providing extensive psychological services to children seems beyond the boundaries of any public school's mission. But in many places, principals are finding the need is undeniable. There are too many students like Dana.

"High-risk kids don't go out after they get home to get services because their lives are in chaos," said South Park High School Principal Theresa Schuta.

In light of last year's survey and a similar one conducted in 2011, the district has dramatically expanded its school-based mental health clinics, with help from Say Yes Buffalo and funding from Erie County.

Dana, whose last name is being withheld because of her age, is a beneficiary of these services. Now a student at South Park, the bright-eyed, smiling 17-year-old seems nothing like the girl who once fantasized about hanging herself in her own home.

Help for Dana

Silver hoop earrings peek out from Dana's auburn hair. Wearing a warm, black fleece that matches her long lashes, the girl could be a poster child for many others whose life traumas require accessible in-school mental health providers.

She still recalls the night when she told her mom she'd deliberately cut herself and promised it was a one-time event. Her mother went into Dana's bedroom, opened the dresser drawer and fished out the knife. Then, Dana said, her mother looked at her again.

"How can I trust you at night?" her mother asked.

Nighttime is when Dana did her cutting, when it was quiet. During the day, she said, the family's apartment can be a stressful place. Worries about money, as the family tries to save for a new home, and other arguments among her parents and siblings usually mean a lot of yelling.

Dana also stays in regular touch with neighborhood friends, many of whom face equally difficult circumstances and whom she wants to help. She pulled out her iPhone and called up a long text message that one of her friends had sent her while she was in class the week before.

It was a suicide note. Dana left class and showed it to one of two mental health staffers who work at South Park High School. That friend wound up at Erie County Medical Center -- the same place Dana wound up a year ago.

"My mom thinks I put everybody's stress on my shoulders," she said.

That has led to a long history of physical health problems for which doctors could find no physiological cause. After going to a friend's house in January 2013, she texted a message to another confidant saying she felt ready to end her life.

That message quickly got passed to Dana's mother, who retrieved her daughter, took one look at the fresh cut marks on the inside of her left arm and dragged her to Mercy Hospital. The hospital then transferred Dana to ECMC, where she spent a week under suicide watch. She has slowly improved with follow-up care.

And a good amount of that care has come from her school, which has two mental health professionals who work there. South Park was one of the first Buffalo public high schools to apply for and receive grant funding to employ a counselor two years ago.

"It helped a lot," Dana said. "It really did. I always felt like nobody's here for me. When people self-harm it's because they feel they are all alone, when they're not all alone."

High school realities

At South Park, Principal Schuta is tired.

In September, her school celebrated its 100th year as a South Buffalo high school with balloons and a pep band. Since becoming principal in 2009, Schuta has seen the graduation rate at her 860-student school climb from 46 percent to 60 percent in 2013.

But as a South Buffalo native and South Park Class of '78 graduate herself, Schuta knows her community of kids belongs to a population at high risk for failure. That makes the need for in-school health services imperative, she says.

South Park's 2013 Youth Risk Behavior Survey reads like a hospital ward summary. Its pages are stacked with pink and red rectangles of numbers, each one indicating high-risk student behaviors that exceed the school district average.

Students reported levels of tobacco and illegal drug use more than 70 percent greater than the district as a whole. And more than 30 percent of students reported symptoms of depression in the prior 12 months. Fifteen percent attempted suicide, and 6 percent required medical treatment -- nearly twice the district average.

Schuta sees those numbers in the faces of her kids. She handles the unending parade of students through her open-door office with motherly interest, though she admits it's fatiguing. She talks with everyone in the same down-to-earth manner, her shaggy blonde hair swept back from her face in no-nonsense fashion.

One talkative teen stands before her explaining that she needs a letter of good behavior from the school so that a judge will dismiss the charges against her. The same girl also worries she won't have any more access to required counseling services once she's out of the court system.

"We have counseling services here," Schuta reassures her.

The school applied for grant money to hire a part-time mental health coordinator four years ago. Since then, the school has brought on a second counselor. Both counselors are employed by Gateway-Longview family services organization. Schuta said she began hunting for more money to support mental health services at the school after seeing many students in crisis repeatedly put on waiting lists by outside agencies.

"It was just evident our kids were struggling with things we weren't equipped to handle," she said.

The mental health counselors are part of the school's Student Family Resource Center, which also houses the school nurse, a food and clothes pantry, a family room, mental health clinic and a site facilitator who can connect kids and families to a long list of other school and community resources.

Will Keresztes, the district's associate superintendent of student support services, called Schuta a "pioneer" in the integration of social support services at her school.

"There's a reason she's considered one of the most progressive principals in the district, and that's because she's taken these kinds of steps," he said. "Terry is mitigating the effects of the social challenges that her children endure, so her school looks and feels different than other schools facing these challenges. There's no doubt about that."

District response

In 2011, the Buffalo Public Schools completed the district's first Youth Risk Behavior Survey of middle and high school students. In December of that same year, Say Yes to Education partnered with Buffalo to provide access to tuition-free college to public school students, as well as provide other in-school health and family support services.

Those two events have resulted in important changes for Buffalo's public schools.

Through Say Yes, the district gained county support this year to expand school-based mental health clinics to 12 other schools in addition to the seven the district already had.

Gateway-Longview, one of multiple mental health service providers working in the district, has handled many cases of student trauma, depression and anxiety, disruptive behaviors and attention deficit disorder, among other issues, said Kristy D'Angelo, the agency's director of behavioral health services.

"Our clinicians have full caseloads," D'Angelo said.

Most clinics operate in schools one or two days a week, she said, though South Park has someone at the school every day.

The district also has nine regular health clinics in schools. That number has shrunk in recent years, but Say Yes officials are working to expand both health and legal services to district schools in the near future.

"Buffalo has powerful partners, like Say Yes," Keresztes said. "That combination means that we have a chance to address student needs like never before in our city."

Since the 2011 survey, the district has developed a wellness policy, though critics complain it's still not being fully implemented. The district has also adopted a suicide intervention policy and is now working on a condom availability program.

Keresztes acknowledges that although the 2013 survey findings show progress in some areas, the numbers remain too high in too many areas.

"We know that family health is critical to how students perform in school and how they plan for college and career ambitions," he said. "It's our responsibility as a school district to do more, much more, to support children and families."

As for Dana, thanks to support she's receiving through her school and from her doctor, she's much more optimistic about the future. Her grades are up, and she's landed a part-time job at Kohl's for the start of the holiday season.

"It really can't rain forever," she said. "I'm still living. I'm a warrior."

To view the 2013 Youth Risk Behavior Survey and other related information, visit the School Zone blog at www.buffalonews.com/schoolzone email: stan@buffnews.com

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