Suffering children in need of mental health care too often starve for help

Feb. 14--Maybe she was trying to commit suicide. She's not sure.

The hydrocodone and ibuprofen the 18-year-old downed that morning last fall in her south Kansas City home would at least make her very sick. Maybe faint.

The senior made it to her school bus. Made it through her first hour at Center High School.

But when assistant principal Sharon Ahuna saw the overdosed student in the hall between classes, she had sunk to the floor against the wall with her arms clutching her legs.

The adults who swept in to her aid were sped by fear but swollen with frustration over the fractured network of mental health services struggling to help the nation's children.

"Their problems are overwhelming, and (mental health services) are not working well for a lot of them," said Mary Kettlewell, program officer for the Health Care Foundation of Greater Kansas City.

"And it's not just two or three kids who need help," she said. "Some 80 percent of students could benefit from services. ... The need is tremendous."

Center knew the student's struggles well. The school's social worker had been meeting with her, and the teen sometimes had dropped in on her own to talk. Her school counselor, assistant principal and others had been supporting her.

But their efforts to secure consistent help with a professional mental health therapist kept running into barriers, especially with transportation.

"I'd come home and there'd be no one to help me," the teen said.

She told her story in an interview with The Star while Ahuna and the social worker, Beth Schroeder, listened in. She did not want to be named.

Her mother had split from her during her high school years over the daughter's complaints about conflicts and serious threats involving her mother's boyfriend, she said.

Her biological father had been shot to death when she was 7.

The psychological pain has been brutal and school would be her way out, if only she could manage the mounting stress.

Although her school supporters would assure her she is a good student, the teen was suffocating in doubt.

"Am I good enough to go to college?"

Her situation spurred Center to redouble its efforts to bring some stability to its mental health services.

Administrators convened meetings with the Missouri Department of Mental Health. They worked it out so Swope Health Services could serve Center High School -- and this is helping the 18-year-old student.

The district and Swope also worked out a pilot program to have a liaison from Swope rotating through district schools.

But it's not enough.

The impact is felt strongest among the poor, where families are transient, disconnected from resources and often uninsured, said Beth Heide, director of student services and human resources in the Center School District.

The Annie E. Casey Foundation research project Kids Count found that 10 percent of Missouri children and 8 percent of Kansas children lack health insurance, and the number reaches as high as 23 percent for children living below the poverty level.

In both states, the research shows, 16 percent of children have one or more emotional, behavioral or developmental conditions.

Too often families don't get help until a crisis -- a suicide attempt or a police call -- said Fred Watts, director of clinical services for KVC Hospitals.

He knows because he witnessed the cycle when he worked in emergency rooms.

"Crisis-based services is not the answer," he said.

KVC has been in the mix in trying to expand care into schools and homes, including grant-funded programs -- now lapsed -- with the Independence and Center school districts.

Other districts also have been trying to create or restore professional mental health services in their schools, including Belton and Lee's Summit, wading into the competitive and elusive world of funding grants.

The school and home services help families get past transportation barriers and also ease the stigma families fear in walking into an agency or hospital, said Kim O'Connor, who helped coordinate the school programs for KVC.

The burden hanging on so many of the school programs is how to make their case for funding. Getting programs is hard. Sustaining them is harder.

Scientific analysis showing a program's benefits is difficult, said Melissa Jonson-Reid, a professor in the George Warren Brown School of Social Work at Washington University in St. Louis.

It's generally too costly to establish a randomized control group that is necessary to make comparisons between children who get services and those who don't. You can't simply isolate families from other services they might seek on their own.

Schools will see benefits -- better attendance, better grades, healthier habits -- "but you can't say that (a mental health program) caused it," Jonson-Reid said.

Correlation and intuition only go so far when there is so little funding in budgets and grant programs to go around.

The Health Care Foundation of Greater Kansas City, which is one of the major grant sources for schools, can dole out $4.25 million to mental health programs a year, Kettlewell said. But it typically sorts through some $15 million worth of requests -- and that's for all community-based proposals, not just from schools.

Another fund, reviewed on a monthly basis, doles out some $400,000 a month, and the foundation culls from more than $1.5 million in requests.

More public funding is needed, Kettlewell said, but that's an even bigger fight during scarce economic times.

So much of the mental health pain that children suffer is invisible, said Sharon Nibbelink, director of assessment in the Center School District. And help is so complicated.

"We can't help them the same way with the coat drives and the mitten drives and the food drives," she said. The children struggle into their classrooms "and we pick up the pieces."

School nurse Cindy Noll gathered the broken teenager into her nurse station that morning while they waited for the ambulance. She recalled the deep, helpless cavity she felt, stating the teenager's name, which is changed here to protect her identity.

"She let out this sob," Noll said, and the nurse withered. "We want to save the world here. We want to save the world. But at that moment, I just wanted to save Clarisse."

To reach Joe Robertson, call 816-234-4789 or send email to jrobertson@kcstar.com.

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