The Other 60 Percent

A new tool in schools’ mental health tool box

Using Crayola markers set on each round table, small groups of adults from the Greeley area — school outreach workers, Boys and Girls Club staff and foster parents — created poster-sized pictures of what mental health problems look like. Glum stick figures sat under rain clouds, a face contorted from happy to sad and a placid face showed no outward signs of distress.

The pictures were just one of several hands-on activities sprinkled throughout a recent day-long training that aims to teach lay-people the signs of mental health or substance abuse problems in youth, and give them action steps to follow when they spot trouble.

Called Youth Mental Health First Aid, the training originated in Australia and was unveiled in Colorado last year. There is also an adult version of the training, introduced here in 2008, called Mental Health First Aid or MHFA.

Both are gaining momentum in what mental health advocates say is a welcome development in a state saddled with one of the highest suicide rates in the country and more than its fair share of school tragedies, including a deadly shooting at Centennial’s Arapahoe High School in December and a self-immolation at Westminster’s Standley Lake High School in January.

Olga Gonzalez, a community outreach worker who participated in the recent Greeley training, said she regularly fields questions from parents who are worried about their children but don’ t know where to turn. She recounted how one family she’d worked with discovered their son had started using drugs. Another learned that their son had stolen credit card information from a customer while manning the cash register at the family’s store.

“He has money in a savings account, you know. He just did it,” she said. “I wasn’t sure what kind of support he needs.”

Youth Mental Health First Aid aims to answer such questions for people who are not mental health professionals but who work closely with young people and their families. The target audience includes lay-people like teachers, coaches, guidance counselors, school nurses and even bus drivers.

Advocates for MHFA say Colorado now has one of the largest contingents of certified instructors—around 230 so far. In addition, it’s among only a handful of states to dedicate public funds to the trainings, with $750,000 appropriated for the program next year.

“We have been at the forefront of this since the beginning,” said Brian Turner, director of Mental Health First Aid Colorado at the Colorado Behavioral Healthcare Council.

Preparing first responders

The concept behind both versions of MHFA, much like medical first-aid, is to equip first responders with the know-how to address emerging mental health or addiction problems. The youth version is also meant to help distinguish between true mental health issues and the normal mood swings and behavior changes that characterize the life of a teenager.

But the training is hardly a technical lecture. It’s participant-friendly approach is evident in the hands-on activities, the video clips, the anecdote-peppered instruction and even the pile of bite-sized candy on each table. Originally, conceived as a two-day training, it has since changed to a one-day format.

“I think we try to make it accessible in a very non-threatening way,” said Pamela Collins Vaughn, one of the instructors at the Greeley training and quality assurance program director at North Range Behavioral Health.

The five action steps in Youth Mental Health First Aid.
The five action steps in Youth Mental Health First Aid.

Gonzalez, an outreach worker with Community Care Corps, said she learned about the training at a resource fair that she helped coordinate. Her work with families at two local middle schools, as well as in surrounding neighborhoods, made her want to refresh her knowledge on mental health issues.

While Gonzalez and other MHFA participants are certainly not charged with providing treatment, they do receive a customized local resource guide to help them connect youth with professional help when necessary.

In fact, encouraging youth to seek professional help is one of five action steps—condensed in the acronym ALGEE–outlined in the training. The other four include “Assess for suicide/self harm,” “Listen non-judgmentally,” “Give assurance/information,” and “Encourage self-help/other support.”

Turner said having concrete action steps is important because “there’s a big difference between learning about mental health and substance abuse problems and being able to do something about it.”

During the Greeley training, participants were asked to come up with gestures that would convey each of the five action steps. Soon, in an effort to commit the steps to memory, Vaughn and co-trainer Noelle Hause were leading the group in miming actions like non-judgmental head-nodding and reassuring arm-patting.

Reaching out to schools

While Turner said Youth Mental Health First Aid is not yet widely offered by school districts, there is growing interest. Among the districts that have offered it for at least some staff are Douglas County, Aurora, Thompson, and Weld County District 6.

Barb Becker, division director for community programs at the Arapahoe/Douglas Mental Health Network, said the one-day format make it a very doable training for educators.

One of the pictures made by participants at a recent Youth Mental Health First Aid training.
One of the pictures made by participants at a recent Youth Mental Health First Aid training.

“It just gives a really good overview,” she said, adding, “It takes away some of the stigma associated with mental health.”

While grants to offer Youth Mental Health First Aid are sometimes available and some mental health centers offer it for free, the price of the training can be a barrier for districts. Costs typically run at least $25 per person and can max out at $50 depending on facility and food costs.

While the new $750,000 in state funding will help with expansion, Turner said advocates are also investigating whether Medicaid reimbursements received by schools can help pay for the trainings. Currently, those reimbursements are used for all kinds of school health and wellness efforts, from paying school nurses to buying P.E. equipment.

If Youth Mental Health First Aid is widely adopted by schools, it will join a growing number of tools used to detect and combat mental health problems in students. Many schools already use suicide prevention curriculums, some are adding instruction on social emotional skills and a few conduct universal mental health screenings among students.

In addition, many schools regularly convene meetings to discuss and create plans for students who are showing signs of mental health or behavioral problem. Others publicize programs like Safe2Tell that allow students, parents or staff to anonymously report bullying or threats of school violence or suicide.

While Becker noted that middle-aged white men, not teens are actually at the highest risk for suicide in Colorado, she said it is still a problem among young people.

In 2010, Colorado had the seventh-highest  youth suicide rate among states and Washington, DC, with 16.7 deaths by suicide per 100,000 people in the 15-24 age group, according to data from the Centers for Disease Control and Prevention. In general, Colorado’s suicide rates are higher in rural and mountain communities than in urban areas. They are also higher among males than females.

Becker said there are a variety of reasons, including biological changes, peer conflicts and dating strife, that adolescents experience depression, which is a leading cause of suicide.

“It’s a hard time in life,” she said.

Ultimately, Turner hopes both versions of Mental Health First Aid will be widely available in all parts of Colorado. They won’t prevent all violent incidents, he said, but they might help. They can also aid in the healing process for communities that have suffered through fires, floods, droughts and other disasters.

How I Help

Why this high school counselor asks students, ‘What do you wish your parents knew?’

Today, we launch a new series called “How I Help,” which features school counselors, social workers and psychologists across Colorado. It is a companion to our popular “How I Teach” and “How I Lead” series.

Through “How I Help,” we hope to give readers a glimpse into the professional lives of school staff members who often work behind the scenes but nevertheless have a big impact on the day-to-day lives of students.

Our first “How I Help” features Cassie Poncelow, a counselor at Poudre High School in Fort Collins. She was the 2016 Colorado School Counselor of the Year and is one of six finalists for the 2018 National School Counselor of the Year award.

Poncelow talked to Chalkbeat about how she creates a legacy of caring, what teens want their parents to know and why peer-to-peer mentoring is better than a social-emotional curriculum taught by adults.

This interview has been condensed and lightly edited.

Why did you become a school counselor?
I was incredibly fortunate to have many powerful educators shape my life in my time as a student, but none did more so than my school counselors. My counselor from high school remains a dear friend and mentor. I knew that I wanted to be a part of what is happening in education and loved the diversity of the school counselor job. They get to collaborate with so many different stakeholders, get to know students in really cool ways and be involved with so many aspects of making change.

Cassie Poncelow

Tell us about an effort or initiative you spearheaded at your school that you’re particularly proud of.
Three years ago, we noticed that students were dropping out continuously because they were short on graduation credits and tired of taking the same classes over and over again. I worked with a team to create Opportunities Unlimited, which is a dropout recovery program for students ages 17-21 that is focused on GED completion and concurrent enrollment opportunities. A fifth cohort started this fall and the program has graduated 26 students in two years.

Is there a tool, curriculum or program you couldn’t live without in your job?
Our Ambassadors program is in many ways the backbone of our climate and culture at Poudre High School. This program trains 50 upperclassmen to mentor freshmen through a year-long curriculum that includes topics like stress management, suicide prevention and sexual assault. This mentoring model means that every freshman has an ambassador that is connecting with them for almost three hours each month. The ambassadors deliver comprehensive, peer-to-peer education that is far beyond and better than any social-emotional learning curriculum that counselors could facilitate. As the co-leader for this program, I also couldn’t live without the hope that this crew gives me. They are the best part of my job.

What’s the biggest misconception you’ve encountered about your role in the school(s) where you work?
I am grateful to work in a place and with people who see the vital role of school counselors and are eager to partner with them. In my time at Poudre High School we have added two new school counseling positions, further demonstrating our school’s belief in the work we do. I have worked at schools in the past that created a lot of systemic barriers to accessing school counselors and I think this was based on a misconception that we were a more frivolous part of services for students.

You spend lots of time with students. Knowing what you know, what advice would you give to parents?
I often ask my students, “What do you wish your parents knew?” What I hear consistently is a plea for them to remember what it was like to be 16: How painful and awkward it was, how boys were all the rage and not getting invited somewhere really was the actual worst.

So, I advise parents to remember that. And remember that a lot of what they dealt with at 16 is even more complicated by the world our kids are experiencing. Social media wasn’t a reality when they were kids and our current students have never known a world where mass shootings haven’t happened often. I know it’s no, “I walked uphill both ways without shoes in the snow,” but this is a scary time to be student — different, but equally hard. Our kids need us to hear them in that. And believe that they can change it.

Tell us about a time when you managed to connect with a challenging student or a student facing a difficult situation. How did you do it?
At my core, I think we all thrive on authentic relationships and I do whatever I can to create these with my students. I want each of my students to feel like I am truly in their corner and a champion not only of what they do but more so of who they are. I hope to not only live this, but to model it for my students in ways that inspire them to do the same.

This semester I have a freshman boy who was consistently skipping class (who knew gas station tacos were such a draw?) and failing multiple classes. His “consequence” is that he has to spend a period working on missing work in my office. I also have a slew of seniors who have made my office their home during this fifth hour, many who are excellent students and are just looking for a place to study. They have taken this freshman under their wing and are committed to his success far beyond what I could ever be. They are constantly asking about his upcoming exams, what he needs help with and celebrating his rising grades with him. I think I have built really authentic relationships with these upperclassmen who then remember what it means to feel connected and cared for and are passionate about showing this student just that. I often stress “legacy” to my students and this seems like a clear picture of that.

What is the hardest part of your job?
Kid stuff is hard. I hurt for kids a lot, as I think all educators do. They live lives far beyond our walls and far beyond what we could imagine and ever control. That’s the hardest. Close second would be trying to operate in a system that seems to be driven by folks who aren’t doing the work. I recognize that there are so many moving pieces and would love to have some of the actual “decision-makers” come spend the day in our role and better understand the work we do.

Tell us about a memorable time — good or bad — when contact with a student’s family changed your perspective or approach.
A year ago, I had a student who was really struggling with some significant mental health issues. I knew that we needed to bring in a parent but the girl was very anxious about this idea, to the point where she had literally crumpled up on my office floor. After calling her mom to meet with us, I joined her on the floor of my office to talk more. Her mom walked in shortly after, assessed the scene and sat right down on the floor with us, despite the chair-filled room. This move shifted everything and I was so grateful for her wisdom to be where her kid was at. It was a good reminder to me to do that always: be where kids are at.

You spend your days trying to help students and staff with any number of things. How do you wind down after a stressful day?
A lot of my unwinding still includes my students as I announce volleyball games or attend other sporting events or performances. I love these opportunities because they let me see my kids in a different light and remind me how awesome they are. I also spend as much time outside as possible, whether it’s going for a quick hike with my pup or a bike ride. Beyond traveling and reading, I cheer hard for the CSU Rams! Go State!

Big money

Millions in grant dollars will bring more counselors to Indiana’s underserved students

KIPP Indy was one of several schools in the county to receive a counseling grant.

Scores of Indiana schools were awarded private grants that will allow them to bolster counseling services for students, many of whom are lacking help for an increasing portfolio of problems, including fallout from the state’s drug epidemic and basic needs like advice on college applications.

The $26.4 million in grants, decided last month, include six for Marion County districts and charter schools. They were awarded by Lilly Endowment, a prominent Indianapolis-based philanthropy founded by key players in the pharmaceutical giant Eli Lilly.

The grants went to 52 school districts and five charter schools, covering about a third of the state’s counties. Based on enrollment, they ranged from about $68,000 to almost $3 million.

Lilly began its push to help schools build better counseling programs last year.

“The response from school corporations and charter schools far exceeded the Endowment’s expectations,” said Sara B. Cobb, the Endowment’s vice president for education. “We believe that this response demonstrates a growing awareness that enhanced and expanded counseling programs are urgently needed to address the academic, college, career, and social and emotional counseling needs of Indiana’s K-12 students.”

As Chalkbeat previously reported, school counselors have been stretched exceedingly thin in recent years, both in Indiana and across the country. On average, each Hoosier counselor is responsible for 630 students, making Indiana 45th out of 50 states and the District of Columbia for counselor-to-student ratios. The American School Counselor Association recommends a ratio of no higher than one counselor for every 250 students.

So far, state-led efforts to expand counseling have fallen short; a bill proposed in 2015 to require a counselor in every school was withdrawn for further study, and the issue hasn’t resurfaced significantly in the legislature since. At the time, cost was the sticking point.

Schools and districts had to apply for the grants and show how they would use the money. Lilly reported that mental health and business partnerships, mentoring programs, improving curriculum and adding in more training for staff were all strategies that grant-winners have proposed.

Initially, 254 districts and charter schools applied, many pointing out how Indiana’s recent opioid crisis has increased social and emotional challenges for students. Counselors have to juggle those serious needs with college and career advising and, increasingly, responsibilities that have nothing to do with counseling, such as overseeing standardized tests.

Because of the level of interest, Lilly is planning a second round of grants, which would total up to $10 million.

“Because the implementation grant process was so competitive, the Endowment had to decline several proposals that had many promising features,” Cobb said. “We believe that with a few enhancements, many of these proposals will be very competitive in the second round of the Counseling Initiative.”

These are the districts and schools in Marion County that received counseling grants. (Find the full list here.)

  • Indianapolis Public Schools: $2,871,400
  • KIPP Indianapolis: $100,000
  • Lawrence Township: $1,527,400
  • Pike Township: $1,114,700
  • Neighborhood Charter Network: $68,312
  • Southeast Neighborhood School of Excellence: $99,870

IPS said in a news release that it planned to use the grant money to build counseling centers in each of the district’s high schools, which would begin operating in 2018 after IPS transitions to four high schools. Superintendent Lewis Ferebee said counselors are “critical” for students as they prepare to graduate high school and pursue higher education and careers.

“We’re thrilled that the students and families we serve will benefit from this gift,” Ferebee said.