Commentary

Arm teachers with mental health providers


 

The gun control bill passed recently in Florida is a promising step forward in helping to protect children from deadly violence in schools. While various attempts to minimize gun violence have been stalled in state legislatures, in some cases for decades, this bill, which includes funding to expand mental health services for students, highlights a simple, sustainable, and nonpolitical solution: mental health providers.

Teen sitting on floor in hallway at school Lisa Quarfoth/Thinkstock
In thousands of schools around the country, school-based health centers employ the expertise of behavioral health professionals to reach young people in need of help. There are school-based health centers in 49 of the 50 states, and more than two-thirds of the 2,315 centers offer in-house behavioral health services, according to the nonprofit School Based Health Alliance. But the last report in 2015 from the National Center for Health Statistics numbered public elementary and secondary schools at over 98,000.* And, there are varying levels of mental and behavioral health services available across these centers. There has never been a more critical time to increase the availability of school-based health services, which provide the comprehensive care of a community health center within a school building.

School-based health centers arm educators with the powerful combination of on-site medical, mental health, and community health services that could address and aid in preventing violence through education, screening, ongoing care, crisis management, and advocacy.

At Montefiore Health System in the Bronx, our school health program plays a crucial role in keeping kids safe and healthy, and sometimes even saving lives. This past fall a potential tragedy was averted when a student disclosed to one of our on-site mental health providers a plan to murder a classmate after school. The child was fully assessed, resulting in a brief hospitalization. The child is back in school, receiving on-site services and being carefully monitored.

Our dedicated staff works closely with teachers and school staff to identify children in need of services. Barriers to care are eliminated as services are provided directly in the school in collaboration with teachers and school administrators. Coordination with the school and family allows for comprehensive, high-quality treatment that cannot be provided in any other setting.

School-based health centers offer protection and support on many levels. Mental health professionals can train teachers and other school staff to recognize red flags in students. They can collaborate with educators to carry out regular school-wide screenings to identify students who need immediate follow-up. And primary care providers in the clinic also screen for troubling behaviors and refer students for treatment within the clinic.

We know mental health providers make a difference. But we also must acknowledge that accessing these services often is a challenge. Estimates suggest that only half of children aged 8-15 years who need mental services actually get them. This is why having school-based health centers and mental health providers located where children spend most of their day is so vital. Often, school-based mental health providers have a chance to reach kids who are the least likely to receive care in the community.

Mental health professionals and school based clinics are invaluable resources; they are on the front lines of recognizing and treating worrisome student behaviors. Funding and providing these services is essential.

Dr. David Appel

Dr. David Appel

Dr. Appel is director of the Montefiore School Health Program, which makes primary care, mental health, dental and vision services available to almost 40,000 K-12 students in 26 school-based health centers throughout the Bronx.

*This article was updated 3/29/2018.

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