By Natasha Robinson, Southwest Michigan Second Wave

For years, Lesa Brenner has been advocating for educators to address her daughter’s mental health needs.

This year, she used Schools of Choice to switch her eighth-grader to Portage Public Schools.

“We felt there was just, across the board, a major lack of trauma-informed care (in the previous district). We were dealing with constant triggers and feeling unsafe. She went through a couple of middle school settings, to the point where she just was not set up to be successful,” Brenner says.

Her child has been diagnosed with Attention-Deficit Hyperactivity Disorder) and Post-Traumatic Stress Disorder – conditions that impact her daughter’s impulse control and cause “a lot of mental and emotional fatigue,” Brenner, of Kalamazoo, says.

The Centers for Disease Control and Prevention (CDC) explains that a person may be diagnosed with PTSD when they develop long-term symptoms (longer than one month) from trauma, which are upsetting or interfere with their relationships and activities. 

The CDC describes ADHD as one of the most common neurodevelopmental disorders, usually first diagnosed in childhood, often lasting into adulthood. A person with ADHD may have trouble paying attention, may act without thinking about what the result will be (impulsivity), or be overly active.

With Brenner’s daughter at Portage Public Schools, Brenner received calls on day one from staff who would be working directly with her daughter to implement the child’s Individualized Education Program (IEP) and help her feel safe and welcome at school. 

Brenner’s daughter has been able to get regular support from her school counselor, a licensed professional counselor, when she’s overwhelmed throughout the day. She has other accommodations included in her IEP that help her have better days at school. And most importantly, her mother says, is that the staff have connected to her and recognized her needs. 

“There are so many different social things happening, and kids are so confused right now,” says Brenner, who is also a licensed master social worker and therapist. “There’s a lot of uncertainty and weird things going on and it just makes our kids feel really sad and anxious.”

What’s different at Portage Public Schools?

There’s no typical-looking day when it comes to supporting the mental health needs of Portage Public Schools’ nearly 8,800 students. And in Marianne Joynt’s new role as mental health initiatives coordinator for the district, she’s able to go wherever support is needed for staff and students and put together plans to meet their needs as best she can. Joynt’s position is one of many similar roles being added to school systems locally and across the nation as needs for mental health support in the schools have grown.

“Over the past several years, all the school districts in the county have seen an increase in anxiety and depression for students. When we look at students who were functioning well in the past, those are students who are now needing extra support,” says Joynt. 

According to the report “Meeting the Mental Health Needs of Michigan Youth with School-Based Health Services” released in 2021 by Citizens Research Council of Michigan, nearly 20 percent of Michigan youth have been diagnosed with depression, anxiety, and/or ADHD. 

“Nearly two in five Michigan youth have reported feeling sad or hopeless every day for a two-week period in a way that impacted their usual activities. The proportion of youth in Michigan experiencing a major depressive episode has increased by 83 percent since 2007,” the report says.

Joynt previously worked with Integrated Services of Kalamazoo in close collaboration with Portage Public Schools to help youth access services. Now, she’s able to work within the district to create systems change, increase awareness, and manage barriers hands-on with proactive strategies.

Solutions to overcome crippling mental health barriers

Joynt says anxiety and depression can be crippling for some students. “It can make it hard to sleep at night, to get out of bed in the morning, and to take care of hygiene. We are seeing an epidemic of children not going to school due to very high levels of anxiety, the transition between home and school is often the hardest time for them,” she says. 

Students with depression may withdraw from social activities, isolate themselves from peers, and experience falling grades. Anxiety can cause work avoidance, falling grades, difficulty testing, and irritability with peers and teachers. At times, the environment in schools can be overwhelming (lights too bright, hallways too noisy) when dealing with anxiety or depression.

“Depending on the weight that students carry into the school each morning, their day can be affected from beginning to end,” Joynt says. “It is crucial that school staff get to know their students and are able to identify when they may need extra support.”

Research supports having schools actively engaged in supporting youth mental health needs. “While there are many valuable strategies to target the major barriers to youth behavioral health treatment, one approach has been proven to check all the boxes: expansion of school-based health professionals, services, and centers,” according to the Citizens Research Council of Michigan report.

Heightened awareness of increasing youth mental health struggles sets the tone for how the 14-school district uses Joynt’s services. The increase in funding from state and federal resources also made it more feasible to offer a dedicated mental health role. 

“That’s what my task is, to really bring a mental health lens and focus and coordinate those different pieces,” Joynt says. “We have lots of people working in the district, but everyone’s focus is different with just a tiny thread of mental health. I get to just focus on mental health.”

Funds bolster support systems in schools

About $30 million was added to State School Aid Act Funding in 2018-2019, and soon after, Michigan became one of the first states to amend the Medicaid State Plan to expand coverage to include reimbursement for all Medicaid-eligible students receiving behavioral health and support services, not just students with an Individualized Education Program or Individualized Family Service Plan. 

This came after Michigan lawmakers were having conversations about how to “harden” schools to keep out would-be shooters – bolstering secure entrances, reinforcing windows, upgrading security tactics, and more, according to Scott Hutchins, School Mental Health and Medicaid Consultant with the Michigan Department of Education. He says lawmakers began to examine how they might also support students and staff and their mental health needs in a more preventive, internal way. 

Each pot of state funding offered has its own set of rules, which allows districts to get creative in meeting their needs. Some may purchase social-emotional learning (SEL) training for staff and materials for students; others may hire therapists to be on-site. Hutchins provides technical assistance to schools to help work through their needs assessments to help them access and utilize available resources.  

“A lot of our schools now have the ability to get that student connected to services right there in that school, so you don’t have to worry about transportation, you don’t have to worry about finding time after school. Now they can literally walk down to an office within the school day and see a therapist and get service within their school,” Hutchins says. “To me, it really has made a huge difference.”

A document, formally known as 31n School-Based Mental Health Services 2021-2022 Legislative Report, offers a comprehensive overview of what’s happening in public schools across the state with mental health initiatives. The overall intent of this funding is to increase the provision of mental health and support services in schools for general education students throughout Michigan. 

More than 62,000 students received mental health screenings or assessments in 2021-2022 compared to 12,030 in 2019-2020. More than 22,200 students received direct services from a School-Based Mental Health Services provider in 2021-2022 compared to 8,885 in 2019-2020. 

“You’ve got to teach kids math. You’ve got to teach them how to read. You’ve got to teach them how to play with each other, get along with each other, right,” says Hutchins, who spent 20 years as a teacher and principal before taking his role with the state. “But they can’t do all those things, they can’t learn if they’re not feeling connected, if they’re not feeling whole, if they’re dealing with depression or anxiety and they’ve got a 12-month waiting list to go see somebody.”

In the 2019-2020 school year, 291 local school districts were served by School-Based Mental Health Services funds. In the 2021-2022 school year, that increased to 436 local school districts served. The number of full-time equivalent (FTE) licensed behavioral health providers hired directly by an intermediate school district or local school district with such funds went from 89.78 in 2019-2020 to 257.74 in 2021-2022. The number of licensed therapists available to provide direct services to students through partnerships with community mental health and private practice also increased.

“Seeing the way the different districts react to the mental health crisis that we’re in goes to show how successful the entire student body’s going to be,” says Brenner.

Districts like Portage Public Schools can blend funds from different pots, including at-risk funding and 31n funding, to create and sustain a role like Marianne Joynt’s. She has a master’s degree in counseling psychology from Western Michigan University and has focused on working with families and children for the past 20 years, including with Integrated Services of Kalamazoo, the local community mental health agency.

“School-based mental health is a vital part of student support systems. Early identification, referrals for treatment, and general support can be life-changing. Mentally healthy students are more likely to go to school ready to learn, use appropriate problem-solving techniques, engage in school activities, have positive relationships with staff and peers, and behave in a non-aggressive manner,” Joynt says. “It is important to support staff needs as well with education and helping to build a continuum of interventions needed to make a significant impact on safety, health, learning, and general well-being.”

Some rules have had to be relaxed around licensing requirements, and it has been difficult to attract job applicants for social workers and counselors to some parts of the state, leaving positions like these open for months at a time. Sometimes, organizations like community mental health will lose their therapists because they get hired by the school system and enjoy more regular hours and scheduled school breaks. The state has a 31n advisory council working to address these limitations, working to create pipelines for staff shortages and assessing what titles and certifications will best meet the needs of schools, among other recommendations.

“An unintended consequence is we’ve stolen from Peter to pay Paul,” Hutchins says. “Michigan has been at the forefront of thinking about those critical things. We’re working with our partners … and coming up with solutions to grow workforce development.” 

Community and belonging enhance youth mental health, resilience

In her role, Joynt is focused on promoting well-being, resilience, and education for students and staff; empowering families to seek services and supports; and collaborating with the community.

“In Portage we are working to identify students and families who need extra support. We are working on preventative measures for threat assessment so that students who are exhibiting risky behaviors can receive the support they need to make better choices, be safe, and be successful,” Joynt says. “We work hard to help all students feel a sense of belonging and community.”

Joynt has spent time building personal connections with teachers and staff and asking directly what they need and what the students need. She said her job is to “clear the way as best I can” for families to access services. Sometimes it’s hard to get good results when families don’t agree with a plan or won’t follow through for some reason or another, or when there’s a shortage of providers available. 

An estimated 9.4 percent of American youth have been diagnosed with ADHD and more than half of these children have at least one other mental, emotional, or behavioral disorder, according to the Citizens Research Council of Michigan. 

“We are working with students to provide mental health treatment and social support to prevent students from entering the juvenile justice system,” Joynt says. “We are working with students and community resources to generate content for staff professional development. I am working with parents and the PTOs to help educate them about understanding the mental health of their children and how it impacts their education.”

She’s building and maintaining relationships with community stakeholders that include primary care physicians, community therapists and ISK, churches, police and juvenile justice, housing resources, the Michigan Department of Health and Human Services, and business partners.

“Over the years I have seen many successes. From individual students blossoming with therapy and support plans to whole system movement identifying the need for mental health support,” Joynt says. “Students, families, school staff, and community providers are working together as teams to support our youth. That is an amazing win in my book.”

For children like Lesa Brenner’s daughter, the wins at school translate to more wins at home and in the community. Now  Brenner regularly receives positive feedback that she has been able to, in turn, use to encourage her daughter. 

“She was refusing to go to school for a while and it was just a really, really tough time for her,” Brenner says. “She’s still got her challenges, for sure, but, we see her smile, we see her laugh.”