Its basic flaw is that it assumes all services to school children will be provided in the schools by school employees, including mental health services.
When you start there, you get nowhere very expensively, less competently, and with considerably more danger in the case of mental health than if the schools were to partner with other government and non-profit services.
This part of the series will deal with child and adolescent mental health services exclusively.
Public mental health, intellectual disability and substance abuse services for children and adolescents are funded by governments at every level. For the federal view of the system of care, see here.
In Virginia, those services are organized, overseen and funded through a state and local agency system.
- The state agency is the Virginia Department of Behavioral Health and Developmental Services (DBHDS) in the Secretariat of Health and Human Resources. The Department of Medical Assistance Services (DMAS) (Medicaid) plays a funding and patient management role as well;
- Local agencies funded and overseen by DBHDS are the Community Services Boards (CSB’s) throughout the state.
Some schools and school systems seem to operate on a different planet from their local CSB’s. Indeed, the Framework mentions them only reluctantly and in passing.
The ed school establishment clearly wants to handle child and adolescent mental health problems in-house, with tragic results. They need to stop it now.
There is absolutely no need to wait.
Let’s take a recent obvious and tragic example of apparent lack of school-CSB coordination — the six-year-old shooter in a Newport News elementary school.
He was profoundly emotionally disturbed, as only a kid can be
allegedly told another teacher prior to the shooting that he hated her so much he wanted to set her on fire and watch her die.
- whose IEP required one of his parents to be at school with him at all times.
There is no report
- that the child was ever referred to the Hampton-Newport News CSB for mental health support; or, as should have happened…
- banned from the school until such support had been provided and the kid had been given the go-ahead by a licensed professional to resume in-school education.
If schools cannot ban a kid like that until he or she is better, they are hopelessly dangerous.
If you think I am picking on Newport News schools, I am not. This is happening with such regularity across the state that we are nearly numbed by it.
CSBs. Let’s examine the Hampton-Newport News CSB’s Youth and Family Services. CSB Boards in Virginia are appointed by the City Council(s) or County Board(s).
That organization offers services provided by licensed professionals. Licensed professionals that the schools do not and will not have.
- For children birth to five years old: Clinical Assessment and Referrals, Linkage and Coordination of Services and Implementation of the Healthy Families of America Curriculum to promote healthy childhood and development.
- For children five to 17: provides therapeutic mentor services including in-and out-of-home services and supports. Services include crisis intervention, behavioral intervention, participation in treatment planning, outreach, service provider linkage, monitoring, advocacy, daily living support, independent living skills, vocational instruction, medication monitoring, supportive counseling, and positive role modeling.
- For children and adolescents.
- Children’s Behavioral Health Urgent Care Center provides rapid assessment, crisis intervention, and comprehensive psychiatric evaluation for children and adolescents experiencing a mental health crisis;
- Children’s Mobile Crisis Services provides comprehensive assessment, short-term crisis counseling, safety planning, linkages, coordination, and follow up.
4. For adolescents and young adults.
- Case management and intensive care coordination;
- Psychological Assessment and Evaluation Services.
The resources are already in place with the CSBs and will be massively increased under the Governor’s three-year Behavioral Health Plan that has bipartisan support in the General Assembly.
The CSB’s already have mobile crisis teams and crisis receiving centers for children and adolescents. Yet they are listed by the authors in the Framework only as “possible community representatives” on school “Advisory Boards.”
The education establishment and Virginia Tiered System of Supports (VTSS). The authors of the Framework list in community schools’ VTSS profile “Deliver Supports, Branch 2 Student’s Emotional and Mental Health Needs.”
- Tier 2 supports (some students) may include:
- Small group counseling on topics such as: social skills, emotional regulation, or coping skills;
- Mentorship programs; and
- Parenting courses that reinforce intervention.
- Tier 3 supports (few students) may include:
- Individual counseling supports;
- Counseling services through a community agency;
- Special considerations for disciplining students with disabilities;
- Homebased counseling supports; and
- Functional Behavioral Assessments.
If you find that sounds exactly like the services that CSB’s provide, except that in the case of the CSB’s, provide with licensed personnel, then we have a winner.
A number of school districts have excellent relationships and partnerships with their CSBs.
I am told that good examples of school division/CSB cooperation exist with Highland County CSB in Abingdon and with the Hanover County CSB in Ashland. Hanover was part of a pilot project that the Governor recommended in the current budget expanding to $15M.
Bottom line. There is nothing that prevents:
- the school divisions calling the CSB’s tomorrow to establish cooperation agreements that can be executed with a phone call;
- schools to stop trying to manage and treat such students and help their parents with school personnel.
To be absolutely clear, I consider this a two-step process.
Step 1. Get students with Level 3 mental health problems out of the schools. Schools have no personnel qualified or licensed to do the job. The results of trying are routinely catastrophic. Do net readmit them until a licensed therapist signs off that they are safe to return to a school setting.
To continue to try under some dysfunctional ed-school view of VTSS is to allow:
- children and adolescents to proceed through school and life untreated;
- other students and teachers to continue to be justifiably terrified; and
- people within the schools to be tragically wounded and killed.
Step 2. The CSB can take over and do what they can.
The Secretary of Health and Human Resources and the Secretary of Education may wish to work this out at the state level with a joint position paper/cooperation agreement.
Local governments do not need to wait for that.
Mayors may wish to call and host meetings between local school division officials and the local CSB to set joint cooperation policy.