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School of Social Work helps Durham Public Schools address students’ mental health needs

Thanks to the success of a pilot project at C.C. Spaulding Elementary, Durham will be adding mental health workers to seven other schools this year

Durham youth will soon have more access to needed mental health services and treatment.

Thanks to the success of a pilot support project at C.C. Spaulding Elementary, Durham Public Schools will be adding mental health workers to seven other schools this year. The sites include six elementary schools—Bethesda, Burton, Eastway, Eno Valley, Merrick-Moore and Spring Valley—and Lakeview, the district’s secondary alternative school that serves students in sixth through 12th grade.

The district will spend about $500,000 to expand the project, mostly to hire the additional mental health professionals and to staff each school with a parent liaison—someone from within each neighboring community who can help connect parents to resources and services inside and outside of the school building.

The support project is a partnership between Durham Public Schools; the Durham Center, which offers behavior health and disability services; and UNC’s School of Social Work. Joelle Powers, a clinical assistant professor, is the principal investigator of the project, which was developed to help teachers and staff better recognize when disruptive behaviors in the classroom might be the result of something more serious, such as depression and anxiety.

“I think all of the partners see this expansion as mutually beneficial,” Powers said. “For Durham Public Schools, I think they see it as an opportunity for students to finally get the services they need in order to be successful in school. For the Durham Center, I think they see this as an opportunity to finally have access to children and families in the community who they know need services but who have faced barriers to traditional services in the past.”

District leaders were also eager to expand the mental health project because they know that without adequate support, students can struggle academically, said Eunice Sanders, assistant superintendent for Student Support Services with Durham Public Schools. The additional school sites were chosen for the project, in part, following a review of student academic performance, suspensions, and attendance.

“Our classroom counselors have been overwhelmed with the number of children being referred, so we knew we needed to do something else,” she said. “The bottom line for our school system is academic success. So we hope by putting together a complete package of wrap-around services, we will see better academic performance for some of our children. We also hope that as our parents become more involved and see what has been going on with their child in school that we can give them the resources they need to take home to help their child.”

Across the country, schools are beginning to face similar challenges in meeting students’ mental health needs. The National Institutes of Mental Health estimates that 20 percent of students nationwide have a mental health disorder—5 to 10 percent of which are considered serious or severe. In addition to academic underachievement, untreated mental health problems in young people can result in erratic school attendance and substance use and abuse.

Increasingly, schools are being tapped as vital places to offer interventions because they provide a convenient, safe and comfortable space for families to turn for needed services and support.

Durham launched the school support project last November at C.C. Spaulding, a pre-kindergarten through fifth-grade school with about 250 students. The pilot project was largely supported by a $75,000 grant that Powers received as a recipient of UNC’s 2009 C. Felix Harvey Award and with additional assistance from MSW student Kate Blackman and from doctoral students Aaron Thompson, Kate Wegmann, and Jeff Edwards.

Once the project was approved, a mental health social worker from The Durham Center and a parent liaison were hired to work closely with Spaulding educators and parents to help identify students’ needs and to ensure that children were connected to community treatment resources, such as a psychologist or psychiatrist and to medication.

Powers also helped train educators on the symptoms and signs of the six most common childhood mental health disorders: depression, anxiety, autism spectrum disorders, behavior disorders, learning and communication disorders, and attention deficit hyperactivity disorder. The School of Social Work also helped teachers learn additional techniques to better manage their classrooms when disruptions occur.

Once teachers understood how to recognize student needs, they followed a referral process, which brought parents, educators, the school mental health worker, and parent liaison all to the same table to discuss how to get necessary services and treatment to the child. From November 2010 to June, 65 students from the school were referred and treated, Powers said.

“By far, the majority of referrals received were for behavior,” she said. Teachers didn’t classify their students’ specific symptoms, but behavior problems generally may include showing a persistent disinterest in school and fatigue, or irritability and outbursts in class.

Overall, there is no evidence to suggest that there is a higher rate of mental health disorders among students at Spaulding than at other schools, Powers added. However, Durham educators have long recognized that Spaulding’s children face many significant risk factors, all of which can affect their mental health and access to services. The school was selected for the project partly because of its high teacher turnover rate and because nearly 80 percent of the school’s children receive free or reduced lunch, a federal measure of poverty.

Other risk factors were also identified based on the school’s use of the Elementary School Success Profile (ESSP), which was developed at UNC’s School of Social Work. The ESSP is an assessment tool that helps researchers and schools identify barriers to learning by looking more closely at the experiences of students at home, in school, in their neighborhoods and with families and friends.

“What we found was the level of risk that these students face is severe,” Powers said. “By far, the majority of students — or about 70 percent — had moved a minimum of one time over the last six months. So the school has an incredibly transient population. School staff felt like that was directly related to poverty because, for example, if parents were unable to make their rent, they’d move.”

Through the ESSP, educators also learned that 43 percent of homes had a caregiver who did not complete high school, while 52 percent of parents also reported that drugs “are somewhat of a problem or a big problem in their neighborhood.”

“Many of the children even reported hearing gunshots at night,” Powers said.

Bea Laney, a social worker from The Durham Center, knows Spaulding’s community well. She’s lived there for 15 years, which is one of the main reasons her employer willingly paid her to work with Spaulding as the school’s mental health worker.

“The needs of this community are very visible,” Laney said. “There are drugs and alcohol. Houses are boarded up, and there’s trash and debris. So this is what these kids are coming out of, and they’re still expected to learn.”

Laney’s ties to the community, as well as those of parent liaison Angela Jeter, helped them both in building trust among Spaulding’s parents, many of whom initially had limited contact with the school because they worked more than one job, lacked transportation or a working phone. Laney and Jeter spent time going door-to-door just to introduce themselves to parents and to let them know that their school was a place they could turn to if they needed help, Powers said.

“For parents, home visits gave them a face for the project,” Powers said. “In fact, they didn’t really think of it as a project. They thought of it as ‘Ms. Bea.’ They would say, I could tell when Ms. Bea. was in my home that she cared about me and that she wasn’t interested in telling my business to other people. That home visit really set the stage in terms of trust, which then allowed families to feel more comfortable in coming into the school to access support.”

Such trust was especially needed to help parents get past the stigma that is often associated with mental health, Laney added.

“Mental health is a serious factor, not just for this community but for people of color in low-wealth communities who tend not to embrace resources as readily,” she explained. “Instead, many come from a background of ‘When I’m feeling stressed, I should be able to deal with that on my own.’”

Educators have used Spaulding’s support project to help families understand that seeking treatment for a mental health problem is no different than seeking treatment for a physical ailment, such as diabetes. Both deserve equal attention.

Parents have strongly supported the district’s efforts to help students largely because researchers and educators took the time to ask for parents’ feedback on the project, Laney added.

“They got a chance to express their concerns, and they saw that we weren’t just approaching them individually because something was the matter,” she said. “So, as a result of that, we were also able to engage parents in a non-threatening way, and we were able to build more relationships.”

Powers also credits the success of the pilot project on the “willingness and desire of both the district and the Durham Center to do something innovative to support their students and the community.”

“It is the creative partnership between the systems that merged their experience and expertise into a program that seems to be making a real difference for kids,” she said.

Although the seven schools where mental health support will be added this year share similar needs, the culture at each site is different, so what works for one may not work for all, Powers added. But the first step toward success is having educators who realize that mental health is a topic that they can no longer afford not to address, she said.

“If there are attendance problems, academic failure and behavior problems, ultimately, I think the district is saying we still own all those problems,” Powers said. “So if we still own it, we might as well address it in a better way.”