Editor’s note: This article is by Howard Weiss-Tisman, of the Brattleboro Reformer, in which it was first published May 2, 2015. This is the last installment of a three-part series on emotional disturbance in Vermont schools. Part 1 is here, Part 2 is here.
BRATTLEBORO — Gregg Stoller spends a good part of every day observing children in the classroom.
As head of the Supportive Team for Educational Progress, or STEP, at the K-6 Academy School in Brattleboro, it is Stoller’s job to come up with a plan when stress, anxiety, depression, or any other emotional or mental health issue plays out in the classroom in the form of disruptive and sometimes violent behavior.
So Stoller can often be found at the back of the room, watching how disruptive students interact with their teachers and classmates, and then developing plans that make it easier for everybody to learn.
“What we do is teach teachers how to include these kids better in their classroom,” Stoller said. “We supply the support and the education so if there is an issue we can help out.”
The Academy School model is just one strategy schools in Vermont are trying as they face a growing mental health crisis.
Vermont has the highest rate of identifying students with emotional disturbance in the country.
As a percentage of all students who received special education services in the 2012-13 school year in Vermont, about 16 percent were identified with an emotional disturbance, according to federal data. That is more than twice the national average of 6.3 percent.
As the number of children with emotional disturbance grows, schools are coming up with programs like STEP to try to address the issue.
Every year more clinicians and behavior interventionists from local mental health agencies are setting up offices in Vermont schools.
And the state is working to encourage collaboration between social service agencies to deliver more intense and comprehensive services in the schools.
“We are historically schools, and we’re there to teach kids to learn to read, write and do arithmetic, and now we have to do all these other things as well,” said Windham Central Supervisory Union School psychologist Tom Daughton. “We are the de facto mental health providers.”
Where the kids are
This is the sixth year Stoller has worked in the STEP program at Academy.
STEP was formerly an autism support program but over the past six years, as the behavior issues at Academy intensified and became more frequent, Stoller has been devoting all of his time to helping teachers, emotionally disturbed students and their classmates find a way to succeed together in the classroom.
Stoller is a board-certified behavior analyst with more than 25 years of clinical social work, and over the past few years Academy School has been able to greatly reduce the number of students who have to be placed in out-of-district programs.
The STEP program has been successful, he said, because it supports teachers, many of whom have very little or no training in addressing serious mental health and behavioral issues in children.
As more children come to school with serious emotional and behavioral disorders schools are hiring more of their own counselors and therapists.
They are starting their own programs, like STEP, as well as expanding their contracts with the local mental health agencies.
Since Vermont rolled out Success Beyond Six in 1992 as a funding mechanism that allows districts to draw down Medicaid money to pay for mental health services in the schools, the number of contracts between schools or supervisory unions and their local designated mental health agencies has increased every year.
“We should be in the schools because that’s where the kids are,” said Charlie Biss, director of the Child, Adolescent and Family Unit of the Vermont Department of Mental Health. “It’s a great way of identifying and getting the services out to the children and families.”
Health Care and Rehabilitation Services of Vermont is the designated mental health agency in southeastern Vermont that contracts with the state to provide the clinicians and behavior interventionists for the schools in Windham and Windsor counties.
In the past three years the HCRS Success Beyond Six contract for all of Windham and Windsor counties grew from $2.8 million to $3.45 million.
Will Shakespeare, HCRS director of Children, Youth and Family Programs, said the agency’s role has shifted during that time.
In 2010 HCRS provided 24.7 clinicians and 18 behavior interventionists to area schools, and by 2014 the number completely shifted to where HCRS employed 14 clinicians and 31 behavior interventionists.
That change, he said, reflects the increasingly violent and disruptive behavior of children struggling with mental illness and emotional disturbance.
“These kids are coming into the classroom who are so escalated and so reactive and so non-compliant,” Shakespeare said. “In some ways teachers are completely unprepared to deal with these behavior issues in the classroom. They may be educationally prepared, but most people don’t know how to handle these kids because they don’t have the training of the behavioral piece. And if we’re going to do anything teachers need much more focus around the social-emotional pieces if they’re going to be effective.”
HCRS CEO George Karabakakis said Success Beyond Six has also made it easier to serve children and their families who might otherwise never be able to access mental health services.
More than 65 percent of those students who receive support in the schools through Success Beyond Six end up working with their local mental health agencies outside of school to bring in additional services to them and their families.
“I think we have done a good job acknowledging that kids with issues and challenges are not going to walk into their local community mental health center and say, ‘I need help,’” Karabakakis said. “It’s not just about academic success or being able to get through the school day. Once the case managers start looking at the family’s needs, once you open up that box there are many other issues that really require a much more comprehensive approach.”
An imperfect system
There are some limitations and challenges to bringing mental health care professionals into the classrooms.
Communication between the mental health agencies and the schools are not always productive.
Conflicting schedules sometimes get in the way of school teachers and administrators meeting with the counselors or behavior interventionists, and confidentiality rules on both the education and health care sides often prevent the flow of critical information.
Biss said it is important to win over the trust of the parents who can allow some personal information about the child and family to be shared.
But there are always parents who don’t trust the school or mental health staff and who do not want their family struggles aired out.
“This is a very complex issue,” said Biss. “The bottom line is that you have to build that good relationship with the parents. But I don’t think everybody has the right to know everything, and sometimes it can really be a Pandora’s Box when you do start sharing that information. There is really no one easy answer.”
Marisa Duncan-Holley, director of special education in Windham Southeast Supervisory Union, said as the mental health and emotional disturbance infrastructure grows it will be important to build in appropriate avenues of communication and collaboration between clinicians, teachers and districts.
“We’re working in all these silos. I don’t know when this family is accessing their therapist, and I don’t know if what we’re doing is counteractive to what they’re doing. We have to be able to work together and that’s not happening,” Duncan-Holley said. “I would like to see a joint blended program where over the course of a day a kid is getting his academic services and they’re getting their mental health piece of it, and they’re working together.”
Duncan-Holley said she has met with HCRS officials to try to establish better reporting networks.
The children who are getting special education services because of an emotional disturbance identification receive those services to better access their education, but Duncan-Holley said the growing number of children with behavioral issues, and the severity of those challenges are broadening the schools’ roles and responsibilities.
“We’re always at odds because we know some of these kids are having issues that require someone who has high skills to work with children who have mental health issues. We don’t do that. We do education. We are trying to get these kids to read and do math,” she said. “But in those moments when things are going awry here and we know it’s other things outside of school, we need to know how we can support that child in the best way possible. We’re working on it, but it’s an imperfect system. We just want the best for them but it is not always easy to know how we can do that.”
Windham Central Superintendent Steven John said the schools are being forced to confront the outcomes of so many social and economic failings.
“Our societal expectations of what the schools are expected to do are changing and as usual the schools are called upon to fill the breach,” John said. “All my staff are trained in suicide prevention, recognizing sexual abuse, alcohol-drugs, de-escalation, blood-borne pathogens. I mean these are all mandatory things in law that we have to train all our teachers about, and you can imagine there are some teachers who didn’t get into teaching to do all these things. It’s commendable the public schools are doing as well as they’re doing.”
And John says sometimes all of the mental health services the district can muster cannot prevent failure, tragedy, or even worse outcomes.
Students in the district over the past few years have faced violence and suicide, and while there are always successful cases of students graduating from high school, the satisfaction of administrators and teachers are tempered by the occasional police reports on current and former students and their families.
“Most of these parents are not bad people. They’re doing the best they can with what they have, and they don’t have much, financially or socially or educationally,” John said. “We are in the business of education. We have to be looking at the positive and be optimistic. We can’t be the end all, be all, cure all for everybody, but we’re certainly going to give it a shot.”
