During an interview last week in her apartment in St. Johnsbury, Desiree Hawkins fell silent at the sound of sirens nearby.
“It’s very hard to hear sirens,” she said, growing visibly emotional. She waited, tearing up, until they faded, and said, “The only time they don’t bother me is when my kids are home.”
Roughly seven months ago, Hawkins’ youngest son, Noah Stone, died by suicide in St. Johnsbury.
In the grief that followed her son’s death, Hawkins pushed Vermont’s Legislature to enact mental health and suicide prevention reforms aimed at youth — the Noah Act, as she called it. She contacted lawmakers, testified in a House committee and staged a small protest outside the Statehouse.
This past session, lawmakers passed two bills intended to prevent suicides and added language elsewhere focused on supporting the state’s mental health system.
But some feel that legislators did little to address the larger, structural problems of Vermont’s youth mental health system — and did little to address an intractable problem that Noah’s parents lamented: Mental health resources for children are few and far between.
“I’m trying to get something done so that they can implement more into our schools,” Hawkins said. “Mental health — I mean, across the board — (it’s) struggling for everybody. But more so our youth. Our youth are falling in the cracks.”
‘It’s only going to get worse’
Noah Stone was 12 years old when he died. He was a bright boy, his mother said, who loved the color pink and rooted for the New York Yankees. But he was bullied at school, and struggled with mental health, Hawkins said. A year or two prior, he had previously attempted suicide.
“Parents often say that it will never be us. Until it is you,” she said. “And I certainly didn’t ever expect to not have one of my children.”
His death is a tragic incidence of a national and statewide trend: American children’s mental wellbeing is slipping.
Recently released data from the Youth Risk Behavior Survey, which tracks self-reported data from American students, shows that Vermont children are not exempt. As of 2021, 35% of Vermont high school students and 22% of middle schoolers said they had experienced poor mental health “most of the time, or always” within the past year, according to the data.
Within the prior 12 months, 30% of high schoolers and roughly 20% of middle schoolers “felt so sad or hopeless almost every day for at least two weeks … that they stopped doing some usual activities,” according to survey data.
Roughly 1 in 5 middle and high school students also reported engaging in self-harm, and about 15% said they made a plan to attempt suicide within the past year. Roughly half that percent actually attempted suicide.
The data shows that female and LGBTQ+ students were struggling significantly more than their male, cisgender and heterosexual classmates.
“It’s a serious issue,” said Laurie Emerson, the executive director of Vermont’s chapter of the National Alliance on Mental Illness.
“All those kids are gonna grow up with these mental health challenges,” she said. “And if they’re not addressed now, it’s only going to get worse. And there’s going to be, you know, not 1 in 5 people affected by mental illness but much more. And our system of care isn’t prepared for that.”
‘The system is failing and must be fixed’
On Feb. 9, early in the legislative session, administrators from four schools and a nonprofit mental health agency tuned in via Zoom to the Vermont House Committee on Education to testify about student mental health.
Schools were contending with increasingly frequent violence, self-harm, threats and other troubling student behavior, administrators said. Meanwhile, mental health resources were few and far between.
Trained staff were hard to find, and waitlists for specialized programs were long, meaning that students struggling with severe mental health conditions had to wait months for services.
“We simply do not have enough services to even come close to meeting the need,” Libby Bonesteel, the superintendent of Montpelier-Roxbury public schools, told lawmakers.
Schools often work closely with designated agencies, which are local mental health care nonprofits, to provide services to students. But the relationships between school districts and those agencies — as well as state bodies — are sometimes fraught, administrators said. In some cases, the different entities competed with each other for staff. In other cases, districts and agencies differed on who should take on the responsibility, and the cost, for services.
“The system is failing and must be fixed,” said Sherry Sousa, the superintendent of the Windsor Central Supervisory Union, referring to the tangled relationships between school districts and other agencies.
On the whole, trying to fill students’ mental health needs was eating up increasingly large chunks of districts’ budgets, according to administrators.
“You could best support us in education by really focusing legislative priorities on the mental health crisis that exists for Vermont’s youth and families,” said Lynn Cota, superintendent of Franklin Northeast Supervisory Union. “And ensuring that our designated agencies have the resources and capacity to better support our youth, in our schools, at home and within our communities.”
‘We’re not finished’
During the session, lawmakers took several steps aimed at mental health. Gun control legislation, framed as a suicide prevention bill, became law Thursday without Gov. Phil Scott’s signature.
The governor signed bills the same day to join interstate licensing agreements for health care providers, including mental health counselors, intended to bolster the state’s workforce.
The upcoming year’s budget, which is awaiting an override vote on Scott’s veto, includes a 5% Medicaid reimbursement rate increase for the designated agencies.
The budget also provides $9.2 million for a 12-bed youth psychiatric unit at Southwest Vermont Medical Center. Another $3 million would go to the Department of Mental Health to address workforce needs at local mental health agencies.
The House Committee on Health Care also drafted a bill intended to improve suicide prevention measures in schools. That bill, H.481, clarifies the responsibilities of the state’s director of suicide prevention and mandates the creation of a “model protocol for all schools regarding suicide prevention, education, and postvention services” by January 2024.
Hawkins’ advocacy played a key role in the drafting of that legislation, according to Rep. Alyssa Black, D-Essex Town, a ranking member of the House health care committee.
“It was identified early on, even before we got in in January, that we would be looking at suicide, suicide prevention, mental health, mental health in our schools,” said Black, whose own son died by suicide in 2018. “And we’re trying to do the work on it. And we’re not finished.”
Room for improvement
In interviews after the end of the session, three superintendents who testified in February said that the youth mental health system needed large, structural changes — changes that did not materialize this year.
Cota, the Franklin Northeast superintendent, said suicide prevention is a “piece of the puzzle,” but she did not see “any kind of broad, sweeping legislation that’s going to significantly improve the mental health resources that we have available to us for our youth.”
“Unless there’s something I’ve missed in the legislative session,” she said. “I don’t see that that is what the focus was.”
Sousa, the Windsor Central superintendent, said she was disappointed that more action was not taken.
“I had hoped that this issue would have been addressed and been a priority,” she said. “But I also understand that this is incredibly challenging in terms of, where do we begin the work.”
Emerson, of the National Alliance on Mental Illness Vermont, said she was encouraged that mental health was a growing subject of policy discussion in the Vermont Legislature. She also praised the passage of a bill that would implement free school meals (H. 165, awaiting action from the governor) and discussion of the not-yet-passed H. 409, proposed legislation that would restrict physical restraints and seclusions in schools.
But, she said, there was room for improvement.
“They’ve worked on a lot of mental health bills,” she said. “Could there be more with youth? Yes.”
No easy answers
It’s clear, however, that there is no easy legislative fix. Asked for what they would like to see in a bill, school leaders did not provide specifics — instead, they urged lawmakers to examine the issue.
“I think what I would hope for is some sort of study as to the barriers in the state for mental health supports for kids,” Bonesteel said. “And then we can do something to fix that.”
And it’s not clear how much the Vermont Legislature could do. The deterioration of young people’s mental health is a nationwide — or worldwide — trend, whose root causes are not entirely clear. Many experts have pointed to social media, climate change, the Covid-19 pandemic, a fraught political atmosphere and other possible causes.
Meanwhile, economic factors in Vermont — widespread staffing shortages, an aging population and demoralizing housing crisis — are constricting the pool of mental health workers.
Asked about the issue, Sen. Brian Campion, D-Bennington, who is chair of the Senate Committee on Education, pointed to other bills approved this year, such as the universal school meals legislation and a bill to improve school safety procedures (S. 138, signed May 30).
Making schools stable and safe environments for children, he said, could make a significant impact on students’ mental and physical well-being.
“That kind of predictability is incredibly important as a way to address mental health,” he said.
In the 2021-22 legislative session, lawmakers passed more targeted bills, Campion noted, putting federal Covid-19 aid money toward school mental health initiatives. He expressed openness to examining the issue in the future.
Peter Conlon, D-Cornwall, the chair of the House Education committee, said his committee did not pass any bills “specific to student mental health, which probably you should refer to as youth mental health.”
Conlon praised the “great and compelling” testimony on the subject and said he hopes to return to the subject in the second half of the biennium. But he questioned how much could be done at the state level to address the issue.
“We’re a citizen legislature. (We’re) there four and a half months a year,” Conlon said. “And this is a global problem that even the best social scientists are at a loss to understand and explain and solve.”
Meanwhile, in St. Johnsbury, Hawkins runs an active Facebook group to advocate for action in her son’s memory. Her living room is full of memorials to Noah: photos, cards, an urn with his ashes, a handprint made at the hospital.
In the long term, Hawkins wants to found a nonprofit and set up a scholarship for a student who wants to study “human services, specifically to work with the youth,” she said.
“There’s just not enough out there for our youth,” Hawkins said.
Correction: A previous caption in this story included the incorrect town and political designation for Peter Conlon.
If you are in crisis or need help for someone else, dial 988 for the 988 Suicide and Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline) or text VT to 741741 for the Crisis Text Line.