'Schools Brace For Pandemic-Fueled Mental Health Needs' Transcript

September 2, 2021

Note: This transcript has been created with a combination of machine ears and human eyes. There may be small differences between this document and the audio version, which is one of many reasons we encourage you to listen to the episode!

Dan Gorenstein: Back-to-school is always a busy, slightly chaotic time.

But this year, the pressure is cranked up.

News clip: Education officials are scrambling to come up with ideas for dealing with COVID learning loss.
News clip: A record number of kids are currently being treated for COVID-19 in U.S. hospitals.
News clip: A protest over masks was held outside Fort Lauderdale High School this morning.

DG: And that’s just in the last month.

Over the last year-and-a-half, kids have built up a pandemic’s worth of mental health challenges.

Sharon Hoover: Students are coming back to school with anxiety, with depression, with post-traumatic stress.

DG: Today, the mental health toll facing kids, and how schools are taking advantage of unprecedented funding to support their students.

From the studio at the Leonard Davis Institute at the University of Pennsylvania, I’m Dan Gorenstein, and this is Tradeoffs.

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DG: Kyron Harvell was thrilled to hop on a bus in June with a bunch of kids and take them to a nature center a little over an hour away from their homes in Lansing, Michigan. 

Kyron Harvell: So many kids in this area don’t get a chance to go anywhere for summer vacations. So just give them a chance to do something fun and reconnect with friends.

DG: Some of these kids had been stuck at home for over a year.

And now it was a beautiful summer day, perfect for running, taking hikes and canoeing in the nearby lake.

KH: There was a young lady there, about 8 years old. And she was being really, really shy. Other kids trying to interact with her, she didn’t want to talk too much. And she had her backpack on. I said, “Hey, sweetie, you want to get into the boat?” She said, “OK, but can someone, one of the adults hold my backpack?” I said, Sweetie, you can just take your backpack and put it back in the little room where everyone else has there’s at.” She said, “I can’t.” I said, “Why not?” “My dad’s in there.” I said, “What do you mean?” Her dad died in March, and he was cremated. And she didn’t get to go to the service. So they gave her the urn. This young lady been carrying the urn around in her backpack all that time.

DG: Even before the pandemic, nearly 2.5 million kids were diagnosed with depression, and more than  5 million with anxiety.

Suicide among young people was also on the rise, especially among young Black kids who along with Hispanic kids, were less likely to access mental health care than their white peers.

COVID unsurprisingly has made things worse.

Data from the CDC show ER visits for mental health and suicide for kids have gone up, and research suggests rates for anxiety and depression have too.

Kyron has seen this play out in his own Lansing School District where he’s been a counselor and administrator for the last 16 years.

He says the district has referred kids from 150 families in the last year for free counseling for all kinds of mental health challenges.

KH: Social isolation because they haven’t been around their friends, around anyone in so long. Anxiety because they’re wondering what’s going to happen. And then depression. A lot of our kids knew people that had COVID, or they had family members that unfortunately had passed away from COVID.

DG: All those challenges are now Kyron’s responsibility.

He’s the new principal of Lansing’s Vivian Riddle Elementary School, which has around 200 pre-K through third graders.

It’s a huge task, one that’s challenging administrators, teachers and counselors nationwide. 

And it’s one Kyron was seemingly tailor made to take on.

He’s got this sort of mantra that he lives by — he calls it the 4 Os.

KH: Obstacles are opportunities to optimize my outcome. If we look at COVID right now, obviously, this is a major obstacle worldwide. This is also an opportunity for us to get creative and focus in on social emotional learning and mental health needs of our kids and families, and we’re going to optimize the outcome, because we’re going to see people who are happy and their mental health needs are being met.

DG: He already put his 4 Os into action with that 8-year-old carrying her dad’s ashes.

When Kyron got back from the nature center, he talked with her mom and helped the little girl get some counseling.  

KH: She’s made a lot of progress over the summer. She’s happier. I believe she’s gonna be alright, and I want her to be alright. I got to believe that she’s gonna be alright. 

DG: As Kyron prepared to take over as principal at his new school, he knew the statistics: about 40% Black, a quarter white and 13% Hispanic; around 80% eligible for free and reduced lunch.

But he wanted to meet the families and see what they needed. 

So he spent several days in July and August walking the streets around his school.

KH: I would go out around like 11 o’clock, just kind of walk around till about three or four each day. Just walk around the neighborhood knocking on doors, just talking to people.

DG: Kids told Kyron they were afraid of catching COVID at school, but also anxious about school going back online.

Parents worried about having enough money to put food on the table.

As he went door-to-door, he kept hearing about kids being cooped up, needing someplace to go. 

And in that obstacle, Kyron saw his opportunity.

KH: I was surprised at the number of little kids that were excited to come back to school. They were saying they’re tired of being at home. They can’t wait to see their friends. There was one little girl that said I just wanna give my teacher a hug. I just want to see my teacher.

DG: Their enthusiasm invigorated him.

Standing on those porches, hiding from the late-summer sun, his confidence grew — in-person school would make a huge difference for the mental well-being of these kids.

Then Kyron knocked on the next door.

KH: I introduced myself, told mom who I was. Little boy came out, hugged my leg and I said, “Hey, how are you doing?” And he said, “Not good. People keep dying.” And I was like, “What do you mean?” He kind of put his hands in his face, and his mom shared the story with me.

DG: The mom told Kyron that in one month, the 6-year-old boy’s dad, uncle and grandmother had all died from COVID.

She said they’d stood outside his grandmother’s nursing home window and watched her take her last breath.

KH: The kid asked me, “Mr. Harvell, why would God take away these three people?” And I was just like … [sigh] Yeah. Yeah. And I just said, “I said I don’t know. And I’m sorry this happened to you.” And I said, “I know what it’s like to lose a parent. When I was younger, my mom was killed in a car accident.” But I shared with him that even though they’re gone, they’re still in your heart. And that’s really all I could give him.

DG: Kyron said goodbye and walked off the porch.

KH: I was pretty shook up. After seeing this little guy and that story, I couldn’t just, I couldn’t just go to someone’s house because I was tearing up. And it was obvious that I wasn’t doing too well. I had to come back and get myself together.

DG: Sitting alone in his office, Kyron felt like he’d finally come up against an obstacle that he had no answer for.

KH: I felt like I completely blew it, I felt like I should have had a better response. I felt like I should have been able to give him something more than what I gave him.

DG: When we come back, Kyron makes a decision and how schools around the country are preparing to meet kids’ mental health needs.

MIDROLL

DG: Welcome back.

Kyron Harvell is one of thousands of school officials trying to figure out how to help kids deal with the trauma of the pandemic.

Sharon Hoover: They’ve never seen this level of mental health need in their students and in their families.

DG: Sharon Hoover is the director of the National Center for School Mental Health at the University of Maryland School of Medicine.

Sharon says schools are an essential front-line mental health provider. 

Nearly 4 million kids got mental health services at school in 2019, roughly the same number who saw a specialist outside of school. 

And while the need is expected to be even higher this year, the good news, says Sharon, is that for the first time in a long time there’s actually a lot of money on the table.

SH: In the past year, Congress allocated over $190 billion in emergency funding to K through 12 schools.

DG: Some of that is earmarked for problems like learning loss, improving building ventilation and retaining teachers.

Part of Sharon’s job is to help schools figure out how to use a chunk of that money for school mental health, something she says is happening across the country. 

SH: More than ever, we are seeing school administrators, school boards, et cetera, really focus on mental health in a way that they haven’t before, so I think there is a general agreement that we have to attend to mental health if we are going to re-engage our learners.

DG: Some states are investing their own resources too.

Michigan is spending $240 million and California $430 million to help schools hire badly needed school psychologists, social workers and counselors. 

SH: One of the challenges is that we know that the workforce just isn’t there. So while we’re seeing increases in postings and hiring to improve our ratios of school mental health providers to students, unfortunately, a lot of these job postings are going to go unanswered because the workforce pipeline just is not full, and it hasn’t been for a long time.

DG: So given these shortages, Sharon, what other ways are schools using this money to address the mental health needs of their students if they cannot find the staff?

SH: So we are seeing schools partner with community providers and also leveraging telehealth in addition to hiring folks in-house when they can find them. But we also know that schools are using this money for things that can just help improve the mental well-being for all of the students in their school buildings. For example, we’re seeing schools invest in what’s called social emotional learning curriculum or SEL and also mental health literacy curriculum that they can introduce right there in their classrooms.

DG: And what is social emotional learning and also mental health literacy?

SH: So social emotional learning in a classroom, that’s things like teaching students empathy and social skills and how to manage and identify their emotions, things like that. So as they’re teaching about an English assignment, for example, or a literature assignment, they are bringing in things like, how do we identify the feelings of these characters in the novel? Mental health literacy is a whole other piece that school systems are investing in. So that’s basically weaving knowledge about mental health and mental illness into the curriculum.

DG: Effectively, I think what you’re saying is, teaching kids what mental health is, what it looks like, so they can better understand it and spot it in themselves and others?

SH: That’s right.

DG: OK, Sharon. So when you look at how school districts are spending these funds, whether it’s on social emotional learning or other things, are the things they’re investing in backed by good evidence and research?

SH: So I would say yes and no. I would say that I am absolutely convinced that embedding social emotional learning in schools is critical to their success. And that really is from the data that we do have to date that shows that not only are kids doing better academically, but also that they are just better in terms of their social emotional competence. However, there’s actually a good amount of research that demonstrates that schools are not always great consumers of behavioral health products. So unfortunately, there are large investments being made not just in trainings that may not be scientifically based or merited, but also in solid evidence-based programming without the investment in the implementation support that we know is absolutely essential for it to actually make an impact. So yes and no.

DG: One state education official we talked to said it’s like schools have seven fires and three buckets of water. 

Given all of this, how hard is it, Sharon, for schools to give mental health the focus and the resources that it actually needs?

SH: Look, it’s hard. I do not envy school boards right now, school administrators, classroom teachers. They are having to make really excruciating decisions, not just about how to invest money, but how to ensure that they’re meeting the needs, the many needs and the complex needs of their communities right now. But mental health is on everyone’s minds these days. So while I think it’s hard for schools to give mental health the focus and resources that it might need when you look at all these other fires they’re contending with, most of them are doing it. They see the need.

DG: It sounds like you think this moment really is a paradigm shift, a game-changer. But you know there is still plenty of stigma around mental health. What do you think, Sharon, it’s going to take to take advantage of this moment and make sure that we’ve got more robust mental health services around the country?

SH: Michigan is a great example. Back in 2019, before the pandemic they actually took two steps. First, lawmakers actually earmarked more than $30 million for schools to hire more behavioral health providers, including counselors and social workers and psychologists. And second, they gave school districts the ability to bill the state Medicaid program, just like any other provider, which really brings in more new funding.

DG: And what’s actually happened in Michigan since then?

SH: They’ve actually been really successful. The number of mental health providers in schools has nearly doubled, and the legislature has continued to invest in this “hiring fund.” In the last two years it’s actually grown to more than $50 million a year. 

Even if Michigan stopped the hiring fund, by allowing the districts to bill Medicaid, they now have a way to cover these new staffing costs and to sustain the services. 

DG: And so with mental health on everyone’s radar more now, you see these two policies — dedicated state funding and allowing schools to more easily bill Medicaid — as concrete steps other states could take to set themselves up beyond this one-time slug of federal COVID relief money. 

SH: Yes, I think these two types of policies are absolutely essential right now. We really need to be investing for the long-term and for the future because mental health challenges are not going to go away. And I’m not gonna say this is gonna be easy, but I am really quite optimistic that we can sustain the efforts beyond right now.

DG: Sharon, thanks so much for taking the time to talk with us on Tradeoffs.

SH: Thank you so much for having me.

DG: Educators from coast to coast must think about things like staffing pipelines and sustainable funding. 

But those were the last things on Principal Kyron Harvell’s mind as he sat in his office that summer afternoon after talking to the 6-year-old boy who had lost his dad, uncle and grandmother in a month.

KH: I’m thinking like I lost my mom, I was 24. And I think about how much I struggled. So imagine losing someone at six. Imagine losing three.

DG: Earlier in the summer, Kyron had lined up a few local graduate students to provide counseling to the kids as school started. 

The entire Lansing School District devotes the first two weeks of school to social and emotional learning.

But sitting there, Kyron decided students had been through so much, he was going to do more.

KH: I’m going to spend the first three weeks with just focusing on SEL and mental health. And if I need a fourth week, I’ll take a fourth week. Because, again, I feel like this is important. I don’t care about math and reading right now. I care about how you’re doing. And building relationships with our kids. If we don’t deal with this, nothing academically is going to happen.

DG: Kyron says they’ll play some academic games but will prioritize developing people skills, team-building, being kind and showing empathy.

KH: We’re going to make sure that those kids who have historically been marginalized, isolated, that they have a friendship group, that they feel a sense of connection with every student in their class, that they see that teacher as someone who values them, cares about them and respects them. We want to build that inclusive and nurturing environment. And then we can get to academics.

DG: Sharon Hoover says many schools are planning to spend extra time on social emotional learning early on this school-year, but Kyron is the first principal she’s heard of considering spending the entire first month.

Sharon understands the move, even though she says some parents and even kids may want to get back to the routine of traditional school work sooner.

Kyron feels really good about his decision. It’s a chance, he says, for all 200 students to forge connections and offer them what Kyron gave that 6-year-old boy — a leg to hug and someone who cared.

KH: Are we going to solve all the issues? Impossible. Is everyone going to be completely happy and there’s no problems? Impossible. But we are going to reach some people, and people are going to know that we are here for them. And we’re going to do our best. That’s all we can do.

DG: I’m Dan Gorenstein, and this is Tradeoffs.

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Episode Resources

Select Reporting and Research on School Mental Health:

Kids Head Back to School—and Bring Covid-19’s Mental-Health Scars With Them (Andrea Petersen, Wall Street Journal, 8/30/2021)

American Rescue Plan Act Presents Opportunities for States to Support School Mental Health Systems (Olivia Randi, National Academy for State Health Policy, 8/2/2021)

8-Year-Olds in Despair: The Mental Health Crisis Is Getting Younger (Christina Caron, New York Times, 6/28/2021)

Nation’s skeletal school mental health network will be severely tested (Kate Rix, The Hechinger Report, 5/30/2021)

Solutions & Challenges for Children’s Mental Health in the COVID-19 Pandemic (NIHCM Foundation, 5/20/2021)

Child and Adolescent Mental Health During the COVID-19 Pandemic (National Association of School Psychologists, 4/15/2021)

The Impact of COVID-19 on Pediatric Mental Health (FAIR Health, 3/2/2021)

For Some Teens, It’s Been a Year of Anxiety and Trips to the E.R. (Benedict Carey, New York Times, 2/23/2021)

Schools As a Vital Component of the Child and Adolescent Mental Health System (Sharon Hoover and Jeff Bostic, Psychiatry Services, 11/3/2020)

Cops and No Counselors: How the Lack of School Mental Health Staff is Harming Students (Amir Whitaker, Sylvia Torres-Guillén, Michelle Morton, Harold Jordan, Stefanie Coyle, Angela Mann and Wei-Ling Sun; ACLU; March 2019)

Episode Credits

Guests:

Kyron Harvell, Principal, Vivian Riddle Elementary School; Lansing, Michigan

Sharon Hoover, PhD, Co-Director, National Center for School Mental Health, University of Maryland School of Medicine

The Tradeoffs theme song was composed by Ty Citerman, with additional music this episode by Blue Dot Sessions.

This episode was reported and produced by Ryan Levi.

Special thanks to:

Elizabeth Koschmann, Lauren Kazee and Robert Boyd

Additional thanks to:

Karen VanLandeghem, Olivia Randi, Nicholas Affrunti, Mark Masselli, Maryjane Puffer, Rebecca Oliver, Nichole Bobo, Elizabeth Clark, John Crocker, Todd Barlass, Kayla Jackson, Nick Jaskiw, Kevin Bauer, Neal Perry, the Tradeoffs Advisory Board and our stellar staff!