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La Crosse public schools, Gundersen propose new peer support program to improve student mental health

La Crosse Tribune - 3/7/2023

Mar. 6—Gov. Tony Evers has declared 2023 the Year of Mental Health for Wisconsin, highlighting what he calls a "burgeoning crisis."

While the psychological and emotional effects of the pandemic are not a surprise, just how profoundly they have affected the population — particularly children and teens — troubles health officials. Combined with the stresses of political divide, social justice issues and social media, youth are overwhelmed. And a shortage of supports and resources — statewide, there is only one mental health provider per 440 individuals of any age — is causing an increasing number to turn to drugs, self-harm and other dangerous practices to cope.

The Office of Children's Mental Health's 2022 report found some 33% of state youth experienced feelings of sadness or hopelessness most days, a 10% increase over the past decade. Over 50% reported anxiety and nearly 25% had engaged in self-harm. In July 2022, the month Wisconsin's 988 Suicide and Crisis Lifeline launched, the service received 6,000 calls.

Evers believes the state of mental health in Wisconsin "will have catastrophic consequences for generations if we don't treat it with the urgency it requires."

$500 million proposed

In effort to interrupt the alarming trend, the 2023-25 state executive budget proposes allocating $500 million to expand access to mental and behavioral health initiatives, including in-school services.

"We all want to improve outcomes and ensure our kids are prepared for success," Evers said. "And I believe that together we will. And we'll start by making sure our kids can bring their full and best selves to our schools and our classrooms.

Youth whose mental health needs go unmet, Evers says, may be distracted in class and thus unable to keep up, but providing the help they need can improve attendance and learning outcomes. In addition, improved mental health can reduce bullying, risky behaviors, violence and substance abuse.

Through the Get Kids Ahead initiative, $30 million in federal pandemic relief funds were dedicated to expanding mental health services in public schools, and the program has now been made permanent, with a proposed investment of $270 million.

As around 75% of the mental health treatment youth receive is in the school setting, the funding will prove essential in fighting the crisis. During the pandemic, the School District of La Crosse implemented the Student Family Assistance Program, a partnership with Gundersen Health System — and with the Wisconsin Office of Children's Mental Health emphasizing the importance of peer support services, area schools are considering implementing such programs.

Teaming up

In February 2021, the School District of La Crosse and Gundersen Health System introduced the Student Family Assistance Program, or SFAP, funded through part of a $2.5 million, multi-year Project AWARE (Advancing Wellness and Resiliency in Education) grant from the Substance Abuse and Mental Health Services Administration.

Project AWARE, which is currently grant funded through spring 2024, aims to increase awareness of mental health issues among school-aged youth and provide training for staff and other adults to help identify and respond to concerns. In addition, the program helps connect students with behavioral health issues, and their families, with necessary services.

Two Gundersen licensed clinical therapists were hired for the SFAP, with Barbara Eisenmenger serving preschool and elementary students and Tara Allert working with middle and high schoolers. Teachers, families and school counselors can offer referrals for students they believe would benefit from mental health support, with each student able to have five sessions with a therapist, either in a private room at their school or at a Gundersen facility, at no charge. Additional appointments are referred to other community agencies.

The SFAP, supplemental to existing school counseling and mental health services, helps address the hurdles some students face in seeking help, such as transportation, insurance coverage, cost of care or scheduling logistics, says Allert.

Thus far, Allert and Eisenmenger have assisted nearly 70 students across 12 La Crosse schools, with Gundersen named to the Wisconsin Association of School Boards' 2022 Business Honor Roll for its work on the program. Gundersen in 2022 applied for American Rescue Plan Act funding to expand mental health service access and increase telehealth opportunities, and with the grant plans to work with the district to set up teletherapy rooms in each La Crosse public school.

Allert believes the SFAP program "has made it possible for student services staff to connect students with the appropriate level of care more seamlessly since we are embedded in the district and buildings."

Among tween and teen students, Allert says, anxiety tops the list of mental health concerns, which in turn can result in poor attendance. She also sees students struggling with mood-related issues, potentially associated with self-harm or suicidal ideation, as well as grief or family stresses.

"Moreover, experiences of trauma often intersect with these presentations," Allert says.

Missing resources

For some, the pandemic has caused trauma-like effects. Curt Teff, director of community services for the School District of La Crosse, says COVID-related closures of schools and community venues, combined with social distancing, has had a negative impact on child development and relationships, a problem made greater by the lack of resources "that otherwise help buffer adversity in a child's life."

Having mental health professionals onsite, Teff says, helps ensure students are able to find help "at the first moment of concern."

"Students served in the program have been able to access the right care at the right time to help them get back on track, or have used the program to get connected to the right kind of community care to support their needs," says Teff.

Josh Court, clinical operations director for Gundersen Behavioral Health, says Gundersen — the largest provider of such services in the area — is struggling to keep up with demand, making in-school care all the more essential.

"There is a lot time and energy that parents need to put into getting a student mental health care," says Court. "Moving services upstream and outside of the walls of Gundersen reduces barriers and provides services more quickly."

The services also alleviate some of the strain on teachers and administrators, who already "have a lot on (their) plates," says Court.

"We are very proud to be able to provide this expertise to allow our schools to focus on education while we support them in their mental health efforts," Court says.

Peer support

The Wisconsin Office of Children's Mental Health last month issued new fact sheets to draw attention to peer support programs. Director Linda Hall stated, "In a period when most psychologists have used peer consultations to manage burnout, and the nation's leading mental health organizations encourage the use of peer support, we need to elevate the role of peer support."

Peer support, Hall says, provides a sense of belonging, supportive relationships and the understanding that comes from mutual experiences. It also helps fill in gaps due to a shortage of mental health professionals, especially those of diverse races and cultures.

"Leveraging peer expertise is resiliency in action," Hall stated. "Witnessing resilient peers can provide hope to youth who are struggling. What's more, peer support offers a critical social connection."

La Crosse County currently has 63 certified peer specialists, trained to support adults with substance abuse or mental health concerns, and certified parent peer specialists, who have undergone a certification program to help other parents whose children are struggling with behavioral health issues.

While over 200 schools in Wisconsin have peer-led wellness programs, per the Wisconsin Department of Health Services, La Crosse County does not have any.

"There have been many and frequent conversations within the district about implementation of peer-to-peer models of support," says Allert, noting Project AWARE has been "instrumental in moving these conversations forward and advocating for peer support."

Allert is "fully supportive" of peer-to-peer support services, as research indicates such models "help to fill gaps of services, empower students and provide necessary knowledge and skill sets to youth who are supporting their peers."

Aimee Zabrowski, director of student services for the School District of La Crosse, notes, "We want to ensure that students are equipped to support their peers."

Teff says students have expressed that in some situations they are "more likely to share concerns with a friend before they share those concerns with a trusted adult. Knowing this, peer support services are important to consider to make sure there is no wrong door when a youth reaches out for help."

Says Allert, "I am hopeful and confident that we will have more peer-led models of support locally throughout the next few years."

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