Could Schools Take on More Mental Health Responsibilities?

I have heard talk recently about relying more on schools to treat, diagnose and de-stigmatize mental illness.

For instance, participants at a recent mental health summit in Kansas City, Mo., suggested several ways districts could help address the mental health needs of youths and young adults.

Ideas from the summit included incorporating mental health screenings and adding licensed counselors in schools.

It’s natural for well-intentioned people to look to schools for help. After all, that’s where kids are for the better part of the day.

But, educators are under the gun to demonstrate student achievement, i.e. good scores on standardized tests. Some districts are even scrimping on fine arts, foreign languages and gym to focus more on test subjects.

Nurses, too, are an unaffordable luxury in some districts.

So, I wondered, could schools take on more mental health responsibilities of its students?

I put that question to Kim Ratcliffe, associate executive director of the Missouri School Boards’ Association and a former administrator with the school district in Columbia, Mo. That she had reservations was not a surprise to me.

“Everybody would like a piece of that educational day,” she said. “There’s no way to divide that and get all of the courses in with the intensity of instruction and the kinds of things that are supposed to be happening. It’s very difficult to do.”

In addition, she said, for the school nurses that remain, the job is way more complicated than it used to be, including the need to dispense medications for conditions like Attention Deficit Hyperactivity Disorder.

“When I was in Columbia,” Ratcliffe said, “I actually had children on full life support. We had dozens of children catheterized, tube fed, oxygen-dependent, I mean these are children who are seriously medically fragile, and the kind of nursing care it takes to meet those intermittent needs or continuous needs of children — it’s huge.”

Meanwhile, she said, people might not realize it, but schools already provide a lot of behavioral health services.

For instance, schizophrenia is a covered condition under the federal Individuals with Disabilities Education Act, which specifies the services districts are required to offer to eligible populations.

Ratcliffe also said schools pay close attention to the Rehabilitation Act of 1973, which prohibits discrimination against persons with disabilities in federally funded programs or agencies.

She pointed out as well that it’s common now for districts to have alternative schools, where students with behavioral problems can learn in environment that is more conducive to their needs.

And finally, Ratcliffe said, schools have integrated lessons into the curricula about behaviors that can lead to psychological problems, such as teaching younger students that certain types of touching by adults is inappropriate.

Schools can’t be all things to all people, she said, and that includes advocates for the mentally ill.

“Is school the place where all mental health services should be delivered? No. It’s not,” Ratcliffe said. “There needs to be a balance between what is needed for that child to be successful at school and then there needs to be services in the community.”

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