Barriers and solutions discussed at Youth Mental Health Collaborative

Three out of four children and adolescents in California with mental health needs do not receive treatment. Of those who do, up to 80% receive it in a school setting.

Mental health specialists and staff members from L.A. Unified and The Los Angeles Trust for Children’s Health met November 18, 2021, at the third virtual Youth Mental Health Collaborative. Their goal: Address the crisis in student mental health and remove barriers to youth mental healthcare for L.A. Unified students.

The Collaborative is part of a two-year investment by Ballmer Group to increase education and prevention efforts, and to identify and resolve obstacles to mental healthcare among L.A. Unified youth. Participants discussed challenges and solutions to the current crisis and heard subcommittee updates on funding, data, youth voice and the referral process. (See meeting agenda and PowerPoint.)

Tanya Mercado, organization facilitator for L.A. Unified School Mental Health, said, “There is a lot of funding for student mental health, but it’s complicated.” It will take several years to apply for and receive grants from the hundreds of millions of dollars allocated to address the youth mental health crisis. We must move from a “reactionary system to a proactive system,” she said.

Jaime Ducreux, LAUSD organization facilitator, said providers are currently “maxed out.” Other participants agreed there was a shortage of social workers, clinicians and psychologists. Marsha Ellis, director of programs for The L.A. Trust and co-chair of the meeting, emphasized, “We want to remove any barriers that may result in youth waiting for services.” With increased need comes the need for prioritizing those seeking services, several participants said.

The voice of youth

Robert Renteria and Noe Rivera, senior program managers with The L.A. Trust, discussed ways to enlist youth voice in the process. The L.A. Trust’s growing network of Student Advisory Boards (SABs) is one platform for youth to participate. The Community Ambassador Network (CAN) is another.

Funded by the California Mental Health Services Authority, CAN will activate 8 to 10 students at five six different L.A. Unified campuses, eventually expanding to 10 sites in 2022. The program started in May 2021 and will continue through June 2023. 

Student CAN ambassadors are being been trained in youth mental awareness, participating in two or three mental health awareness activities per school year, joining SAB engagement efforts and community needs assessments, and conducting outreach to peers, families and teachers in the school community.

“If you give students the data, they know how to communicate it to their peers,” said Renteria. He and other members of The L.A. Trust staff have been working with students and L.A. Unified staff on campaigns this fall, covering topics like Suicide Prevention Awareness, Healthy Relationships and Self-Care.

Referral and treatment

Aimee Phillips from L.A. Unified School Mental Health (SMH) discussed clinic services and the referral process. The district provides both individual and family therapy for children and students ages 2 and older who are uninsured or covered by Medi-Cal.

Evidence-based practices focus on family stress, dysfunction or poor communication; depression and anxiety; trauma; and disruptive behaviors. Students who are likely to meet any diagnosis listed in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) can avail themselves of SMH clinic services, except for certain diagnoses such as autism. A referral to L.A. Unified School Mental Health does not replace the need to follow district procedures regarding child abuse or potentially suicidal students, Phillips added.

Addressing student mental health issues is often a family matter. SMH is actively recruiting parents and caregivers in Parent Child Interactive Therapy (PCIT) to improve family relationships and address severe behavior problems.

Most affected

According to the report, “Every Young Heart and Mind: Schools as Centers of Wellness”, 1 in 6 high school students in California has considered suicide in the past year, and 1 in 3 report feeling chronically sad.

“Some students fare even worse,” the report says. “LGBTQ students experience victimization at school, persistent sadness and suicide ideation at more than twice the rate of their non-LGBTQ peers. Students of color disproportionately carry to school the burden of poverty, racism and discrimination, parental incarceration, exposure to violence and intergenerational trauma.”

“We must address this crisis,” Maryjane Puffer, executive director of The L.A. Trust. “Our students and communities are not getting the mental health support they need. That’s what makes L.A. Trust Student Mental Health Initiative and the work of our collaborative partners so important.”

The need is urgent

Attendees were told L.A. Unified Student and Family Wellness Hotline at (213) 241-3840 received 27,000 calls in the first month following students’ return to school. In a recent L.A. Barometer Survey — reported in the paper School-Age Children’s Wellbeing and School-Related Needs in Los Angeles County (Dudovitz et al.) — 62% of L.A. County parents cited the need for mental health supports – the share was higher in communities of color.

According to research cited by L.A. Unified School Mental Health, “21% of youth ages 13-18 have a mental illness that causes significant impairment in their daily life, and half of all mental illnesses begin by age 14. In California, three out of four children with mental health needs do not receive treatment despite having health care coverage. Of those receiving care, up to 80% receive it in a school setting.”