Student mental health challenged by COVID, recession and racism

Idle busses and empty classrooms are reminders of the scale of the education and healthcare void caused by the continued coronavirus shutdown.

Student mental health in Los Angeles is facing unprecedented challenges, according to Maryjane Puffer, executive director of The Los Angeles Trust for Children’s Health.

“Our students are under tremendous pressure,” she said. “Many were already dealing with inadequate access to mental healthcare and the impacts of poverty and racism. The isolation and economic hardships brought on by COVID-19 threaten to create a student mental health crisis in Los Angeles.

“Students miss the structure of school, their friends and their support system, including access to counseling and mental health treatment,” said Puffer. “Some students may be in stressful situations at home or even the targets of abuse. We must redouble our efforts to help them.”

New initiative

This fall The L.A. Trust will launch its Student Mental Health Initiative. The collaborative is funded by a $100,000 grant by Cedars-Sinai and a $50,000 grant by Health Net.

The initiative will train students as peer leaders through The L.A. Trust’s Student Advisory Boards, increasing awareness of symptoms like anxiety and depression, and building positive coping mechanisms and self-referrals to care. The initiative will foster student social media campaigns and conduct online trainings such as “First Aid for Mental Health,” scheduled for August.

“Student voices are critical in addressing mental health awareness and to ensure access to services,” said Pia V. Escudero, executive director of  Student Health & Human Services for Los Angeles Unified. “We are grateful for this grant opportunity that will lift stigma and access to services for students and families that need it the most.”

Puffer added that “as a backbone agency for student health in Los Angeles, The L.A. Trust has a unique role and responsibility. We are committed to lead on this issue, helping support students, family members, healthcare providers and LAUSD tackle these issues.”

Racism and mental health

Puffer noted that July is BIPOC Mental Health Awareness Month and that racism must be factored into any discussion of student mental health. This is especially relevant in Los Angeles, where four out of every five LAUSD students is Latinx or Black.

A review of literature on the impact of racism on child health found that 11 out of 12 studies showed an association between racism and depression, while three studies showed an association between racism and anxiety. “We can’t ignore the impact of racism on the mental health of our students,” Puffer said. “Our programs, outreach and training must acknowledge the racism that many of our students live with every day.”

Resources available

Puffer saluted LAUSD Student Health and Human Services, the Los Angeles County Department of Public Health and other public and private organizations for adapting and expanding to serve students and family members during the COVID-19 crisis.

LAUSD Mental Health Hotline (213) 241-3840. Open weekdays 6 a.m. to 6 p.m. It is staffed by counselors and mental health professionals who can provide support in English and Spanish. Teachers can also call and get advice on how to connect their students to services. Questions can also be emailed to mentalhealth@lausd.net.

Los Angeles County Department of Mental Health (800) 854-7771. Open 24/7 for all mental health services.

2-1-1 Hotline. The central source for all health and human services support in Los Angeles County.

National Suicide Prevention Hotline English: (800) 273-8255 Español: (888) 628-9454.

Teen Line Text “TEEN” to 839863 between 6:00pm-9:00pm PT to speak to a teen.

Posted July 15, 2020 at 9:55 a.m.

Wellness Centers discuss COVID challenges at virtual collaborative

Pia V. Escudero of LAUSD Student Health and Human Services addressed more than 100 participants at The L.A. Trust’s online Learning Collaborative. 

Wellness Centers online meeting (recording)

Representatives from the Los Angeles student health community met online Thursday, May 7, 2020 at The L.A. Trust’s Wellness Center Learning Collaborative to discuss how to serve students and their families during the COVID-19 health emergency. More than 100 clinicians, educators and healthcare advocates attended.  

The coronavirus is impacting patients — and the clinics that serve them. Nine of the sixteen on-campus Wellness Centers have suspended operations (see list). Fewer students and community members are visiting clinics, putting their long-term health at risk. It also threatens the financial health of some clinics that have been serving high-need communities for years. 

Dr. Yohanna Barth-Rogers, chief medical officer of the UMMA Wellness Center at John C. Fremont High School in South Los Angeles, told the Learning Collaborative that her clinics were moving the majority of patient visits to video conferences and phone calls.  

In-person visits must be approved in advance and be deemed medically essential. Two of the needs deemed essential are vaccinations and contraception. 

One challenge is finding safe spaces to have sensitive conversations with students, she said. “My worry is that we’re missing things, such as violence in the home.” She said the clinic was developing ways to have confidential conversations with students during the coronavirus shut-down. 

Reaching out 

In addition to telehealth, clinic operators have been staying in touch with patients through community networks and social media. “Asian Pacific Healthcare Venture Inc., serving Belmont and John Marshall High Schools, cares about you,” they said in an email to The L.A. Trust. “If you have any health concerns, call us. We’ll make a telephone appointment to talk to a provider or get your medication refilled. We are also open for confidential services. Stay safe!” 

North Hills Wellness Center at James Monroe High School issued a “stay at home challenge” for students: “Eat an apple instead of chips. Get outdoors (with your mask on!). Follow a workout routine on FaceTime or YouTube. Learn a TikTok dance. Be creative and remember that social distancing and face coverings save lives!” 

Dr. Rosina Franco and Student Medical Services reported that while the Hollywood High Wellness Center was closed for safety reasons, “we are currently working on a re-entry plan for when schools, and our clinic, will re-open. In the meantime, please log on to the LAUSD SHHS webpage.” 

Data xChange points way to better healthcare solutions

Dr. Ron Tanimura said The L.A. Trust’s Data xChange would drive new healthcare strategies to better serve students and communities. 

Technologies like telehealth and initiatives like The L.A. Trust Data xChange are key to better student health outcomes, according to speakers at the online Wellness Network Learning Collaborative on May 7, 2020. Dr. Ron Tanimura, director of student health services at LAUSD, and Sang Leng Trieu, wellness program manager for The L.A. Trust, gave an update on The L.A. Trust Data xChange, which compiles and compares detailed Wellness Center patient data. They spoke to more than 100 representatives from LAUSD and the District’s Wellness Centers. 

Pia V. Escudero, executive director of LAUSD Student Health and Human Services and a member of the executive committee of The L.A. Trust, noted that the clinic network was founded almost 15 years ago “to reduce health disparities impacting the lifespans of our children in families.” She said “there’s still a lot of work to do,” and insights like the Data xChange are key to finding effective solutions. 

“The data is so wonderful,” Escudero said. “It gives us a good baseline to start having future conversations and doing some hypothesis working and strategic planning in this transformational time that we’re living in.” 

Tanimura said data was critical. “We have to look at every one of our divisions and departments and integrate and (utilize) some of the resources we have outside, mainly The L.A. Trust. I thank you for the work you are doing, especially on Data xChange.” 

He added, “The more data we get the better. When we look at the Data xChange, this is a thousand times better than just encounter data. We look forward to integrating all the data – dental, mental health, attendance and other academic data. Imagine what we will be able to do for our kids and their communities.”  

Current reports include such measures as unique patient visits, type of patient encounters, co-morbid conditions, demographics and student vs. community visits. The database also tracks services provided and benchmarks on key performance standards, including risk assessments, well-child exams, BMI screening, chlamydia tests and depression screening. 

The L.A. Trust distributed report cards with clinical metrics to each clinic in February and will add new datasets on mental and oral health later this year, expanding the database insights.