Mental health is a key concern as students return to class

As students return to campus after a year of lockdown, youth mental health will be a paramount concern. 

As Los Angeles Unified and other local school districts reopen, the question becomes, “What comes after COVID?”  

 “We can’t carry on as if the past year hasn’t happened,” says Maryjane Puffer, executive director of The Los Angeles Trust for Children’s Health. A year of isolation, economic and food insecurity, distance learning and delayed healthcare have created a crisis for hundreds of thousands of Los Angeles County public school students — one that will not disappear when in-person learning starts  later next month.  

Existing healthcare systems, like the 16 LAUSD Student and Family Wellness Centers offering mental health services to schools and communities hardest hit by COVID, will play an important role in the post-COVID recovery process. So will programs like The L.A. Trust’s Student Mental Health Initiative ramping up this year.  

 Wellness Centers key  

“School wellness centers could be an answer to soaring mental health needs in California,” according to a report — “Every Young Heart and Mind: Schools as Centers of Wellness” — released last December by the California Mental Health Service Oversight & Accountability Commission. According to the report, 1 in 6 high school students in California has considered suicide in the past year, and 1 in 3 report feeling chronically sad. LGBTQ students and low-income Black and Latinx students experienced higher rates in both categories and were less likely to receive services intended to help them, the report said.   

 The American Psychological Association recommends teachers use existing processes and referral protocols to identify students who need extra support — especially those suffering anxiety and depression, which can be hard to identify under the best of circumstances.  

Youth Mental Health First Aid  

Teachers, counselors and healthcare professionals are not the only ones who can help. The L.A. Trust staff was trained in Youth Mental Health First Aid (YMHFA) last fall and is sharing its knowledge with after-school providers and others.   

The first YMHFA class of 20 after–school providers was held online March 12. “The participants were eager for the information and the feedback was very enthusiastic,” said Eddie Hu, program manager at The L.A. Trust. “Mental health is an urgent issue and this training curriculum is timely and compelling.”   

The Youth Mental First Aid training will be expanded later to include members of The L.A. Trust’s Student Advisory Boards and other students on L.A. Unified campuses.  

“People who work with students — and students themselves — need to be aware of the danger signs of suicide and self-harm,” said Hu. “The crisis is real  —  without training we can miss the red flags.”  

YMFA training is part of The L.A. Trust’s Student Mental Health Initiative, a multi-pronged effort funded by Health Net, Cedars-Sinai, Dignity Health and Ballmer Group. It includes a Youth Mental Health Collaborative launching this month, made up of LAUSD leaders, Wellness Center staff, and community mental health organizations to identify and resolve obstacles to care. Student input will be a key component informing the group’s work. The group will also advocate for needed policy change at the district and county level.   

 The state of student mental health in Los Angeles Unified School District was acute even before the pandemic. In a screening of 572 LAUSD students, 88% reported experiencing three or more traumatic events in their lifetime, 55% of whom showed symptoms of PTSD, depression or anxiety. LAUSD recorded 7,661 suicidal ideation incident reports in the 2018-2019 school year.   

Time will tell how much damage has been wrought by a year of lost education, healthcare and outside contact and support. The pandemic of trauma caused by COVID-19 will be felt for years according to the National Education Association, which states “the disproportionate impact of COVID-19 on communities of color has magnified the trauma of Black and Latinx students.”  

 “Teaching and learning can’t just pick up where educators and students left off,” the NEA observes. Trauma-informed policies and care are critical. ”Moving forward with grief or loss is better than just moving on.”  

Fighting substance use through awareness and peer education

Vaping is rampant among L.A. students. According to the CDC, more than 30% of L.A. County high school students have reported using e-cigarettes. 

The Los Angeles Trust for Children’s Health is working with partner Children’s Hospital Los Angeles and funder California Community Foundation to educate and prevent substance use  among Los Angeles Unified students.  

“This is one of our most urgent initiatives,” said Robert Renteria, program manager for The L.A. Trust. “Whether it’s vaping tobacco or using marijuana, alcohol, methamphetamine or opioids, substances are a real threat to our student community —one that’s likely to have grown during the pandemic.” 

The Wellness & Adolescent Substance Use Prevention Project (WASUP) substance use prevention partnership includes Screening, Brief Intervention and Referral to Treatment (SBIRT) training and peer education by student health advocates from The L.A. Trust’s Student Advisory Boards.  

WASUP training for school-based healthcare professionals included a series of webinars discussing vaping and SBIRT. The  SBIRT project  — designed to increase the screening tool’s utilization in L.A. Unified Wellness Center clinics — was deployed at five such clinics, reaching nearly 2,700 students.  

Peer education  

 A toolkit for conducting a preliminary scan of the substance use situation at schools — Conducting a SBIRT Environmental Scan at Your School-Based Health Center — was published last year by Children’s Hospital Los Angeles and The L.A. Trust.  

The toolkit “reflects lessons learned by The L.A. Trust and CHLA during a multiyear initiative to integrate SBIRT into five school-based health centers across South Los Angeles. Funding for this project was provided by the California Community Foundation and the Conrad N. Hilton Foundation.”   

WASUP includes student health advocates and Student Advisory Board members like former Manual Arts High School student Melissa Riaz Reynolds, who is now in college.   

She said her favorite part of being a WASUP advocate was “presenting to the leadership class about underage drinking and making safe decisions.  

“It helped a lot with my personal life as most students are curious and like to experiment, so I am constantly surrounded by drugs or people who abuse drugs,” she said. “The WASUP project taught me how to handle certain situations and protect myself and those around me.” 

As vaping epidemic grows, educators and healthcare providers join forces

LAUSD Superintendent Austin Beutner appeared with students and educators outside Federal Court to announce a class-action vaping lawsuit.

L.A. School Superintendent Austin Beutner stood on the courthouse steps in downtown Los Angeles October 29, 2019 to declare war on vaping. Flanked by educators, students and community leaders, Beutner announced a class-action lawsuit to hold industry-leading vape-pen manufacturer Juul “accountable for the role it has played in creating an epidemic that affects the health of our students, disrupts student learning and is taking money away from our core mission—educating students.” 

“We are here to join others in the cause to stop this epidemic,” Beutner said. “The money we are spending to deal with the trauma vaping is bringing into our schools is money not spent on instruction.”

Tobacco use prevention and education (TUPE) is one of the top missions of The L.A. Trust, which brings the worlds of education and healthcare together to tackle urgent challenges facing more than 600,000 students in the LAUSD. 

The crisis is urgent, Renteria said. Student cigarette smoking has declined sharply in the past few decades, but total tobacco use — driven by vaping — is on the rise. A federal survey shows 27.5% of high school students have used an e-cigarette in the past 30 days.

Vaping 101

Dozens of school-based health professionals joined The L.A. Trust and Children’s Hospital Los Angeles November 13 for its latest outreach, a webinar called “Vaping 101” hosted by L.A. Trust Program Manager Robert Renteria and featuring Stephan Lambert, prevention education coordinator for the Orange County Department of Education. It’s the first in a series of three Wellness & Adolescent Substance Use Prevention (WASUP) webinars hosted by Children’s Hospital and The L.A.Trust.

Watch the webinar now

As of November 13, health officials in 49 states, Puerto Rico and the U.S. Virgin Islands have 2,172 cases of vaping-related lung illness. Forty-two deaths have been reported from 24 states and the District of Columbia.

The L.A. Trust works with the LAUSD’s Beyond the Bell Branch on vaping abatement programs that give students facts about the health dangers of vaping, and resources to foster peer-to-peer conversations that promote cessation. The L.A. Trust also works with Student Advisory Board members, adult allies and staff at LAUSD Wellness Centers to coordinate education, train advocates, provide treatment referrals, sponsor outreach events and publicize the dangers of cigarette smoking and vaping in social media.