Patrick Schirmer has been working on youth behavioral health struggles in school settings for more than a decade. As a mental health clinician that focuses on work with children, he understands the challenges facing today’s youth, as well as the myths surrounding mental health practices for kids.
School-aged kids in Sacramento County are facing unprecedented life challenges amid a world increasing run by technology, unrest in schools across the country, picking up the pieces after a traumatic global pandemic – all while navigating the complexities of playground politics, new relationships, increased educational demands and the pressure of graduating high school into a bleak economy. Studies demonstrate the alarming prevalence of mental health challenges: 1 in 5 children and youth have a diagnosable emotional, behavioral, or mental health disorder, and 1 in 10 experience severe impairment in their daily lives. Tragically, as many as 80 percent of those in need do not receive essential mental health care. In Sacramento County alone, this translates to 50,000 students with diagnosable mental health disorders, with upwards of 40,000 potentially going without vital treatment.
Ensuring that our children have access to adequate mental health resources is a top priority in Sacramento County. Recognizing this need, Sacramento County's Department of Health Services (DHS) has forged a groundbreaking partnership with the Sacramento County Office of Education (SCOE) to bolster mental health services within the school setting. The School Based Mental Health and Wellness program through the Sacramento County Office of Education is an innovative and successful venture to recognize that mental health wellness begins early and isn’t just about the child, but rather their entire system of care. Currently in more than 30 school sites, the long-term goal is to have programs in every single school site under SCOE – nearly 350 sites.
Funding for this program comes from reimbursable Medi-Cal dollars for ongoing sustainable mental health services and extends the County’s Federally Qualified Health Center (FQHC) status to the school sites, creating satellite centers of the FQHC. It is estimated that with the current program model, the program will generate sufficient revenue to support costs.
Patrick and his colleagues are challenging the profession to address mental health needs differently – for kids and the whole system.
What are the most common myths about mental health needs in children?
“A myth in mental health that I'm passionate about trying to shift is helping redefine what we view as mental health symptoms in children. Traditionally, mental health symptoms as outlined in our diagnostic manual are largely seen through the adult lens. However, many of these symptoms present incredibly different in children. When we see a child who is frequently becoming frustrated or angry, we often don't slow down and view it from a mental health lens. We just ask, "what's wrong with this kid?" instead of asking the deeper question of "what happened to this child to lead to this?". For example, we don't see that the child is frequently angry because they come from a household where violence is often used, and the child had to develop anger to protect themselves in that kind of setting. But when we slow down and dig deeper, we can see the underlying cause, bring some empathy to the child and then begin to actually help heal what's underneath the anger.“
What do the school teams look like? How do students access care?
“We have Peer Specialists who can help through mentoring students or working on school wide interventions such as social emotional learning. We have Family Navigators who can support students and families connecting to resources in their community so that they can have a stable foundation that is crucial to truly engage with their mental health and school. We have Associates and Licensed Clinicians who do therapy in a way that centers the students' and families' voice and cultural background to best serve families. Students can request care from a teacher or clinician, they can be referred into care or, in our high schools, we post QR codes around campus for students to fill out a questionnaire if they are interested in talking to someone.”
Not only students access care, but so can their families?
“Our services recognize that a student's mental health is intimately tied up in the larger family unit in which they live. Therefore, from the very beginning of working with a student we include the family in the process. We partner with the family to better understand their cultural background and how our services can support ways in which they may already find healing and joy. Our Associate and Licensed Clinicians support families by offering family meetings to support the family unit on growth and healing. Our Family Navigators can support families through helping the parents or caregivers find what resources they need to show up as the best caregiver they can be for their child. As well, our Graduate Level Interns and Peer Specialists partner with the Clinicians and Family Navigators to support in all this work.”
What kind of positive changes have you seen in kids that are using this program?
“The positive changes I've seen in the students that have received our services are enormous. I've watched students in our program begin to see themselves not as just a "bad kid" but as someone who sometimes struggles AND someone who frequently has moments of excellence. I've seen students begin to shake that label that they can so easily internalize and begin to live into who they want to be and the greatness that is already inside of them. I've seen children begin to finally talk to their parents about grief they've held inside for years around a loss that they never talked about. I've seen families come together and work towards healing collectively through learning how to communicate in an open and loving way. I've watched schools truly become centers of wellness where the culture of the school site shifts away from a punitive mindset and more towards a mindset of community and connection.”
What more needs to be done to truly support our students in schools?
“The biggest issue I've seen in schools revolves around school staff mental health and wellness. Unfortunately, teachers often have crowded classrooms filled with students who are struggling with mental health issues while they're still trying to juggle all of the expectations put on them. These pressures often spill over onto other school staff as well such as the administration and aides. There can frequently be a culture of reactionary supports offered that stem from not having enough time or people to manage all the things that come up on a school site. I believe this is such a huge aspect of why we have the teacher shortage we currently have. Unfortunately, if a school staff member's mental health is doing poorly then it's incredibly unlikely that they'd be able to support a student who is struggling with mental health issues. We can't give from an empty cup. I'm hopeful that the supports our program offers can begin to help address this issue so that school staff can get the help they need as well.”
To learn more about the groundbreaking partnership and program, visit the School Based Mental Health and Wellness webpage.
