Social Services Innovations: The Case for School-Based Mental Health Services
By Julia Buccini, LCSW, LCADC, CCS
Social Work Today
Vol. 22 No. 2 P. 8

Even before the pandemic exacerbated the need for comprehensive mental health services in schools, the Bound Brook School District in New Jersey was taking a proactive approach to address students’ needs. The district’s program ensures every student is evaluated regularly; plus, in-school clinical social workers and counselors, many of whom are bilingual, provide counseling services to students and their families.

The district’s unique initiative to prioritize students’ mental health can serve as a model for K–12 educators who are navigating the ongoing challenges to students’ mental, emotional, social, and academic well-being during the COVID-19 pandemic and beyond.

Shortly before I joined the school district in 2019, Superintendent Daniel Gallagher, EdD, and Assistant Superintendent Beth Fischer, with support from the board of education, recognized the growing need for extensive mental health services in the district’s five school buildings. At Bound Brook, which serves more than 2,000 students in prekindergarten to 12th grade in Somerset County, approximately 75% of the student population is Hispanic.

District leaders recognized the barriers to support for students and their families, some of whom had recently emigrated from Central America. Many students previously referred to outside clinicians had difficulty getting appointments or transportation, lacked insurance coverage, or faced language obstacles, among other challenges.

By investing in mental health, Bound Brook took a step that many other school districts have not. In 2019, it hired three licensed clinical social workers and created a robust team of professionals that includes eight school counselors, an intervention specialist, a child study team, a student assistance counselor, and a guidance secretary.

In October of 2019, the school district administered a mental health survey basis. The first survey identified 688 students in need of counseling services, risk assessment, or other follow-up. The counseling team contacted those students individually or met with them in person to assess their needs and offer a safe space to share concerns.

This was, and still is, a major undertaking, but one worth taking. It’s been rewarding to offer individual, group, and family counseling services inside the schools, while also working with community agencies to refer students to services outside our schools when necessary. Not many school districts have such teams inside school buildings, and even fewer boast licensed clinical social workers on staff.

1 in 5 Youth
The American Civil Liberties Union’s report “Cops and No Counselors” found that 10 million students are in schools with police but no social workers, even though professional standards recommend at least one counselor and one social worker for every 250 students.1 We know that students are more likely to receive mental health support if it is offered at school. This holds even truer in low-income districts.

The lack of social workers in schools is more troubling given the fact that 1 in 5 youths has a diagnosable mental health disorder and 1 in 10 youths has serious mental health problems that are severe enough to impair how they function at home, in school, or in the community.2 These mental health concerns can have serious impacts on students’ academic performance.

The COVID-19 pandemic has heightened the crisis. There has been a significant increase in mental health concerns stemming from isolation, lack of connections, financial hardships, and grief. With mental health and counseling services having been already established at Bound Brook, the district was positioned to address these issues quickly and adequately during the early days of the pandemic. Even when many external agencies shut down and stopped offering mental health services for students, Bound Brook students were able to continue care through the school counseling program.

Flexibility in Delivery of Services
Bound Brook’s clinical social workers play an important role in the internal counseling services and external referrals. As of late February, 112 students this year have been identified as moderate to high risk and referred to the in-school counseling program. On average, the counseling program provides eight hours of individual/family counseling per day, as well as crisis response, individualized education program meetings, and program development.

This is possible because of the “buy-in” of and dedication from staff members across the district who have relationships with students and are in a position to identify their individual needs.

Families have direct access to counseling regardless of their ability to afford services, immigration status, and/or other limitations. The program offers wrap-around services such as working directly with community agencies, school personnel, and students’ families.

In addition, students determined to be high risk are often referred to external agencies. Before the student returns to school, the team meets with the student and guardians to identify areas of support and to create a safety/wellness plan.

Clinicians are also available to help and assess crisis situations as they arise. There are some students who are not officially a part of the counseling program but still meet with counselors as needed.

The key to the program’s success is flexibility in delivery of services. During the pandemic, the district was able to offer in-person and virtual meetings, as well as both individual and group sessions. Bound Brook also allowed students who were virtual learners to come in person for their sessions, if requested, creating meaningful connections. Students are also incentivized to come during school hours so counseling does not take away from their extracurricular activities.

The counseling program has supported students with building coping skills, as well as time management, stress management, and emotional regulation skills, which has led to a reduction of symptoms. All students are treated with dignity and respect and are supported through an individualized treatment plan focused on their specific needs.

The counseling program is also culturally sensitive to the demographics of Bound Brook. For example, two-thirds of clinicians speak Spanish, creating a stronger relationship between home and school and allowing for family sessions and communications in their native language.

District employees have flexibility to meet with students on an as-needed basis and are not limited to specific regulations or insurance coverage. However, the three clinicians offer each other peer supervision and case consultation, all of which lead to better outcomes for students.

Training to Recognize Danger Signs
The district has taken the program a step further by providing MindWise Innovations’ Signs of Suicide (SOS) training to staff and students in grades six through 12. SOS is an evidence-based youth suicide prevention program that has demonstrated an improvement in students’ knowledge about suicide risk and depression.

SOS teaches students how to identify signs of depression and suicide in themselves and their peers while providing materials that train school professionals, parents, and communities to recognize at-risk students and take appropriate action.

The district also monitors students’ computer web searches for signs of self-harm or violence and has been providing training on sexual orientation, gender identity, and gender expression in partnership with HiTOPS, an organization fostering strong and healthy young people of all identities.

The COVID-19 pandemic has been difficult and stressful for everyone, especially students who lost months of socialization and had to adapt to virtual and distance learning. Fortunately, Bound Brook School District was ahead of the curve by implementing in-school counseling services and prioritizing mental health before the pandemic, providing a framework for support when it was needed the most.

— Julia Buccini, LCSW, LCADC, CCS, is a clinical school social worker in the Bound Brook School District and an experienced therapist and leader with a demonstrated history of working in the mental health and substance use field. She is skilled in adolescent/adult/family therapy, cognitive behavioral therapy, treatment planning, crisis intervention, and trauma therapy. She received a bachelor’s degree in clinical social work from Rutgers University and a master’s degree in clinical social work with children and families from Monmouth University.

References
1. American Civil Liberties Union. Cops and no counselors: how the lack of school mental health staff is harming students. https://www.aclu.org/sites/default/files/field_document/030419-acluschooldisciplinereport.pdf

2. Stagman S, Cooper JL; Columbia University, Mailman School of Public Health, National Center for Children in Poverty. Children’s mental health: what every policymaker should know. http://www.nccp.org/wp-content/uploads/2010/04/text_929.pdf. Published April 2010.