On Sept. 27, two students told a resource officer at a Lakeland school that a classmate had sent them multiple messages threatening to kill himself, them and other students.
“(The classmate) posted a picture of himself holding what appeared to be a rifle and stated ‘do you want this’, ‘I don’t got (anything) to lose’, ‘if you’re with me you’re good’ and ‘if I can’t have you then nobody can,’” the officer wrote in a report, a redacted version of which was given to LkldNow by the Polk County Sheriff’s Office.
The names of all the students, as well as the name of the school, were removed. “(He) also sent a photograph in the messages of him holding a handgun to his head stating ‘say you love me or I will kill myself.’”
The officer found the student, took him into custody and sent him to the Peace River Center for a mental health evaluation.
This is the kind of situation Polk County Public Schools officials face more than a thousand times a year in many of the 160 schools around the district. Per state law, the amount of money the district is spending on taking care of students’ mental health has increased in recent years.
But PCPS Superintendent Frederick Heid said the investment isn’t seeing the kinds of results he would like, mainly because there is a shortage of mental health professionals throughout the country. Currently, 32 of the district’s 95 mental-health-related positions are vacant. PCPS has job openings for behavior interventionists, counselors, mental health facilitators and school social workers.
Despite the need, there are a handful of residents who oppose the school system providing any mental healthcare to students.
Students are struggling
By almost every metric, today’s children and teens are in crisis. The American Psychological Association points to a confluence of factors — negative effects of social media, bullying, residual effects of the pandemic, fears of mass shootings, familial economic stress, political polarization and natural disasters, on top of the normal ups and downs of adolescence.
A 2021 survey of Florida’s high school students by the Florida Department of Health showed:
- 39% of students felt sad or hopeless
- 19% of students did something to purposely hurt themselves without wanting to die
- 18% seriously considered attempting suicide
- 14% made a plan about how they would attempt suicide
- 9% attempted suicide
- 3% of those who attempted suicide had an injury, poisoning or overdose that had to be treated by a doctor or nurse
Feelings of despair among students have been increasing. The percent of high school students surveyed in 2015 who said they felt sad or hopeless was 26% — one in four students. In 2019, a year after the Marjory Stoneman Douglas High School mass murder in Parkland, the number went up to 34%. Now it’s at 39%.
Sadness and hopelessness have also increased dramatically among middle school students.
Mental health problems can affect students’ ability to learn by lowering their energy level, concentration, social engagement, attendance and cognitive functioning. “It affects how children think, feel, and act. It also plays a role in how children handle stress, relate to others and make healthy choices,” according to the Centers for Disease Control and Prevention.
Legislature increased funding for mental health
Following the Marjory Stoneman Douglas High School shooting on Feb. 14, 2018, in which 14 students and three educators were murdered by a former student, the state legislature increased funding to care for the mental health of students. Since 2019, each school district has received annual allocations based on student enrollment.
This school year, PCPS received $6.25 million from the state for its mandated Mental Health Application and program. It also has $2.97 million in unspent funds from prior years, largely because of the difficulty filling positions.
House Bill 5101, sponsored by Polk County Rep. Josie Tomkow, R-Polk City, requires each school district to implement a school-based Mental Health Assistance Allocation Plan that includes training to detect and respond to mental health issues. In terms of staff, the plan must include a “multi-tiered system of supports” with full-time school-based counselors, contracts with local community behavioral health providers or Community Action Team services, and policies and procedures for:
- Timelines for services.
- Parental/household notification.
- At-risk students.
- Early identification.
- Requirements for contacting mental health professionals.
Polk County Public Schools’ plan is below:
What does school-based mental health care look like?
For a student in crisis — like the Lakeland student who sent the alarming messages — school officials or law enforcement must make a reasonable attempt to contact a mental health professional to initiate an immediate exam, which can include telehealth services. If the professional believes the student is a risk to themselves or others, the child can be involuntarily hospitalized for up to three days under Florida’s Baker Act.
In the 2021-2022 fiscal year, 21% of the 115,239 Floridians who had involuntary Baker Act exams were under the age of 18.
However, a major part of the district’s program involves trying to identify and address social, emotional or behavioral problems before they reach crisis level. In some cases, school is the first place signs of depression, anxiety disorders, substance abuse or suicidal tendencies appear.
The school district’s mental health efforts generally fall into three tiers. Tier 1 is directed toward all students with a focus on prevention, progress monitoring and positive behavioral intervention. Tier 2 is targeted problem-solving for students with mild or emerging mental health needs, typically delivered in small group settings. Tier 3 is the most intensive level; interventions are usually one-on-one.
Polk County’s plan calls for students with mental health concerns or those identified as being “at risk for mental health disorders” to be evaluated by school or community-based mental health providers within 15 calendar days of receiving a referral. Families of students receiving mental health services are also provided with information about services through other programs or providers.
Students who need help can receive one-on-one sessions with a licensed or certified mental health professional at school weekly for six to eight weeks. The short-term counseling focuses on relaxation strategies, coping skills, resiliency and self-esteem support. For many families, free onsite services solve problems related to transportation and insurance.
The district has contracts with two major providers for mental health services — BayCare Health Systems and INVO Healthcare Associates.
This year, the School Board approved:
- A $1.2 million contract with BayCare’s Center for Behavioral Health to provide 16,000 hours of mental health services at $75 an hour to students with Individualized Education Plans (IEP) that list emotional or behavioral needs. The services can include individual therapy, group therapy, parent/family counseling and education, case management, advocacy and problem-solving consultations with school personnel. Services must use evidence-based strategies to improve school performance.
- A $1.68 million contract with INVO for the IMPACT Elementary program, supporting students with severe behavior challenges in eight “Behavior Academic Cluster” classrooms at four designated elementary schools. The contract funds 25 full-time positions including one clinical supervisor, two board-certified behavior analysts, four mental health providers and 18 behavior support specialists. The four elementary schools are: Sleepy Hill in Lakeland, Loughman Oaks in Davenport, Lake Shipp in Winter Haven and Floral Avenue in Bartow.
- A $1.385 million contract with INVO for the IMPACT Secondary program, working with middle and high school students with significant mental health or behavioral challenges in four classrooms at three designated secondary schools. The contract funds 19 full-time positions including one program manager, one board-certified behavior analyst, four ESE-certified classroom teachers, one floating teacher, two mental health providers and 10 behavior support specialists.
- A $345,450 supplemental contract with INVO for up to five floating elementary teachers to increase supports for students with severe behavior challenges.
“Due to increased student needs, the amendment will allow the IMPACT team to increase supports for students with severe behavior challenges with the addition of floating classroom teachers,” the contract states. “These floating teachers will directly support the behavior academic clusters. (The) floating teacher rate is $45 per hour for up to five floating teachers.”
Hiring challenges stymie district’s efforts
Despite the funding and some successes, Heid said the district is not seeing desired results.
“There aren’t enough licensed behavioral or mental health counselors in the state of Florida to adequately meet the need,” Heid said during a September education forum hosted by LkldNow.
PCPS spokesman Kyle Kennedy said the district’s Behavior and Mental Health Department has 63 filled of its 95 positions, but there are still 32 vacancies for everything from behavior analysts to mental health facilitators.
The district’s state-approved plan shows there is one school social worker for every 8,177 students, with a goal to bring that down to a ratio of 1:4,770. There is also one licensed mental health provider for every 2,862 students, with a goal to reduce the ratio to 1:2,290 by June 30, 2024.
Part of the district’s plan to improve those ratios is for all school-based mental health service providers to work with students, including psychologists, school social workers, school counselors and other licensed mental health professionals.
Those positions should not be confused with a school counselor or guidance counselor, whose job is more related to course selection, testing and college or career planning. Counselors “support the academic achievement of all students … (and) facilitate the successful transition and progression of students throughout the system.”
Stigma keeps some students from seeking help
Heid said the shortage of licensed counselors is not the only obstacle to addressing students’ mental health. Another is a lingering stigma about getting help.
He said the rising numbers of depressed and suicidal students was probably slightly exacerbated by COVID, “but mental health issues have plagued our society for a very long time. And because of the lingering stigma behind mental health, it’s largely been hidden and it hasn’t really been addressed.”
The school district recently expanded its contract with Hazel Health so students to could have free telehealth visits for mental health issues as well as physical injuries or illnesses. But, he said, students aren’t using the counseling services in the same number as those for physical ailments.
“We’ve not seen enough utilization on the mental health side … that’s a good preliminary step prior to a student being evaluated for additional mental health services,” Heid said.
The Hazel Health program allows students up to five telehealth visits and then the counselor can make a referral to a local provider. That is helpful because Heid said if a student in Polk County — and almost everywhere in the United States — tries to get a preliminary appointment to see a mental health counselor, unless they are in crisis, they might have to wait up to six months for an appointment.
In addition, he pointed out that the cost burden of a visit is “far beyond the reach of many of our families. That’s why we partnered with a company like Hazel and that’s why we partner and the school board just approved a new contract with one of our local hospitals in Winter Haven.”
The contract with BayCare’s Center for Behavioral Health is a school-based service. Heid said if the district relied solely on outsourcing students to be seen after school, the utilization would be less than 30%.
“Why? Because parents are still working, they have difficulty in transportation, there’s a reluctance to attend,” he said. “I think people need to realize there’s still a very significant stigma that exists surrounding those issues. And we all at some point in our lives need that person we can talk to in a safe space. And I would hope that more people become receptive of it, including our families. I think sometimes they are reluctant to participate because ‘What are my neighbors gonna think?’”
Heid divulged at the forum that he received treatment while working in Illinois, but was so concerned that this fact would be revealed, he researched the counselors available through the employee assistance program to ensure none had children in the school district.
“At the end of the day, I was even worried about getting out of the car and being seen walking across the parking lot to enter that facility because it was a shared complex,” Heid said. “So if that’s my position, I’m … well-educated, I have a long career, been successful, but if I’m fearful to seek out mental health (help), imagine what this means for everyone else.”
A call to stop providing mental healthcare in schools
Not everyone in Polk County supports the school district’s efforts to help students struggling with mental health.
At a recent school board meeting, several members of the ultra-conservative Polk County political group Winter Haven 9-12 criticized the funding measures.
Those protesting mental health initiatives included the group’s secretary, treasurer and events coordinator Glynnda White, who is also the secretary of the Polk County Republican Executive Committee.
“We’re already spending copious amounts of money on supplemental education and support. Last month you voted to provide health clinics in schools. Providing health care in school is completely inappropriate,” said White. “I understand the need to ensure our kids are getting appropriate health and mental health care. However, the school is not the place for the services. The school system should not have access to kids’ private health records and mental health records.”
White, a U.S. Army veteran, has admitted to being outside the U.S. Capitol on Jan. 6, 2021. She said parents should be fully involved in the health care and mental health care of their kids and not turn over that responsibility to the school system.
“The school should contract these services out and collect critical information and recommendations from the contracted providers,” White said. “It’s evidence (sic) that in-school provision of these services has done nothing to improve education delivery, prevent school violence.”
White pointed to failing test scores in PCPS schools to show that the money already spent hasn’t worked. And that bullying has continued.
“The school board has virtually ignored (the) self harm done by kids to themselves who have serious mental health issues. Now we want to spend multiple millions more on additional service,” she said. “Please turn over health and mental health services to the professionals. Polk schools should stay in their own lane and provide a solid education for our kids.”
Heid countered that this is not something the district does on a whim.
“This is not something that’s new, nor is it something we do haphazardly or just simply because it’s a pedagogical or philosophical opinion of ours,” Heid said. “This is a mandate by federal policy and state requirements to make sure that we’re adequately serving our students of need.”
School board members hope to avoid ‘mistakes of the past’
Heid and school board members also emphasized that addressing students’ mental health is vital to educating them and keeping schools safe.
School Board member Kay Fields, who has been on the board for more than 20 years, said during the LkldNow education forum that there is a mental health crisis.
“I don’t think that I’ve ever seen as many cases of contemplated suicides or suicides by young people — it is very sad,” Fields said. “And so as parents, if you are listening: If you see anything that doesn’t even look right, it doesn’t feel right. You know your child. You should know your child better than anybody else. You need to make sure that you seek help for them. And there are many, many resources available, even outside of the school district … Call Superintendent Heid. They can call any of us, and we will direct them as best we can.”
Former teacher of the year and retired school psychologist Lois Horn-Diaz said when she was in the classroom, there was more of an emphasis on prevention.
“Especially at the elementary level, where the guidance counselors did lessons in classrooms to address these things on the front end, and that has virtually been eliminated,” Horn-Diaz said at the forum.
“As a school psychologist I used to go into classrooms and do lessons about self-esteem and empathy and bullying and all kinds of topics. But that got eliminated because it was a waste of — say it with me — instructional time. So until we prioritize some of these other important elements, we’re going to keep trying to deal with it on the back end, instead of getting it you know, (as) prevention.”
In October, School Board member Justin Sharpless took one of the last walk-throughs of the building where the shootings took place at Marjory Stoneman Douglas High School in Parkland. He was shocked to find that the shooting scene was much as it was the day it happened — dried blood was still on the floors and walls, as was broken glass. But what affected him deeply was seeing classwork left behind on desks after students ran from the building — it had been an ordinary day at school until the moment the gunshots started. He couldn’t help but think of his own three sons, his students at Warner University and all 116,000 students in Polk County public schools.
“On the tour, we learned about the many systemic failures that contributed to the horrific outcome, as well as what factors would lead a student to resort to such brutal violence,” Sharpless told LkldNow. “As for mental health, it was apparent the warning signs were not taken seriously. While no approach is fail proof, I am optimistic our school district has taken many strides against repeating the mistakes of the past. We must remain vigilant and never take our foot off the gas pedal when it comes to prioritizing student mental health supports and overall safety.”
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