This article is part of an ongoing series in The Recorder focusing on the child and adolescent mental health crisis. This in-depth series will examine the barriers and difficulties teens and children face in receiving care, as well as a ground-breaking local initiative to address the problem. Future articles will share the perspectives of students, parents, mental health providers and emergency practitioners, among others. Articles contain material that some readers may find upsetting.
By MELISSA WHITWORTH
About two years ago, Jen Lamia, superintendent of the Byram Hills Central School District, accompanied a parent and their child to a residential mental health facility to get help. There, they were turned away as the facility had no space.
It was a low moment in Lamia’s career overseeing the 2,300 kids in the district, she said. It is not protocol for a school superintendent to be involved in seeking mental health support for students, but this is how dire things have become, she said, and this is how personally she takes it.
Lamia has been strident about the lack of outside help for students experiencing mental health issues in her district and other Westchester schools. Parents are unable to get adequate outside psychiatric support for their children, said Lamia; what she describes is a system that is binary. A child in distress is taken to the ER and, if deemed a danger to themselves, they are held there, or given the green light to go back to school.
Her perspective mirrors one articulated by Dr. Richard Catanzaro, head of
psychiatry at Northern Westchester Hospital. In The Recorder’s first installment in this series, Catanzaro talked about the all-or-nothing nature of the youth mental health system and why this is failing our children.
“We all know that there is a lack of resources in the system to cover the need, which means sending children to the hospital emergency room, where they don’t really know what to do with them,” observed Lamia. “And they say, ‘OK, are you in danger of harming yourself right this minute?’ And they say, ‘No.’ And they give us a green card to come back to school and the student isn’t ready to come back to school. The student needs mental health support and that’s just not available out there. Parents are on waiting lists forever.”
Arguably, teachers and superintendents should not be expected to handle mental health issues but they do so, nonetheless. In interviews with Lamia and Robert Glass, superintendent of the Bedford Central School District, both senior officials emphasized how their respective districts look at their children holistically — and if their goal is to educate kids and a health problem gets in the way of that, then that too becomes their issue.
Glass is seeing the exact same problems with his district’s students and their mental health, he said.
“What we’re experiencing isn’t really any different than what is being experienced around the country, but it has become very difficult,” he commented. “I can say that we see our students in crisis frequently. And I see that with an increasing frequency; the number of crisis moments that require intervention happen, and it’s happening with more frequency.
At BCSD there is an alert system set up to identify key words that might indicate a student communicating a crisis.
“We have the ability when anyone uses one of our devices and they have a keyword that is of concern that we are alerted to, that it goes to a call center and that call center lets us know,” he said. “It might be an immediate threat where someone may be in crisis or sometimes it’s not quite at that level, but there are concerns that are expressed; there’s hopelessness or there’s inappropriate behavior that is maybe fueled by whatever they’re facing at that moment. You see that and you see that in real time. Those alerts come across our desk every day.”
When The Recorder spoke to Glass, he had attended to a crisis just three days prior.
All the school districts in our area have a mix of school counselors, social workers and psychologists on staff. At Byram Hills there are 10 full-time counselors and one part-time counselor, six psychologists and one social worker.
However, educators are seeing an uptick in their needs, and for serious mental health issues and crises there are very few options available to them to help their students outside of school. The level of expertise needed extends beyond what a school district can do, Lama said.
“We have to expand our reach to more mental health services,” said Glass. “And it’s not something schools can do alone. It’s going to require state resources.”
“We have to engage in partnerships with larger entities to resource it and to make sure we meet our students’ needs emotionally. Because like anything else, if you’re not in a good place emotionally, mentally, you’re not in a good position to learn.”
At Byram Hills, Lamia instituted extra support for their students around 14 years ago, she said. At the time she was an assistant principal of the high school.
“We had students who clearly needed extra support,” she said. “We had students who were being hospitalized. We knew back then that there was a need for these kids. And initially we thought from our perspective, the need was: ‘How can we set up programs within our own schools to help support those kids that are finding their way?’”
So, she and her colleagues developed a flexible support program, which at any given time has about 14 children participating in it. “And these are kids who are typically transitioning back into school. Maybe they are school phobic, maybe they are school avoidant, maybe they have had some psychological situation that has kept them out of school — and it’s really about trying to help these kids get back in and to get assimilated back into the school world.”
That program is manned by a social worker, a special educator, and an aide who works collaboratively with every teacher.
What the Northern Westchester Hospital and Northwell initiative means for Lamia is potentially a game changer. NWH plans, as The Recorder has reported, to roll out four phases of a new approach to mental health treatment for our adolescents. The leader of this initiative is Dr. Vera Feuer, a child and adolescent psychiatrist at Northwell Health who has implemented similar programs on Long Island with extraordinarily successful outcomes. In the initial phase of the program, 98 percent of children and adolescents seen at a new behavioral health center are discharged, and only 2 percent are hospitalized. The Long Island community saw a 60 percent decrease in the number of students from partnering school districts going to the emergency room with behavioral health issues.
“She is a genius,” said Lamia. “That is all I can say about her. A genius.”
“This program means I have the means to connect you with these outside providers,” she continued. “There is the means to determine if a student needs hospitalization. It then has connections to these hospitals. They have the resources to provide a liaison to mental health care. This is what this system has always been lacking for our kids and their parents.”
Glass agrees. “I think it’s pretty close to a win-win-win all around. If we can have this kind of service, I think it would be a big benefit to the entire community.”
Contacted by The Recorder for this article, Katonah-Lewisboro School District provided the following statement from KLSD Superintendent Ray Blanch: “The Katonah-Lewisboro School District is in the process of rolling out the program and is excited about participating in this ground-breaking initiative to support our students’ mental health and well-being.”
In the next article in this series, parents will share their personal perspectives and experiences with youth mental health issues.