Help When It Matters Most: The School-Based Mental Health Program (Part 2 of 3)

In Part 1 of this blog, Marisa Parrella, Manager of Mary’s Center’s School-Based Mental Health (SBMH) Program, described the need for the program, which provides children in 12 Washington DC schools with the social, emotional, educational and behavioral support needed to reach their goals.

Now in Part 2, Marisa describes the challenges students face, what can happen if they don’t get help and how Mary’s Center’s SBMH team (pictured above during a retreat) works with parents and schools to achieve positive outcomes for students.

What Grades Does Mary’s Center Currently Serve?

We are in 5 elementary schools (about to launch our 6th), 3 high schools and 3 middle schools. We are also in Briya Public Charter School, which provides adult education.

What Kinds Of Challenges Do The Students Usually Face?

Most elementary school children get referred for disruptive behavior, which means that they are bothering people around them, teachers can’t teach, and the student can’t learn. While older children tend to be referred for disruptive behavior too, they may also be struggling with substance abuse, self-harm, anxiety, and depression.

The most common symptoms we see include anxiety and depression, which are two of the most common mental health disorders in childhood. Probably the most common source of these symptoms is chronic stress and trauma. Our newly-arrived immigrant children may have experienced and witnessed a lot of violence in their home countries or while crossing the border. 

We also see a lot of sexual trauma, community violence, neglect, as well as attachment and separation issues.  With immigrant children, parents usually move here first, leaving kids back home and bringing them to the U.S. a few years later. The kids really struggle with leaving their home countries and attaching to a parent whom they have not seen in 3-10 years.  A lot of the issues we see are in reaction to the separation, loss of home country and family back home, and reintegration with family here.   Some of our youth live in foster care, so they are managing that separation and loss.

Community violence cannot be overlooked.  The media spends a lot of time and the government spends a lot of resources on terrorism, but we continue to have unacceptable levels of violence on the streets of DC that disproportionately impact children’s mental health.  I’d like to see more media and resources aimed at a real action plan to reduce violence in our communities.

What Happens If The Children Don’t Get Help?

When children don’t get the help they need, their anxiety and depression can worsen. They can develop self-harming behavior, substance abuse problems, and problems within their families. Peer relationships suffer when children are anxious and depressed. Positive peer relationships are a critical part of a child’s social and emotional development. Academic underachievement is another big issue, which is why being in the schools is so important, so we can work together with teachers and staff to make sure the students achieve academically, while they are supported emotionally. It’s our holistic care model on which we base our treatment.

What Is The Role Of the School And The Family? How Do You Work With Them?

We partner 100% with our schools and families. When children see that their teachers, families, and therapist are working together, it’s very powerful for them, building their trust in the process.

Every 3 months, we measure children’s functioning in 8 key areas, using a reliable instrument, called the Child and Adolescent Functional Assessment Scale (CAFAS). If we see that a child is mainly struggling with anxiety or depression, we focus on those symptoms.  We ask teachers, family members, and students about functioning, so we get a comprehensive report.  Our child therapists are amazing! They are constantly building and strengthening their intervention toolboxes. 

We use many creative interventions, such as sand tray therapy (pictured at right), play therapy, art therapy, somatic therapy (a holistically oriented therapy, which integrates the mental, emotional, spiritual and physical aspects of the person), cognitive behavioral therapy, family therapy, and trauma-focused therapy.  What’s great about being in the schools is that we can get very creative and think “out of the box” or “out of the office”.

In one case, a five year old boy was unable to separate from his mother without acute anxiety symptoms after he experienced a trauma.  He was beginning to show school refusal.  Our therapist used a combination of interventions – the most notable being that he brought the child around the school to meet all the staff, teachers, office administrators, etc.  This Pre-K student felt safe and supported when he walked through the hallways.  Teachers and staff “high-fived” him, waved hello, and knew his name.  One aspect of a true trauma-informed school is that teachers and staff build strong relationships with all students, so they create an environment of physical and emotional safety that’s so critical for the healing process. 

But, we don’t just rely on the student’s reports. We also ask teachers about the child’s progress, which is a great way to harness the energy of the school. We’re in the school, so we can have access to the teachers. We also ask the family how they see the situation.  We measure symptoms through assessment and outcomes tools. Certainly, if we see that the student is doing better academically, we treat that as a success. Our goal is to remove the barriers – disruptive behavior, anxiety, depression, etc. so students can achieve academic success. 

What Do You Like Most About The Team With Which You Work?

What excites me the most about my team is to see this group of professionals learn, grow, and take initiative.  They really care about the participants and have a fierce commitment to doing more for them and that’s how our team is – they are always thinking about how they can better meet the needs of this child and his or her family or how they can make our program better and think more creatively. They feed off of each other’s energy; it’s incredible to watch.

Don’t miss Part 3 of this blog, which explores some of the techniques our therapists use to make a difference in the lives of the students.

If you’d like to make an appointment for your child or yourself, call us at 202-420-7122.

Read Help When It Matters Most: The School-Based Mental Health Program (Part 1 of 3)


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