Where can Minnesota students access free mental health care?

In 2000, few students in Minnesota public schools had access to mental health therapy in the school building. Today, more than half of students do.

A new study, published in the Journal of Human Resources, quantifies how many lives these integrated therapists could have saved. The researchers calculated that suicide attempts decreased by 15% in 263 Hennepin County schools that implemented school-based mental health.

Health officials want families to know that students can access mental health services at school, whether they can pay or not. School mental health differs from district to district, and even from school to school. And high demand can lead to long wait times. But state grants ensure that more than 1,000 Minnesota public schools offer therapy in their buildings.

Farah Hussein, a mental health therapist, says her team at South High School in Minneapolis tries to make sure students have equitable access to therapy. We asked Hussein for more details on exactly how students and families can access services; their answers are below.

Previous school-based mental health assessments have shown promise, but Minnesota researchers believe this new study is one of the first to use rigorous statistical methods.

The results are incredibly encouraging, said the study’s lead author, Ezra Golberstein, who studies mental health economics and mental health care policy as an associate professor in the School of Public Health from the University of Minnesota.

There are countless examples of promising programs that, when rigorously evaluated, don’t seem to be doing as much as we hoped, Golberstein said. In this case, we have very significant results, especially regarding suicide and increased rates of mental health service use.

The researchers made their calculations using data from Medicaid and the Minnesota Student Survey, which includes self-reports of suicide. The researchers were able to examine this data during the time period when Hennepin County launched school-based mental health programs.

We realized that we could see what the effects are when schools implement this model, Golberstein said.

Still, the results were more of a relief than a surprise.

Mark Sander has been working with Hennepin County and Minneapolis Public Schools since the mental health program began in 2005. (In Hennepin County, therapists typically share space with a school medical clinic, but the location of therapists’ offices vary by school). , district and county.)

Sander and other program coordinators had already estimated that about half of the students seeking therapy at school were receiving mental health treatment for the first time. And of those, about 40 percent were very emotionally disturbed, Sander said.

These are children who were potentially at risk of being placed out of home in the next year, Sander said: The children could be referred to foster care or hospital care. It wasn’t just the worried well, meaning people who can be unnecessarily anxious. They were students who could not access community care.

Black and brown youth benefit most from school-based mental health care

The new study confirms that black and brown youth showed the greatest increase in the use of school mental health services. And the researchers found some evidence that increased access to therapy is linked to fewer suspensions and involvement in juvenile justice.

We work hard to prioritize families that have historically been marginalized, said Farah Hussein of South High School. We try to reach those students and families who would not normally have access to these services. We work with school counselors and social workers; they are mocking families who have additional resources versus families who cannot access services.

Often, this is due to socioeconomic status or cultural stigma, Farah said.

Despite some positive findings from the study, increased access to mental health care did not show benefits in all areas of schooling. For example, children with access to mental health at school did not appear to perform better on tests or attend school more often.

But Sander hopes the study will help more cities, counties and schools get funding for services, especially since these new school services often can’t keep up with demand.

There is a great need in every school, Farah said. Minneapolis Public Schools has two therapists at each of its school clinic centers, instead of one. But children often have to be put on a waiting list before receiving treatment, Farah said.

South High School in Minneapolis is home to a small clinic that offers a variety of basic services, including mental health. Credit: Aaron Nesheim | Sahan newspaper

How mental health works in school

Students can see therapists for everything from major mental health conditions (such as anxiety, depression, self-harm, suicidal ideation, and trauma) to less pressing problems (such as poor concentration in school, conflicts with peers or life transitions). , Farah said. Therapists work in collaboration with school counselors and social workers. Teachers are often the first to identify a student who would benefit from therapy.

Do you want to know more? We’ve come up with common questions that students and families may have about Farah at South High School. Their answers below have been slightly edited

The programs operate similarly in all Hennepin County public schools. If you are outside of Hennepin County, see if your school offers services here. School principals, social workers, or counselors should be able to answer any school-specific questions.

Frequently asked questions for students

Question: I haven’t felt like getting out of bed. When can I come and talk to a therapist? Do I need an appointment?

Farrah: You can come in and ask about mental health services. It’s called self-referencing. The reception assistant will check if it is available immediately. Then explain our services well, review our mental health informed consent form, and discuss next steps.

Or you can meet with your school counselor if you already have a relationship with that person. You will then be assessed and referred if necessary.

I’m a high school student stressed out about college. Who should I talk to?

If you are not already seeing a therapist at school, you may want to connect with your school counselor. School counselors are doing a lot of college and academic planning, so when a question like this comes up, you’ll want to talk to that counselor.

Do I need to tell my parents that they are asking to see a therapist at school?

As of this year there is a mental health consent form for minors. Therefore, if you are 16 or over, you can consent to your own mental health treatment. If you’re really uncomfortable with your parents knowing, if there’s a significant cultural stigma around therapy, or you wouldn’t be safe at home with your parents knowing that you can consent to your own treatment and we don’t need to talk to your parents. [Editors note: If youre under 16, parents need to consent to treatment.]

The student is the main customer, but often young people are fine with their parents knowing. And we can do family therapy if the students and parents are open to it.

If you are in serious danger of harming yourself or another person, or if you are being abused or have been abused (verbally, emotionally, physically or sexually) in the past three years, we are legally and ethically required to break confidentiality.

I don’t have health insurance. How much will an appointment cost?

There is no cost for our services, although if your family has private insurance and can pay something, we will bill the insurance. If it’s a high co-pay that you can’t afford, we pay it, we don’t put that burden on families. And not having insurance is not a barrier to seeking our services.

There is no cost for our services, although if your family has private insurance and can pay something, we will bill the insurance. If you can’t pay it’s a high co-payment, we pay it.

Farah Hussein, a mental health therapist at South High School in Minneapolis

How long will I have to wait for an appointment? What if I need to see someone today?

If we are not full, we follow up in 1-2 weeks. If we are full, we are communicating with the support team, and it is the responsibility of social workers and school counselors to connect you with community services.

Frequently asked questions for parents

I am worried about my student. Can I make an appointment for them?

Parents can refer their children. This is absolutely an option.

If my student talks to you, can you explain?

We don’t share details about what we talk about unless we have a security issue.

We like to involve parents as much as possible and necessary, but we don’t share details about everything we talk about in therapy. In order to respect the privacy of our students to trust us, we did not call parents and divulge details of what happened in therapy.

We will not share things about a student’s identity or whether or not they are in a relationship without their consent.

But we often encourage our students to share things with their parents.

How long can my student continue to see you? Do they have to move somewhere else in the end?

We work all year round, we weren’t off for winter break, spring break. Even when school ends in mid-June we continue to see students as needed: either at school, if the building is open; or telehealth; or at home; or in a park near your home. Students can be in our care for as long as they see fit.

The older ones can see us until the end of August after their senior year. And if they still want therapy, we connect them with someone in the community or at their university.

How much class will my student miss?

We schedule appointments so they don’t have to miss the same class every time, even though the teachers are very supportive and excused from class. We also offer appointments before and after school.

What if I don’t speak English?

I speak Somali so I can explain the process in Somali. We also have a Spanish-speaking family link with whom I have worked.

And schools can use the language line to communicate with parents who don’t speak the same language as school staff.

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