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They are teens, preteens, and even elementary school students who avoid school and rack up absences. They grapple with severe depression, anxiety, and eating disorders, and sometimes it gets so bad they need to be hospitalized.
“I’ve been doing this a long time, and the number of kids who are struggling with mental health issues and the severity of those issues has increased dramatically over the past 10 years,” said Belmont school psychologist Eileen Wiznitzer, PsyD. “Simultaneously, community supports have decreased. It’s harder and harder for kids to get the help they need.” That’s where McLean’s School Consultation Service comes in. The program, now in its second year, brings the expertise of child and adolescent psychiatrists and psychologists to teachers and administrators in the Belmont school district and six other Massachusetts communities. Its goal is to better equip teachers and other staff to work with students whose mental health struggles get in the way of learning.
The McLean team provides three types of help: trainings in techniques like cognitive behavior therapy (CBT) and dialectical behavioral therapy (DBT) that help shift negative thoughts and behaviors; case consultations on specific students; and assistance with developing or enhancing in-house therapeutic programs to serve students with severe needs.
“During the didactic trainings, we teach the skills that will be most universally helpful—skills like mindfulness, relationship-building and behavioral strategies that are useful for all students, not just the ones struggling,” explained Katie Thorpe Blaha, PhD, a psychologist on the McLean team. “Often, the schools are already doing a lot of skillful things, so it’s just a matter of helping them make adjustments.”
In Belmont, in addition to trainings in CBT and DBT, the McLean team has also educated parents and school staff on topics ranging from the college transition for teens with behavioral health challenges to LGBTQ youth and mental health. Trainees from the combined MGH/McLean Psychiatry Residency Training Program also do clinical rotations at Belmont High School to learn about psychiatry in an academic setting. In Falmouth, a community that has been hard hit by the opioid crisis, the McLean team has conducted case consultations for kids whose families have been affected. “It’s heartbreaking,” said Mona Potter, MD, medical director of McLean’s Child and Adolescent Outpatient Services and one of two psychiatrists on the School Consultation Service team. “Multiple students have lost parents and other family members.” The weekly meetings with Falmouth staff are conducted via videoconferencing—technology that has greatly extended the reach of McLean’s experts.
According to Falmouth Director of Student Services Charles A. Jodoin, the McLean team helped the high school create a new therapeutic program for non-special education students with serious behavioral health needs. (There was already a therapeutic program for students with special needs.) He credits McLean, the new program, and some other initiatives for the district’s dramatic decrease in student hospitalizations for behavioral health reasons and the drop in at-home tutoring requests for those too anguished to be in school.
“Our staff is grateful to have someone to turn to when they are grappling with how to help students struggling with mental health issues,” said Jodoin. “These are not things they learn when preparing to become a teacher.”
Blaha said that it’s exciting to be able to help more students than she would only working with youngsters one-on-one. “We’re disseminating effective practices and making clinical interventions accessible to public students across the state, regardless of ability to pay,” she said.
The McLean team also has partnerships with the school systems of Burlington, Dracut, Foxborough, Haverhill, and Wilmington, Massachusetts, and does ad hoc consulting with other communities. Because of limited resources, the program isn’t actively pursuing additional partnerships at this time, but it is exploring ways to broaden its reach through technology.