McLean Hospital 115 Mill Street Belmont, MA 02478
Growing up has never been easy.
Multiply the normal angst of the teenage years by the deluge of smartphones, texts, tweets, Instagram photos, and Snapchat snaps. Then add the realities of post-9/11 societal stress, poverty, homelessness, anxiety, depression, and substance abuse, and you have a new reality.
That’s what was facing the Falmouth Public Schools in Massachusetts, when in 2016, school district leaders met up with Mona Potter, MD, and Katie Thorpe Blaha, PhD, of the McLean Anxiety Mastery Program at a special education conference.
“We have been seeing a great increase in the social-emotional and psychiatric needs of our students across grade levels, particularly over the past few years,” said Charles A. Jodoin, director of student services for the 3,400-student Cape Cod school system.
“We realized that because the profile of the student really has changed over the past years, many of our teachers needed new tools in their toolbox. They needed to have a new lens to be able to see the effects of anxiety and depression, the effects of poverty, the effects of trauma on children, and to be able to be better informed on how best to help these students be ‘available’ to learn.”
That moment helped launch a partnership through which McLean clinicians offer training in evidence-based practices, case consultation, and program development for all Falmouth school staff within a three-tier framework, according to Potter.
“Tier 1 is universal intervention, some things that are good for everyone to learn,” she said. Tier 2 focuses on children at risk—for example, those who might have frequent visits to the nurse’s office due to complaints of stomachaches and headaches. These students may not meet criteria for a psychiatric diagnosis, but the interventions are designed to prevent issues from becoming larger.
Students in Tier 3 are identified as having a mental health diagnosis that interferes with their ability to access their educational curriculum.
“These are the kids who are so anxious they can barely make it to the school, and if they do, they’re not able to sit in class. They’re spending the majority of the time in the nurse’s or counselor’s office,” explained Potter.
The students range across the age and grade spectrum, from pre-K to high school.
Thorpe Blaha points to a wide variety of stressors, from traditional spats between male and female friends to technology-based issues like social media, the internet, or the 24-hour news cycle.
“People who are not in a state of anxiety might use social media differently or experience it differently,” she explained. “If I am anxious and I am on social media, the way I use social media actually exacerbates my anxiety.”
The partnership launched in September includes regular weekly teleconferences between McLean and Falmouth faculty that provide the tools the staff need to help students tackle social and emotional challenges. The sessions also focus on helping avoid “empathy fatigue” that can develop while working with students, many of whom can be hospitalized for their issues.
Jodoin said it is still early to draw broad conclusions, but there are initial signs of success. At the end of December 2016, 17 Falmouth students had been hospitalized, and home tutoring costs for the first three months of the school year were close to $16,000. For the same period in 2017, only four students had been hospitalized, at the cost of approximately $500.
In addition to working with Falmouth, the McLean team also has been working with districts including Belmont, Burlington, Dracut, Foxborough, and Wilmington, with plans to further expand in the coming year.
The reason is simple, Potter said.
“You cannot treat a child in isolation. A child is part of systems: a family system, a school system. Our clinical work is greatly enhanced when we collaborate with these systems. We have found that schools feel they cannot ignore the growing social-emotional demands of their students. They are hungry to learn the language we teach the children when they come to us, and we are eager to share.”