Putting mental health in schools to reach students in need

Published July 9, 2019

The Blue Cross of Idaho Foundation for Health helps connect schools and families with behavioral health services.

Across elementary, middle and high school, students are regularly navigating emotional disturbances, behavioral adjustments, traumas and anxieties. Many families are either ashamed to seek help or face barriers accessing it, and the problems go untreated. But what if professional counseling was available in school to meet students where they already are?

For 11-year-old Jacob Jones,* the summer before sixth grade was a difficult one. He recently found out his dad was not his biological father. His grandparents—who had been like a second set of parents to him—moved out of state. His own family had just moved to a new home, and he was about to make the leap from elementary to middle school.

But it was a surprise to the West Middle School staff when Jacob walked up to the Pathways behavioral health services table during fall registration and signed himself up for counseling. 

“The table was there for parents,” says West Middle School Principal Stefanie Duby. The school wanted to let parents know that they offered wraparound services for their children. “But this boy needed to talk to someone, and he knew it.”

This kind of safety net is not typical in Idaho, or elsewhere. More than half of all children and adolescents diagnosed with a mental health condition go untreated, according to the U.S. Health Resources & Services Administration. Millions more are estimated to be undiagnosed. 

The support Jacob received was the result of a strategic partnership between school districts, behavioral healthcare providers and the Blue Cross of Idaho Foundation for Health (Blue Cross of Idaho Foundation)—all made possible by a federal class action lawsuit.

Idaho parents faced challenges in accessing counseling services

West Middle School in Nampa, Idaho, serves 730 students, ages 11-14. An estimated 80% come from low-socioeconomic-status households, about 14% have a documented disability, and 8% are homeless. 

“We have one of the most difficult student populations to support in our district,” says Duby. “I was seeing kids miss a half day of school or more because they needed to go to counseling appointments. Or they were missing counseling appointments because they were in school.”

As Duby explains, many families don’t know how to access counseling services. For others, it’s an issue of access. Many West Middle School parents don’t hold the kind of job that lets them leave work for an hour or more to take their kids to counseling. “And often, they can't afford the gas,” says Duby.

So she and social worker Diane Brown set out on a quest to bring behavioral healthcare to their school campus. Their ultimate goal? Remove the barriers to critical help they knew their students needed. But when the city denied their request, “we kind of quit dreaming,” Duby says. 

That was eight years ago—four years before Idaho settled its federal class action lawsuit, Jeff D. v. Otter. The settlement required Idaho to make mental health services more accessible to children in need. One of the ways Idaho makes good on that promise is using Medicaid money to fund behavioral health services for youth. 

Shortly thereafter, the idea of an on-site licensed professional counselor (L.P.C.) resurfaced: the Healthy Minds Partnership. And this time, in addition to state resources, there was help from the Blue Cross of Idaho Foundation to make it happen.

Integrating behavioral health into schools provides structure, reduces stigma

“The cool thing about this partnership is that it’s intuitive,” says Blue Cross of Idaho Foundation Program Officer Connor Sheldon. By making the simple shift to integrate behavioral healthcare into the school day, the Healthy Minds Partnership keeps students on a regular therapeutic schedule and helps eliminate a layer of stigma that therapy often carries. 

“Our goal is to expand the program even further to impact the most people,” says Blue Cross of Idaho Foundation Executive Director Kendra Witt-Doyle. They are investing in the big-picture sustainability and scalability of the program. Most recently, they created a simple, open-source roadmap to walk other schools through the process of implementing a provider partnership. They are also hard at work to develop a data collection and evaluation framework for the program. 

This fall, four additional schools in Eastern Idaho will begin offering behavioral health services on-site. The Blue Cross of Idaho Foundation will also begin working with a new group of schools to help set services up for the 2020 school year. 

Program participants show gains

Since implementing the school-provider partnership in Nampa schools two years ago, students are showing signs of improvement. West Middle School saw a 57% reduction in absences among participating students and an average of 14% clinical improvement, as reported by the on-site provider. Nampa High School noted a 5% reduction in absences, 4% clinical improvement and 14% increase in GPA among participating students.

Jacob was one of the students to demonstrate these improvements. “He went from being angry and disrupting classes to a kid who still struggles academically, but isn’t on our [disciplinary] radar at all,” says Duby. “Kids are still dealing with battles that they're fighting. And that’s always going to be the case, but [the Healthy Minds Partnership] is giving them different coping skills to use. And one hundred percent of the time, parents are so thankful.”

*We’re not using this student’s real name to protect his privacy.

Blue Cross of Idaho Foundation for Health

Blue Cross of Idaho Foundation for Health is an independent licensee of the Blue Cross Blue Shield Association, an association of independent, locally operated Blue Cross and Blue Shield companies.