Bringing more mental health professionals onto campuses, training teachers and reducing negative stigmas surrounding mental illness are critical to students’ wellbeing, according to experts at Friday’s Select Committee on School Climate and Student Safety meeting.
From kindergarteners to high school seniors, students across California are still struggling with mental health challenges in the aftermath of the Covid-19 pandemic — and districts across the state have come up with various strategies to provide support.
“We need to shed light on the current state of student mental health, identify key challenges and explore potential solutions,” said State Senator Susan Rubio (D-Baldwin Park), who led the discussion.
Mental health challenges
While most of society has moved on from the Covid-19 pandemic, a large proportion of students have not.
“A lot of us — not only children, but adults as well — we became a lot more isolated,” said Jonathan Wicks, a social worker at YWCA San Gabriel Valley, at Friday’s hearing. “Now that we’re all reintegrating back into social spaces, a lot of times, it’s not as easy to connect, and so that connectedness that belongingness isn’t always there.”
Most mental health conditions start to manifest when someone is in their youth or young adulthood; Jeannine Topalian, former president of California Association of School Psychologists, who also serves on the California’s Advisory Commission on Special Education, cited an ACLU report which found that more than 63% of students reported experiencing an emotional meltdown, while nearly half said they were depressed.
Wicks added that over the past few years, young people have increasingly turned to marijuana and other substances to cope, which has led some to “over indulging and going into psychosis.”
Mental health staff
Schools often don’t have the staffing and resources to support struggling students.
According to Topalian, there are 1,041 students for every school psychologist in California and 7,308 students for every social worker.
“There are six year olds out there who are in crisis today, who are in need of a lot of support from mental health professionals,” she said. “And what better place than a school where that’s the hub of the community to provide these services.”
Mental health professionals at schools are overwhelmed with hefty caseloads which makes it harder to pay attention to students’ individual needs or to take a more preventative approach.
Loretta Whitson, executive director of the California Association of School Counselors, said that some progress has been made in California’s counselor-to-student ratio. In the 2012-13 academic year, the ratio was 826 students to one counselor. Now, it’s roughly half that.
“I think 800 would be more like urgent care. We’re responding to crises,” she said. “….When you have 400, then you are able to do comprehensive strategic work.”
The national suggestion is a 250:1 ratio, she added.
“We’re not where we want to be…., but we’re moving in the right direction,” Whitson said, adding that there are more counseling services in elementary schools now, where students start learning social skills and ways to cope.
Fifty percent of all school counselors nationwide in California, and 33 university programs in the state are turning out new counselors, Whitson added.
A ‘first line of defense’: involving teachers
Involving teachers is a critical support for students in their mental health challenges, the speakers agreed.
Kim Griffin Esperon, a project director of Mental Health & School Counseling at the Los Angeles County Office of Education, emphasized the importance of creating step-by-step protocols that teachers and staff can be trained to implement.
Teachers should also be provided with guidelines to help them spot signs of depression, and their input should always be considered, Topalian said.
“We often tell teachers or staff what to do. It’s very important to think about asking them what they need and where their skill set is before we implement or develop programs,” she said. “They need to be part of the process rather than being the people who are in the frontline trying to do this work for our students.”
Off campus
Reducing the stigma around mental illness is also critical to students accessing support, the speakers agreed.
“Traditionally, schools and communities have understood mental health supports and services to be necessarily only for those students who have been identified as having a mental health disorder, or they have assumed that all students experiencing mental health challenges require intensive mental health interventions,” Esperon said.
“Fortunately, our understanding has evolved to refocus our attention on prevention and earlier identification of students who are struggling as well as referral to the appropriate level of services to meet students’ needs.”
Wicks said there are several intergenerational families in the San Gabriel Valley — which can make it harder for students to access support because of varied attitudes toward mental health support and counseling.
“I could see the challenge, you know, for the youth to hear the information and maybe want to move in that direction [of seeking help],” Wicks said. “But when they would go home and have those discussions, they would kind of come back with a ‘No thank you.’”
He added that youth advisory opportunities, where students can interact with one another, can be particularly helpful. And some districts have explored peer-to-peer counseling, which can also reduce students’ feelings of isolation.
Other ways to expand access
The Los Angeles Unified School District has attempted to expand community outreach to reduce stigmas around mental illness — while using Telehealth options to provide students with mental health supports, according to the district’s Administrator of Student Health and Human Services Joel Cisneros.
He said LAUSD also has its own psychiatric emergency response team, which intervenes in crises where students could harm themselves or someone else.
“[It’s] going beyond the idea that we’re just producing students to an academic process in order to graduate and to be successful,” Whitson said. “It’s also looking at the whole child. And that shift in perspective, I think, is really contributing to some of the changes that we’re trying to do.”
Students who are chronically absent from school are much more likely to struggle with mental health challenges, with pre-teen boys and teen girls reporting some of the highest signs of distress.
When students need help, availability of mental health support often depends on the income of families. “As household income increased, so did the availability of mental health services” in children’s schools, University of Southern California researchers found in a survey of 2,500 households nationwide.
Their findings are part of an in-depth report on the continuing national school absenteeism crisis in which 25% of students, or about 12 million children, across 42 states and Washington, D.C., were chronically absent in the 2022-23 school year. That rate remains higher than the pre-pandemic national rate of 15%.
EDITORS NOTE
This in-depth report on chronic absenteeism is part of an EdSource partnership with the Associated Press and Stanford Professor Thomas Dee.
“Chronic absenteeism in California is still twice what it was prior to the pandemic, and roughly 1 in 4 kids in public schools are chronically absent. That is just really striking and is a serious barrier to achieving academic recovery for this generation of students who were so harmed by the pandemic,” said Thomas Dee, a Stanford University education professor and economist who gathered nationwide data in collaboration with The Associated Press and the release of the USC research.
Emotional and behavioral problems also have kept kids home from school. University of Southern California research shared exclusively with AP found strong relationships between absenteeism and poor mental health.
For example, in the USC study, almost a quarter of chronically absent kids had high levels of emotional or behavioral problems, according to a parent questionnaire, compared with just 7% of kids with good attendance. Emotional symptoms among teen girls were especially linked with missing lots of school.
Families with the lowest incomes reported a much higher rate of using mental health services if they were offered to their children in school — more than five times higher than those with the highest incomes. And, crucially, the researchers also found that 1 in 5 respondents would have used mental health services if they were made available at their school, with higher rates among Black and Hispanic families who were surveyed.
“There is tremendous opportunity here for schools to increase the offerings but also, if they have the offerings, to increase the outreach to the kids and the families that need it because there is clearly an unmet need,” said Amie Rapaport, who co-authored the report and is the co-director of Center for Economic and Social Research at USC.
‘I had a very bad year’
If Jennifer Hwang’s son made it to his first grade classroom, it was rarely without a fight.
He struggled with severe attention deficit hyperactivity disorder (ADHD), and Hwang says his teacher’s habit of discarding art work in front of him would spike his anxiety, leading to violent outbursts and refusing to even get in the car or walk onto campus.
“I thought I would have a good year in first grade, but I didn’t,” said her son, 8, whose name Hwang declined to share to protect his privacy. “I had a very bad year.”
The absences began piling up during the second semester of that 2022-23 school year; he started missing two to three days most weeks. He soon became chronically absent, meaning he missed at least 40 days total. That classified him as chronically absent because he had missed at least 10% or more days in one school year. He began to see a therapist outside the L.A. Unified district.
Hwang tried getting her son an individualized education program (IEP), which would grant him access to school-based counseling services given his ADHD diagnosis. But because her son’s academic performance was up to par, the school said he didn’t need it.
She also inquired about him seeing a child psychologist who went to his Riverside Drive Charter campus in Sherman Oaks once or twice a week — but the waitlists were too long. Because he was already seeing a therapist outside of school, Hwang gave up on pressing for school resources.
The USC report published Thursday highlights that pre-teen boys, which includes children ages 5 to 12, are struggling significantly with symptoms of hyperactivity and conduct problems, while teen girls, ages 13 to 17, are struggling most with emotional symptoms, such as depression and anxiety.
Morgan Polikoff, a co-author of the USC report, said they cannot confirm there is “a cause and effect here,” noting that the correlation between chronic absenteeism and mental health challenges could “go both directions.”
“In reality, it’s probably both ways. There’s probably some kids for whom increasing anxiety is leading them to stay home, and there’s probably kids who are missing a lot of school and that’s increasing their anxiety. So it probably is bi-directional or multi-directional,” Rapaport agreed.
Both the USC researchers and Dee advocated for more research to better understand the causes of persistently high chronic absenteeism rates.
LAUSD’s chronic absenteeism problem
Last year, for second grade, everything changed, Hwang said, largely thanks to a teacher who adapted assignments to suit her son’s social-emotional needs and incorporated “brain breaks” into the school day, which Hwang’s son said helped him concentrate.
“She understood him. She knew that he was bright and he felt things much more deeply, and he saw things differently and with a very different perspective,” Hwang said. “She allowed him to feel heard.”
“One day (his teacher told me), ‘Oh, my goodness, your son just gave me a hug!’ Hwang said. “That doesn’t come cheap because he does not give out hugs very often. So that he actually hugged the teacher … that says a lot.”
Hwang and her family aren’t sure what third grade will bring, but they were able to at least secure a 504, a type of plan that helps level the playing field for students with disabilities, so her son could have access to a special chair and space to doodle.
LAUSD, the second-largest school district in the nation, has struggled with high rates of chronic absenteeism since the onset of the pandemic. Nearly 33% of their over 400,000 students were chronically absent during the 2022-23 school year, down from about 40% the previous year.
Most recently, in 2023-24, preliminary data shows their rate is hovering at 32.3%, a spokesperson said.
Still not enough
LAUSD has increased its staffing of social workers and pupil attendance workers, but staffers say it’s just not enough.
“We have what we can afford at this point — more than ever before — but still not at an appropriate ratio that I think this board, or myself, would feel comfortable,” Superintendent Alberto Carvalho said at a news conference Monday.
Carvalho described the district’s staffing as “an unprecedented network” but did not specify how much staffing had increased.
Ofelia Sofia Ryan is one of roughly 400 LAUSD pupil services and attendance workers trying to bring students back to school.Credit: Mallika Seshadri / EdSource
Ofelia Sofia Ryan is one of LAUSD’s roughly 400 pupil services and attendance counselors who are on the front lines helping get chronically absent students connected with mental health resources and Medi-Cal so they can get back to school.
This year, the 20-year district veteran works in five elementary schools, including Orchard Academies in the city of Bell.
“Poverty is the No. 1 issue. Financial issues are … second — the inability of a parent to monitor because they are having two jobs, which also relates to the poverty issue,” Ryan said. “Mental health, I would say that will be maybe next.”
Darlene Rivas, one of the district’s 800 psychiatric social workers (PSWs), is assigned to two East Los Angeles elementary schools: William R. Anton and Lorena Street.
“We have to be team players because it can’t just be one person,” Rivas said. “I think that’s why you see a lot of exhaustion within PSW professionals.”
There is a long waitlist for students in need of therapy, she said. If a parent can’t make it to an initial appointment, it can take months to reschedule.
Adding staffing can come from school funding, but there are competing demands.
This year Ryan said she started on an LAUSD campus two days a week. At the last minute, “boom,” they dropped a day, she said.
“That’s very unfair, because (the district tells) you, on one hand, mental health matters, attendance matters. You’re working your butt off to get attendance improved. I improved attendance in all my schools. Everything was done by the book, and then (the school) just took the money away,” said Ryan. “You cannot do anything. You are powerless.”
Carvalho regularly touts the district’s iAttend program, where he, among others, visits the homes of chronically absent students to coax them back to school. The district made more than 34,000 home visits last school year, contributing to a more than 4 percentage point decrease in chronic absenteeism, according to the district.
What the public doesn’t know is how much work it takes after the house visit to get the child back in school, Ryan said.
Local barriers require local solutions
Researchers like Dee offer advice for lowering chronic absenteeism rates: “Be acutely aware of the problem” and “look to the really local barriers.”
That advice appears to be playing out successfully farther north, in Placer County, where more and more of Roseville City School District’s 12,000 students are attending school regularly each year.
Placer’s 2023-24 absenteeism rate is expected to be about 11% — nearly double what it was pre-pandemic. But that is down from 20% in 2022-23 and 26% in 2021-22.
School staff have found the two main reasons for the absences are “misinformation and a lot of struggle,” said Jessica Hull, the district’s executive director of communication and community engagement. They zeroed in on these top reasons by closely tracking absenteeism over several years with their attendance system plus a notification system managed by a third-party team, SchoolStatus, that they hired specifically to address chronic absences.
The misinformation largely centers on families being unsure of whether to send a child to school when they are sick, not knowing they can rely on independent study if the family is going on a lengthy vacation, or not understanding the importance of enrolling in pre-kindergarten known as TK.
Roseville City School District’s attendance roadmap for parents.
This misinformation is part of what Dee and other researchers are calling “norm erosion.”
“The learning experiences of families and students during the pandemic, in particular the experience of remote schooling, may have reduced the perceived value of regular school attendance among students and parents,” said Dee.
He cautioned against blaming parents for the erosion, saying that “we’re in a crisis now that merits immediate attention and perhaps a little less finger-pointing.”
The struggles that Hull, from Roseville, said families face are often mental health challenges, particularly with middle schoolers, or families with unmet basic needs, such as unstable housing.
One of their solutions to both barriers has been constant check-ins with those chronically absent students in order to offer resources, such as access to mental health specialists, gas cards to families facing transportation issues, and offering families bags of food from the local food bank.
Another help is clearly explaining the notices behind their child being absent. “Schools are all about the acronym and all about words that no one else understands, so we start sending letters home and talking about truancy and chronically truant and excused absence and unexcused absence — all of that’s a mess,” Hull said.
Instead, parents can expect to see at schoolshalf-sheets of card stock paper explaining the terms andprinted in five languages from English to Ukrainian to Pashto.
“It’s really trying to remove that language barrier when we are talking jargon, and they’re just saying, ‘my kid needs help, we need help figuring out how to get them to school,’” Hull said.
Kids who identify with their educators are more likely to attend school, said Michael Gottfried, a University of Pennsylvania professor. According to one study led by Gottfried, California students felt “it’s important for me to see someone who’s like me early on, first thing in the day,” he said.
A silent crisis is unfolding in our schools and impacting millions of California students: chronic absenteeism. The consequences of unchecked absenteeism are severe and far-reaching.
It starts innocuously with a few missed days, but can quickly spiral, decimating a child’s future prospects. When dropout rates increase and college readiness declines, the ripple effects harm entire communities.
Traditionally, students and their families are penalized for missing school, but this hasn’t resolved the issue and instead, targets marginalized student groups. As an educator with years of experience in the classroom and administration, I propose a radical shift in our approach — treating chronic absenteeism as a public health emergency.
The rise in social isolation, health concerns and economic hardships have dramatically increased the number of students consistently missing school nationwide. In California, we are seeing consistent, distressing high chronic absence rates, particularly among high school studeents and historically marginalized populations.
We can’t simply discipline our way out of this crisis. Instead, we need a comprehensive strategy that addresses the complex roots of absenteeism, from persistent health issues to limited transportation access, from heightened stress to trauma.
Imagine if schools treated chronic absenteeism with the same urgency and collaboration used during the Covid-19 pandemic. We mobilized resources to fight a global crisis, and we can apply that same level of commitment to ensuring every child attends school regularly.
By framing chronic absenteeism as a public health crisis, we open the door to more effective interventions. One crucial strategy for dealing with public health emergencies is risk communication, which helps convey urgency, provide accurate information, and mobilize stakeholders to take collaborative action. The impact of proactive attendance management has shown to improve attendance rates threefold for chronically absent students.
Here are strategies schools can implement, drawing from public health approaches:
Convey urgency: Research shows attendance is the most crucial predictor of school success. Schools must create a “relentless drumbeat” about the importance of attendance through daily text messages, visual aids, public recognition and personalized follow-ups with absent students.
Provide accurate information: Transparency is key. Schools should share clear data on absenteeism and its effects. Implementing user-friendly attendance management systems can automate positive intervention letters and free up staff for more personalized outreach. Training teachers to analyze attendance data enables early, tailored interventions.
Mobilize stakeholders: Thirty-seven percent of K-12 families want actionable steps to improve their children’s attendance. Schools must provide specific, consistent messaging about attendance importance to all stakeholders — students, families, educators, board members and policymakers. Offer concrete ways for everyone to contribute to the solution.
Advocate for prevention: Positive messaging encourages attendance; punitive actions deter it. A multilevel approach works best:
District level: Superintendents should regularly communicate about the importance of attendance.
Building level: Principals should celebrate good attendance and offer incentives.
Classroom level: Teachers should reach out personally to families, highlighting successes and addressing issues promptly.
Foster two-Way, equitable communication: A Harvard study found that students with the best outcomes for remote learning during the pandemic were in communities with high levels of trust. Schools must establish open dialogues with families in their preferred languages and communication channels. This approach helps identify root causes of absenteeism and builds the trust essential for consistent attendance.
The responsibility for addressing chronic absenteeism extends beyond individual schools or districts — it requires a unified national effort. However, we needn’t wait for a grand solution. By prioritizing consistent, positive communication in our classrooms, schools and communities, we can make significant strides in reducing absenteeism.
Treating chronic absenteeism as a public health emergency isn’t just a metaphor — it’s a call to action. It demands we recognize the severity of the issue and respond with the urgency, coordination and comprehensive strategies that have proven effective in addressing other public health crises.
By reframing our approach, we can foster healthier educational environments and brighter futures for our students, one attendance record at a time.
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Kara Stern, Ph.D., is the director of education and engagement at SchoolStatus, a provider of K-12 data-driven communication, attendance and professional development solutions.
The opinions in this commentary are those of the author. We welcome guest commentaries with diverse points of view. If you would like to submit a commentary, please review our guidelines and contact us.
California’s 1.6 million high school students are starting another year, but without a critical school supply that I would argue is necessary for teens: condoms.
Why should California public high schools be required to provide condoms to students? Because condom availability programs are an effective public health strategy supported by the federal Centers for Disease Control and Prevention (CDC) to help keep sexually active high school students safe. According to the CDC:
This year, the Golden State has a golden opportunity to protect high school students in California from alarming statistics like these in the form of the YHES Act.
The Youth Health Equity + Safety (YHES) Act (SB 954) would expand access to condoms by requiring public and charter high schools to make free condoms readily available to students, giving them the opportunity to protect themselves from STIs that negatively impact their well-being, shorten their lifespan and easily spread to the wider community.
The organization I lead, the California School-Based Health Alliance (CSHA), helps improve health access and equity by supporting schools and health care partners to bring health services to where the kids are — at school. The alliance is a proud co-sponsor of this bill because providing condoms in California’s high schools equips young people to make healthier decisions if they choose to be sexually active.
Although some districts, such as Los Angeles Unified, San Francisco Unified and Oakland Unified, already offer condom access programs, the majority of schools in California do not.
An online survey by TeenSource, an initiative of Essential Access Health, found that 68% of California teens lack access to condoms at their high school, and 98% agreed that easier access would increase condom use among sexually active teens.
SB 954 would require all public and charter high schools to make internal and external condoms readily available to students for free beginning at the start of the 2025-26 school year. Condoms would need to be placed in a minimum of two locations on school grounds where they are easily accessible to students during school hours without requiring assistance or permission from school staff.
California’s high school students have a right to consent to and access medically accurate, confidential, culturally relevant, and age-appropriate health services in schools. Our state has made great strides in reducing unintended pregnancy among adolescents in the past 20 years. Unfortunately, half of all reported cases of STIs in 2022 were among young people aged 15-24. The scope of the epidemic requires bold action.
This year marks the second time state Sen. Caroline Menjivar, D-Van Nuys, has moved this sensible bill through the state’s Legislature. Menjivar has secured $5 million to cover the costs of distributing free condoms in public high schools for three years. The bill also specifies that if funds are not designated for this purpose, schools have no obligation to provide free condoms — addressing any concern as to an unfunded mandate.
To reduce public health disparities, we must ensure that California youth have equitable access to condoms in high schools. Advocates for youth health and education equity urge Gov. Gavin Newsom to sign the YHES Act into law.
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Sergio J. Morales, MPA, is the executive director of the California School-Based Health Alliance (CSHA), a nonprofit organization that aims to improve the health and academic success of children and youth by advancing health services in schools.
The opinions in this commentary are those of the author. We welcome guest commentaries with diverse points of view. If you would like to submit a commentary, please review our guidelines and contact us.
LAUSD student board member Anely Cortez Lopez says she’s grateful for the privilege of offering a voice to students.
Credit: LAUSD
Vowing to uplift student voices, Anely Cortez Lopez was sworn in as the Los Angeles Unified School District school board student board member on Aug. 13 — the second day of the 2024-25 school year.
While student board members, who are elected by their peers, cannot formally vote on resolutions that come before the LAUSD school board, they can issue advisory votes, voice opinions and introduce resolutions.
“Since I was very little, I knew that student advocacy was a large priority — not only for my community, but just in my heart — knowing that I have the opportunity to advocate for the most needed issues and most important issues,” Lopez said.
Although only 17-years-old, Lopez has already served on the Superintendent’s Advisory Council, a group that provides student input to the superintendent on various district efforts, and has volunteered at local retirement homes, where she was also able to witness disparities in health care.
Lopez, the daughter of Mexican immigrants, said that from a young age, her mother would take her to town hall and neighborhood meetings where she would often help translate for her mother. That was where she quickly developed a passion for civic engagement — which has morphed into college plans for studying political science, with an emphasis on public health.
Soon after she was sworn in, Lopez spoke to EdSource about the issues LAUSD students feel are most pressing. This interview has been edited for length and clarity.
What motivated you to run for the position of student board member?
Being from a Title 1 school has allowed me to see a lot of the struggles of my community, and not only within my own community at school, but also within my family. And I have seen what happens to students when they succumb to the … .conditions within the neighborhood, and I believe that is one of the reasons why this position means so much to me. I’ve seen the situations that are occurring within our districts firsthand and can see what changes need to be implemented. And, I’m just so grateful for this opportunity and so grateful for this place of privilege to offer a voice to students.
Are there things at your own school that you wanted to see improved?
A large majority of students are low-income; and a large majority of those students are minorities, first generation, English learners. And that is primarily where the achievement gap exists within our schools. I feel as though seeing that and being in those shoes — especially as a first-generation student myself — I’ve seen the need for our community, for mentors and programs in place to amplify the needs and voices of our students.
You’ve been elected to represent Los Angeles Unified’s huge and diverse student body. What do you see as the challenges students are most concerned about as the new school year gets going?
Students’ voices are desired to be heard and not overshadowed. They’re the ones who are sitting in the seats eight hours a day and have such a unique perspective on the issues that, to them, need the most attention. And … when they feel their input is not taken into account, that is when issues begin to become present in the student body. So definitely, the amplifying of student voices and also an increase in mental health and wellness.
From the pandemic, we’ve seen an increase of issues in our student body, pertaining specifically to mental health and wellness and seeing how, at a systematic level, we can learn to combat that. And going into that also is preventive measures surrounding drug use within our youth and ensuring that our school environment is a sanctuary for opportunity to flourish, and ensure only the best for our students here in LAUSD — and also focusing on the fact that a lot of these students may come from households that might not provide mentorship. So, also providing mentorship for some of our most marginalized groups in LAUSD, such as first- generation, low-income and English learners to, once again, help close that achievement gap.
What are the issues you are most passionate about?
I definitely am very passionate about amplifying the student voice. Because although there might be issues that specifically pertain to me, I found that being in this position of power means not being led by my own ideas, but being led by the needs of my peers. Since I represent such a large group of students, it’s so important for me to take into account the various issues that are being presented to me from the student population, and ensuring that those are the perspectives that are being shared and not just my own.
What do you hope to accomplish during your time in the position?
One of the biggest goals for this year is to … amplify student voices. But especially since my term falls within our election year, ensuring that students understand the value of their civic engagement — whether it be in volunteering for their community, pre-registering to vote, ensuring that everyone in their families who is capable of voting and is 18 and older is voting in this election, and knowing that their voices are not overshadowed, that they have a place here in this country, that they are able to share their needs and problems and that they will receive solutions to them.
Early this year, the California Department of Health Care Access and Information introduced the new Certified Wellness Coach program, aimed at improving the state’s inadequate capacity to support growing behavioral and mental health needs in California’s youth.
The program is part of the historic five-year, $4.6 billion state-funded Children and Youth Behavioral Health Initiative, of which the Department received $278 million to recruit, train and certify a diverse slate of mental health support personnel, or certified wellness coaches, in schools and community-based organizations across the state.
Sharmil Shah, assistant deputy director of the California Department of Health Care Access and Information.
According to Sharmil Shah, assistant deputy director of the California Department of Health Care Access and Information, certified wellness coaches work under a care team of licensed clinicians and professionals in pre-K, K-12 and post-secondary school settings. Most coaches have relevant associate or bachelor’s degrees in social work and human services and are trained in nonclinical behavioral health support.
Shah says the program strives to become a long-term response to a long-term crisis in California — that rates of anxiety and depression among the state’s children shot up by 70% between 2017 and 2022, and that following the COVID-19 pandemic, many adolescents experienced serious psychological distress and reported a 20% increase in suicides.
As part of a five-year initiative’s broader push to redefine student success, the program builds on research that behavioral interventions also improve academic performance and attendance in schools. In fact, anxiety, depression and mental health are the top health-related drivers of absenteeism since the onset of the pandemic, according to the Los Angeles Trust for Children’s Health. Simply put, students who feel better do better in school.
EdSource interviewed Shah about the new wellness coach program. Her remarks have been edited for length and clarity.
Describe the Certified Wellness Coach program. What can young people expect from the new wellness coaches?
Certified wellness coaches are meant to be an additional, trusted adult on a school campus — whether it’s an elementary school, middle school, high school or a college campus. This is a person that young people can turn to in times of need. Coaches would offer preventive and early intervention services and are intended to support a child or even a 25-year-old before a severe behavioral health need arises.
Some of the things that a parent or a child might see are classroom-level presentations, supporting school counselors with [mental health] screenings, individual and small group check-ins, wellness education and referrals to advanced behavioral health providers in times of crisis, among many other services.
What are the two types of wellness coaches, and how are their roles different?
There is a Certified Wellness Coach 1 and Certified Wellness Coach II. The Certified Wellness Coach 1 offers entry-level behavioral health supports, such as structured curriculum, to small groups or classrooms, which are focused on wellness promotion and education, mental health literacy — understanding the language of mental health — and life skills. They also support screenings for young people, connect them to behavioral health resources and professionals. If it becomes apparent that someone has a more significant need for behavioral health services, they’ll do a warm hand-off to a higher level of care.
The Certified Wellness Coach II provides a little more in-depth prevention and early intervention support to children and youth. They provide structured curriculum for groups or classrooms that’s focused on enhancing awareness of common behavioral health conditions like depression, anxiety. The Certified Wellness Coach II can help young people overcome maladaptive thinking patterns, distraction strategies and emotional regulations, and are able to do higher level interventions than a Certified Wellness Coach 1.
To support a mental health screening, a Certified Wellness Coach 1 can give the child some information about it, but they won’t administer the questions. The Certified Wellness Coach II can actually facilitate a screening process, be in the room and get everything set up, but they must still all be under the guidance of a school counselor who has qualifications to administer the screening and ask the questions, for example.
Why was it important to implement the program at all levels of schooling — from early education to community college?
It’s essential for children and youth to get help earlier on in the continuum of care, especially before a crisis arises. We believe that by supporting them at a younger age, we can provide them with the tools and skills to support their behavioral health and build resilience as they age. Wellness coaches can support youth through all the different changes, not only as related to age, but to life in general. We start at a very young age and then continue to an age where they can actually remember and hold onto the skills that they’ve learned.
How did the pandemic shape your vision for the program?
For students, we saw increased levels of anxiety, depression, social isolation, a disruption in their education, economic difficulties, and, of course, a lot of loss and grief. Children and adolescents lost family members who did not survive the pandemic. From research, we knew that there was already a youth mental health crisis in the state of California. The pandemic exacerbated it.
One system alone cannot address these challenges, but the school system is where all the kids are. There’s just not enough school personnel to address the need across the state. Through the development of this workforce, we hope that we can complement the incredible work that the educators are already doing by being a partner in their students’ health. Our wellness coaches can focus on social isolation, anxiety, feelings of sadness, and feeling connected and able to talk to somebody.
In a 2022 survey, about 55% of teachers said they would retire earlier than planned due to burnout from the pandemic. Could wellness coaches help relieve some of that ongoing burnout?
I was a PTA president, and I was in those environments in which I saw that there’s a child in the classroom that clearly looks like they need behavioral health services, and the teacher is spending maybe 90% of his or her time on that student, and the rest of the [students] are just kind of running around in circles. The current counselor-to-student ratio in California is about 1 to 464. It’s impossible, and it’s nearly double the recommended ratio. As the staff that spends the most time with students, the burden of supporting student behavioral health often falls on the teacher. That’s just not sustainable. That’s not helpful for the teachers, and they can’t do their job. By adding additional behavioral health professionals on campus, like wellness coaches, we can hopefully alleviate some of that burden and allow teachers to focus on the academic success of their students.
How will certified wellness coaches serve youth from multilingual or multicultural backgrounds? Will coaches reflect the demographics and experiences of their school’s student body?
Equity and effective access to care is a cornerstone of our programs. We have been recruiting diverse candidates to become wellness coaches and making sure that we adequately address cultural responsiveness and humility as part of their training. We have done very extensive marketing and outreach campaigns that use a variety of channels and messaging to get to as many populations as we can, including underserved and underrepresented communities.
We also selected our employer support grant awardees, mostly schools and some community-based organizations, based on geographic spread, to make sure that all 58 counties were represented and could hire coaches. And then we also provided special consideration to Title 1 [low income] schools, organizations whose staff speak multiple languages, and organizations that support Medi-Cal students. And then we had two scholarship cycles to support students who wanted to become wellness coaches. We [will support] their tuition and living expenses, especially for those who came from different backgrounds or didn’t have a lot of resources.
We are also partnering with California community colleges, which offer resources and support for underserved and underrepresented populations to enter the wellness coach system. What we found in our research is that 65% of their students were classified as economically disadvantaged. So we’re already addressing those groups.
And as part of our certification requirements, we’re focusing on specific degrees such as social work, human services and addiction studies, which already include cultural responsiveness and cultural humility as part of their key learning outcomes. What we’ve heard anecdotally from a lot of young people is that, “I don’t see myself in the people that are helping me or serving me,” and we want them to feel safe and comfortable with the person that they’re talking to.
Where are you in the rollout of the program?
In February 2024, we launched the certification program for wellness coaches. As of Sept. 17, we have certified 383 coaches, and that number is steadily growing. We’ve done so much outreach and engagement and social media blips and radio ads, because we need to be able to reach the young people where they are. As of August, the Department executed 64 21-month grant awards of $125 million to employer support grants for schools and community-based organizations to hire wellness coaches. That will fund the placement of more than 1,500 certified wellness coaches between this school year and next school year. And then, also, in August, we awarded 99 individuals with scholarships totaling about $2.8 million for those pursuing degrees with which they apply to become a certified wellness coach.
How can the program address broader post-pandemic issues such as chronic absenteeism and declining school enrollment?
We’re hoping that wellness coaches will strengthen young people by providing them with a safe place to share their fears and teaching them the skills necessary to cope with life’s challenges. We believe that equipping them with these skills will decrease absenteeism, help them focus on their schoolwork and also be able to have them integrate themselves into the school environment. Young people with behavioral health conditions are sometimes isolated, bullied, made fun of and may not even like school as a result of all of those things that are going on. If they have a safe place, a safe adult, a safe person that they can talk to about some of the feelings they have, they will be happy to come back to school, look at it as a place of learning and a place to make friends.
What kind of challenges do you foresee in keeping the program running and successful?
Sustainability. Everything runs on the mighty dollar. We are in the final years of the [Children and Youth Behavioral Health Initiative] right now, and we can use those funds to sustain the program for probably another year or two. We are actively partnering with the Department of Health Care Services, and other state departments, to make certified wellness coaches’ services billable through Medi-Cal [and commercial insurance], which will support sustainable financing in our schools [beyond the five-year initiative].
Extensive research has demonstrated that students who feel like they belong in schools perform better in the classroom and have better rates of attendance. This not only benefits the student, but it also potentially benefits the schools in retaining coaches, as school finances are based in-part on school attendance.
What kind of feedback have you received about the program?
I had a student who said, “I didn’t really feel like there were a lot of places to go to, even though they had help available. I didn’t trust people to confide in.” You never want people to feel like they have nowhere to go or that they’re alone. This was a student who would then become a wellness coach. Another student who became a wellness coach said that she didn’t feel there was enough support when kids needed help where she lived. She said, “If I’m struggling, I want to know there’s someone there for me if I genuinely need it.” She said she’s had really hard days, but being able to open up and talk about it makes the world seem a little more colorful. It makes her feel lighter on her feet.
We had some parents indicate that wellness coaches are a great way to give back to the community, because they’re giving back to our future, our children. It’s helping them be productive members of society and be the best version of themselves.
What are education leaders doing about transformingthe way schools address learning, behavior and emotional problems? The current answer, it seems, is: not much.
We do see increasing discussions among education leaders about transforming education in general. Naturally, much of the focus is on improving instruction and making major changes in how schools are managed (e.g., financed, administered, held accountable). However, when it comes to improving how schools play their role in providing support when students are not doing well, proposals for transformative changes generally are not forthcoming.
The result: As the number of learning, behavior and emotional problems increases, schools continue to react in inadequate ways.
What’s wrong with what schools are doing now?
All schools devote resources to coping with student problems. Some are able to offer a range of student and learning supports; others can provide only what is mandated. In the majority of schools, what is available usually covers relatively few students. More resources would help. But school budgets always are tight, and adding the number of student support staff that advocates call for is really not in the cards.
In general, districts plan and implement student and learning supports in a fragmented and piecemeal manner, generating a variety of specialized programs and services. Over many years, increasing concern about fragmented approaches has produced calls for “integrated services” and, recently, for “integrated support systems.”
However, by focusing primarily on fragmentation, policymakers and school improvement advocates fail to deal with a core underlying problem. What drives the fragmentation is the longstanding marginalization in school improvement policy of the role schools must play in addressing barriers to learning and teaching.
A fundamental challenge for education leaders and policymakers is ending this marginalization. Meeting the challenge requires escaping old ways of thinking about how schools address learning, behavior and emotional problems.
What might a transformed approach look like?
Addressing the pervasive and complex barriers that impede effective teaching and student learning requires a systemwide approach that comprehensively and equitably supports whole-child development and learning. This involves districts and schools rethinking how they frame the practices they use to address learning, behavior and emotional problems.
In this respect, the current widespread adoption of some form of a multitiered “continuum of interventions” (commonly known as MTSS) is a partial step in the right direction. This framework recognizes that a full range of intervention must include a focus on promoting whole-student healthy development, preventing problems, providing immediate assistance when problems appear, and ensuring assistance for serious and chronic special education concerns. But moving forward, our research has clarified the need to reframe each level of intervention into subsystems designed to weave together school and community resources.
Moreover, our research indicates that the various programs, services, initiatives and strategies can be grouped into six domains of classroom and schoolwide student and learning support. The six arenas encompass interventions that:
Embed student and learning supports into regular classroom strategies to enable learning and teaching
Support transitions (e.g., new grade, new school, before/after school, during lunch and other daily transitions)
Increase home and school connections and engagement
Respond to — and, where feasible, prevent — school and personal crises
Increase community involvement and collaborative engagement
Facilitate student and family access to special assistance.
Organizing the activity in this way helps clarify what supports are needed in and out of the classroom and across each level of the continuum to enable effective teaching and motivate student learning.
We recognize that the changes education leaders are already pursuing represent considerable challenges and that the changes we discuss can be daunting.
But maintaining the status quo is untenable, and just doing more tinkering will not meet the need.
Transforming how schools play their role in addressing barriers to learning and teaching into a unified, comprehensive and equitable system that is fully integrated into school improvement policy and practice is essential to enhancing equity of opportunity for students to succeed at school and beyond.
•••
Howard Adelman and Linda Taylor are co-directors of the Center for MH in Schools & Student/Learning Supports at UCLA, an initiative to improve outcomes for students by helping districts and their schools enhance how they address barriers to learning and teaching.
The opinions expressed in this commentary represent those of the authors. EdSource welcomes commentaries representing diverse points of view. If you would like to submit a commentary, please review our guidelines and contact us.
Students work on homework during an after-school program in Chico, the largest city in Butte County. (File photo)
Credit: Julie Leopo / EdSource
At 14, Charlotte Peery dropped out of high school.
“I was one of those silent sufferers,” Peery said. “I was battling with addiction, and once I finally decided I couldn’t go to school anymore, there wasn’t anyone around to say, ‘Well, let’s see what we can do’.”
It took another four years for Peery, raised in rural Tehama County, to return to school and enroll in an alternative education program. There, she met a counselor who provided the academic guidance and mental health counseling she needed to graduate from high school. Peery has since started earning her bachelor’s degree in social work and has become one of Tehama County schools’ first certified wellness coaches.
“When I had the opportunity to apply to be a wellness coach — it was everything I’ve always wanted to do — to provide the kind of support that I lacked when I needed it most,” Peery said.
As an entry-level wellness coach, Peery provides students with nonclinical support such as quick check-ins, screenings, referrals to specialists, structured mental health curriculum and outreach to their families.
Peery’s role is part of the state’s $4.6 billion Children and Youth Behavioral Health Initiative, for which the Department of Health Care Access and Information received $278 million to recruit, train and certify a diverse slate of mental health support personnel, known as certified wellness coaches, for schools and community-based organizations. Since February 2024, the department has hired over 2,000 certified wellness coaches.
“The wellness coach program helped define what coping skills and home-to-school services I could focus on,” said Jacque Thomas, who serves as a certified wellness coach II and is able to provide more in-depth services to students, such as individual 30-minute sessions focused on coping skills, goal-setting and life skills.
According to a 2021 study, 45% of California youth between the ages of 12 and 17 reported having struggled recently with mental health issues. The overall suicide rate in Tehama and neighboring counties is more than twice the state average, and according to a 2017-2019 survey, more than a third of 11th graders in Tehama County reported feelings of depression.
Research shows that children ages 2 to 8 in rural communities consistently have higher rates of mental, behavioral and developmental disorders than children in urban communities, largely due to financial difficulties and geographic isolation. Students in Tehama County tend to start struggling with mental health issues at a younger age, said Savannah Kenyon, a parent to a fourth grader and an education behavior assistant at Red Bluff High School.
“Our neighbors could be acres and acres away, and we don’t know them by name — so there’s a lot less socializing,” Kenyon said. “A lot of our students also come from a family of addiction or have to be the providers for their families.”
In Tehama County, nearly 1 in 5 children, and a third of children under the age of 5, live below the poverty line. The county also ranks sixth in California for the number of children who have experienced two or more adverse childhood events, such as abuse, neglect, substance use or mental health problems, known to have lasting impacts on health and well-being.
“It’s hard to see our children dealing with adult problems, and as a result, adult mental health problems, way younger,” Kenyon said.
Wellness coaches like Thomas and Peery try to understand students’ needs as they evolve. Thomas said that in the past school year, they saw an increase in students referred for substance use intervention, mirroring troubling rates of adolescent drug use and fatalities in the U.S.
In response to the increase in referrals, Thomas and Peery decided to become trained in Mindfully Based Substance Abuse Treatment, a program focused on building emotional awareness and examining cravings and triggers in youth substance use. In the process, they also learned about students dealing with unhealthy relationships or domestic violence at home. In response, Peery developed and ran a 16-week curriculum in three schools and a juvenile detention center, teaching students how to identify and respond to issues like abuse and family trauma.
Charlotte Peery, certified wellness coach I in Tehama County.
Peery is often the first point of contact for a student struggling with mental health issues. On paper, her job spans the next two or three steps in the process — a mental health screening, a mindfulness and stress reduction session, or a referral to a specialist. But in practice, she hopes to strengthen the long-term network of care available to students. She has partnered with the Tehama County Department of Behavioral Health, which provides substance use recovery treatment, and Empower Tehama, which helps victims of domestic violence, for example.
“I’m making connections with drug and alcohol counselors and becoming more aware of which clinicians are accepting new clients once students transition out of our program,” Peery said. “To have that open communication, I’ve seen a huge shift in the way all of our partners are working together.”
School-based support is likely the most effective way to reach Tehama County students in need, she said, because most families cannot easily access major services, in part due to a disproportionate shortage of mental health providers,
“We’ve been able to provide more services to the farthest outreaches of our community and helped build rapport with every school,” Thomas said. “We go out to all 33 schools in the county to provide check-ins and open up the doors for our clinicians to meet with high-need students.”
Early intervention matters
After her daughter’s school shut down at the onset of the Covid-19 pandemic, just as she was starting transitional kindergarten, Kenyon noticed that her daughter was missing some key developmental milestones.
“We were realizing that the kids were not socializing at some of their peak times when they should be learning social skills,” Kenyon said. “I knew at an early age that she was going to be struggling with her ADHD (attention deficit hyperactivity disorder), so we knew that starting young was going to be the best way to help her in the long run.”
Early intervention for Kenyon’s daughter began with a screening and diagnosis of ADHD. From there, she said, her daughter’s counselor and teacher helped with little things like — motivating her through action-oriented feedback on her work, or teaching her mindful, deep breathing when she feels anxious — that allowed her daughter to handle emotional distress as well as social expression and inattentiveness in the classroom on a day-by-day basis.
“We’re always having open communication with the counselor or teacher. Being able to tell them, ‘We struggled last night, so she might be a little tired today; she might be a little bit emotional,’ has been imperative to her success,” Kenyon said.
Research shows that early, multidisciplinary interventions, such as a combination of school-based programs and family support initiatives, significantly reduce the risk of carrying mental health disorders into adulthood.
School shutdowns during the pandemic compounded the youth mental health crisis in California. About 65% of young people with depression did not receive treatment during the pandemic, while the rate of suicide among adolescents rose by 20%.
“We saw heightened anxiety, depression and delays in social development for students that had gone longer without intervention than they typically would have if they were on a school campus,” said JoNell Wallace, school mental health and wellness team coordinator at the Tehama County Department of Education. “We’re now starting interventions in third or fourth grade that we would’ve caught in second grade.”
Jacque Thomas, certified wellness coach II in Tehama County.
Despite the additional support, Thomas said she has been flooded with students approaching her for help (“which is amazing,” she adds) and that students’ needs in Tehama County are still outpacing available staff and services at schools. She frequently eats in her car on the way to a counseling session, or sometimes skips lunch altogether, to fit another student into her schedule.
“You start to get stretched thin, and I don’t want any one student to have to be on a waitlist,” Thomas said.
Understaffing has also underscored the weaknesses of the referral system, a process through which schools assess students and refer them to wellness coaches, depending on the level of support they need. Schools do not always connect students to the support they need because of how time-consuming referrals can be.
“I think schools would much rather prefer it if we were on site,” Thomas said. “And that’s the goal — that more schools are qualified to have more wellness coaches, so their referral process will be in-house, and those services can start happening with a lesser barrier.”
There will be some relief starting this fall, when five additional certified wellness coaches will be placed at elementary and middle schools in Tehama County. Kenyon said the expanded service is a win for students like her daughter.
“She used to hide under the table if she got any type of feedback or if she felt like she had done something wrong,” Kenyon said. “But she hasn’t done it this entire year, which is such a big change from how she would try and escape her feelings.”
Now, with help from her counselors, coaches and teachers, her daughter comes home excited to talk about her day, feeling more confident and self-assured.
“Knowing that she’s coping, and for me to have help beyond just parental help — I know she’s a hundred percent supported through these programs,” Kenyon said.
West Contra Costa Unified School District administration building.
Credit: Louis Freedberg / EdSource
TOP TAKEAWAYS
West Contra Costa Unified anticipates it will receive only about $600,000 of $4.2 million it was awarded last year.
The cut is part of a big push by the Trump administration to roll back or eliminate funding to support student mental health in schools across the nation.
The district was one of only three school districts in California to be awarded grants from the Mental Health Professional Services program.
The West Contra Costa Unified School District is the latest school district in California to feel the direct impact of the Trump Administration’s elimination of a range of grant programs approved by the U.S. Department of Education during the Biden administration.
At its meeting on Wednesday night, Interim Superintendent Kim Moses told board members, who were caught unawares by the news, that she had received a letter the previous day from the department of education indicating that the five-year, $4.2 million grant awarded last fall will be cut to one year.
The letter stated that the grant was no longer “aligned with the current goals of the administration,” she said.
As a result of the cut, the district anticipates it will only receive about $600,000 of the funds it was expecting, all of which must be spent between August and December of this year.
Board president Leslie Reckler summarized her reaction in two words: “Total bummer.”
The district was one of three in California to receive a five-year grant last fall. They were among 46 grants awarded last year under the Mental Health Services Professional Grant program begun by the Biden Administration.
The grant was supposed to enable the San Francisco Bay Area district to address the mental health needs of its students by placing graduate student counseling interns in its schools, in collaboration with San Jose State University and St. Mary’s College in Oakland.
The goal of the program, as described in the Federal Register, is “to support and demonstrate innovative partnerships to train school-based mental health services providers.”
Interim Superintendent of West Contra Costa Unified, Kim MosesCaption: Courtesy West Contra Costa Unified
Moses said she was taken aback by the news of the drastic reduction. “Of all the things that I am worrying about being reduced or taken away, I didn’t have this grant in mind,” she said in an interview after the meeting. “The grant is to build our workforce (of mental health workers). How could building our workforce and supporting students with their mental health needs be against what the administration stands for?”
School board member Demetrio Gonzalez-Hoy described the funding cut as “atrocious.” “This is just another way they (the Trump administration) are going to start hurting our kids, our staff, our school district, because of what we stand for, because of what we look like.”
The drastic grant cutback comes as a blow to the district, which has made significant progress over the past year in cutting major budget deficits and averting the prospect of a state takeover. Especially since the pandemic, educators have realized that addressing the mental health needs of students is essential to their ultimate academic success. A particular challenge has been to boost the number of school mental health professionals, especially those reflecting the backgrounds of students.
The reduction appears to be part of an aggressive drive by the administration to eliminate mental health programs serving schools. On the same day West Contra Costa heard about its grant reduction, the Associated Press reported that the U.S. Department of Education is moving to terminate $1 billion in mental health grants to schools, signed into law by President Biden after the school shooting massacre in Uvalde, Texas in 2022.
The district applied for the funds in the spring of 2024 and was awarded them in the fall. It had been working on signing a Memorandum of Understanding to begin implementing the program this fall.
The funds were designated to be spent in “high-need” school districts like West Contra Costa Unified, where nearly two-thirds of its almost 30,000 students qualify for free and reduced-price meals.
Program probably targeted because of emphasis on diversity
What almost certainly caught the Trump administration’s eye was the emphasis on diversity in the grant application guidelines, a term the current government is using as a rationale to cut federal funds to education institutions at all levels.
One of the goals of the program, according to the guidelines, is to “increase the number and diversity of high-quality, trained providers available to address the shortages of mental health services professionals in schools served by high-need districts.”
The mental health professionals serving students in those districts, according to the guidelines, “shouldreflect the communities, identities, races, ethnicities, abilities, and cultures of the students in the high-need districts, including underserved students.”
“We considered appealing, but the reality is that they just erased this whole grant, and everybody is in the same boat,” interim Supt. Moses said. “This isn’t a case of ‘we picked on you because you’re doing something wrong, we picked on you because the grant is going away.’”
Looking forward, board member Gonzalez-Hoy said, “We must just continue to reassure our students that even if we have less resources, we are here to support and protect them, and we will give them what we can with what we have.”
Other districts that received grants under the program are Trinity Alps Unified and the Wheatland Union High School District, both in Northern California. Also receiving grants are the Marin County Office of Education, Cal State East Bay and the University of Redlands, as well as two charter schools, Entrepreneur High School in San Bernardino and Academia Avance in Los Angeles.
Born and raised in the agricultural foothills of Tulare County in California’s Central Valley, Greg Salcedo attended the only K-8 school and high school serving his rural town of about 3,000 people, where everything seemed out of reach — backpacks and notebooks, teachers and administrators and, in particular, school counselors and social workers.
Friends and family, Salcedo said, never spoke about adolescent depression, anxiety, post-traumatic stress or suicide, issues that have, for decades, disproportionately affected rural, high-poverty communities in the United States.
But after the Covid-19 pandemic exacerbated a decades-long mental health problem in Tulare County — with psychiatric hospitalization rates for students 9 to 13 years old climbing 23% during the first year of the pandemic — Salcedo decided to pursue a master’s degree in social work. In his first year as a graduate student, he helped shape the county’s emergency response through Rural Access to Mental Health Professionals, a program that placed him as a student mental health support worker in schools serving his community.
“I was able to talk to students and set them up with resources, call parents to set them up for therapy referrals or services with outside agencies [and] do a lot of outreach to promote mental health,” Salcedo said. “Being in this community for so long has helped me have a better sense of empathy and understanding of these kids and what they’re going through.”
The program places early-career mental health workers in 33 of Tulare County’s high-poverty school districts. Through the program, Salcedo served a one-year unpaid internship at an elementary and high school in Tulare, after which he was hired full time as a social worker at a high school in the Tulare Joint Union High School District.
Participants are first- and second-year graduate students in social work who provide education-related services such as interim therapy and student group services, according to Marvin Lopez, executive director at the California Center on Teaching Careers, which helps coordinate the program. Since 2019, the center has supported 50 candidates through a $2.5 million grant from the U.S. Department of Education.
“In our district alone, we started out with three social workers last year, and now, we have seven new social workers that came on through the grant,” Salcedo said.
In 2019, Tulare County had a student-to-counselor ratio of about 870:1 — one of the highest in the state and well exceeding the recommended ratio of 250:1.
Districts in Tulare County have improved shortages of mental health providers using funds from the state. Tulare Joint Union High School District, for example, reported that the district’s student-to-counselor ratio improved significantly from 300 students per counselor in 2019 to 268 students per counselor in 2021.
But, few participants could afford to stay in the school-based mental health field after completing their unpaid placements, said Lopez.
“It became evident that we needed to support candidates to make sure we retain them,” Lopez said. “We began looking at resources like clinical supervision and additional training, but also financial incentives that can allow them to continue working at school sites.”
Last year, the center secured a $15 million federal grant to develop Preparing Rural Inclusive Mental Health Educators, a program that pays final-year graduate students a $45,000 stipend for a yearlong internship and a three-year commitment to remain in the field of school-based mental health care. To date, the center has sponsored 23 interns.
According to Lopez, these candidates are able to offer more long-term, advanced care, such as individual student therapy, group therapy, parent and family consultation and school faculty support. The center intentionally recruits from partner universities closest to Tulare County, such as California State University Bakersfield and Fresno State, whose students largely come from the rural communities they will serve.
Jeovany Martin, who completed his master’s in social work at CSU Bakersfield, was an intern in the program at a local elementary school. Martin was raised in neighboring Kings County by his Mexican immigrant parents, and he applied for the program to serve families whose needs have been shortchanged by language barriers.
“I’m able to relate to these students. I speak their language, and I’m able to communicate with parents in their language, which goes a very long way in creating a working relationship with them,” Martin said.
Martin said that the program was also his most realistic path to the field of education-based mental health care. Most providers are overworked and underpaid — with nearly 59% of school counselors leaving their positions in their first two years — and non-white, low-income candidates have much less financial and professional support to enter the field.
Nationally, most school counselors are overwhelmingly white, and they do not represent the backgrounds of the students they serve. For Tulare County’s student population — where nearly 80% of students are Latino — the two programs address a shortage of cultural competence in mental health support available to students, according to program supervisor Rosie Hernandez.
“We’re also having folks who are bilingual be part of our program because it allows families to be a bit more open to services because of that simple fact that they speak their native tongue,” Hernandez said.
Most children living in rural, low-income households, Lopez said, are also more likely to experience higher rates of anxiety, depression and behavioral problems, often due to stressors such as food insecurity, parental job loss and geographic isolation.
“We’re recruiting, preparing and supporting candidates from our own communities who represent our student population,” Lopez said. “That, in itself, allows our students to connect at a much higher level with our interns to bring them comfort, a space where they can interact and feel safe.”
A legacy of bias and neglect
Martin and Salcedo’s internships in Tulare County also provided the opportunity to tackle a decades-long legacy of mistrust between social workers and immigrant families.
“A lot of our families, especially from the Hispanic culture, think of social workers as ‘the people that take away my kids,’” Salcedo said. In his first year, Salcedo felt stifled by the number of permission slips that would have allowed him to help more students, but were returned unsigned. “Our job is also about breaking down that barrier and [explaining] our role for them to understand, ‘This person is here to help my kid with anxiety. They’re not here to judge me as a parent.’”
The National Center for Youth Law found that across the country’s child welfare, education and mental health systems, providers and educators have routinely over-referred Latino students for behavioral issues and subjected them to harsher disciplinary measures than white children. Black and Latino children were also found to be removed from their families and into out-of-home care at higher rates, while receiving fewer mental health services, such as psychotherapy and counseling, than white children.
Families that include at least one undocumented member or non-citizen — 14.3% of Tulare County’s overall population — are also less likely to opt into care if they rely on citizen children to receive basic benefits like food stamps and housing subsidies, which can be jeopardized by family separation. In a county where more than a quarter of residents receive SNAP food assistance, and two-thirds of these recipients are children, signing a permission slip could come down to what some parents feel is a calculation between their child’s mental health and access to basic services.
To address fears of bias and neglect, which remain the highest barrier for underserved communities to access to mental health care, program interns adapt a traditionally siloed approach in school counseling to work more directly with parents, caretakers and community support systems.
Salcedo, for example, partnered with the local Boys and Girls Club to run a regular backpack drive for students in the neighborhood. He also helped set up a resource closet at his school, where students frequently stop by for necessities such as food, school supplies and personal hygiene products. Most recently, he partnered with a local church to serve boxed meals to students at the end of the school day and to parents on back-to-school nights.
“We have this daily check-in routine with our students, where we say, ‘Whether you’re needing to talk to a counselor, or you just need some deodorant, a snack, or pencils, we can provide it,’” Salcedo said. “‘If you’re looking for housing, or babysitting, or transportation to get to an appointment, we can try to help.’”
Broader post-pandemic challenges
Martin, who was hired as a social worker after completing his placement, said that the need for broader support has especially spiked for K-8 students in Tulare County, many of whom lost crucial social and cognitive development to remote learning during the Covid-19 pandemic. Many of Salcedo’s high school students, he said, withdrew from their counseling sessions online — some did not have reliable Wi-Fi or could not turn on microphones due to chaotic environments at home, for example.
Many also experienced life-altering trauma as a result of the pandemic. They grieved family members, experienced debilitating illness and lost access to basic needs like shelter and food.
“That’s why it’s important for us to take a holistic approach,” Martin said. “We might be doing an intervention here at the school for the student, but there might be something going on at home that the family needs extra resources for. We’re able to help bridge those gaps, wherever they might be, for the students and their families.”
