Despite new choices, need for mental health services outpacing supply

Feb. 19—When it comes to student mental health — as unlikely as it may sound — some area school administrators talked of living in a time of feast and famine.

"We have more money, we have more financial resources," Greater Nanticoke Area Superintendent Ron Grevera said, citing an increase in federal and state money for mental health and social/emotional learning programs since the COVID-19 pandemic struck in 2020. "But we can't find the people."

Wyoming Valley West School District Superintendent Dave Tosh noted a surge in resources beginning with the state's introduction in 2019 of the Safe2Say Something anonymous tip line, and extending into the more recent availability of web-based student support such as the Rhithm and Kooth programs, but also said it hasn't been enough.

"There has been a very significant rise in mental health concerns," he said, "And finding resources has become our biggest challenge."

What they've got

Long-time WVW School Counselor Shawn Kelly gave a rundown of new resources available to districts.

The web-based Rhithm system is being tested in the high school with a select group of students.

"We use it as a screening tool. There are five questions with emoji responses that the administration has access to. If they use the 'feeling down' emoji two or three days in a row, for example, we may meet and see if something is going on."

Questions are simple, like "how are you feeling?" or "how is your social life?" Answers are subject-specific. "Hungry" could be one answer for the former, "I have lots of opportunities" for the latter. If a student wants a little more help, "There are short calming videos that might suggest 'try this approach' to what they are feeling," Kelly said.

Students have daily access to Rhithm on their district laptops, but can simply choose not to use it. Parents can take an additional step to opt out and have the program removed completely. Kelly said that of about 400 students given the option so far, there have been zero opt-outs.

Kooth is also just in the high school, but is intended more for students to use whenever they want rather than at the start of the day. "There are three levels of therapeutic resources," Kelly said. "They can just read an article about a topic of interest," like having some anxiety. "The second level is moderated chats," where the student can more directly discuss issues online. "The third level is for students 14 and up. They can have a pre-planned therapy session set up through Kooth."

The district gets weekly reports from Kooth, so counselors or administrators can take additional action if deemed useful. Like Rhithm, participation is completely the student's choice, and parents can opt out. None have.

The programs can "help us understand the problems kids bring to school," Kelly explained. But Anthony Dicton, who has taken on multiple roles in the district including security coordinator, suggested they are in some important ways compensating for the decline in teachers due to both availability and tight budgets.

"If we could hire more teachers, they might pick out that student who needs help."

The District also formed a new mental health committee this year comprised of Dicton, counselors, school social workers, mental health specialists and teachers. "They meet monthly to look at initiatives" in helping students, Tosh said.

Plans call for a school climate survey to help learn what is working for students and what isn't. And an older program called BARK that tracks student use of district online offerings like email will soon be replaced with GAGGLE, expected to be more capable of detecting potential problems and relaying them to administrators to consider if someone should reach out.

That may sound a bit "Big brother," gut Tosh points to one case when BARK suggested a student might be experiencing thoughts of suicide. A local police officer met with the family and found problems the student was dealing with, and interventions helped resolve them. "I can't tell you how grateful we were that we found out."

Like many area districts, WVW uses a School Based Behavioral Health (SBBH) team of specialists who can work daily with students individually or in groups on problems, and connect them with other agencies or resources. WVW only has an SBBH at State Street Elementary, and Tosh said it works best when the specialists on the team stay on board long enough to develop a real rapport with students. But "turnover is an issue."

Despite all those assets, Kelly said "the sticking point is this. We provide everything we can for the moment, but can't provide the higher levels of interventions."

What they need

That dovetailed with much of what Greater Nanticoke Area Superintendent Ronald Grevera said. Asked about district efforts on student mental health, he gave many of the options other districts use — including a new grant to pay for a behavioral specialist, a new grant-funded part-time home school visitor to link resources to families in need, and a new in-school suspension program designed to teach students how to regulate behavior.

But he felt the other side of the equation is becoming more important: "Let's talk about the lack of resources.

"We contract with Northeast Counseling Services. We can only have a counselor three days a week. We really need a counselor every day to help kids with problems."

"In 28 years of education, this is probably the worst I've seen," Grevera added.

He cited, as did Tosh and Kelly, the closing of First Hospital in Kingston. "We no longer have a mental hospital for mental crises," Grevera said. "We have kids who end up at the Geisinger ER and wait in the hallway for hours for intake. When they don't have someone to help the kid, they send him home."

Tosh agreed. "I'm really concerned at the lack of resources for those who need 24-hour care." The district can do everything right during school, but "there may be nothing" for them once they leave the building. The nearest facilities akin to First Hospital are in Allentown and as far away as Pittsburgh, and parents may be understandably unwilling to send a child that far away.

Post-COVID behavioral issues

A growth in behavior problems has occurred since returning from COVID shutdowns and hybrid learning (some students in school and others at home), Grevera said, a point echoed by Kelly at WVW."I think we have at least three times as many issues, if not more. They are the same issues, but it's the quantity that just seems to increase."

Kelly added that even when all students returned full-time, COVID intruded, especially when teachers contracted the virus, requiring them to take a week off. "It became stop, go, stop, go" for the students.

The increase in student problems can cause a ripple effect, with more teachers deciding to retire or leave the profession, Grevera said. Couple that with a shortage of counselors and other professionals needed to help the students, and the problems compound.

Both Grevera and Dicton pointed to another, less publicized loss. Pre-COVID, Luzerne County had two Alternative Learning Centers for students with behavioral problems too disruptive for the regular classroom, one run by a private company in Edwardsville and one run by the Luzerne Intermediate Unit in Plains Township. Both closed, though Kelly said it probably had more to do with regulation changes by the state than the impact of the pandemic.

And Grevera said many overlook a lack of county resources impacting students. "A couple of years ago we had a Children and Youth (Services) caseworker embedded right here in the school. That's no longer the case. They are also dealing with a caseworker shortage."


School officials almost universally agree the real solutions are beyond any single district's ability. A replacement for First Hospital inpatient services, for example requires government or another health care provider to step in (Tosh and others pointed to Friday's closing of the state-run White Haven Center as an opportune location for student inpatient services). Dicton suggested in-school alternative learning programs could help fill the gap left with the closing of the two ALCs, if money and staff were available.

The Luzerne Intermediate Unit has dramatically increased behavioral health and mental health services, including the new Lighthouse Academy, though that has already used up what was once expected to be room for expansion.

But the bottom line may be that schools are simply being asked to do too much. Grevera noted how districts "have become more of a social institution than an education institution." It's a transition that encompasses using schools decades ago to spread vaccine use as a mandate for entry and as a nutrition outlet with subsidized meals. Then schools and teachers became mandatory reporters of suspected child abuse. Now they are becoming the nexus of mental and behavioral health diagnosis and treatment.

Dicton summed it up with a succinct — and cautionary — sentence.

"I don't know if we will ever have enough resources."

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Reach Mark Guydish at 570-991-6112 or on Twitter @TLMarkGuydish