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RUSD mental health clinics address students' emotions, trauma

The Journal Times - 3/5/2023

Mar. 5—RACINE — Everyone agreed the problem needed to be addressed, but they had to figure out how.

About a decade ago, Racine school officials and community members were determining how to assist students dealing with mental health challenges. After many discussions, the Racine Unified School District opened mental health clinics in schools.

The first two clinics opened in 2015, and nine schools now have clinics staffed by a full-time therapist.

The clinicians aim to help students better handle the emotions caused by life's stresses.

"We're here to talk and figure out how we go about life," said Derek Alcala, school-based therapist at Park High School.

Addressing the mental health of students is crucial because that is foundational to learning.

Students ages 6-17 with mental, emotional or behavioral concerns are three times more likely to repeat a grade, according to the National Alliance on Mental Illness. High school students with significant symptoms of depression are more than twice as likely to drop out compared to their peers.

"If I am feeling well, I can do all the other things better," said Andrea Rittgers, RUSD executive director of student services. "If I am sad, I'm not going to do math as well. If I'm angry, I'm not going to read as well."

Student-led sessions

The mental health clinic at Knapp Elementary began in fall 2016, and Kristine Jacobs has been its school-based therapist that entire time.

Jacobs said student challenges include anxiety, depression and anger. Many kids also are dealing with trauma caused by violence.

Children and teens could have post-traumatic stress disorder if they have lived through an event that could have caused them or someone else to be killed or badly hurt, according to the U.S. Department of Veterans Affairs. Studies show that about 15% to 43% of girls and 14% to 43% of boys go through at least one trauma.

Alcala and Jacobs are employed by Children's Wisconsin but work every day in Racine Unified schools.

Therapists work with school counselors and social workers to determine which students could be best aided by therapy. Most therapists have between 25 and 35 cases at a given time. Those could involve individual work, group therapy or family therapy.

Therapists generally meet with students multiple times each month but not every week. Jacobs, for example, had 95 sessions per month in recent months.

"It's a little bit of a juggling act," she said.

All sessions are confidential and usually last 30 minutes for elementary-schoolers and 45 minutes for high-schoolers.

The length of time therapists work with students depends on their needs, and clinicians let students lead the way before making a mutual decision to end the sessions.

"They're the drivers in all of this," Alcala said. "We're the passengers trying to help them with the map and say, 'OK, this is where we're going,' but ultimately they're the ones who know best what they're looking for."

Therapy may also include several episodic sessions.

For example, Jacobs is working with a fifth-grade student who began seeing her as a kindergartener. The student has not been in therapy that entire time but has worked with Jacobs as needs arose over the years.

Jacobs mainly uses family therapy because Knapp students are ages 11 and under.

With family therapy, parents and students talk with Jacobs about goals they want to achieve and how to reach them. She often tells participants that they will all learn as they go.

"There's no one way to do this," Jacobs said. "We're just going to figure it out as we go along."

Jacobs sometimes uses family therapy so a student will open up.

"If a child is reluctant, having their parent in session with them modeling openness" can help, Jacobs said. "They can see, 'It's a thing we do in this family. It's an OK thing.'"

'A needed service'

One of the newest RUSD mental health clinics is at Park, where Alcala is working with about 25 students.

The clinic opened last fall, and he said building administrators and educators have fully supported him.

"Everybody knows it's a needed service," Alcala said.

He appreciates that the clinic is in the school, which makes therapy more accessible.

"It just makes mental help so much more normal, that it's OK to be stressed, it's OK to have anxiety, it's OK to be depressed," Alcala said.

Some students don't know what therapy is, so he offers explanations during initial meetings.

"When it boils down to it, I think it's really just people interacting," Alcala said. "It's a conversation."

Most of his sessions have been one-on-one, but Alcala anticipates more group therapy sessions in the future involving multiple students who are likely facing similar challenges and can support one another.

To assist students, it is essential to know them as people.

Alcala asks high-schoolers about themselves, what they are expecting from therapy and how he can help them.

"It's more or less getting to know them," he said. "'Who are you as a person?' as opposed to, 'What are we focusing on at this moment?' because we'll get there. It's really just being a person who they can trust."

"I'm going to sit and listen to you and be with you wherever you're at and stay there with you," Jacobs said. "Whatever they bring to the meeting is where we go."

Jacobs has elementary-schoolers fill out worksheets that include questions about their hobbies, favorite music and food.

She has pictures of thermometers students can color to illustrate the intensity of their emotions. Kids can also draw on an outline of a body to show how their emotions manifest.

The clinicians noted the importance of therapy providing a quiet, stable place for students.

"I really try to make my office a sanctuary," Jacobs said.

Challenges, rewards

Therapists also train school staff on trauma-informed care, and Jacobs said knowledge of mental health has improved at Knapp since she started working there in 2016.

"Having a therapist in the building, we could start conversations about behaviors," Jacobs said. "Let's talk about the behaviors and what emotions might be driving them, and (there was) just a whole infusion of mental health into the building."

Therapists said the main challenge is the lack of time to address everyone's needs. Demand is high for therapy, but with only one clinician at each school, not all students get the help they would ideally receive.

"We only have so much time in our schedule," Jacobs said. "There's only so many hours in a school day. It goes fast."

It can also be difficult for clinicians to not allow job stresses to affect their personal lives.

Their work can be "heavy, and learning to find something that makes you happy" is key, Alcala said.

Alcala and Jacobs rely on family support to maintain their own mental health, which is vital to doing their jobs well.

The most rewarding aspect is when therapists feel they assisted clients on their life journeys.

"You feel for these families, and you want good for them, so to see gains and progress, you really are along with the ride for them," Jacobs said. "It feels so good when things happen in these families, and they did it themselves. You feel proud right along with them."

Alcala and Jacobs both graduated from Racine Unified and find fulfillment in helping their hometown.

"Being able to give back to your community, being able to see students who look like you, talk like you, and seeing them and being able to help them" is gratifying, Alcala said.

More to come

Rittgers said RUSD plans to add at least two more mental health clinics in schools during the next few years.

Rittgers said there are many challenges to helping students, and not everything goes perfectly, but clinicians and school staff are working to provide assistance.

"We are always here trying to support our kids and our families," Rittgers said. "It's not always the best way and not always the right thing, but it is always with positive intent."

Julie Hueller, RUSD manager of the Racine collaborative for children's mental health, said the clinics show what can happen when the community and schools work together.

"We're always looking for different, innovative approaches to addressing the mental health of our kids and our community, so this has been one great example of what collaboration can do," Hueller said.

After opening the mental health clinics nearly a decade ago, RUSD plans to continue aiding students going forward.

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