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Addressing mental health in public schools poses a challenge for staff and psychologists

As students have returned to school this year, mental health issues related to the pandemic are surging.
Cavan Images RF/Getty Images
As students have returned to school this year, mental health issues related to the pandemic are surging.

"Kids have reported to me that (the) pandemic has ruined their life," said Desire DeSoto, a counselor at Waiʻanae Elementary School.

For 27 years, DeSoto has helped Waiʻanae's students with their academic and personal needs. The last two years have been the most challenging for children and the community, she says.

"There is a lot of depression and anxiety. There was this going on before the pandemic, but the pandemic just kind of exacerbated that."

Nikki Kiliona, a counselor at Waiʻanae High School, says she's noticed the pandemic has stalled the social growth of students.

"I had a 10th grader run away from me the other day, and I thought I was being punked... I was escorting him, and he ran," said Kiliona. "The child-to-adult relationship is weird, like we're not even authority here. You can tell the kids don't respect adults like how it used to be."

Nationally, educators and school staff are noticing the same behaviors and effects on their students.

"The pandemic has made, because of the isolation and other associated components — uncertainty, anxiety — mental health challenges have gotten worse," said Alec Marentic, a nationally certified school psychologist based in Pāhoa.

Counselors are often the "go-to" source at schools for helping students academically and addressing mental or behavioral issues. DeSoto and Kiliona tell HPR it's "easier to list what counselors don't do."

However, the increased need among students is having an effect on educators and staff. DeSoto tells HPR that prior to the pandemic, her caseload was 30 students.

Today, it's 460.

"Personally, this is the closest I've come to just saying, it's time for early retirement," said DeSoto. "Because the need is so great, and I don't feel like I can fill it. I'm just putting out fires everywhere, and not really feeling proactive."

But there's another resource available to public schools.

"A lot of what school psychologists do is consult with teachers and administrators, and try to put in positive behavior supports in the classroom," said Leslie Baunach, a board member for the Hawaii Association of School Psychologists.

Some of this work includes building multi-tiered support systems for classrooms.

While counselors are the first or second to respond to student needs and challenges, Baunach tells HPR that psychologists can assist in working with students and their families with their mental well-being.

However, there are other challenges these professionals face.

"We're not really perceived, at least in my experience, as school-based staff," Marentic tells HPR. "So our schools don't necessarily look at us as theirs."

This could be due to a lack of understanding of what school psychologists can do.

Baunach tells HPR that school psychologists are trained to help schools implement multi-tiered systems of support. These are systems that not only provide a better learning environment for students but also provide support to their emotional and mental well-being.

She tells HPR that these systems have been applied in several schools in the state, going as far back as 2011, but it's still not widely used. She says the state Department of Education is now looking to these systems to address the impacts caused by the pandemic.

However, these professionals are not usually tasked with implementing these systems. Marentic says they are mostly used for other, smaller aspects of their job.

"So much of my time is taken up by special education evaluation components — whether that's meetings, doing evaluations, report writing, whether that's eligibility meetings, et cetera," Marentic tells HPR. "In the first month of school, I had 20 evaluations open. So more than 95% of my time is taken up by doing the least favorite part of my job."

Baunach and Marentic tell HPR this could be addressed by discussing how school psychologists can be useful in school districts and individual schools.

But the biggest challenge to this resource is a shortage of these professionals in the state. The National Association of School Psychologists recommends a ratio of one psychologist for every 500 students.

At the start of the 2021-22 school year, Marentic says there were roughly 60 school psychologists working in the public and charter school systems. That equates to a ratio of roughly one psychologist for every 2,900 students.

Baunach says this is due to two factors: licensing and money.

"We're the only state in the nation without a credential for school psychologists," she said. "Because we can't get licensed here, we've had colleagues that move to other states, and they'll say your years of service don't count in Hawaiʻi because it was without a credential."

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Hawaii Association of School Psychologists
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The Keiki Caucus introduced a proposal that would have given these professionals a state license in the last legislative session. However, the measure wasn't approved due to questions of who would be responsible for licensing these professionals, and whether or not there needs to be a study before creating a new regulated profession in the state.

Several education advocates have told HPR that they are hopeful the measure will be discussed again in the next session.

Another challenge is money. School psychologists aren't part of the collective bargaining unit associated with teachers and other DOE staff.

"Our contracts aren't negotiated with the Department of Education," said Baunach. "What happens is we don't pay very much either, comparatively with the high cost of living."

DOE: Network of services available

The state Department of Education has been getting reports from schools that more students are being referred to support services — such as counselors.

But the department is in the process of finding out how extensive the need is, and what students are experiencing.

"Our schools are trying to learn more about that by screening their students," said Annie Kalama, assistant superintendent at the DOE's Office of Student Services. "They're doing a screening three times a year. This screening captures their understanding of application of social and emotional competencies."

These competencies are categorized in areas of sense of belonging, self-management, social awareness and emotional well-being.

Kalama says the results of this screening will allow teachers to better understand their students' needs, and how to provide assistance through lesson plans and other class activities.

DOE says there are a variety of mental health services available for students
Morning Edition on HPR - Oct. 4, 2022

But when it comes to what services are available to students now, Kalama tells HPR there are a number of options.

One is the use of school counselors. The other is the Hawaiʻi Keiki program.

"That provides access to health services, and this does include mental health referrals. There's also the Hawaiʻi Keiki hotline, which is available to families," said Kalama.

Another resource is a telehealth service through a DOE contractor Hazel Health.

"This program provides supplemental supports to families and students, and provides, in some cases, immediate access to mental health services," Kalama tells HPR.

The DOE is working on another resource for students in the form of a smartphone app. Kalama says the app would help students access social and emotional learning supports and activities. It is expected to launch sometime next year.

The DOE believes these resources, combined with the implementation of school support systems, provide a wide net of assistance. However, Kalama acknowledges there are challenges to making this network wider — mainly capacity and staffing.

"We train [educators and staff] every year on identifying youth at risk of suicide. That's one of the things that's ongoing and will continue," said Kalama. "Also building our internal capacity by building staff members, or adding staff members."

Kalama tells HPR the DOE has received two grants from the U.S. Department of Education and the U.S. Department of Health and Human Services to expand staff capacity over the next five years.

Parents and students can find out more about these services through their school's administrators.

When it comes to school psychologists, Kalama says the department recognizes their importance in providing tiered supports to students and training or consulting with school faculty. But she adds that it's up to the schools on how they are utilized.

"We're looking at changes that might allow them to refocus on that training, or refocus on the duties or responsibilities, or area of expertise — which is not particularly in the area of assessing students," she said. "That is something that they can do, but to refocus them on a more preventative approach, I think is what we want to do."

Updated: October 4, 2022 at 9:47 AM HST
The story has been updated with a response from the state Department of Education.
Casey Harlow is an HPR reporter and occasionally fills in as local host of Morning Edition and All Things Considered. Contact him at charlow@hawaiipublicradio.org or on Twitter (@CaseyHarlow).
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