Should every Colorado kid get a mental health exam after enduring coronavirus? It won’t be easy.

February 18, 2021

By: Erica Breunlin

Originally appeared in The Colorado Sun

Rep. Dafna Michaelson Jenet, a Commerce City Democrat, isn’t sure how to accomplish the logistics, but she thinks her idea is a matter of school safety and statewide health.

When Mark Sass has a parent-teacher conference these days, the discussion often isn’t immediately focused on grades. It’s focused on wellbeing.

“We need to lead with that mental health concern before we jump into the academics,” said Sass, a part-time social studies teacher at Legacy High School in Broomfield who also runs the Colorado branch of Teach Plus. The nonprofit educates Colorado teachers on policy and helps them engage with policymakers.

That mental-health-first mindset is reflected in many schools across Colorado and among some state lawmakers, including state Rep. Dafna Michaelson Jenet, a Commerce City Democrat who plans to introduce legislation providing every K-12 child in Colorado an optional mental health evaluation before the start of the 2021-22 school year.

“After being quarantined in our homes, and experiencing the traumas of COVID, every single one of our kids deserves to be heard from and (be) provided a warm handoff to a qualified mental health care provider in the community, should they need ongoing support,” she said.

Michaelson Jenet, a longtime advocate for more robust mental health services in the state, hasn’t solidified all the details behind rolling out a mental health evaluation for every kid in Colorado. The state’s public school system, alone, serves 883,281 students this school year.

In fact, the legislator may have just as many questions as answers about what a universal evaluation offering would look like.

“How do we do that? How do we pay for it? How do we stand it up? These are all questions that I’m trying to answer right now,” Michaelson Jenet said.

But she’s committed to figuring out how to make sure every kid at least has the option to get one ahead of the fall term. “We’re working really hard to figure out what is the right way to do that.”

She envisions her plan operating with a National Guard-like army of volunteers.

Michaelson Jenet is also working on another mental health measure, House Bill 1068, that would require health insurance companies to fully cover an annual mental health exam of up to 60 minutes. She brought the legislation last year, but it died after Gov. Jared Polis refused to sign any more measures during the pandemic that included insurance mandates.

Michaelson Jenet hasn’t yet introduced the student mental health evaluations into a bill, but she hopes to have it finalized in the next few weeks.

Sass acknowledges that mental health evaluations for students would be valuable, but he also has many questions about the details: Who will be proctoring the evaluations? What will the state, communities and schools do with the results? And how will students end up receiving critical mental health supports that they need?

“Who’s going to provide the necessary services for those students who we know are going to need support?” he asked.

Sass is particularly worried about trying to meet the needs of so many students at once.

“We just don’t have a system that will be ready to accept and assume responsibility for just thousands of kids who need this support,” he said.

Vincent Atchity, who leads Mental Health Colorado, said his organization supports the bill’s concept. The mental health advocacy group even considered whether vaccination sites should double as a place for people to check in with a counselor.

“We need to have this heightened awareness of the potential mental health needs of a whole cohort of kids of all ages,” Atchity said. “They’ve been bewildered and distressed for a whole year by this state of affairs. To think that we wouldn’t check in with them is kind of a catastrophic failure to understand human need.”

But like Sass, Atchity worries about the capacity of Colorado’s mental health care system to handle so many cases at once.

“I’ve never heard of anything this ambitious for mental health,” he said. “The question is just what is the capacity to meet the need.”

Amie Baca-Oehlert, president of the Colorado Education Association, shares that concern, especially after having faced the enormous responsibility of serving a mass of kids firsthand.

Baca-Oehlert previously worked as a school counselor at Northglenn High School under Adams 12 Five Star Schools, where she, alone, was responsible for helping more than 600 students.

“It’s very challenging as one person to meet the needs of 600 students,” Baca-Oehlert said. “And that reality plays out across a lot of our schools.”

Many of Colorado’s elementary schools don’t even have counselors on staff because districts can’t always afford to hire them, she added.

Mohamed Ibrahim has seen how much some of his peers have come to rely on help from school counselors and educators. Mohamed, a junior at Wiggins High School in rural Morgan County, said that all students felt mentally exhausted at one point during the pandemic and felt like “their lives were being halted.”

Mohamed, 17, sees value in offering mental health evaluations to all students but worries about whether they will prove to be an equitable resource across Colorado districts and accessible to all students, including minority groups.

The teenager, who is helping ignite a conversation on mental health among youth in Colorado, also wants lawmakers to include voices of his generation in their own conversations on tackling mental health. Young people are the ones who will be affected by decisions, he said, and so they should have opportunities to offer their input.

“I think the biggest thing is just understanding and really valuing youth perspective,” Mohamed said.

At least one district has already screened students’ behavioral health

Baca-Oehlert pointed to the direct ties between social emotional wellbeing and academic achievement. One can’t happen without the other.

“It’s very hard for students to learn when they are carrying around these big, heavy mental health burdens,” she said.

That’s why many Colorado districts have made social emotional health as much a priority as academics this year — if not an even higher priority.

Students who are grappling with mental health struggles are often in “survival mode,” no different than adults who are distracted by their personal lives and whose stress often interferes with their work performance, said Jamie Murray, behavioral health coordinator for Cañon City School District.

“If students are struggling in just maintaining on a daily basis,” Murray said, “it’s extremely difficult for them to excel in academics.”

Cañon City School District opened the school year with a narrow focus on its students’ social emotional health. The district created K-12 social emotional activities for all teachers to facilitate during the first two weeks of school, said Murray, who is a licensed school psychologist. Those activities largely centered on increasing connections and building genuine relationships. Teachers gradually introduced academics back into the school day, but the core focus remained on students’ social emotional wellbeing.

Cañon City School District offered mental health support to students in a variety of other ways, including by developing surveys for students — starting in third grade — and parents so that families could indicate how they were doing and students could request additional support. The district also offered social emotional learning virtual groups and classes, ensured a consistent check-in time between counselors and students, connected families to community resources and found opportunities to embed peer interactions in social emotional learning experiences.

Another key strategy for the district: a universal social emotional learning and behavioral health screening tool administered to students in October. The electronic questionnaire, composed of 34 questions and sent to students’ school email addresses, assesses students on several factors, including social skills, academic functioning, anxiety, depression, problem solving, self-advocacy, friendships, critical thinking skills and goal setting.

The district looks at results of the screenings broadly to better understand what students are communicating about school culture, socialization and their sense of belonging, Murray said. The findings help the district tailor curriculum, professional development and programs around social emotional learning and behavioral health, which includes substance use and mental health.

Additionally, Cañon City School District staff meet with students individually to check in and link families with community resources and services, such as therapy. Data from the screenings also helps the district pull together small-group interventions and identify whether certain grades of students are struggling overall, Murray said.

The screenings are a starting point for a conversation with students, she said.

“Our goal is not to label them or categorize or increase mental health stigma,” Murray said. “Our goal is to connect with students and provide an opportunity for students to share what’s working in their life and what are struggles for them in a safe and accepting environment.”

Murray favors expanding mental health evaluations to all Colorado students, noting the importance of being proactive when it comes to mental health. Half of lifetime mental health illnesses begin to show symptoms by the age of 14, she said, with 75% of lifetime mental health illnesses starting to reveal symptoms by age 21. Any type of screen that can help identify mental health challenges and link students with the appropriate resources is beneficial.

“Knowing in advance may potentially reduce the impact to a child’s daily functioning,” she said.