Haley's Proposal Regarding Mental Health Resources at Schools

Context

Reference to a current Michigan bill or law that relates in some way to your proposal:

 

HOUSE BILL No. 5524: This bill requires the development or adoption of a professional development course for teacher on mental health first aid. It must include instruction on at least both of the following:

  1. Identifying potential risk factors and warning signs for certain mental illnesses such as depression, anxiety, trauma, psychosis, eating disorders, substance abuse and self injury.

  2. Strategies for helping students experiencing a mental crisis by listening respectfully, supporting the individual, identifying professional help and other resources for the individual

This bill relates to my proposal because it exemplifies the need for additional mental health resources. Teachers are being stretched too thin and their duties are expanding to things that are not in their job description. We need people that are aspiring to be, or are, licensed in mental health work to begin handling this problem in schools.

 

Why this proposal will make a difference in the lives of students of all ages across Michigan, or a significant subgroup (by age, background, economic status, and/or region, etc.) of students in Michigan:

This proposal would increase mental health services for those seeking mental health help in schools. The ultimate difference is that it would give students the resources they need to begin dealing with their mental health issues early on before they worsen. This proposal would not treat students with different socio-economic backgrounds differently. Every school would receive mental health resources.

How and where did you learn about the issues underlying your proposal?

I first learned about the issues underlying my proposal by looking into my University’s counseling services (CAPS) and a University club, Wolverine Support Network. I saw that the counseling services were understaffed and that it took around 3 weeks to get an initial consultation. Additionally, I saw that these services provided mainly only 3-4 sessions per students. I also saw that there was an overwhelming demand for the Wolverine Support Network services. While it is wonderful that so many people are seeking support groups, the lack of staffing and availability was concerning. Therefore, I began researching Michigan’s student to counselor ratios and the mental health services that k-12 schools provide. This was even more astounding; Michigan has the third highest student to counselor ratio in the country which led me to conclude that Michigan is behind on mental health standards in relation to the rest of the United States. I also found that on a student level, half of college students with a significant mental health illness, such as symptoms of anxiety or depression, did not seek help. This led me to research the stigma of mental health and the lack of resources for mental health issues in schools. From there, I came to my solution to make sure that every person aspiring to get their license as a licensed clinical social worker, psychologists and licensed therapists must perform 50 hours of pro-bono work in addition to their required hours of supervision. These pro-bono hours must be through Michigan public high schools to increase the amount of counselors and decrease the counselor to student ratio.

How has your service activity influenced your thinking about this proposal?

Through my service activity, I have seen how economic status and students’ backgrounds influence students' mental health or awareness of mental health. While I work with first through fifth graders (which is rather young) at Ericksen Elementary School for the Science Olympiad, I am still able to get a sense of how their upbringing and this school has influenced their mental health. Additionally, I was able to ask about the services they have for older students and how their school focuses on at-risk students. While this is a great and necessary focus, it has shown me that there is a lack of mental health education and known resources for non-at-risk students. For instance, at this school there are many underpriveledged children that have programs like Bright Futures to go to after school. However, the more fortunate children are less likely to go to these programs, so there is less attention on them in school because the teachers and staff believe these children are not in need of additional services. There are a few children I work with that go to Bright Futures, and I think this has made a big impact on them as they are gaining positive experiences and people are looking out for them. In our science olympiad group, these are the students that are stepping up and leading the group. Just becuase the other students are more fortunate does not mean that their home life or their mental health is automatically better. This has influenced me to focus my proposal on an increase in mental health resources at schools through the implementation of pro-bono hours for future licensed clinical social worker, psychologists and licensed therapists.

Link to your media artifact(s) giving background on the issue:

 

My Infographic: Mental Health Resources at Schools

 

Consultations

Talk directly with at least 3 real live people who have special knowledge about this topic or the impact your proposal would have, and summarize their comments. These may include people appearing in your media artifact (video, podcast, etc.).

CONSULTATION 1:

Christopher Kasper (Counselor at Pioneer): I wanted to interview a counselor from a high school in the area to get an inside look at the topic of mental health resources in schools. He mentioned that Pioneer High School has a better ratio than the state itself and that they have 1 counselor for every 310 students. Ann Arbor is a wealthier area in Michigan, and therefore, there are more resources and more funding to work with. Still, he explained that there is a lack of counselors and the waitlist to have an appointment with a school counselor is still problematic even with their ratio. He shared that most of the students he sees come in for anxiety, depression, academic struggles, or intrapersonal issues. He said that collaboration between teachers, parents and hospitals is key to having a successful mental health team at a school and to make the biggest difference in these kids’ lives. This made me think that I needed to find a solution that would help more than just areas that have money to spend. I wanted to find a solution that would be feasible in every area of Michigan.

 

CONSULTATION 2:

Anonymous high school student with mental illness that used their high school’s services: I wanted to understand the experience from a student perspective that went to a school counselor at my high school so I contacted someone I knew. He mentioned that the school psychologist handled more at-risk students or students that were misbehaving. Therefore, he went to the school counselor. He talked to this counselor once a week and this counselor worked with the hospital (that he was an in-patient at previously) to keep open communication and information flowing between the school, the student, the parents, and the hospital. The counselor was on a student-need basis and students could go to the counselor however often as needed. The ratio for my high school in Illinois was approximately 1:267 students so this service is an outlier and should be something that other schools strive to achieve. I wanted to find a solution that would help not only at-risk students, but also any student that needed or wanted to talk to someone about mental health. I also wanted to find a solution that would decrease the ration of students to counselors in schools and this consultation helped me come up with these desires.

 

CONSULTATION 3: 

Nicole Skinnion (Student leader for WSN and incoming director of leader development): This consultation was where I first started delving into my proposal on mental health. The information I gained from this consultation was what led me to look into the lack of mental health resources in schools. She mentioned that although CAPS has great counselors and they care deeply about students, the demand is too high for their capacity. It can take up to three weeks for appoint at CAPS and only 3-4 sessions on average for each student. Wolverine Support Network is getting almost too popular and shows the need for more services. WSN has grown exponentially since it started. They are expected to have at least 1,000 students involved next year and 1,500+ weekly groups held. In WSN, students come in once a week to talk about their week and debrief. WSN is not in place of professional counseling but it is a good supplement or place to vent even if you don’t need counseling. WSN is currently in the process of hiring new leaders to make sure they can accommodate the number of participants they’re expecting. Topics include schoolwork, friends, drinking, and uncertainty. Students join if they care about mental illness or if they have a connection themselves. The environment is conducive to all mental health statuses and the organization has a close relationship with CAPS.

CONSULTATION 4:

Lynne G Tenbusch (private practice psychologist): I wanted to interview someone within the field to see what they thought further perpetuates mental health issues. She mentioned that face to face communication is lacking. Because there is not as much of a personal connection between people, people are unsure how to deal with their emotions and internal issues. She explained that technology has created a barrier in between people and has made meaningful relationships more rare to come by. She believes that the lack of personal relationships have increased the amount of shootings and violence because these people are lacking the relationships that tie people together and create empathy. She suggested that counselors should do focus more on recognizing these issues and influencing people to make more meaningful connections, even if it is just a small gesture such as having dinner as a family with all technology turned off. Activities like this strengthen personal bonds and decrease the likelihood of violence. She said that a great way to decrease the use of technology and increase personal connections is by simply asking people how they are doing, asking caring and substantial questions (not surface level), and learning to have face-to-face communication. Counselors are able to focus on and understand the relationship between people’s development and technology (among many other things). Because of this, she believes that more counselors would be beneficial. This relates to my proposal because the more counselors and mental health resources are available at schools, the more chances students will have to talk out their problems face to face. From this, students will have the chance to release their inner tensions, and develop skills to increase their personal connections with people.

Prospectus:

Describe the specific issue or problem, being sure to provide sufficient context so that someone less familiar with the issue has a sense of the bigger picture, but know that your focus here is on a more detailed spelling out of the specific problem or issue that you’ve identified. (250 words minimum)


Adolescents’ mental health has recently become a significant topic, especially in the United States. Children with mental health issues are at risk for academic failure, juvenile disciplinary issues, and substance abuse issues. However, although this problem affects so many aspects of so many children’s lives (family and friend relationships, grades, extracurricular involvement, etc.), the lack of awareness and the stigma surrounding mental health make it difficult for these adolescents to get help. In fact, 17.1 million young people have or have had a diagnosable psychiatric disorder, and about one in five students in U.S. public schools have a mental illness. However, nearly half of all children with emotional or behavioral difficulties receive no mental health services (Simon, Pastor, Reuben, Huang, & Goldstrom, 2015) and only 7.4% of young people report any mental health visits in the past year (Merikangas et al., 2010). These statistics display the enormous stigma attached to mental health, and the lack of education regarding how to get help or how to support those with mental health issues. A Michigan poll found that “82% felt that training about mental health issues would be beneficial for school staff” (Summary Report 2010 Michigan Parent Opinions). However, teachers have many other roles and demands that take up their time and this is stretching their responsibilities too thin. We need to rely on professionals so that students can get the quality help they need. While high-risk students generally have some degree of support at their schools, there is a lack of support for middle class students that do not show warning signs based on their socio-economic status or family situation. On average, there is one counselor for every five hundred students. In the state of Michigan, there is on average, one counselor for every 729 students. Not all schools have a psychologist; although these professionals are usually an important aspect of support students should have at their schools. Ideally, schools would have counselors, nurses and psychologists all working together to provide a full mental health support team. Therefore, the lack of resources at schools, as well as the large amount of students not getting treatment for their mental health problems is creating an epidemic in today’s society. By increasing the prevalence of a full mental health team at schools as well as educating and de-stigmatizing mental health, we can encourage students to take the steps they need for their own specific situation to combat mental health problems from becoming more harmful and prevalent in adolescents’ lives.

Potential Solutions:

Describe three reasonable, feasible potential solutions or approaches that would help address this problem.

SOLUTION 1:

Solution #1

One proposal I think would be beneficial is to mandate a mental health unit that schools would be required to teach in their already required and existing health classes. I think this unit should be aimed to be taught around 7th, 8th, or 9th grade so that all information gained from this unit could be put to good use, and so that students know how to deal with mental illness before their illness becomes more severe and reduce the risk of their mental illness being left untreated (in most cases, mental health issues start at around 14 years old). This mental health education will give students the knowledge and resources they need to recognized the early signs of mental health issues and how to get help. I think a unit on mental health could work to de-stigmatize it by educating kids and helping them understand the causes of mental health as well as what steps they should be taking should they experience certain symptoms or emotional issues. This possible solution is less costly than others, and it allows every student, regardless of whether they have mental health or not, to be educated on the topic, and know what resources are available to them or others they know. It also enables students to learn the environmental and biological causes of mental health issues and enables them to learn the warning signs and better support their piers going through these issues. One of the biggest issues regarding mental health for young adults is that they do not seek out help even though they need it. In fact, nearly half of all children with emotional or behavioral difficulties receive no mental health services (Simon, Pastor, Reuben, Huang, & Goldstrom, 2015). This could be a result of stigma surrounding mental health issues, or just a lack of education of the subject. This solution can at least help educate all students, better advertise the mental health services available to them, and hopefully work to de-stigmatize mental health.

 

SOLUTION 2:

Solution #2

Another solution is constructing a program that allows college students to be trained by professionals and go to k-12 schools around the area for support group sessions in which k-12 students can confide in these college students and the college students can provide guidance and an open ear. This program could allow for both individual and group therapy options to cater to the k-12 student preferences. This program will take place at the k-12 school at least once a week. While these college students definitely would not suffice as therapy for any k-12 students that have serious mental illnesses, it would be a great support network for k-12 students that are struggling, need a mentor or need someone to talk to. I am basing this idea off of the club, Wolverine Support Network that aims to “empower University of Michigan students to create an inclusive community and support each other’s identity, mental well-being, and day-to-day lives through peer-facilitated groups and bi-weekly community events”. Mental health is often escalated or onset by relationship issues, lack of friends or lack of a supportive family. Therefore, having a supportive community and a safe space to discuss real issues can be a great way to improve students’ mental health. Additionally, having a college student facilitate these conversations can ensure that k-12 students are having productive and open dialogues. This program would be relatively cheap compared to other alternatives with the exception of potential costs from training or holding social events for these k-12 students. The only drawback is that a program like this may be limited to places that are relatively close to a college campus. However, if this is viewed as a big issue, the program could be changed so that it is not college students facilitating these support groups, but instead professionals or students themselves. Bringing in professionals to facilitate may increase the cost of the program, and some age groups may not be old enough to facilitate conversations themselves and/or want to talk to someone one on one instead of their peers. This is why I have intentionally decided on college students as being the best option for the program to be administered state wide to decrease costs and increase community connectedness.

SOLUTION 3:

Solution #3

The last solution I have created is focusing on creating a larger team of social workers, psychologists and other mental health resources at schools. There are around 1503 students for every 1 school psychologist in the state of Michigan on average. There are 729 students for every 1 school counselor in Michigan- This is the third worst student to counselor ratio in the country. Michigan would need 1,757 more school nurses just to meet the federal recommended staffing level (according to a 2014 Michigan-based survey). If we estimate paying around $50,000 per nurse per year, it would take $88 million a year just to get up to the amount of nurses recommended for Michigan. Therefore, it might be unrealistic to rely on complete funding from the government. So in order to create larger mental health teams at schools, schools should have better connections to hospitals and outside resources. Aspiring licensed clinical social workers, psychologists and licensed therapists must perform 50 hours of pro-bono work at a public high school in Michigan in addition to their required practice hours and hours of supervision. These pro-bono hours must be through Michigan schools to increase the amount of available hours of mental health resources that are provided at schools and decrease the counselor to student ratio. This would ensure that students would have more accessibility to mental health resources regardless of their economic status. This would be a way to avoid excessive costs while still greatly expanding mental health resources to students all over Michigan.

Reaction or advice from a Topic Coordinator:

You must solicit a critique from a topic coordinator, and explain the impact that advice has had on the final draft of this proposal.

During office hours, I was told that it is important to find something slightly unique and exciting to get the class on board as well as to spark the interest of the Legislature. Because of this, I decided to go with my solution of pro-bono hours rather than my safer, more conservative solution of a mandated mental health unit in already-existing school health classes. My topic coordinator, Glen, also mentioned that the more people I talk to, the better. Therefore, I changed my research strategy and focused more on asking community members about their thoughts and experiences and focused less on researching articles online. However, he mentioned that statistics and Michigan specific evidence is important to have, so I made sure to devote time to researching those things as well. His advice impacted the way I researched my topic and encouraged me to stray away from the safer option. He told me to take a chance with my final solution as long as it was still well researched and I had evidence to back up my claims and projections Research process:

Describe your research process — indicate who you talked to (including but not limited to consultants), what you read, what your thinking was, how it changed over time, and how your consultants changed your thinking. This description of your research process definitely could include “dead ends,” or ideas you had that didn’t ultimately bear fruit.  In short, we want to know what you did and how it led to your legislation, and we also want you to give us a window into your thought process.

I began my research process by analyzing the mental health resources at the University of Michigan and consulting a student leader of WSN that knew about CAPS and WSN. Through this information, I found that there was a significant shortage of mental health resources for students. I then shifted my research to k-12 schools and researched specifically Michigan statistics. I found that Michigan had one of the worst student to counselor ratios. I also researched more and found statistics that identified the problem. I found that many students did not receive help early enough or at all. Throughout my research, I tried to find statistics that were specific to Michigan and compared them with other states to highlight the issues I wanted to solve with this proposal. Additionally, I tried to relate my solutions to things that worked in other states or in other fields. In doing so, I came to my solution of requiring 50 pro-bono hours at a public high school in addition to the other hours these mental health professionals must complete in order to get licensed. I was looking into a few other solutions as well. I really liked my idea of a mental health unit that would be taught in health classes already existing at schools. I liked this idea because the infrastructure was already there and the cost would not be that high because the only thing needed that was not already in place was a mental health curriculum that would be school specific in relation to which mental health illnesses affected their community the most. However, I found that this proposal would likely not gain backing because it was safe and not necessarily unique. I was also looking into my second solution in depth, but I found that this solution could be done without the help of the government so I decided it was not the best course of action. I also looked into requiring pro-bono hours for already licensed mental health professionals. However, I thought that there would have to be an incentive such as tuition forgiveness or something similar. This would entail government subsidies for public schools and it would not translate to private schools. Therefore, this solution would cost more money, there would be more strict mandates, and it could not be equally implemented since the government could not control the private colleges and make them participate in this tuition forgiveness incentive. As a result, I found that my current solution was my best option.

Author contributions:

Please delineate--in detail--who made what contributions to the process and to the finished proposal? Who took on which responsibilities in researching ideas, drafting language, etc.?


I do not have a partner, so I did all the work myself.

===FORMAL PROPOSAL===

The sections below should comprise your final proposal language, submitted for consideration by your peers and potential inclusion in the MSC Platform.

Preambulatory clauses

These set up the PROBLEM, but not the solution.

WHEREAS....the student to counselor ratio in the state of Michigan is the third highest in the country; 1:729.

WHEREAS....half of all lifetime cases of mental illness begin by age 14.

WHEREAS....recognizing that there is a lack of early intervention when it comes to mental health education and action.

WHEREAS….17.1 million young people have or have had a diagnosable psychiatric disorder, and about one in five students in U.S. public schools have a mental illness.

WHEREAS....nearly half of all children with emotional or behavioral difficulties receive no mental health services.

WHEREAS….1,410 people in Michigan died by suicide which is the second leading cause of death for ages 15-37 in 2017.

WHEREAS….House Bill No. 4091 is insufficient; asking teachers to take on more responsibilities that are not in their original job description is like asking lawyers to also take on the responsibilities of an accountant.

(Add more "Whereas" clauses if necessary.)

Operative clauses

These describe in detail, the solution you are proposing (not the problem itself; those should go in the "Whereas" clauses above).

THEREFORE BE IT RESOLVED....

1. All aspiring licensed clinical social workers, aspiring psychologists and aspiring licensed therapists must render at least 50 hours of pro-bono work at a public high school in addition to their existing required practice hours and hours of supervision in order to be licensed.

2. The structure should be similar to the teaching certification process; teachers need a certain amount of student-teaching hours before becoming a teacher.

3. These hours would be rationed out so that each counselors’ required hours do make a difference. To go into greater detail, these aspiring professionals will come in for an hour to two hours each week for around 50 weeks. There are 36 5-day weeks of school in a year. Therefore, the students assigned to these aspiring professionals would have them for at least a year, which would ensure permanence for the children receiving therapy and will also ensure that these hours will be effective for the aspiring professionals as well (they will not be able to just complete these hours in a matter of a week).

4. This bill will reduce the student to counselor ratio in Michigan, increase the amount of available mental health service hours at schools, and increase early intervention for students with mental health problems.

5. Half of all lifetime mental health illnesses begin by age 14, and seventy five percent of these begin by age 24. However, it takes 8-10 years for people to deal with these mental health issues. By increasing the amount of mental health services in schools, mental illnesses will be dealt with at an earlier stage when symptoms are just beginning and as a result, the gap between onset of symptoms and intervention will decrease.

 

(Add more "Resolved" clauses if necessary.)

Counter-arguments:

What are three reasonable arguments against this proposal?

1. Aspiring licensed clinical social workers, psychologists and licensed therapists will not want to do work unpaid. The additional pro-bono requirement will decrease the amount of people interested in pursuing these careers and therefore worsen Michigan’s problem with understaffed mental health teams in schools.

REFUTE: Most of the people in these above fields pay a lot for education. Undergraduate degrees are anywhere from 54,000 to 145,000 dollars from a four year school. A masters in social work costs another 35,000 dollars on average. These people are also aware that they will not be paid a lot in their field (the average counselor makes 47,460 dollars annually) and that their job is hard and has a high turnover rate. Therefore, since most people are not in these fields for the money, and most are in these fields to do good and help people, this requirement will not stop people from becoming licensed clinical social workers, psychologists and licensed therapists.

2. There are many people that need pro-bono services in the state of Michigan, not just students.

REFUTE: While this is true, Michigan has the third worst student to counselor ratio in the United States and most mental health issues begin at an early age, around 14. Currently, many students do not receive the help they need and this affects them later on in life. The average delay between onset of symptoms and intervention is 8-10 years. Therefore, mental health professionals need to focus on children to encourage early intervention so that these statistics can decrease and so there are fewer adults needing to seek these services in the future. Employment falls sharply as mental illness severity increases. So if people learn to manage their mental health issues at an earlier age, there will likely be less people unemployed and less people on welfare which will actually save the government money and boost the economy as a result of increased employment in the state of Michigan.

3. Aspiring licensed clinical social workers, psychologists and licensed therapists are unqualified to serve our youth.

REFUTE: Increasing mental health resources in any way will help the issue of understaffed mental health teams in schools. These aspiring professionals have had schooling specific to mental health issues and are able to practice in the real world to complete their existing required hours. Therefore, they should be trusted with counseling children in schools as well to gain their ground in this field.

  Costs and funding:

What will your proposal cost (in direct expenses, lost tax revenue, lost economic opportunity, and/or non-monetary costs)? How will you pay for your proposed legislation? Where will/could the funding for your proposal come from?  Who might object to dedicating resources to your proposal (competing interests)?  

Implementing pro bono hours for licensed clinical social workers, psychologists and licensed therapists costs nothing and it helps students that cannot afford private counseling as well as aiding understaffed schools that need a bigger mental health team. Each aspiring licensed clinical social worker, psychologist and licensed therapist must render at least 50 hours of pro-bono public services at a Michigan high school. This means that it is on the individual’s own time to complete these hours to become a licensed clinical social worker, psychologist or licensed therapist through LARA and not through any additional or supplemental organization or government program. Currently LARA (the Department of Licensing and Regulatory Affairs) is responsible for the state's regulatory environment. They oversee the licensing and regulation of more than 1.2 million individuals and entities on an annual basis including the licensing of psychologists, social workers and counselors. Therefore, there is already an existing system that will oversee these aspiring professionals' hours. Aspiring licensed psychologists, social workers and counselors are all required to perform about 2,000 to 4,000 hours on average before they are licensed in their field. Therefore, the additional 50 hours will also be overseen by LARA, in the same way their existing hours are monitored and there should not be significant additional costs involved.

References:

These can include websites or other information you have found about the issue.

https://childmind.org/downloads/2015%20Childrens%20Mental%20Health%20Report.pdf

http://www.parentactionforhealthykids.org/sites/default/files/report_on_mental_health_survey_of_parents_final_12-28-11_1.pdf

https://www.edweek.org/ew/articles/2018/02/28/michigan-house-moves-along-5-mental_ap.html

http://www2.ncte.org/report/new-york-state-requires-mental-health-education-students/

http://probonocounseling.org/about_us/frequently_asked_questions

https://www.americanbar.org/groups/probono_public_service/policy/aba_model_rule_6_1.html

http://www.9news.com/article/news/education/mental-health-education-required-for-new-york-students/73-489238713

http://hls.harvard.edu/content/uploads/2008/07/guide-pro-bono.pdf

http://www.michigan.gov/documents/budget/FY19_Exec_Budget_613184_7.pdf

http://www.michigan.gov/som/0,4669,7-192-47796-455893--,00.html

https://www.bridgemi.com/economy/students-left-little-guidance-high-schools

http://www.apa.org/about/offices/ogc/apa-aba/index.aspx

https://www.nimh.nih.gov/health/publications/treatment-of-children-with-mental-illness-fact-sheet/index.shtml

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2713574/

http://www.legislature.mi.gov/documents/2017-2018/billengrossed/House/pdf/2018-HEBH-5524.pdf

 

 

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Total votes: 31

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