Public Schools in Nebraska Work to Destigmatize Mental Health

May 28, 2019, 6:45 a.m. ·

(Photo by Brandon McDermott)

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May is Mental Health Awareness Month around the country. NET News is focusing on mental health issues for the next several months. We look at how public schools in Nebraska are trying to destigmatize the perception of those dealing with mental health problems.

Jen McNally is a mental health coordinator and psychotherapist based out of Lincoln.

Suicide rates per 100,000 population for people ages 10-24 has nearly doubled from 2013-2017. (Courtesy Nebraska Department of Health and Human Services)

She started work with Educational Service Unit (ESU) 5, which covers three counties and is headquartered in Beatrice in 2017. ESUs in Nebraska are like an agricultural cooperative for public schools. ESUs pool funds together and contract out to school districts for special education, professional development, technology assistance and integration. McNally says mental health awareness is somewhat new. Her job wasn’t easy at first.

“How can I come from Lincoln, into these rural towns, where they know everybody and destigmatize mental health?" McNally said. So kids are going to be engaged with speaking to me – and staff are going to see the value of the program?”

McNally says the first step to destigmatizing mental health is to understand depression isn’t always what you think it is.

"Depression doesn't always surface as ‘this is what it looks like only.’ We have kids that are high ability learners, 4.0 students, multiple sport athletes who have a lot of pressure and feel stressed out," McNally said.

She’s seen a big difference in students’ mental health since she started. There’s also been an increase in interest from the school districts in ESU 5. Next year, eight of the ten school districts within ESU 5 will have a licensed mental health provider working with their schools; that’s a boost from the five that started last year. Matt McNiff is the director of special education at ESU 5. He says before McNally came in to help ESU 5, the need for mental health services for students was “extremely unmet.”

Breakdown of suicide rates per 100,000 population by area in Nebraska of people ages 10-24. (Courtesy Nebraska Department of Health and Human Services)

"She made the program acceptable and accessible for all the students," McNiff said.

McNiff says that started with the work to destigmatize, by being active in the schools and being seen by the students regularly.

"She made it so that mental health was more mental wellness," McNiff said.

The work McNally has done in ESU 5 has reached other ESUs across Nebraska. Five other ESUs around Nebraska have reached out to McNally to have her work with them, by visiting their schools, training their teachers and developing best practices. The needs and resources in each ESU are as varied as the demographics and area they cover. Some school districts have as few as 150 students from kindergarten through 12th grade, some districts support many more. ESU out of Fremont has two “Social and Emotional Navigators” working with students to identify their mental health needs. ESU 11 in Holdrege has one mental health practitioner and a psychologist working with the 13 school districts they support. ESU 15 has four mental health practitioners working with four-out-of-nine school districts. Omaha’s ESU supports 52,000 students, while the ESU for Lincoln Public Schools supports more than 41,000 students. OPS and LPS have more resources than smaller ESUs in Nebraska.

One program being utilized by ESUs around the state is called “Adverse Childhood Experiences”. It’s a survey offered to students which focuses on traumatic events for children. Experiences range from physical, emotional abuse to sexual abuse, as well as whether a child’s parents divorced or if they have parents incarcerated. Katie Carrizales is the director of behavioral and mental health for ESU 13 in Scottsbluff. She says the survey has been helpful and so has having a mental health provider right in the schools.

"If we have our providers in a school districts and they're just a part of the school system, I think it's going to be much easier for youth to feel the comfort in asking for help," Carrizales said.

ESU 13 has three mental health providers supporting 14,000 students and 14,000 square miles in the panhandle. Carrizales says those providers have to deal with a variety of situations, including ones rooted in trauma. She says trauma causes students to respond in one of two ways: by externalizing like disruptive and destructive behaviors or by internalizing behaviors like anxiety and depression.

A look at the suicide rate per 100,000 population breakdown of people ages 10-24 in Nebraska. (Courtesy Nebraska Department of Health and Human Services)

"So the behavior itself is really the tip of the iceberg. So it's all the stuff that's happening underneath that we can't see that causing it," Carrizales said.

Carrizales says often times that includes a history of hurt, loss or mental illness.

"If we as the adult can connect to the root cause and not focus on just the presenting behavior, which in itself will defuse the scenario," Carrizales said.

She says when it comes to mental health diagnosis and treatment – rural areas in Nebraska suffer from a lack of resources and clinics.

"What we've really realized within the Panhandle is we don't have the type of facility to treat higher level mental health behavioral needs and so what happens is our youth have to leave the area (and) they go to eastern Nebraska," Carrizales said.

Carrizales says that creates a burden on families. What could be a day service can turn into a residential placement because of the distance. Matt Blomsedt is the commissioner of the department of education in Nebraska. He agrees with Carrizales.

"We do feel like there have to be more resources, more equitably distributed resources – across the state. There are pockets of areas that may lack certain types of mental health provisions," Blomstedt said.

Blomstedt says the reality is Nebraska is not a one-size-fits-all type of state. He says that’s why it’s important ESUs have the ability to shape preventative mental health services for their communities. McNally says mental health issues can play into how a student is functioning and potentially be the source of suicidal thoughts or actions. In Nebraska, suicide rates among 10-to-24-year-olds have nearly doubled from 2013 to 2017. The suicide rate for people 10-24 in ESU5 is more than double the statewide rate (see inset pictures for data). McNally says one factor in this suicide rate hike is social media.

"What I was seeing when I was doing suicidal assessments within the schools is that 99 percent of the time I get directly related to social media," McNally said.

McNally says students are constantly scrolling their phones, from Instagram to Snapchat – even dating apps.

"Now what's happening is that kids are comparing their behind the scenes to all of these highlight reels," McNally said.

She says when the school day ended 20 years ago, kids could go home and get away from the stresses and pressures of school life.

"It's just a constant saturation of information," McNally said. "And then we want them to learn and be involved in activities and be positive 24 hours a day and that's unrealistic for kids."

McNally says the work to destigmatize mental health issues in schools – and in society – is hard. But the effort can be life-changing and life-saving.

"Kids who have been suicidal who have had active plans, who had attempted more than a handful of times in the past and watched them find hope…is the most powerful thing a clinician can ever experience in their career," McNally said.

McNally says childrens’ formative years have a direct effect on their mental wellness as an adult. She says schools can help their students get off to a good start on their lifelong journey toward mental health and wellness.

If you or someone you know may be considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (En Español: 1-888-628-9454; Deaf and Hard of Hearing: 1-800-799-4889) or the Crisis Text Line by texting HOME to 741741.