Billings high schools each got a new counselor who specializes in mental health this winter. And their caseloads are already full.
In some ways, that’s a good thing, Skyview counselor Tina Boone said. It reflects that more students are willing to seek help for an often-stigmatized health problem. But one counselor per school isn’t enough, she said.
Six Skyview students attempted suicide last week, according to school records. And that’s only the number of students that school officials know about.
“I’m more worried about the kids who attempt, and then boom, they show up at our school Monday morning,” said Boone, who heads Skyview's guidance department. “We don’t know; teachers don’t know.”
That was an unusually high figure for Skyview, she said. But it illustrates why School District 2 is asking for funding for two more positions as part of a levy up for a vote this spring.
Nationwide, schools provide more mental health services than any other outlet, said Billings Clinic Pediatric and Adolescent Psychiatrist Eric Arzubi. In part, it’s a more accessible and less obtrusive environment.
“The chances of someone seeking out and getting help is much higher in a school building than in a community setting,” Arzubi said.
Arzubi, who’s well-versed in mental health statistics, nearly fell out of his chair when he heard Skyview’s weekly suicide attempt figure.
“The fact that (new counselors) filled up in four months — kind of important to note,” he said. “This is a crisis.”
District officials have said that their options are maxed out, from a budget standpoint. Without the levy they can’t hire any more specialized staff. In Montana, school districts that want to increase budgets about state-mandated minimums have to ask local taxpayers to raise taxes. Maximum budgets are also capped by the state.
“I guess in the end, as a community, you have to decide if you want to stay on the offensive or defensive,” Arzubi said.
It’s not just struggling students who deal with mental health problems.
Boone had a group of high-achieving students who regularly ate lunch in her office eight years ago and found conversations about school pressures "astonishing."
“They always kind of forget that you’re there,” she said. “They really had no clue how to go about relieving that stress or dealing with it.
“They literally are taking all their energy, smiling and pretending that everything is fine, but then they go home and they crash.”
About half of the U.S. population will develop a mental illness at some point in their lifetime, according to the CDC. About half of those cases begin by age 14. And about half of students 14 and older with a mental illness drop out of school, according to the National Institute of Mental Health.
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A 2015 survey of Montana high school students showed that almost 9 percent of students attempted suicide and almost 20 percent of students seriously considered it.
“To think that this only is (an issue) of these clusters of suicide, no. To think that this only is (an issue) of violence, no,” Arzubi said.
When problems manifest themselves in ways like anxiety causing stomach aches, students can miss class. Behavioral problems stemming from aggression can land students in detention.
“On a whole, mental illness does negatively impact school performance,” Arzubi said.
Specialized counselors offer more help than what a typical guidance counselor is trained to, and they typically handle a caseload of about 30 or 40 students.
Skyview mental health counselor Erin Bratsky, who was hired in January, said that she usually tries to meet with a student for a time as long as a class period.
Traditional guidance counselors are supposed to focus on things like scheduling, career planning and testing.
“We can help them with some things, but we don’t do therapy,” Boone said.
“I think that demand for mental health (resources) is beyond what one therapist can do here,” Bratsky said.
It can be more difficult for parents to accept that their kids need help than it is for kids.
“I think sometimes it’s the adults in their lives that just tell them to suck it up,” Boone said.
While many parents are proactive, some won’t even take children to the hospital after a suicide attempt.
“If your kid has a heart attack, do you not take them to the hospital?” Arzubi said.
The Yellowstone Youth Crisis Network, a collaboration between several community groups, works to coordinate resources. A coordinator for the network, housed in SD2’s administrative building, works with students and families to connect them with resources before a problem becomes a crisis.
SD2 opened its first school-based health clinic at Orchard Elementary this year, which Arzubi visits. It’s a model more popular in several other states, and a host of research calls for additional mental health resources in schools.
For now, SD2’s resources are tapped out, officials said.
“You can’t take care of everything that you need to,” Boone said. “You need more bodies.”