On one of the last afternoons of the school year, five women sat around a table in an Amana Elementary classroom, trading tips and making plans to meet the mental health needs of their school district's students.
As school counselors, four of the women are divided among Clear Creek Amana Community School District's elementary schools, where they work with students navigating growing pains as well as more pronounced issues such as homelessness or transience.
Leading the weekly discussion was Chandran Lapel, one of two licensed therapists who works full-time in the rural Eastern Iowa school district.
She and the counselors discussed quiet, cozy places in their schools where overwhelmed students can escape - and why such spaces should be accessible to all students, not just those with significant issues.
'You want to provide those tools for every single kid in the district, and not just the ones that are identified as having the behavior problems,” Lapel told the group. 'Because really, there's kids that I can think of who don't necessarily have any behavior problems, but they're going through a lot right now with family things.”
'Even if they're not going through something right now - eventually they will. We all do,” added Peggy Somerville, a counselor at Clear Creek Elementary. '…
It's not a very good message to be like, ‘Only some people need coping strategies.' ”
The school district added Lapel and Lindsay Miles, a licensed master social worker, to its full-time staff last school year in an effort to address the mental health needs of its students.
The rural school district in Johnson and Iowa counties is one of the first Iowa public school systems to make full-time therapists available to any student deemed in need. The district has hired a third therapist who will start in the 2019-20 school year.
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Other school districts have taken notice of the unusual staffing, Student Support Services Director Barb Hunt said.
'We don't typically have licensed therapists in a school building,” she said. 'I think that part is what's more intriguing to other districts. They hadn't really thought about having them on our staff.”
School counselors have long been at the forefront of schools' approach to students' mental health, said Aimee Hospodarsky, immediate past president of the Iowa School Counselor Association. Approaches like Clear Creek Amana's are becoming more common, she said.
'I think you'll be seeing more of that, especially after this past legislative session,” Hospodarsky said, referring to the passage of the first-ever statewide children's mental health system. 'I think that this is something schools will be continuing to look at - how to provide school-based mental health.”
A frequent barrier, she said, can be funding the positions. In Clear Creek Amana - where counselors are paid annual salaries between $50,000 and $57,000, according to the district - Hunt said funding for the positions is sustainable because the therapists are paid primarily with state dollars earmarked for services for students considered at risk of dropping out.
That pot of money is growing in Clear Creek Amana as the district's student population explodes - it is expected to grow by 250 students every year for the next five years. State education funding primarily is allocated on a per-pupil basis.
Hunt, though, said she believes any school district, regardless of its size or growth, could identify funding for similar positions.
'When it comes to funding, that's just called ‘being creative' in every district,” Hunt said. 'This is sustainable. It's an integral part of our infrastructure.”
Shifting focus from academics
Schools have long been expected to focus solely on student academics. That was how Clear Creek Amana approached students, Hunt said, until they realized their data was pointing to a lack of socio-emotional support - what she calls 'the other half” of students.
Schools across the country are grappling with how to respond to the baggage students bring with them to class. A healthy body of research suggests childhood trauma - which includes events such as emotional neglect, separation from a parent and witnessing domestic violence - can make it difficult for affected children to succeed at school.
Children who have experienced one or more traumas are more likely to fail a grade, score lower on standardized tests and to be suspended or expelled, according to studies conducted in Washington state, which began studying the issue years before Iowa, Liz Cox, the executive director of Prevent Child Abuse Iowa, told The Gazette last year.
Washington state's data also shows children with seven or more traumatic events - known as 'adverse childhood experiences” - are nearly guaranteed to have a developmental delay, Cox said.
Elementary schools in College Community School District, in nearby Cedar Rapids, were the first in Iowa to become trauma-informed schools. Trauma-informed practices emphasize understanding why a student is misbehaving rather than on reactive punishments.
Administrators in Clear Creek Amana chose to make new personnel investments in students' mental health needs after reviewing office referral and disciplinary data, as well as student surveys that included questions about how students feel at school - calm? anxious? safe?
'We're going to truly do therapy,” Hunt said administrators decided. 'It's not that they're doing interventions in the classroom, they're not (answering) when there's a behavior happening in the classroom. That's not what their purpose is.”
Instead, Lapel and Miles work with their caseload of students while providing professional development for teachers - many of whom, Hunt said, were not trained to respond to students' emotional needs. The district's rapid growth made that apparent, as staff searched for ways to be proactive about new families' needs.
'We have families that just come in and go, ‘Help,' ” Hunt said.
'We want to be able to have those resources to connect them (to what they need). To support that family - I think that's what we're here for. We want to make sure that we're making well-rounded young adults, and if we're only focusing on the academic side, we're missing a very large portion.”
Addressing academic struggles
Lapel and Miles spent several evenings this spring talking to parents about the work they do with students.
'We have a lot of students who don't come to school because of anxiety, because of symptoms of depression,” Miles told a group of a dozen adults in a high school classroom one Tuesday in April. 'We have a lot of kids who come to school, but they struggle significantly in an academic setting - whether it's just shutting down or having outwardly defiant or difficult behaviors.”
Mental health manifests in the classroom in many ways, she said, and it's an issue schools nearly everywhere are trying to address. Often, they lack staff.
For every one counselor in Iowa, there were 418 students in 2015, according to the American School Counselor Association. The recommended ratio is 250 to 1.
'We strive for proactive supports,” Iowa School Counselor Association's Hospodarsky said. 'But sometimes when you have a large number of students, you can get caught in a crisis response type of thing. That's not the most effective way to work with kids.”
Having additional professionals on staff can improve that ratio, she said, as well as remove some students' barriers to therapy.
'As opposed to outside, contracted organizations coming in, this allows us to approach mental health with a more inclusive, holistic perspective,” Miles told parents.
Lapel, who works primarily with the district's elementary students, has a caseload of 25 students in three schools.
Students' paths to a therapist's office most often begin with a teacher or parent referral.
Once students join Lapel's roster, they see each other once a week. Lapel said she does 'play therapy” with most of her young clients and emphasizes body regulation, such as taking deep breaths or lying beneath a weighted blanket to calm down.
Elementary students often don't understand what feelings are, what they mean or that it's OK to talk about them, she said.
As a staff member, she also has open access to the adults who interact most with her clients - their teachers, counselors and principals. Lapel previously had sessions with students in another Iowa district as a therapist employed by an outside agency.
She believed she made progress with students then, she said, but had no influence over their day at school once a session ended.
'Being connected to the school is a whole different level,” Lapel said.
'I love doing therapy, but I also really wanted to touch on that other piece - the systemic piece of what can a district do, district-wide? …
This (position) gives me both of those things together, and I feel like I can do more for that kid or that family.”
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