Editorial: More school mental health counselors a good start. This should be next.

Seanna and Tom story from June:

COLUMBIA — Students’ access to mental health counseling in South Carolina schools has improved significantly in the last year, but much work remains to address the ongoing youth crisis, according to this week’s update to Gov. Henry McMaster. 

The number of mental health counselors in schools rose by 66%, to nearly 1,000 statewide, as of a January survey by the state’s Medicaid agency.

In all, 118 schools gained access to a mental health professional since last spring. And in 42 districts — up from 35 — every school has access, state Health and Human Services Director Robby Kerr wrote in a June 5 letter to the governor.

“South Carolina has made remarkable progress,” McMaster said. “However, our work is not done. We will continue to prioritize professional mental health counseling services for our students and look forward to seeing even more progress.”

The progress report comes a year after the governor ordered Kerr, who reports to him, to review mental health services in public schools and make recommendations on how to increase access.

Changes implemented last summer include giving school districts more flexibility to hire their own mental health professionals or contract with private counselors while increasing their reimbursement rates for billed services, reducing dependency on higher-paid Department of Mental Health counselors, according to the agency. 

As of January, there was one counselor available for every 829 K-12 public school students, an improvement from one for every 1,300 last spring. The long-term goal is a ratio of one for every 325 students, Kerr wrote. 

While the increase is encouraging, teachers haven’t noticed a difference yet, said Patrick Kelly, a high school teacher and lobbyist with the Palmetto State Teachers Association. 

“We’re just not seeing that trickle down to classroom interactions at this point,” he said, adding youth mental health issues are at a high he hasn’t seen in his 20 years teaching. 

“The governor’s right to call it a crisis,” said Kelly, who’s also an organizer for the state Coalition for Safer Schools. “There was some hope that coming out of the pandemic it would abate somewhat. But I think in some ways this year was even more challenging than the years immediately coming out of the pandemic.”

The improved numbers still mean 45% of school districts don’t have a counselor available in every school, meaning many students struggling the most still lack help in the place they’re most likely to seek it, he said.

Research shows children are 21 times more likely to access the services in schools than anywhere else, according to the state Behavioral Health Academy at the University of South Carolina. 

In his order last year, McMaster cited the rising number of children needing mental health services showing up in emergency departments. Other state officials noted the Medical University of South Carolina was seeing an average of six a day in the ER needing urgent mental health care.

Despite the state efforts, so far that number has not changed, said Dr. Christopher Pruitt, medical director of the Emergency Department at MUSC’s Shawn Jenkins Children’s Hospital.

“We’re still seeing the same amount of kids and still dealing with the same amount of issues, unfortunately,” he said. “Most are teenagers, but we get kids down to age 5 with these kinds of concerns.”

Pruitt regularly talks with ER leaders at other hospitals and said this is an issue for them, as well.

“We are certainly not the only ones dealing with this problem, even in our area,” he said.

Nationwide, children visiting the ER for mental health care rose 66% in 2020 compared to the year before, according to the Centers for Disease Control and Prevention.

Those problems didn’t go away. Nearly half of high school students expressed lingering feelings of sadness and hopelessness, and one in five contemplated suicide, according to a 2022 survey from CDC.

Part of what might drive kids to seek care in the ER is a lack of resources, particularly for lower-income families, Pruitt said.

Community counselors and primary care physicians can help families address these issues, and school mental health can be a “linchpin” for helping these students. Having more school-based services will certainly help, he said.

“I am optimistic that these efforts will lead to a positive change and impact for these kids and thus less emergency department” visits, he said.

Other efforts will also help. 

The state Department of Mental Health is working with a behavioral health coalition in the Spartanburg area to create a crisis diversion and evaluation program, including referrals from schools, to get kids and families to services without having to go to an ER to get urgent help.

The Legislature also lowered the minimum age for patients to be seen in crisis stabilization units from 18 to 5 so children can access those services, as well, said Mark Binkley, special projects manager for DMH.

State schools Superintendent Ellen Weaver said she’s encouraged by the progress. 

“Superintendent Weaver has long advocated for the harnessing of community partnerships to increase to these services for students,” said her spokeswoman Laura Bayne. “She is happy for the opportunity to collaborate with the governor, his team, teachers, and parents to support the well-being of every student.” 

This June:

UNDER EMBARGO Until June 14, 2023, at 12:01 a.m. ET Contact: Bett Williams, bwilliams@scchildren.org, 803-744-4042 Health Measures Drive Low Ranking for South Carolina Children Annual Report Released by the Annie E. Casey Foundation Shows Show Alarming Trends for Infants Born at Low Birth Weight COLUMBIA, S.C. — Several critical health indicators show opportunities for South Carolina to improve the health and well-being of its youngest citizens, according to the 2023 KIDS COUNT® Data Book, a 50-state report of recent household data developed by the Annie E. Casey Foundation analyzing how children and families are faring. Statistics for children born at low birth weight are particularly alarming. In South Carolina, 10% of babies born weighed less than 5.5 pounds at birth, putting them at higher risk for short- and long-term complications. A tiny baby may have a harder time gaining weight and fighting infections. In the long term, people born smaller are more likely to develop diabetes, obesity, heart problems and high blood pressure. All these outcomes put stress on families and have immeasurable costs to society. To improve maternal and infant health, Children’s Trust invests in evidence-based programs, like home visiting. “Home visitors work one-on-one with parents, connecting pregnant moms to quality prenatal care and giving infants a strong and healthy start,” said Sue Williams, CEO of Children’s Trust, South Carolina’s member of the KIDS COUNT network. “Investments in home visiting programs drive the outcomes we want for our mothers and babies.” Children’s Trust administers the federal investment for home visiting in our state, delivering Healthy Families America, Parents as Teachers and Nurse-Family Partnership. Only 10% of eligible families receive home visiting services. The annual ranking in the Data Book uses indicators from four key domains — economic well-being, education, health, and family and community — to produce an overall child well-being ranking for each state. South Carolina persistently sits in the lowest fourth of states, with this year’s ranking being 41st. In the health domain, South Carolina is ranked 47th. In addition to the high number of low birth-rate babies, obesity rates are also alarmingly high – 40% of children (10 to 17 years-old) in the state have a Body Mass Index at or above the 85 th percentile. The child and teen death rate is also concerning at 41 deaths per 100,000, which ranks 43rd in the nation. The 2023 Data Book also explores the lack of affordable and accessible child care and its effects on families and employers. With almost 15% of South Carolina children birth to age 5 living in families in which someone quit, changed or refused a job due to child care problems, the state ranks at the fifthworst in the nation. National indicators show that more than half of working parents report being late to work or leaving early at least once in the past three months for lack of child care. A quarter of parents reported that at some point they have been fired for it.

last year

Annual Annie E. Casey Report Shows South Carolina Experienced a 55% Increase in Children’s Anxiety or Depression

COLUMBIA, S.C. — Twelve percent of children in South Carolina have reported experiencing depression or anxiety in 2020, a 55% increase from 2016, according to the 2022 KIDS COUNT® Data Book. The 50-state report of recent household data developed by the Annie E. Casey Foundation analyzes how children and families are faring.

The annual ranking in the Data Book uses four key indicators — economic well-being, education, health, and family and community — to produce an overall child well-being ranking for each state. South Carolina persistently sits near the lower fourth of states, with this year’s rank at 39.

For the first time, this annual resource focuses on youth mental health, concurring with a recent public advisory by the U.S. surgeon general that current conditions amount to a “youth mental health pandemic.” The Data Book shows a national 26% increase in anxiety and depression reported among children ages 3 to 17.

South Carolina is one of six states that saw an increase of more than 50% in children’s anxiety or depression from 2016 to 2020. Other states with significant increases include Alaska, Arkansas, California, Massachusetts and South Dakota; the District of Columbia also saw such an increase.

“The pandemic has taken a toll on everyone, and the heaviest burdens often fall on the shoulders of children who rely on others to meet their needs,” said Sue Williams, CEO of Children’s Trust, South Carolina’s member of the KIDS COUNT network. “We are in an ongoing emergency, and we need to invest in young people and families so they can navigate these challenges and recover stronger.”

In addition, the child and teen death rate has increased by 13% in the past decade. According to the South Carolina Committee on Children, death by suicide is one of the leading causes of fatalities for children and youth ages 10-17.

The Annie E. Casey Foundation calls for lawmakers to heed the U.S. surgeon general’s warning and respond by developing programs and policies to ease mental health burdens on children and their families. They urge policymakers to:

• Prioritize meeting kids’ basic needs. Youth who grow up in poverty are two to three times more likely to develop mental health conditions than their peers. Children need a solid foundation of nutritious food, stable housing and safe neighborhoods — and their families need financial stability — to foster positive mental health and wellness.

• Ensure every child has access to the mental health care they need, when and where they need it. Schools should increase the presence of social workers, psychologists and other mental health professionals on staff and strive to meet the 250-to-1 ratio of students to counselors recommended by the American School Counselor Association, and they can work with local health care providers and local and state governments to make additional federal resources available and coordinate treatment.

• Bolster mental health care that takes into account young people’s experiences and identities. It should be trauma-informed — designed to promote a child’s healing and emotional security — and culturally relevant to the child’s life. It should be informed by the latest evidence and research and should be geared toward early intervention, which can be especially important in the absence of a formal diagnosis of mental illness.

As Children’s Trust develops its priorities for the upcoming 2023 legislative session of the General Assembly, the organization expects to focus on these issues.

The Data Book does share some positive outcomes for the Palmetto State. Most significantly, teen births have decreased by 56% since 2010, and there are 42,000 fewer children living in high poverty areas. There are also more parents employed full time and more teens who are attending school or working.

“While these are positive outcomes, if South Carolina wants to improve its rank, it must work to keep pace with other states, which have more children attending preschool and which are reducing the number of babies who are born at low birth weight,” said Williams.

Organizations and individuals who want to work toward building better futures for children and families are encouraged to visit scChildren.org and sign-up for our mailing list.

About Children’s Trust of South Carolina

Children’s Trust is the only statewide organization focused on preventing child abuse and neglect in South Carolina. It leads and supports a network that shares our belief that all children should thrive, live in secure families and be surrounded by supportive communities. Children’s Trust coordinates the state’s efforts for the Strengthening Families Program; Triple P (Positive Parenting Program); S.C. Adverse Childhood Experiences Initiative; Maternal, Infant and Early Childhood Home Visiting; Child Abuse Prevention Month; and KIDS COUNT. For more information, visit scChildren.org.

About the Annie E. Casey Foundation

The Annie E. Casey Foundation creates a brighter future for the nation’s young children, youth and young adults by developing solutions to strengthen families, build paths to economic opportunity and transform struggling communities into safer and healthier places to live, work and grow. For more information, visit aecf.org. KIDS COUNT® is a registered trademark of the Annie E. Casey Foundation.

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