Kurt Michael

Kurt Michael — project director of the Assessment, Support and Counseling Center and the assistant chairperson of psychology at Appalachian State University — speaks at the Aug. 12 Watuaga County Board of Education meeting.

BOONE — Mental health services for Watauga County Schools could experience a cut in staffing for the 2019-20 school year due to low productivity, according to Billy West, the president of Daymark Recovery Services.

Daymark contracts with WCS to provide mental health professionals who come into the schools to provide therapy services to students. In the previous year, WCS benefitted from six dedicated in-school mental health counselors from Daymark. In the coming year, the school system will only have one full-time and two half-time mental health professionals from the service provider, according to Superintendent Scott Elliott.

“With all of the emphasis we have been giving to school safety and to promoting the health and wellness of our students, it does not seem to make sense that we would be cutting mental health services,” Elliott said.

It had been thought by school staff that perhaps the staffing change was due to budget cuts that VAYA Health — the managing partner for Daymark — is planned to experience. VAYA Health could be experiencing a $9 million cut to funding by the state, said Brian Ingraham, VAYA’s CEO.

Ingraham explained that the N.C. General Assembly has continued to reduce single stream funding to Local Management Entity/Managed Care Organizations, including VAYA. This is the fifth year in a row that there have been reductions from the state, and Ingraham said that would add up to $57 million, including the amount VAYA plans to lose this year.

However, West said the staff reduction for the Boone Daymark location is a “rightsizing” action based on productivity and administrative overhead reductions, not the potential reduction in the state budget or any actions from VAYA.

“(VAYA has) not reduced any funding to us and worked with us and all of the other providers on a plan to curb spending growth but continue to make sure the needs of the community are met,” West said. “In Watauga County, we did it based on the data. It wasn’t enough business to justify more than one staff member.”

However, Elliott said WCS has a significant number of students who need these services, and he is concerned that fewer students would be served in the coming school year. According to Elliott, a Daymark therapist had to reduce the amount of time she was assisting students last school year due to the size of her caseload.

“We have a significant need that appears to be about to be unmet,” Elliott said.

Daymark has services located in roughly 40 counties. Not all of the counties have public schools that offer in-school therapy or day treatment programs; Watauga offers both.

West said one staff member provided by Daymark should be able to handle the case load WCS experienced last year. He added that staff should be able to obtain four hours a day of billing time, and employees from the Boone location in the schools were seeing closer to one hour a day of billing time.

“It’s not a reflection of staff or school; there may just not have been a need,” West said.

Elliott said the school system enjoyed a “fantastic” relationship with Daymark.

“We’ve worked very closely to try to meet the mental health needs of our students, and I hope that continues,” Elliott said.

School mental health services was a topic of conversation for the Watauga County Board of Education at its Aug. 12 meeting. Kurt Michael — project director of the Assessment, Support and Counseling Center and the assistant chairperson of psychology at Appalachian State University — addressed the board on the services the center provides. The ASC Center is a 13-year partnership between WCS and App State that provides Watauga High School students with mental health services.

Michael explained that in 2018-19, the ASC Center provided analysis of the local Youth Risk Behavior Survey, suicide prevention education, assessment, consultation, individual therapy and crisis intervention and safety planning. The center’s featured service is its cognitive behavioral therapy it offers to assist young people who are struggling with depression, anxiety or suicidal thoughts.

Michael pulled data from the 2018 YRBS — a national school-based survey that provides data on health-risk behaviors among ninth- through 12th-graders. This was the first year the survey was also administered to middle school students in sixth through eighth grade.

At 15.4 percent, 2018 data for WHS students was consistent with 2016 data showing students who seriously considered attempting suicide in the past 12 months. Proving to be higher in females and those who identify as non-white, 6.1 percent of the students said they had attempted suicide one or more times in the past 12 months. Of those between grades sixth through eighth, 17.2 percent had seriously considered suicide in the previous year — this percentage was higher for nonwhite students.

Michael explained that the ASC Center had served 397 students last year; this included 42 students who were involved with individual therapy, 55 student consultations, 41 students who were seen for a reported or referral related to suicide and 62 events (meaning students reported more than once).

Of those receiving services, 67 percent of students who started in a clinical range were significantly improved by the end of treatment, according to Michael. Data showed that 30 percent of students reported their status being unchanged, which means the symptoms did not get worse nor better, Michael said. In the case of the 4 percent that reported deteriorating post-treatment, Michael said staff would then refer them to more treatment or find a helpful alternative.

Additionally, Michael drew conclusions of how shows such as the Netflix series “13 Reasons Why” can impact a person’s ideologies of suicide. He explained that the show is a dramatization and fairly graphic depiction of issues that teenagers struggle with such as suicide, sexual assault, substance abuse and domestic violence. He presented four studies that examine the trends of suicide among youth after watching this specific series.

A determination that was made from one of the studies was that in the 19 days after the release of season one, there were 900,000 to 1.5 million more searches on topics like ‘how to kill yourself’ than before the release, according to Michael.

However, he said another study found that after the release of show’s second season, Netflix had partnered with Crisis Text Line — a help-seeking texting service that’s available 24/7. Michael said trends have been found that people are turning to resources like the Crisis Text Line after media exposure to events — such as the show or the deaths of Kate Spade and Anthony Bourdain — to process what’s going on. The Crisis Text Line has been exposed to some of the students at Watauga High School, Michael said.

The ASC Center is in the process of obtaining grants to expand its services to students. Michael said staff were able to obtain a $1.3 million grant from the Institute of Educational Sciences to provide intervention for youth across the multi-tier systems of support in the school system. This grant will be applied starting this fall.

“We remain committed to addressing the problem of suicide and general mental health and wellness of all Watauga students by sustaining this collaboration,” Michael said.

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