When therapist Andrea Patten met the elementary school boy, he couldn't sit still in class and frequently yelled and threatened classmates. Sometimes, he even threw chairs and desks.
After several conversations with him, Patten discovered he had recently been homeless and that his parents had their own mental health and chemical dependency concerns. Patten began addressing the issues through weekly therapy sessions at the boy's school in the Burnsville-Eagan-Savage district.
"I worked really, really closely with this child's teacher to help her understand his needs," said Patten, who is employed by Headway Emotional Health Services. Over time, "He just made a significant amount of progress."
And without on-site therapy, Patten added, he likely wouldn't have received professional help.
Patten is one of nine Headway therapists who worked in the Burnsville-Eagan-Savage district last year to meet the increasing mental health needs of its students.
The district has collaborated with the Twin Cities-based nonprofit for two years to provide kids with therapy and other mental health services that counselors and social workers can't offer. This year, the district will add four Headway therapists to its roster, bringing the total to 13. Every school in the district has a therapist or shares one with another school.
"Really, it's those mental health conditions that we're seeing quite a bit more of now than we ever have," said Dawn Willson, the district's health services director. "Will these type of issues affect … students in school? Absolutely."
Willson was instrumental in getting the therapists into schools, but it was principals in the district who asked that four more be added, she said. Principals said the Headway partnership was working well, and several schools had waiting lists.
"A lot of it is anecdotal, but what we've heard from families and some of the teachers and principals is that it's really, really been a success story," Willson said.
Districts including South St. Paul and Anoka-Hennepin also use Headway and its model of locating services on site.
Headway therapists have offices located at the school, preferably separate from administrative offices. They interact regularly with teachers and other staff to identify students with mental health needs and help solve the problems, said Pat Dale, Headway's CEO.
Of course, "The parents are an integral part of this," Dale said. Parents must sign release forms to allow their children to be seen by a therapist.
Therapists are visible in the hallways, so students can approach them with concerns about themselves or others. Because of this, "A lot of our referrals happen on the fly," Dale said.
The arrangement also makes things more convenient for families, Willson said. In the past, school staff would refer a student to a therapist across town for a behavior issue.
"What we were actually finding was we would make the referrals, but how many actually get there? How many actually follow through?" Willson said. "Whatever barrier there is to receiving those services, this way they're able to get that help they need right here."
Now, students can visit therapists during the school day, after school or before school — even over lunch. "A lot of attention is paid to minimizing disruption," Dale said, both for students and teachers.
Students are referred to therapists for many reasons, Patten said, with the most common diagnoses being adjustment disorders, depression, anxiety or trauma.
The partnership is cost effective for the district, Willson said. For insured students, Headway's billing department charges the insurance company directly, as would happen at a typical clinic. For uninsured students, Headway has a sliding scale and works out a payment method with families.
Most of the district's costs go toward additional services Headway provides, like having therapists attend teacher-parent meetings or give presentations to teachers, Willson said.
By hiring an outside agency, Willson said, the district avoids overhead costs — like hiring a billing person.
"If we were to come up with that entire cost, schools would find that nearly impossible," Willson said.
Both Dale and Willson emphasize that therapists don't take the place of guidance counselors. While counselors and social workers may have some training in dealing with emotional and behavioral problems, they're best at "dealing with academic-based interventions," Dale said.
Dale said that often, guidance counselors' response to having therapists at school is that "they're just relieved," he said. "They just don't have time to deal with these issues."
And Willson noted that the district's elementary schools haven't had school social workers or counselors on staff in the seven years since she's been there.
Dale said that the best thing about the collaboration is how it allows different parties to work together to help kids.
"I think there's a lot of hope that this is a magic deal … [but] there's nothing magic about this," Dale said. "The best thing that's going to come out of this is partnerships, where people with different skill sets … can work together with a common direction and common goal."