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The first time Kristy Collier's daughter flew into a manic rage at school, the teacher and school leaders weren't prepared to handle her screaming or chair-throwing.
By the time Collier arrived, the worst was over. Her daughter, removed from the classroom, had crashed asleep in the nurse's office. Bruises on her wrists were the only tangible sign of the struggle.
It was the beginning of a cycle that brought Collier back again and again to the Hopkins-area elementary school. In the course of that school year, she took time off work on 78 days to deal with her daughter's outbursts. Her boss eventually threatened to fire her, but she was already feeling the impact.
"As a single mom, every time I leave work, that's money lost," she said. "That really counts."
It's a problem statewide for parents of children with mental disorders and for schools with little to no expertise in mental health care. Former Gov. Tim Pawlenty attempted a solution in a set of mental health reforms in 2007, which paid for school districts to hire mental health providers and help teachers develop action plans when children have outbursts. Thousands of students have since used the service, but the funding stretches only far enough to cover 17 percent of the state's schools right now, and it was nearly eliminated altogether in 2011.
On Tuesday, Collier and others testified before the House Health and Human Services Policy Committee in favor of a budget proposal by Gov. Mark Dayton, which would double annual funding for these school-based mental health services and expand them to a third of the state's schools.
Collier's daughter is now 16, and her early struggles occurred before state funding began. Had the services been available, Collier said, they might have prevented many of the crises her daughter experienced in class, as well as the teasing from classmates and other problems that ultimately prompted her to drop out of that school and fall behind academically.
"We're hearing about all of these incidents on a daily basis now," Collier said. "It's really time that we start to have the conversation. Let's figure out what we can do about it."
Signs of success
Dayton wants to increase funding beyond the current annual amount -- $4.7 million -- by 50 percent next year and to double spending every year after that. The proposal needs to be tempered against state budget constraints -- and the public appetite for possible tax increases to pay for any expansion of state-funded services. But Sue Abderholden of the National Alliance on Mental Illness said school-based services have proven their worth over the past six years and have even reduced state spending in other areas, such as special education.
About a third of the sickest kids -- those whose mental disorders required hospitalization or round-the-clock care initially -- showed significant improvement after four months of treatment including school-based services, she said.
Schools, she added, can be a gateway to mental health care. Half the children who received school-based services did not have any prior diagnoses, Abderholden said.
"Schools are where kids spend such a huge percentage of their time," she noted.
Private and public insurance plans cover many of the direct mental health services and counseling provided to children in schools, but not all of them.
Principals report fewer outbursts and suspensions, as well as improved attendance and academic performance among children receiving school-based mental care, said Tom Steinmetz of the Washburn Center for Children, which receives state funds to provide school-based mental health services in several metro-area schools. Nationally, only 15 percent of children referred to mental health services actually follow through and receive those services, he said. Among children referred to Minnesota's school-based providers, 85 percent receive some form of help.
Lawmakers at the hearing expressed some concerns, including whether the grants are spread evenly among urban and rural districts. The House author, Rep. Jim Davnie, DFL-Minneapolis, said there are gaps in the state, but they aren't defined by geography. The Anoka-Hennepin district receives none of these funds right now, for example, despite concerns about recent student suicides. Davnie wants a quarter of the grant funding to go to districts where poverty limits access to mental health care and schools that report high rates of using restraints to deal with agitated students.
Rep. Glenn Gruenhagen, R-Glencoe, worried about some of the questionnaires administered in schools, such as the Minnesota Student Survey, that probe students about suicidal or depressive tendencies.
"It was as if they were looking for ... problems," he said.
Abderholden stressed that the confidential surveys are a separate issue and aren't what prompt schools to identify individual students in need of help. Most students receive services either due to noticeable problems in class or referrals by teachers, parents, school counselors or others.
Jeremy Olson • 612-673-7744