'How Can I Help You?' Schools Try To Reach Students Struggling With Mental Health During Coronavirus

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Even before the pandemic, thousands of Los Angeles Unified students were depending on the district for mental health support.

And it's clear that the need for those services during the coronavirus crisis is huge -- and growing.

With school campuses closed to slow the spread of COVID-19, districts like LAUSD now have to provide students mental health services remotely. But without face-to-face interaction with counselors or teachers, who are often the first to see signs of students in crisis, effectively connecting with struggling students has proven challenging.

"On a normal, given day, a teacher gets to interact with the student, and if a student is having a crisis, there's a way for that teacher to communicate to one of our mental health providers," said Tony Aguilar, LAUSD's Chief of Special Education, Equity, and Access. "Right now, our teachers could be experiencing that exact same scenario, but without a hotline, they didn't have a means to connect to somebody right away."

He said that's why LAUSD opened up a mental health hotline last month, connecting callers dealing with "fear, anxiety and other challenges related to COVID-19" to members of the district's Crisis Counseling and Intervention Services Unit, like Patrick McCauley.

He answers calls to the hotline in four-hour shifts from his garage. He likens it to "psychological first aid."

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It's not therapy, but "just very basic, helping assess their needs, helping people remain calm, or helping them regulate their emotions ... then really trying to get them connected with appropriate resources," McCauley explained.

Here's the thing, though: According to call data provided by LAUSD, the hotline received 581 calls last month -- and more than half of them were from callers seeking help with basic resources like food, diapers, or electronic devices.

McCauley says he's fielded a variety of calls, from a fifth grader worried about her parents to an older adult in search of a hot meal.

"It definitely reminds me how much need is out there," McCauley said.

Data provided by LAUSD (KPCC/LAist chart)

A little less than half of the calls were directly related to mental health concerns like anxiety, stress, sadness, or anger. District data show 36 calls were about someone in "crisis," meaning they were considered at risk of harming themselves or others. In those cases, psychiatric social workers may perform a risk assessment, or call 911.

Data provided by LAUSD (KPCC/LAist chart)

The district is quick to point out that the hotline is only one of the ways LAUSD is helping students navigate mental health struggles.

Even though campuses are closed, the district emphasizes that clinics, special education services, school-based providers and crisis counselors are still connecting with students virtually.

According to data provided by LAUSD, in a six-week span from mid-March to mid-April, when campuses were first closed to slow the spread of COVID-19, the district served more than 3,500 individuals.

"ERICS" refers to special education, "SB" stands for school-based, and "CCIS" is short for Crisis Counseling and Intervention Services. (Tables provided by LAUSD)

During the same six-week span last year -- long before campus closures, coronavirus, and social distancing -- the district provided mental health support to more than 9,100 through clinics, special education, school-based services, and crisis counseling.

LAUSD isn't the only district dealing with the challenge of serving students under the unusual circumstances.

I spoke with representatives from national and state associations of school psychologists, counselors, and social workers about what they and their members have noticed, too.

Jolene Hui with the California chapter of the National Association of Social Workers said members of her organization report that "students who were normally engaging just aren't anymore."

She thinks the distance plays a big role in that.

It's not as simple as waiting for a kid to call a hotline. The LAUSD hotline data also show that only 19 calls came from students themselves -- the vast majority were initiated by parents, teachers, and community members.

"Mental health with children is a little different because sometimes they can't verbalize that they're anxious, or having depression," Hui explained. "So I don't think they're as good at reaching out when they should be for those specific issues."

And even if a young person, family member, or school staff member realizes that something might be wrong, the student might not have a cell phone or internet-enabled device at home to communicate with a school psychologist, counselor, or social worker.

And even if they do have a device at home, there's the issue of trying to find a place to chat privately with a trusted adult.

"I have a student who talks to me in his pantry, surrounded by cans," said Rachel Andrews, a school counselor in Redondo Beach Unified and Los Angeles County area representative for the California Association of School Counselors.

When McCauley isn't doing shifts on the LAUSD hotline, he's performing his regular job as a mental health consultant assigned to Local District South.

When checking in with students over the phone, he finds himself asking questions like, "Are your parents right next to you? Are they hearing what you're saying? Do you want them to hear what you're saying? Or do you not? And if you don't want them hearing this, you know, how are we going to work that? Do you need to go to another space in the house?"

Aguilar, from LAUSD, says the district is trying to find ways to provide confidential counseling via telehealth.

While officials sort out when and how students and teachers will return to campus, Kathleen Minke of the National Association of School Psychologists says there's a lot at stake.

"Typically, [when] there's a hurricane, or there's a wildfire, or there's a school shooting, it's localized," Minke explained. "And there are lots of outside helpers. In this case, everyone is experiencing this ongoing difficulty and challenge ... And so, as school administrators, I think that we have to be thinking about, 'what's the long term plan here for recovery?'"

And what roles do teachers, psychologists, social workers, and counselors play in that plan?

Andrews, the school counselor, said even with a tough budget year coming, she thinks it's more important than ever that counselors have a presence in the classroom.

"To help normalize what's going on with students, to help process their grief, to hear their concerns, and to really just look at specifically how they're feeling and what they need from the school," Andrews explained.

Hui, from the association of social workers, said she believes the need for mental health services "will increase for a long time," and warns that if the trauma being experienced by young people is left unaddressed, that "can cause problems in the future, such as ... not finishing school, not finding work, not being able to function in relationships, not being able to function in society."

"So we could have major interpersonal difficulties on our hands after this if we don't help students," she said.

Or, as L.A. County Department of Mental Health director Dr. Jonathan Sherin told my colleague Robert Garrova, "the mental health pandemic -- is mounting ... it will grow and it will fester and will far outlast the public health pandemic."

For now, child psychiatrist Dr. Sheryl Kataoka, who works with LAUSD students, has advice for parents.

"If any parent out there sees that their student is really struggling, not being able to cope with this new normal that we find ourselves in, or have a change in behavior, or are becoming more depressed, sad, nervous, beyond what they typically see in other kids at home or at school," Kataoka explained. "They should definitely reach out."

That's why Patrick McCauley is still answering calls to the mental hotline from the workbench in his garage, one by one.

"Thank you for calling school mental health," he begins each time, purposefully warm and personal. "My name is Patrick. How can I help you?"

And then, he listens.

If you or someone you know is struggling with mental health, the LAUSD mental health hotline - 213-241-3840 - accepts calls from 6 a.m. to 6 p.m., in both English and Spanish.

Los Angeles Department of Mental Health also has a hotline which is staffed 24/7. That number is (800) 854-7771, or you can text "LA" to 741741.