In the vast labyrinth of services for juveniles in need, perhaps no other organization is closer to the front lines than the school system.
During a normal school year, more than 50 percent of a child’s waking hours are spent in school. By age 10, a typical child will have spent some 6,000 hours in a classroom, or more than 30 percent of their waking life.
The more than 63,000 students in Volusia County Schools represent 90 percent of all children of school age in the county.
The criminal of today was more than likely once a child in the school system. As recent high-profile juvenile cases have made clear, that criminal may still be a child in school.
“The school system’s job is to prepare citizens to be contributing members of society. And, if we don’t do that, then there’s going to be big-time issues for society to have to deal with,” Volusia County certified school counselor Dr. Cheryl Taylor said. “That’s what we want to prevent from happening — besides the fact that it’s just the most humane thing to do.”
To achieve a safe learning environment, schools have been forced to step into the mental health arena. Since 2018, in the wake of the massacre at Marjory Stoneman Douglas High School in Parkland, Florida school systems have had a direct mandate from the state to address mental health in schools.
But, as with every other juvenile system we’ve inspected, schools face the dual challenges of high caseloads combined with less-than-adequate funding.
Funding and resources
“Unfortunately, the state of Florida as a whole suffers greatly in terms of services and resources provided to our students,” Rose Roland explained.
Roland is the Volusia County Schools assistant superintendent for Student Services.
Including adults, Roland said, “Florida ranks at the bottom in terms of per-person spending for mental health services.”
In fact, Florida is ranked dead last of all 50 states in mental health funding per capita, according to a December 2020 report issued by a statewide grand jury formed in the wake of the Parkland shooting.
Volusia County Schools spent around $2.4 million on mental health in fiscal year 2020-21, or less than a quarter of 1 percent of the total budget.
The district plans to increase that to more than $3.2 million in 2021-22.
In both years, nearly a million more dollars in state funding monies is provided to pay for school resource officers.
As the grand jury report notes, “It is clear to us that inadequately addressed mental health issues have the peculiar potential to spiral out over time into criminal acts and violent behavior resulting in serious injury and loss of life.”
Most of the state mental health allocation money goes to lowering the ratio of mental health professionals and counselors to students, a ratio that, in almost all cases, falls well short of national standards.
Volusia school counselors face caseloads of 400 students, and sometimes more, while school social workers have 10 times the recommended number of students to keep up with.
“The American School Counselors Association recommends a caseload of like 250 students per counselor, but we rarely see that across the country,” school counselor Taylor said. “Up until this coming year, there were elementary schools with 600 to 800 students, and there was only one school counselor.”
Although the district plans to place second guidance counselors at elementary schools with 600 or more students, caseloads for counselors in middle and high schools can still reach 500 or more students.
Since counselors are charged with the goal of meeting with each child at least twice a year, they may need to have some 1,200 meetings in roughly 180 days.
Florida’s less-than-competitive wages have also led to general shortages of counselors and psychologists.
“The deficit that we have in our behavioral health system is that what is provided, that cost, does not cover what it costs to pay qualified workers — a counselor with a bachelor’s degree, a therapist with a master’s degree. The numbers don’t add up,” House Next Door CEO Jennifer Nadelkov said.
As of 2020, the median salary for qualified mental health workers in Florida was $19.35 an hour, according to the U.S. Bureau of Labor Statistics.
What Volusia’s children are dealing with
Students are facing more challenges today than they were 10 years ago — data from the Florida Department of Health show that anxiety, depression, hospitalizations for self-harm injuries in ages 12-18, binge drinking, bullying, fighting, arrests and more, are all higher among Volusia County children than the state average, and in some cases, are increasing in frequency.
Around 30 percent of all children in Volusia have been exposed to four or more “adverse childhood experiences,” according to a 2020 Department of Children and Families study.
That means Volusia’s children are more likely than other children to be physically abused, sexually abused, or exposed to mental illness, emotional neglect, or emotional abuse at home.
The Florida Department of Education estimates 20 percent of students “experience mental health issues that interfere with school, and most will turn first to their school for help.”
A child doesn’t have to be diagnosed with a mental illness to have unwanted behavior: children’s brains just work fundamentally differently than adult brains.
Regulatory processes — like those that control impulse, emotions, and risky behavior, are undeveloped in the brain of the child, most noticeably in the limbic system and the prefrontal cortex.
Children are primed to take action, rather than think about the consequences, and have stronger emotional reactions than adults do.
Combine this natural childhood physiology with trauma — like that found in an unstable home — and a child’s already tenuous grasp on appropriate behavior is even more impaired.
“We know that trauma, in general, any kind of trauma, has the potential to deregulate emotions, which impacts overall functioning,” Nadelkov said.
“The brains of traumatized children function differently from that of other children, and they are less likely to distinguish between right and wrong, and more likely to respond inappropriately or in a manner seen as disruptive,” Clinical Mental Health Counselor Intern Lisa Rickman said.
Rickman has specifically dealt with traumatized children.
“Keep in mind, a healthy teen brain is still primed to seek reward, risk, and basically sucks at decision-making without the full use of the frontal cortex for executive functioning, anyway, so traumatized kids/teens are at a major disadvantage,” Rickman added.
Former foster parent Dena Scroggins knows this deeply — her three adopted children have a variety of developmental issues stemming from trauma. In 10 years as a foster parent in Volusia County, Scroggins has taken in 19 children, all who had varying degrees of traumatic experiences, she said.
“People don’t know what their traumas are. [One girl] was brought into my home at 21 months old and, at 21 months old, she weighed 19 pounds. Do you know what that means? That’s the size of a 12-month-old,” Scroggins said.
“She had cigarette burns all over her body. Nobody knows the amount of trauma that this kid has dealt with. And, yes, she explodes on me sometimes. But I love her with everything in me,” Scroggins added. “And there’s never going to be a moment that I stop fighting for her.”
This child has a lot of difficulty in school, she said.
In Scroggins’ experience, the schools are ill-equipped to deal with the special needs her kids have. Instead, Scroggins said, the child is often referred to the Child & Adolescent Behavioral Services unit at Halifax Hospital in Daytona Beach.
“When they do have a mental health crisis, they call the mental health professional out. They can’t even do anything with the child. They refer you out to Halifax, and then when you take them to Halifax, they don’t do anything,” Scroggins said.
Halifax Hospital’s mental health unit for children is one of the community agencies the school district partners with to serve juveniles in need.
Contracted community agencies
The school system is working hard to make improvements, school counselor Taylor said.
Mental health teams and additional counseling specialists are connecting the dots between services and schools, and new training and prevention methods at every level of the school system are giving teachers tools to deal with unruly students before situations escalate.
But interacting with outside agencies can be a problem.
“I think the system is fragmented,” Taylor said. “Depending on how difficult it is to connect with the outside groups, sometimes we feel like we’re left holding the ball.”
One example is in the use of the Baker Act. The Baker Act is a mental health mechanism that allows a person — including a child — who is deemed to be a danger to themselves or others, is taken into involuntary (or sometimes voluntary) custody for up to 72 hours.
In 2018, nearly 1,200 children under the age of 18 were taken into involuntary custody under the Baker Act in Volusia County.
Statewide, an average of 36,000 children a year are involuntarily Baker Acted, and nearly 4,700 of them are age 10 or younger.
“It’s extremely traumatic for the child,” Taylor said.
Although it can be necessary for the child’s own protection, she added, the process often doesn’t connect the child with help they really need.
And, Taylor said, it can be a week or more after a child is Baker Acted before the child’s school learns anything about their treatment.
“The trouble that we see with the Baker Act is that we have too few receiving facilities and crisis stabilization units, and oftentimes they are understaffed and/or underfunded,” Roland said.
Especially in the case of younger children, Roland said, use of the Baker Act can be a disservice to children and adolescents, and to parents who may not be educated about the mental health system.
Since the 2018 state mandate after the Parkland massacre, Volusia County School has provided in-house mobile crisis teams that can respond to and evaluate situations at schools during school days, Roland said, curbing the number of unnecessary Baker Acts.
That’s a good thing, according to Taylor, potentially sparing already-troubled children a new level of trauma.
“I mean, the police come, they go in a police car … depending on their age, they get handcuffed, and I mean, I’ve been in tears watching it happen,” Taylor said. “I’ve seen it as young as 6 years old.”
Another piece of the puzzle: insurance
While schools can provide evaluations and training, identify at-risk kids, and beef up curriculums for teaching social and emotional skills, more intensive services must be provided by other agencies.
The district contracts with five organizations for in-school behavioral mental health services: Adapt Behavioral Services, Children’s Home Society of Florida, Chrysalis Health, Devereux Services, and SMA Healthcare.
One complicating factor, however, is that these agencies’ services have to be paid for, usually by insurance. Some families use private insurance to obtain the services outside of school, but when the services are provided on a school campus, the dollars must come from Medicaid, and not everyone is eligible.
“Our county has a partnership with community mental health agencies, so that they can come in and meet with students — of course, it’s with parent permission and so on — but it’s funded through Medicaid — so those services are only provided for children who have Medicaid,” Taylor explained.
Florida KidCare, which includes the state’s Medicaid program for children, was supposed to help.
But in the past year, according to Taylor, Florida KidCare changed its requirements, requiring the various agencies’ mental health providers to be licensed. That, Taylor said, has reduced the number of providers available.
“They have their master’s in counseling, but you have to get hundreds of hours of supervised experience before you can get your actual license.” she explained. “And so, if they don’t yet have their license, they’re not able to bill Florida KidCare. That means that there’s less counselors available, and that means that the kids who had Florida KidCare aren’t able to get services in the school anymore.”
Services outside the schools, Taylor said, involve a host of new obstacles. Kids could miss school because there are limited appointments available, and some families don’t have access to the required transportation.
Already, children with private insurance have to find help outside school; plus, their families must pay copays.
And, about 6.2 percent of children under the age of 19 in Volusia have no insurance whatsoever.
“That’s why the in-school services are so helpful — because it takes out one of those obstacles,” Taylor said.
“We talk about health care in general — well, mental health is a part of health care. So, all the problems that we have in health care in terms of getting insurance for people, it’s the same thing for mental health care,” Taylor added.
Along with the perennial issue of funding, fragmentation of services across many agencies, who often all interact with or overlap each other, is one of the biggest roadblocks to successful care for juveniles. Even with the school district’s best efforts, without connection and coordination between state, federal, and local agencies, children will fall through the cracks.
The statewide grand jury’s report on school safety put it this way:
“Funding for the provision of mental health care services is spread out over state, federal and local agencies, each with different missions, priorities, metrics and definitions of success, making for treatment ‘plans’ that are unfocused, inconstant and often ineffective at the individual level. To put it bluntly, our mental health care ‘system’ — if one can even call it that — is a mess.”
Florida House Bill 945, passed in 2020, aims to create a comprehensive and coordinated system of mental health care for children. A response by “behavioral health managing entities” is due by Jan. 1, 2022.
One problem for those who will be tasked with administering that comprehensive system?
“This is a mandate with no funding attached,” The House Next Door’s Nadelkov said.
Editor’s note: Next time: A web of other agencies. If you want to talk with writer Eli Witek to share your experiences or expertise, email firstname.lastname@example.org.