Northeast San Antonio Metrocom-area school counselors are reporting a greater number of students are needing mental health care services to address depression, anxiety and traumas, such as food insecurity and homelessness.

“From a mental health perspective, I’d say anxiety and trauma have really skyrocketed—and suicidal ideation and homicidal ideation,” said Cassandra Gracia, director of counseling; and college, career and military readiness for Schertz-Cibolo-Universal City ISD.

She explained that students who may have experienced suicidal thoughts have moved to more extremes, such as planning a suicide attempt, or a student who may have self-harmed is now considering harm or violence against others.

Students have always faced challenges, Gracia said, but when they returned to their classrooms for the 2022-23 school year, there were second graders entering their elementary school for the first time and ninth graders who missed out on much of middle school because of the COVID-19 pandemic.

“I don’t think anyone had any idea what we would be facing,” Gracia said. “There was trauma. There was food insecurity. The lack of socialization was really impactful.”

To address mental health, school districts are hiring more counselors, expanding programming and funneling more money into services.

SCUCISD adds resources

SCUCISD students are surveyed three times per year to gauge how they are feeling about their social-emotional and mental health, Gracia said.

“We have seen a steady increase in students who are aware of where to find resources, which is where we want to see those percentages,” Gracia said. “After COVID[-19], we saw an increase in students reporting symptoms of anxiety and depression.”

As a result, the district hired three licensed professional counselors in the 2022-23 school year. The district also contracts with ANEW Family Counseling Center, a Stone Oak counseling office with therapists who treat individuals, couples and families. Some of the center’s interns work with students who need outside referrals.

The district has a total of 31 school counselors, three licensed professional counselors, and one licensed clinical social worker who is part of a partnership with Communities in Schools, a nonprofit based in New Braunfels that helps students overcome challenges in schools.

The district also partners with Texas Child Health Access Through Telemedicine, which offers telehealth services to help identify and assess students, and provide access to mental health services. Gracia said the partnerships have proven to be effective tools.

“Even with all of these supports in place, the number of referrals is more than we had anticipated,” Gracia said.

For the 2022-23 school year, SCUCISD launched its new Mental Health & Safety Series focused on topics meant to help teachers and parents identify warning signs in children. Topics included suicide, drug use and abuse, social media and internet safety, cyberbullying, and more.

Gracia said parent participation was so good—with some parents even bringing their children— that the district plans to expand the program for the 2023-24 school year.

“We’re really getting good feedback,” she said.

Judson ISD strengthens partnerships

In Judson ISD, on July 20 the board of trustees unanimously voted for a one-year renewal of its $108,600 contract with the Meadows Mental Health Institute, a partnership the district first entered into as part of its 2021 Social Emotional Learning Plan.

The Meadows Mental Health Institute is the district’s lead agency for the San Antonio Mobile Wellness Collaborative, which includes partner organizations—such as Clarity Child Guidance Center, Rise Recovery and Meadows Mental Health—and provides health services to district students and their families as well as teachers and other staff, Board Chair Jose Macias said.

The program is geared to make access to mental health counseling and treatment, and crisis and substance use interventions easier by delivering services at school. Services are free to students and their families.

“I’m excited,” Macias said. “I’m hopeful. I think the renewal is indicative of the program’s success, and I think we’re looking to build on that success.”

District officials have plans to expand services and will be building a new facility that will house some of the social services, Macias said. District officials plan to use some grant money from Bexar County that was earmarked to help school districts expand their mental health care within schools, Macias said.

Trustees have been told there is a greater need for mental health services, Macias said, and the district’s approach is to address not just mental health care and counseling but also food insecurity, homelessness and other social services.

“It’s just not enough in my opinion,” Macias said. “Maybe, it’s time we had three full-time counselors. There’s just more need than what we have coverage for.”

Increasing crises

One of JISD’s partners in providing care is Clarity Child Guidance Center, a San Antonio-based nonprofit mental health care provider and crisis center specifically for youth.

Clarity CEO and President Jessica Knudsen said prior to the pandemic, school counselors and other health care workers were seeing that more children were needing help.

One in five youth suffer from a behavioral issue or a mental illness, and 35% of referrals to Clarity are from school districts around San Antonio, Knudsen said. Since the pandemic has subsided, Clarity has seen a 162% increase in the use of its crisis center.

“Someone you know is going through this,” Knudsen said. “It’s very isolating.”

The pandemic only exacerbated things, Knudsen said. School-age children reported greater social anxiety and depression.

“I think we grossly underestimated the effects of closing schools,” she said.

County priorities

When Bexar County Judge Peter Sakai took office in January, one of the things he identified as a top priority was health care and, in particular, mental health care.

“Healthy families are the bedrock of our economy,” Sakai said in his state of the county address in May.

Sakai moved quickly to set up a new county department of public health and appointed Dr. Andrea Guerrero-Guajardo to lead it. The new department is focused on behavioral health, environmental services, preventative health and agriculture.

One of the department’s first acts, and the first aimed at youth, was to award $20 million in American Rescue Plan Act funds as grants to 14 school districts for the expansion of mental health care services. The ARPA provided emergency funding in response to the COVID-19 pandemic. The county has until 2026 to use the funding.

JISD received over $1 million. North East and Northside ISDs also received $2.6 million and $4.5 million, respectively.

SCUCISD did not receive any funding because it is located in Guadalupe County, where officials opted to use $32.5 million in ARPA funds to address the county’s growth.

Guerrero-Guajardo said the county set up the grant to enable districts to decide how to spend the money for mental health services.

Leticia Dominguez, the manager for the county’s behavioral health department, said each district knows best what students need. Those needs helped determine which outcomes each district would track as part of the grant. Criteria includes metrics such as absenteeism, disciplinary referrals and expulsions, Dominguez said.

“We wanted to make sure that each school district could use the money the way they wanted to based on their needs,” Dominguez said.

School districts can also use the grant funds for their staff, and some districts are working to train teachers and others on campus to identify students who may need help in what is being called “mental first aid.”

The county’s approach is deliberate, Dominguez said, and officials want to take a focused view of youth and meet the children where they are in school.

“Even before the pandemic, we knew schools were underserved,” Dominguez said.