Reading, Writing and Psychotherapy: When Schools Step In
WNYC; Cindy Rodriguez, 2/3/2015
Inside her pink bedroom, Olivia Ingles stood on top of her bed and posed next to her favorite teen “it-girl” poster, Scotch-taped to the wall. Next, she was on the floor wrestling with her younger sister, 7-year-old Tiffany.
“Must eat brain!” Olivia said, repeating the zombie refrain between giggles, while her older sister Sierra looked on. The three girls share the only bedroom inside this modest Bronx apartment.
They are happy and rambunctious, but things weren’t always this way.
“Back in ’07, I lost custody of my children,” said their mother, Menjit Kainth. She said the girls were placed in their father’s care after she was accused of physical abuse. Kainth said she spent the next two years trying to win her daughters back.
“I went to parenting classes, to anger management, I went to individual counseling,” she said. By the time she regained custody, Olivia was about to start kindergarten and was showing signs of emotional trauma and distress.
“When I got Olivia back, her self-esteem was very low,” said Kainth. “She thought of herself that nobody loved her, that nobody wanted her.”
Science suggests that too much stress at a young age — without any buffers such as a caring adult — can disrupt rapidly developing brain circuitry, causing a host of problems. It’s called toxic stress, and scientists say it can lead to a child not being able to control emotions, pay attention or remember things. Without treatment, kids struggle to learn and mental illness may develop.
Olivia would throw fits.
“I would catch a tantrum,” said the 9-year-old. “Screaming, being really upset.”
In some schools, she would have been suspended. But Olivia is lucky: She goes to therapy every Tuesday during her regular school day at P.S. 8 in the Bronx. The mental health clinic sits behind the gym and down the hall from the cafeteria. That’s where she meets with her therapist.
“We talk about, like, my anger and my problems at home,” Olivia said. “She, like, tells me to take 10 deep breaths when I’m angry and calm myself down and go in a room all by myself.”
The program is run by Montefiore Medical Center and the limited slots fill up fast. Last school year, 61 children made more than 2,000 visits to the clinic. Most of them were referred by teachers struggling with a disruptive child.
Angela Kang, the mental health director and Olivia’s therapist, said the kids she sees are dealing with homelessness, losing a relative to violence or watching a parent struggle in an abusive relationship.
“Our kids are witnessing things that they can’t really process and understand,” Kang said. “And a lot of times our families, our parents, are not really being able to support their children through what they are seeing.”
Kang said that’s often because parents are also dealing with their own histories of trauma. So a worker on staff tries to find services for them too. Ultimately, the goal is to break the cycle of poverty and give kids a shot at doing better than their parents did. Eighty-five percent of the kids qualify for a free lunch at P.S. 8. For a family of three, that means earning less than $26,000 a year.
There are 471 mental health clinics scattered around the city’s 1,800 public schools, and the number keeps shrinking. Sixty-two have closed since 2010. Besides clinics, schools have screening programs and consultants who refer kids to clinics in their neighborhoods. It’s a patchwork system that does not meet the demand.
“There is not a week that goes by where I don’t get calls from either principals or their designees — ‘We need mental health services!'” said Scott Bloom, director of mental health services for the Department of Education.
Bloom believes the demand is coming from an increase in poverty and from the failure of the mental health system to provide enough services in communities where kids live.
“It’s not a DOE problem,” he said. “It’s a systemic problem.”
The de Blasio administration announced plans in November to increase mental health services at the city’s most troubled schools. And there’s little time to waste, because once a child gets older, they start acting out in ways that could expose them to police. At that point, the interventions could be the difference between a high school diploma and a trip to Rikers Island.
On a brisk fall day, that’s exactly the problem that Eric Schlothan and a colleague were trying to solve. The two were out searching for a 17-year-old boy with a history of abusing drugs and alcohol.
His distraught mother said the boy stopped going to school, was arrested for trespassing and recently threatened to kill himself with a knife. They were at the teenager’s home in the Bronx. But only his mom was there.
“She said optimistically he’s been talking about wanting to re-engage with us since Monday,” said Schlothan, a psychiatric social worker, when he returned to his car. “So that’s always good news — that somehow we’ve crammed ourselves in his mind as an option.”
He’s part of a pilot program called a mobile crisis team. When possible, schools are supposed to call them instead of calling 911 when a child is in distress, because taking a child to an emergency room by ambulance is expensive. Plus, the city was sued over the practice by upset parents who said the emergency response was often unnecessary and only added to their child’s trauma.
This is psychiatry on the fly — trained professionals on call to intervene when a child is in crisis. The mobile crisis team is run by Visiting Nurse Services of New York. When a call comes in, they have two hours to respond.
Back at his office on 153rd Street in the Bronx, Schlothan described a recent case: “It was a kid who was having homicidal ideations, and at this particular instance it was a moment of crisis where the kid acted out, got intoxicated and then at school aggressively released his energy out on the room.”
That means the teenager threw a clock against the wall. It shattered and cut a teacher’s face. The team couldn’t get him an appointment fast enough at a community health clinic, so he got worse and had to go to a psychiatric emergency room instead.
He was facing a school suspension and Christine Garcia, Schlothan’s partner, was on the phone with the boy’s overwhelmed mother, telling her she would attend his suspension hearing.
“I’ll try to get there as soon as possible,” she said into the phone.
The hospital was ready to discharge the boy, but Schlothan and Garcia wanted him to stay longer.
“I’m going to speak to mom about the benefits of having him stay longer,” Garcia told Schlothan as she walked out the door.
In the end, the hospital kept the 15-year-old for a few extra days. It turned out the school wasn’t following his special-education plan so he was spared a suspension. Schlothan and Garcia reconnected him to a therapist, closed his case and moved on to the next one.
http://www.wnyc.org/story/reading-writing-therapy-schools/