A stunning increase in the number of ninth-graders asking for urgent help with their mental health – 37 came forward in just four days last fall – is putting heavy pressure on a year-old school program provided by the Mental Health Association.

The violence and suicide prevention program was proposed by the nonprofit MHA and the Indian River Hospital District the day after the Valentine’s Day 2018 school shooting in Parkland, Florida, and was put into effect last February.

Last year’s entire spring semester generated about the same number of students seeking counseling – 40 out of 970 in the program – as in the four days this past October.

“The problem is much greater than we ever imagined,” said Dr. Nick Coppola, CEO of the Mental Health Association. “We were patting ourselves on the back last year. Then we went back this year, and now that we’ve earned their trust, we realized last year we were only scraping the surface.”

So far, the program has been funded by the Hospital District and $50,000 in grants.

Now, though, as the MHA extends the program’s reach to more than 2,000 students, the number of crisis interventions Coppola’s team will oversee seems certain to increase dramatically, creating a need for more funding for additional therapists.

Coppola appears poised to get additional help from the Hospital District, after his statistics jarred trustees at their January meeting.

Trustee Dr. Michael Weiss, who initially voted against funding the MHA program, encouraged Coppola to come forward for more money if necessary.

“Don’t be bashful when it comes to asking for funding. This is a very important program,” said Weiss.

Adding to the alarm over children’s mental health is a recent increase in pediatric in-patient admissions at Cleveland Clinic Indian River’s Behavioral Health Center. Those admissions rose 31 percent between 2017 and 2018, to 418 kids. In 2019, there were 404 admissions, a slight decrease but still a large number of troubled children and teens. 

When some Hospital District trustees initially balked at funding a program they felt should be paid for by the school district budget, Coppola countered that schools are the best place to reach suffering kids with mental healthcare, making it a mental health issue more than a school issue.

In the fall 2019 semester, 54 Indian River County students were involuntarily admitted for in-patient mental health treatment under Florida’s Baker Act, and 142 were assessed for self-injury.

In all, 225 students were referred to the school district’s own mental health staff, though that number is “definitely an understatement of students served,” according to the Indian River County schools’ mental health coordinator, Dr. Sharon Packard.

Hospital District chairwoman Marybeth Cunningham called the numbers “staggering.”

Indian River County students’ own impressions, taken as a whole, reflect more detachment, discouragement and fear than at most schools nationally.

In a fall 2018 survey designed by a national company specializing in research on school climate, some 7,000 students here responded to questions about social and emotional health as well as how safe they felt at school.

The answers of middle- and high school students came in at the survey’s lowest percentile range of 0 to 19 on three measures – how well they could persevere through challenges; how confident they were about accomplishing academic goals; and how well they could empathize with others. The percentile numbers mean that students here were in the bottom one-fifth of U.S. students in their self-expectations.

In the two other measures – whether students believed they could change factors affecting their school performance, and how well they managed their emotions, thoughts and behaviors – the sixth- through 12th-graders’ assessment still appeared darker than most kids in the country, though not as dire, falling within the 20 percent to 39 percentile nationally.

Regarding student’s perception of safety at school on both a physical and psychological level, the survey again put Indian River’s teenagers in the bottom 20 percent.

Following the survey, an alarmed school system established the Office of Mental Health Services, under Packard’s leadership. This is separate from the Mental Health Association’s violence and suicide prevention program.

“The skills that allow students to achieve academically and in life are often the same skills that promote mental wellness,” said Packard. She said the district’s goal is to have all faculty and staff receive six hours of training in youth mental health first aid, which serves to identify symptoms of mental illness and the risk of harm, and teaches adults how to connect students with professional help.

“When children feel safe, secure and healthy, they are free to learn,” said Packard.

In the 2019-20 school year, the school system got $516,000 in mental health funding provided by the state through a post-Parkland law intended to make schools safer. The money was used to hire Packard, along with eight mental health providers and a part-time social worker.

Packard said there are counselors in every secondary school, and “behavior intervention specialists” at every school, though MHA therapists say they find students often associate those roles with meting out discipline or concern for failing grades, and need an outsider – someone other than a school employee – to discuss depression or thoughts of suicide.

As for psychologists and mental health specialists, the school system assigns multiple schools to one provider, though the new school district superintendent, Dr. David Moore, said at two townhall meetings this month he wants a therapist in “every school building.”

In 2018, there were 10 psychologists and two clinical licensed social workers for nearly 18,000 students.

Cunningham made it clear that the Hospital District is making mental health a priority. She, Cleveland Clinic Indian River Hospital president Gregory Rosencrance M.D. and others met with local mental health providers last week to outline optimal care for the community.

“We challenged them to come up with a vision of what mental healthcare in Indian River County should be, what already exists and where are the gaps,” said Cunningham. “When everyone agrees on the gaps, then we can prioritize them and work with funders on a five-plus year plan for funding.”  

She said she is talking to United Way, the Community Foundation and others on the plan, calling it potentially “very exciting.”

“We’re behind,” said Coppola. “I’m trying to catch up to get in front of it because our goal is to prevent a suicide, is to prevent a violent outcome of any kind. We need to get in there deeper in hopes that something bad doesn’t happen.”

While the school district has been spared the horror of a full-scale attack or other catastrophe, bad things that have happened have caused some kids to feel powerless, confused, profoundly sad or unsafe.

Setting aside divorce or separation of parents, a prime contributor to kids’ distress, according to MHA therapists, there are also painfully inexplicable events to cope with. In the last school year alone, a Sebastian River High School senior collapsed and died on the basketball court; one Sebastian River student allegedly shot another in the head, killing him; and a girl at Charter High School reportedly took her own life over a boy at Sebastian River.

Just this month, a horrific crash near a landmark bridge killed a member of a visiting college rowing team and left a dozen others injured. The accident was wrenching for rowers at both Indian River and Sebastian River High, who used their afternoon practice carefully breaking down the Massachusetts’ teams’ boats to spare them the effort and writing notes of support to victims’ families and team members.

Then four days later, there was another crash involving past and present students of Vero Beach High, after an 18-year-old Vero High senior allegedly fired shots into a parked car, killing a former student and leaving a 17-year-old girl in critical condition with a gunshot wound to the head. Among the car’s occupants was a student at the Freshmen Learning Center.

The first day of school after that tragedy, two MHA therapists were at Vero Beach High School as part of a crisis response effort. “They’re in disbelief. They’re shocked,” Christina Aspromonte, MHA’s clinical manager, said of students.

A third therapist, Jared Buchanon, was at the Freshman Learning Center leading a session of the MHA’s depression awareness course.

Divided into three 50-minute sessions, the course began with an 18-minute video of six students with depression. Follow-up discussion included having students identify symptoms in each vignette and discuss ways the students get help to feel better.

“Some of these kids feel they can’t be helped,” said Aspromonte, who regularly leads the sessions herself. The vignettes and their outcomes show kids that “mental health professionals are equipped to help them,” she said.

A post-program survey of the students backs that up: 91 percent felt the program showed them ways to get help. Prior to the course, “a lot of these kids think no one can help them,” Aspromonte said.

At the same time, students were given self-referral forms to get help within 24 hours or within a week if they felt they needed it.

Of those 37 ninth-graders who last fall checked the box for a free mental health screening, 26 asked for continued help after being assessed.