At Berkeley High School, all freshman take a class meant to prepare them for the social and cultural challenges they will confront during their four years there. There are lessons on time management and substance abuse, on racism and sexual health.
Senior Ruby Spies remembers taking that Social Living class and feeling like something was missing. To her, the absence of a unit on mental health and the resources available to students experiencing depression or anxiety was striking.
“I’m someone who lives with multiple mental illnesses,” said Spies, 17. “In middle school, I went through a lot of emotional turmoil. I learned what the mental health system was like by going through it.” But she witnessed many of her peers, especially in the LGBTQ community, dealing with similar challenges for the first time in high school — and saw their friends struggle to know how to support them.
Last spring, Spies and her classmate, Abby Steckel, both on the city of Berkeley’s Youth Commission at the time, conducted a survey of their peers’ mental health needs. The data they gathered corroborated their observations on the extent of mental illness at BHS and the stigma shrouding the issue, and shed light on student groups whose needs were least likely to be met.
Based on the findings, Spies and Steckel have designed a student-led program that would bring mental health education into all freshman classrooms, and they are asking the city and school district to fund it. The proposal has already gone before both the City Council and the School Board, earning initial encouragement from officials, and will be presented to the board again on Nov. 15.
The survey of 242 students, which Spies and Steckel conducted with then-classmate Athena Chin, revealed that 60% of the students identify as having a need for mental health care. But of that group, 58% said they had not accessed care. According to the findings, male students are at particular risk, with 75% of the black, white and Asian American boys who reported having needs not having accessed care.
“Mental health service access is fundamentally an equity issue,” said Steckel, 17. “If you’re struggling with mental health and not getting support, that’s one more barrier to getting an education” for students who are already at risk, Steckel said.
A separate survey conducted by another student around the same time highlighted the possible outcomes for students who need, but do not receive, services for emotional health. Just over half of the 148 students surveyed reported having missed at least one day of school due to mental health issues, and 32% reported self-medicating with drugs or alcohol.
The data and conversations Spies and Steckel have had with their friends suggest a range of reasons why students do not access care, from lack of awareness of what is offered at Berkeley High to discomfort with the idea of speaking to an adult or a stranger about one’s personal life. Of those surveyed, 51% said they would prefer to receive support from a peer — but only 22% believed their peers were comfortable talking about mental health.
Steckel and Spies think those last findings offer the key to what could be done.
On the Youth Commission, the students dreamt up the Mental and Emotional Education Team, or MEET. The program would train a diverse group of students on the facets of mental illnesses that are common among high schoolers, the appropriate language to use when discussing them and what treatment opportunities exist on and off campus. The students would then deliver two-period presentations relaying the information to every single freshman class.
The program is modeled closely off of an existing peer-led sexual health education program at Berkeley High, called SHIFT.
MEET is not only intended to serve students who need health care, Spies said, but also to foster “a culture where folks can actually talk about these things.”
“Students don’t know what different terms mean and they perpetuate stigma by using ableist language,” Spies said. It is common, for example, for students to jokingly call their friends “bipolar,” alienating those who actually have the disorder, she said.
Even some teachers they surveyed said they cover stress in their Social Living classes, but shy away from talking more deeply about mental health, for fear of accidental insensitivity or because they have not been trained to do so, Spies said.
The proposal for joint funding from the city and school district asks for $92,778 to pilot MEET in 2018-19, covering the cost of a new part-time mental health professional staffer or an Americorps intern to oversee the program, a $7 per hour stipend for the student educators and supplies.
“MEET is in line with the city and district’s existing model of trying to have prevention services and to intervene early,” Steckel said. “The data shows that mental health issues start when students are in high school.”
Though budgets are tight, officials have expressed interest in the program. In June, the City Council agreed to consider the proposal in the city’s mid-year budget update.
“I feel very positive about the project and hopeful it will be supported,” said School Board member Judy Appel, who has been an advocate for mental health resources in the district. Appel appointed Spies to the Youth Commission.
“I appreciate a student-led approach,” said Appel of MEET. “They have a good sense of what’s needed to help address some of the stigma and feelings of isolation.”
What mental health services are available to students?
While leaders recognize the need for more mental health resources, and have a commitment to improving what is currently provided, there is still a ways to go at Berkeley High, Appel said.
“It’s really clear there’s a large number of our students who are anxious, depressed or have considered suicide,” she said. “We really don’t have the resources we need to be able to support them to succeed in school and life.”
The city of Berkeley runs the BHS Health Center, where all students can access crisis services. Ongoing counseling is offered to students with financial need. The city is unique in that it has its own health department, and the Mental Health Division contracts with the county to provide youth and family care, including the school-based care.
Berkeley Mental Health also provides state-mandated school-based services to students with special needs. Other programs offer screening, diagnosis and treatment to students with severe mental illnesses who are uninsured or on Medi-Cal.
The county’s 2016-17 Berkeley High School Health Needs Assessment, published in August, praised the quality of mental health providers at the school, as well as the many other teachers and staff who offer informal support groups, and the academic counselors who provide emotional support.
“This all-hands-on-deck approach was seen as both admirable and a reflection of the enormous need for additional social-emotional supports for students,” the assessment report said.
That study also found that many students consider the Health Center a valuable resource, but many others are unaware of the services available there, or uncomfortable accessing them due to “unrelatable” staff or concerns about confidentiality. (The services are confidential.) The assessment also called for more leadership from the district on developing a health and wellness plan, and stronger coordination between BUSD and the city.
Presenting at an October meeting of the 2×2 Committee, which includes representatives from both the city and the school district, Berkeley Mental Health Manager Steven Grolnic-McClurg said the institutions share the admirable goal of focusing on preventative care. The reality, he said, is that staff time and attention is dominated by a few high-needs students and those in crisis.
“We provide virtually no preventative care at Berkeley High,” Grolnic-McClurg said. “Ongoing crisis treatment takes all the bandwidth. We love the care model you’ve adopted — let’s put more resources in prevention.”
Steckel said she agrees that “you need all those different tiers of mental health resources.”
Some new services have been introduced in recent years. Some school personnel have recently been trained in Youth Mental Health First Aid, a national program focused on identifying and addressing emotional health needs and addictions in adolescents. The district and city secured a $135,000 grant from the Substance Abuse and Mental Health Services Administration to offer the training for three years.
The city also funded a pilot program training some preschool, elementary and middle school staff in “trauma-informed care,” which Grolnic-McClurg said was successful.
The needs identified by the students’ survey and the county assessment are hardly unique to Berkeley. According to the National Institute of Mental Health, over 20% of all teenagers have, or have had, a “severe” mental health disorder. It is only relatively recently that educators and officials have begun to recognize the extent of the issue and talk openly about the role they can play in addressing it.
“In my opinion, mental health historically has been an under-represented need,” Appel said. “There’s still a lot more education people need to have to recognize the importance.”
With MEET, Spies and Speckel hope they can make mental health part of the curriculum.