President's Letter: Struggling to Support Student Mental Health

When I completed my degree in school counseling, I quickly realized a major disconnect between the expectations versus reality of referring students for outside mental health services. I was under the impression that when students needed outside, ongoing counseling, it would be as simple as suggesting that need to parents/guardians and providing them with a list of potential providers, then it would magically be done! “Surely,” I naively thought, “with my newly minted graduate degree, parents will value my professional opinion and seek out the resources I suggest.” How surprised I was to realize that my suggestions were met with opposition or, even worse, apathy. More frustrating has been the time spent trying to coordinate appointments, just to have the students not show.

Of course, I cannot generalize this to all parents with whom I have worked. Many parents are concerned for their child’s well-being and are willing to do anything and everything they can to help their child be successful. Even with these motivated parents, however, I have often (and continue to) hit brick walls with the options of where I can even refer them. As an elementary school counselor, my options for mental health professionals who work with children in West Virginia are few and far between. Over the years I have learned that even when I am fortunate to get agreeable parents for outside mental health services, the first question I must ask is “Do you have private insurance?” I openly admit that I am confounded and perplexed by what is and is not available. The nuances, limitations and guidelines for programs like CHIP vs. Medical Card vs. Medicaid vs. The Medical Plan overwhelm my brain.

The options afforded to the low-income families I serve are typically agency-based companies. I perceive such places to be most concerned with turning out as many clients as possible to meet their bottom line. The clinicians from these agencies take these positions as a stepping stone for more experience, only to quickly move on to a private practice (that does not take government-funded insurance plans) or other opportunities with higher pay. I mean, who can really blame them? As a result, the turnover rate within these agencies affects the quality of services for my students, many of whom are dealing with complex attachment trauma, typically the point of my referral for outside services in the first place.

Quality mental health treatment in the United States is a luxury. In West Virginia, we are struggling with parents who have untreated complex trauma themselves, which is now being passed from generation to generation. Grandparents are struggling after being forced to raise their grandkids because of the opioid crisis. In my opinion, unless and until our society appreciates the importance of addressing mental health issues – specifically allocating the funds to help licensed and certified clinicians sustain a livable wage – we are at an impasse.

I do, however, see some light in the darkness. We have people who are passionate about advocating for our students and their families. I have had the pleasure to speak at two events now through the nonprofit group West Virginians for Affordable Healthcare. At a recent virtual event, I spoke as a part of a roundtable discussion group that included professionals who are pushing for school-based health centers. I remain positive in my hope that such centers would not only provide medical care, but mental health care as well. I can only hope for the day when such programs employ at least one full-time licensed mental health professional, with a manageable caseload, whose sole responsibility is providing individual and/or group counseling to students.

The reality is that, as school counselors, we simply do not have time for ongoing individual and small group counseling. We shoot for the ethical ideals provided by ASCA when referring higher need students to outside mental health services. We get stuck, however, when there is a lack of resources and/or follow-through. So, we can only continue to move ahead, using the resources that we do have and advocating for those that we do not – hoping for a brighter future for our students, their families and our great state of West Virginia.

One excellent group, West Virginia Prevention Solutions, has given me incredible support for programming and resources for my comprehensive school counseling program.

Contact Matthew Tolliver, WVSCA president, at mtolliver@k12.wv.us.