As a part of our ongoing policy work in rural eastern North Carolina, we hold monthly sessions in which we listen to our community to identify priority issues and then fuse community knowledge, international best practices, and local connections to solve them.

We focused June’s policy listening session on mental health in schools. Participants highlighted growing challenges including resistance to therapy, peer pressure, social media and gaming addictions, and staff burnout. For many of these challenges, we discussed what truly systems-level and trauma-informed solutions might look like. As ROI has recently received a grant from the Camber Foundation to expand mental health care in schools through Medicaid billing, this session was a great example of our community-led innovation process. We will use insights from this session to inform the delivery of our mental health in schools programming, both through the recent grant and through nascent programs initiated by our Community Accountability Board.

Discussion highlights

• We discussed reticence among students and school systems to engage directly with mental health issues
  • “I am the PTO president at my son’s school, used to work at a title 1 school. When a student would die, there would be a big initiative, grief counseling, and students would talk about their feelings. This shouldn’t be limited to when it is death related. Kids need to talk to each other, not just a counselor.”
  • “People are not approaching therapy because of background – we have young parents raising young kids and they have not had the education or practice of using therapy.”

• We discussed other systemic barriers to students accessing mental health support, including punitive justice systems, gang violence, teenage pregnancy, and peer pressure
  • “I worked at a title 1 school and I had students in 5th grade who had to charge their anklet because they were on house arrest. Girls in 7th grade who had babies, girls in 8th grade who had to run away to join gangs”
  • “There is so much peer pressure, but it’s on a different level. It’s like peer pressure on steroids..”

• We discussed challenges to teachers, staff, and therapists providing or directing students to mental health care
  • “Therapist pay is not great, the job stretches you thin because you have a lot of demands with not a lot of time and money”
  • “Many teachers are making less than $40K per year, which creates a lot of challenges. You aren’t that far from low income, but not eligible for a lot of assistance. But you’re still expected to show up and be happy every day.”

• We discussed a wide range of creative, trauma-informed solutions:
  • “We need therapy before therapy is needed, to make sure issues don’t happen in the first place”
  • “Train teachers to recognize signs of mental health issues in students and pay attention to students who seem like they might be on a bad path.”
  • “A mental health basics or mental health first aid training program for teachers and admin could be great and this could happen a couple times of year… if we don’t use it, we forget it.”
  • “I like the idea of an after school program – incentives can help get kids to try new things. We would need to provide transportation for this.”
  • “Kids are addicted to gaming and social media. How can we help them pivot? I took my son to a conference and he was so happy because they heard about esports. How can we battle this gaming addiction by making it something more positive that can help their future, through something like an esports scholarship?”