Youth mental health needs are growing. Without more funding, providers say they could face cuts

Maine school officials are reporting rising rates of anxiety, depression and other disorders in students — and to address those challenges, many districts now bring in contracted outside mental health clinicians.

The clinicians spend their days within school buildings, alongside teachers and social workers, to provide ongoing treatment. But some providers are warning that those services could be at risk as they face financial shortfalls.

Inside her living room in Brunswick, Rebekah Strasburger scrolls through her phone to show off the very distinctive style of her 6-year-old son, Henry. In one photo, he's decked out in rainbow heart light-up sneakers and a rainbow backpack.

"I mean, it looked like rainbows threw up on him," Strasburger said. "And he went into school with the biggest grin on his face, just so happy to be himself."

Strasburger family

Strasburger said Henry is unusually empathetic, and is constantly sharing with and caring for his little brother, Connor. But Strasburger said Henry has always had a hard time sitting still.

"He's definitely, you know, 'He's a body in motion,' is a phrase that both of his teachers in public school have used, independently of each other. So he's just really full of energy," she said.

When Henry entered pre-K, his teachers began to notice that energy was disrupting his learning. He struggled with impulse control, self-confidence and feelings of isolation, and was prone to some emotional outbursts.

Henry was diagnosed with ADHD. And now, in kindergarten, he meets every Monday morning with an in-school clinician, who is just a short walk from his classroom.

"And so his therapist Hannah, helps him really understand, you know, why he's feeling a certain way, and how to think about it, and maybe talk himself up and feel better about himself in those situations," Strasburger said.

These types of clinicians are located in hundreds of schools across Maine. They often aren't directly employed by a district, but instead work for a health care provider and get reimbursed through insurance.

Holly Blair, with the Maine Principals' Association, said bringing in a qualified clinician — even for just a day or two a week — has filled critical gaps in youth mental health services, particularly as many schools struggle to provide an adequate number of social workers and counselors.

"And it didn't require the parents having to transport them, but it didn't require us to transport them," Blair said, remembering her own experience with a school-based clinician from when she was a principal.

"So having them on property, helps the kids be able to get their regular check-ins, or their regular appointments. But then if there was a crisis moment, you know, they had a clinician right there on property that was able to help step in," Blair said.

But providers now warn that the funding behind these arrangements isn't enough to pay the real costs of operating them.

"We are on target to lose over $1 million in this program this fiscal year," said Jayne Van Bramer, the president and CEO of Sweetser, which has clinicians in more than 100 Maine schools. "That kind of loss is not sustainable."

While clinicians get reimbursed for each appointment with a student, Van Bramer said, they are not paid for time spent on other parts of job, such as meeting with teachers or responding to students in crisis.

"What makes the model successful is that our staff and our clinicians are part of this whole blanket that surrounds the child with support. And that interface takes time and energy and attention," Van Bramer said. "Yet none of that is billable, traveling to a child's house, sometimes it's two hours. Not billable."

In response, several organizations are pushing for legislation that would appropriate about $1.5 million a year to create a state grant program that they say would help keep these services afloat.

Holly Blair, with the Maine Principals' Association, said that if providers are forced to make cuts to these programs, the mental health crisis affecting Maine youth is only going to get worse.

"Educators — they're not certified social workers. They have very limited training, versus those that have a social work or guidance counseling degree," Blair said. "And if we don't have the funding for those services, it's going to be detrimental for schools."

Back at her home in Brunswick, Rebekah Strasburger shows off a "feelings dictionary" that her son Henry put together at school — just one tool that he and his school-based therapist have created to help him better handle his emotions.

She said the prospect of losing those services is unsettling — for her own family, as well as many others in her community with limited access to alternatives.

"And so the thought of having to go through that for Henry and for his little brother, Connor, is a scary one. I hope that this incredible resource stays," Strasburger said.

The legislature is expected to determine the fate of any additional funding over the next few weeks, as it takes up a supplemental spending package.