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Coronavirus is straining Colorado kids’ mental health. The state hopes free counseling sessions will help.

Two plans have been floated to address increased instances of depression, anxiety and suicide attempts among school-age children and, in some cases, their teachers.

Gov. Jared Polis visits a second grade class in Aurora. (Cherry Creek School District handout)
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East Grand School District’s 1,305 students have been forced to cope with an immeasurable amount of stress this year, first in the form of a pandemic, followed by a wildfire racing through their community, burning more than 100,000 acres within hours.

Amid the ashes left by the East Troublesome Fire last fall, there remains a deep sense of trauma that will continue to impact students for years to come. 

Like many leaders of Colorado school districts, East Grand School District Superintendent Frank Reeves worried about his students’ mental health long before a pandemic or wildfire threatened his community. He’ll keep worrying long after.

After a year of turmoil, Reeves says “almost every decision we’ve been making lately is really weighted on that social-emotional piece as much as anything academic.”

It’s a concern that cuts across Colorado’s 178 school districts as they split their focus between students’ well-being and their academic progress.

Two proposals, one in the statehouse and one included in a roughly $700 million state economic stimulus plan made public by state lawmakers and Gov. Jared Polis on Wednesday, have been floated to help screen students’ mental health. Educators, parents, health care providers and state officials know that statistically, kids’ mental health is in crisis after more than a year into the pandemic. Emergency room visits for students reaching a breaking point have risen, with more kids reporting thoughts of suicide.

“We know that the pandemic has had an enormous impact on students’ mental health across our state,” Shelby Wieman, acting press secretary for Polis’ office, said in a statement. “This proposal, which is part of the Colorado stimulus package and our behavioral health roadmap, will help to connect students with critical services to help provide support during these difficult times.”

Under the state economic stimulus plan, Polis’ office in collaboration with the state Office of Behavioral Health — within the Colorado Department of Human Services — hopes to begin providing support to both students and teachers who are facing mental health challenges exacerbated by the pandemic. It would connect teachers and students age 12 and older with licensed mental health professionals for three free sessions. Those sessions, likely conducted through telehealth, could serve as a bridge to more long-term mental health services, said Robert Werthwein, director of the Office of Behavioral Health.

Harrison School District 2 special education teacher Vanissa Lopez spaces desks farther apart in her classroom at Centennial Elementary School in Colorado Springs on Wednesday, July 15, 2020, in preparation for a return to in-person learning in the fall. (Mark Reis, Special to The Colorado Sun)

The state economic stimulus plan would set aside $8 million to $9 million for voluntary screenings and three free telehealth sessions. With those one-time funds, the Office of Behavioral Health looks to serve about 15,000 students and about 3,000 teachers across the state. The mental health program could run a year or longer depending on demand and resources, Werthwein said.

The proposal’s emphasis on linking students and teachers with mental health support in some ways mirrors a separate idea that state Rep. Dafna Michaelson Jenet, a Commerce City Democrat, plans to introduce through legislation. Michaelson Jenet, a longtime advocate for more comprehensive mental health services in the state, is pushing to provide every K-12 child an optional mental health evaluation before the start of the 2021-22 school year.

Both concepts arise from the increasing numbers of students and teachers who have suffered mental anguish during the pandemic.

In Colorado, student mental health worries are nothing new, but the intensity has changed.

“The mental health concerns of youth in the state of Colorado have always been of concern,” said Dr. Jessica Hawks, a clinical child psychologist and the clinical director of the ambulatory mental health services at Children’s Hospital Colorado. “We’ve always seen higher rates than other states across the country when it comes to the prevalence of emotional and behavioral mental health challenges.”

Suicide was the number one cause of death among Colorado teenagers before the pandemic, Hawks said. COVID-19 has only made things worse and affected students’ mental health in a “profound” way, she said.

At Children’s Hospital Colorado, the overall volume of emergency department visits has dropped by about 50% from pre-pandemic numbers. However, mental health-related visits have doubled, Hawks said. Across Children’s Hospital Colorado, there also has been a 10% increase in the number of kids who visit the psychiatric emergency department unit due to thoughts of suicide.

The fact that providers have seen more frequent and more serious suicide attempts among children is alarming to Hawks. That means that the chances of an attempt resulting in a suicide death is higher. She said Children’s Hospital Colorado is seeing more patients admitted to the pediatric intensive care unit following a suicide attempt. 

Based on research from the nonprofit Mental Health America, loneliness or isolation is the top driver of youth mental health problems — 78% of respondents ages 11-17 who completed a mental health screening through the nonprofit in 2020 reported experiencing loneliness.

Hawks, like Reeves in East Grand School District, worries that students will struggle long term. Chronic stress as a young person is a predictor of negative life outcomes, like struggles excelling in school, difficulties with jobs, poor physical health and alcohol or drug abuse, Hawks said.

“Without effective mental health supports,” Hawks said, “our youth broadly are at risk of having tremendous negative implications for their well-being long term.”

That concern also extends to adults, including teachers. About a third of adults nationwide are reporting a worsening of their mental health overall since the pandemic began. A Kaiser Family Foundation report from February stated that about four in 10 adults nationwide have expressed symptoms of anxiety or depressive disorder during the pandemic. That’s an increase from one in 10 adults who reported those symptoms between January and June of 2019. Another statistic, published in October in Pediatrics, the official journal of the American Academy of Pediatrics, noted that 27% of parents reported increased struggles with mental health since March 2020. 

In Colorado, schools and districts have grown more concerned about supporting both teachers and students’ mental health as the pandemic has dragged on. A needs assessment conducted by the Colorado Department of Education and the Colorado Education Initiative in October clarified those concerns. While 90% of respondents indicated that teacher mental health was a top teacher priority, 52% cited high school student mental health as a top student priority and 41% listing middle school student mental health as a top student priority.

Misti Ruthven, executive director of student pathways at the state education department, also is worried about the significant impact of loneliness on students.

An American flag is in a classroom as students work on laptops in Newlon Elementary School early Tuesday, Aug. 25, 2020. The school was one of 55 Discovery Link sites set up by Denver Public Schools where students participated in remote learning during COVID-19. (AP Photo/David Zalubowski, Special to The Colorado Sun)

“Isolation is happening in different ways” for students in classroom learning environments and taking classes online, Ruthven said. Kids studying remotely may have trouble connecting to their peers and teachers through a computer. Students attending in-person school can feel similar isolation when their out-of-school activities and social interactions take a more limited shape, with mask wearing, smaller groups and social distance.

Ruthven added that teachers are shouldering a greater burden of stress amid the pandemic, particularly as they move between hybrid, remote and in-person learning platforms.

“Those pivots are taking a little more planning time and effort certainly for educators,” Ruthven said.

“It’s completely OK not to be OK.”

Prior to the pandemic, more than a third of Colorado students said they felt sad or hopeless, said Werthwein, of the Office of Behavioral Health, adding, “we know that number has gone up during COVID.”

The initiative will serve students age 12 and older, who under state law can consent to their own treatment and can call and schedule their own appointments. Werthwein wants to ensure teachers and parents can identify mental health issues among younger students and contact a clinician, or, if the student is facing a crisis, contact Colorado Crisis Services

Colorado Crisis Line: A statewide hotline. 1-844-493-8255, or text TALK to 38255.

At the very least, he aims to create a public service campaign to educate communities about the signs of mental health struggles, raise awareness about the state’s crisis hotline and provide up to three telehealth sessions for students and teachers.

Each session could cost between $90 and $100, said Werthwein, who has grappled with his own mental health challenges. His office plans to call in all providers across the state, and he’s optimistic that many providers would be interested in participating. Even if a provider could assist only one or two students or a handful of students, Werthwein said, that would contribute to the broader cause.

He acknowledged that Colorado needs more providers. A number of providers operate in private practice because of the administrative burden that comes with being in the public sector, Werthwein said, noting that his department is trying to reduce that burden to draw more providers to the public sector.

Hawks, of Children’s Hospital Colorado, said the state lacks enough trained, quality mental health providers for the state’s kids.

Still, she believes it would be possible to help students if the state focused on supporting the training and education of providers who are already working in environments where kids are, such as schools.

“I think that anything the state can do to promote the mental health wellbeing of youth and teachers is (an) applaudable effort and should absolutely be supported,” Hawks said.

The option for kids to meet with a professional could be transformational, said Bethany Taullie, a junior at Swink Junior-Senior High School in southeast Colorado.

Bethany, 17, has seen how lonely the pandemic has made students feel, noting that teens base their energy off the people around them. She’s also navigated her own mental health challenges, both before and throughout the pandemic. Her struggles have included depression and anxiety, and just before the pandemic was beginning to invade Colorado last year, she felt like she was finding her stride with her friendships, relationships with family members and involvement in different activities and clubs.

That all came crashing down.

The month before COVID-19, she wrote in her journal, “this is the best I’ve ever been in my entire life.” A couple months later, her journaling took a turn: “Why do I feel so alone and, like, empty?”

Without much to look forward to, it was hard for Bethany to even get up in the morning. She has since found ways to regain her motivation through the pandemic — delving into Bible studies, writing to penpals all over the world and learning how to entertain herself. But she knows students are still having a hard time coping after so much change and uncertainty.

Bethany, who is a member of the Colorado Youth Congress trying to drive conversation about mental health through its Systems Change Network, said connecting students with mental health providers could go a long way toward completely changing a kid’s day. But ideally, she would want the state to expand its telehealth support to younger students, who may be susceptible to mental health challenges and in need of learning how to cope.

Bethany, who also belongs to a health and wellness team in her district that focuses on student mental health and morale, underlined how important it is for people to understand that “it’s completely OK not to be OK.”

“You’re not alone,” Bethany said. “And I just wish someone would have told me that when I was a lot younger.” 

Reeves, of East Grand School District, also backs the proposal, so long as it won’t pull funding from another critical area that would lead to more stress. The idea, he said, is “wonderful and so needed.”

East Grand Middle School was in the path of smoke from the East Troublesome fire in October. East Grand School District canceled classes after many families evacuated. (Handout)

The superintendent, whose district has beefed up its counseling staff to seven employees over the past four years, remains concerned about the mental health of both his students and his teachers. Educators have been up against chronic pressure and stress all school year.

The stress will only be amplified this summer, once snow melts and his community gains a clearer picture of the extent of damage caused by the East Troublesome Fire. Trauma from the past, he said, is likely to resurface. And in some cases, trauma will shape the community in new ways.

He also has reason for more immediate concerns, with stress mounting as students and teachers have had to shuffle back and forth between classrooms and homes.

“It’s hard on adults,” Reeves said. “It’s super hard on kids who need a little more structure.”

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