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Without schools, how are students accessing counseling?

In addition to telehealth, counselors offer car-side visits and app-based support

As public schools and colleges move to remote learning to minimize the spread of the novel coronavirus, students and counselors are faced with a new challenge: How do students access school-based resources for counseling and mental health support?

Throughout the Four Corners, mental health providers and school counselors have worked to adjust services in a rapidly shifting environment to ensure students' basic needs are met.

Many students who rely on schools for emotional support were left stranded with the abrupt nature of the transition from in-person learning to virtual learning, something that will last for the remainder of the school year, if not longer.

The transition can be difficult for children and young adults. In addition to being scared and confused about the public health crisis, students have fewer in-person interactions with their peers and mentors. And being confined at home can spark feelings of isolation and detachment.

Counseling is perhaps more important than ever. But counselors can no longer offer support in they way they used to, perhaps with a hug or a high-five. But they are finding other ways to offer therapy, including car-side visits, if necessary.

Here's how schools across the Four Corners are responding.

Durango

Samantha Tower, coordinator of student support services with Durango School District 9-R, said the relationships school counselors have built with students helped with the rapid move from in-person sessions to virtual visits.

“But, it's rough. It's hard for students, families and counselors when you are not there physically. When a student is having a rough time, you want to be there to be able to offer a hug, and it's difficult when you're unable to offer that support,” she said.

Earlier this month, counselors began making home visits to students to try to maintain personal relationships, Tower said.

“We're maintaining social distance, and it provides some personal contact that you can't get in a virtual format even if it's just to drive by a student's house and wave,” she said.

Sarah St. John, a counselor at Miller Middle School, holds office hours with students. One question she asks them is how they are feeling that day.

While bullying can still be a concern, the novel coronavirus has also led to more isolation, an especially difficult emotional adjustment for middle and high school students, and counselors are working to help students adjust.

“Social life is so critical in middle school and high school, and when you lose those social interactions with your peers, it creates a sense of loneliness,” Tower said.

Beyond emotional needs, counselors are seeing more families needing help with basic needs.

The economic disruptions caused by COVID-19 have school counselors finding more families under stress to provide adequate meals or to pay the monthly electric bill.

Manna soup kitchen works with Durango schools on the Backpack Program to provide meals for families over the weekends when school is not in session.

The number of students who are taking home backpacks – which consist of seven meals, two breakfasts, two lunches and three dinners – has increased from 200 before COVID-19 restrictions to 400 since in-person classes were replaced by at-home and remote learning.

9-R Superintendent Dan Snowberger said the district is seeing new families reaching out for support with the unique pressures created by COVID-19.

“We've seen stressors emerge in families who have not always needed assistance,” he said.

Courtesy of Durango School District 9-R<br><br>Kim Osbey, a counselor at Escalante Middle School, meets with a students weekly over the computer. Osbey has daily office hours so students can reach out to her.

Life without soccer clubs, gymnastic practice or the high school game night produces its own kind of difficulties that some families struggle with.

“Staying in the house is not always so easy,” Snowberger said.

If 9-R is not seeing a child attend his or her remote classes, Snowberger said the district strives to check on the family to ensure “everything is all right.”

Snowberger said teachers are also adjusting the amount of work they give students based on the different stresses families are under.

“Families are seeing an increased level of stress. And if school is adding another stress point to the family, if they are feeling burdened by school, we want them to reach out to us. School is important, but family health is, too,” he said.

'There was no preparation for this'

In Montezuma County, school counselors and mental health providers have had to rapidly shift their programming to connect with students from afar.

At Montezuma-Cortez Middle School, counselors Robyne Cote and Carrie Schneider say it's all about maintaining relationships. When the coronavirus suddenly canceled school in March, they were worried about how to connect with students, particularly because the closures were so abrupt.

“There was no preparation for this,” Cote said.

They hope to have a school staff member reach every student. And a big part of the job is making sure students' basic needs are met immediately – like Maslow's hierarchy of needs, Schneider said.

“Just making sure that our students have food, a place to stay, money to be able to pay their rent or whatever else they need to,” she said. “Then being able to go, 'OK, do you have computers, do you have internet access?'”

A constant thread among district counselors is figuring out how to support students in adverse home situations. Shortly after in-person classes were canceled, they sent out a survey to students with questions related to safety and whether basic needs were being met.

“We had a really high response to that,” Cote said.

They've been seeing different types of young people. When campuses were open, the counselors more frequently saw students with school-induced anxiety, but now many of those young people are fine – instead, counselors worry about students facing stressful home circumstances.

It's been easier to connect directly with older students, who are more likely to have their own technological devices. For younger students, especially at elementary schools, counselors tend to speak with parents, which can change the situation.

“Usually a kid comes in, it's a space to be able to talk,” Schneider said. “And then when you have a parent there, you have siblings there – there's a whole shift in dynamic.”

Another persistent discussion has been the issue of connecting with students remotely. This has been the hardest part for Cote – her strength is her ability to build relationships, and she can't high-five students or take them for a walk from a computer screen.

But they've held group hangout sessions via Google Classroom, and the Piñon Project and Ute Mountain Ute education department have jumped in to help provide internet access.

The Four Corners Health Clinic, which operates at Southwest Open School in Cortez and at the Dolores school campus, has remained busy, although its style has shifted.

“We've changed our business model,” said Rebecca Doughty, program manager for both sites. The school-based health clinics offer physical, behavioral and mental health services to all young people up through age 21.

They've adjusted their practices but still encourage patient visits. The lobby doors remain locked, with signs posted in front asking people to call first, and if an in-person visit is necessary, they limit the number of patients allowed in at a time. The providers are using telehealth, telephonic and even car-side visits.

While patient visits have substantially decreased, they're also looking to the basics – the sites are seeing students with a greater need for essential supplies, as family members lose work.

“As a clinic, we don't have a lot of resources to help students with some of these kinds of things, so we just do a lot of it out of pocket,” Doughty said.

And once school starts up again, they expect an uptick in appointments.

“I have a concern that these kids are losing a lot of their social contact, their social interaction,” Doughty said.

She believes they might see an increase in depression and anxiety among patients.

“It's the fear of the unknown,” she said. “You just don't know.

Older students have different concerns

Mental health services are easier to access for college students than younger children, who might need to rely on a parent to provide virtual access. But older students face their own challenges.

Older students have more varied needs. They may be worried about paying rent or stressed about future job prospects. To understand those needs, San Juan College conducted a listening campaign of sorts. While mental health was a component, many students were concerned with basic needs like financial aid, a lack of access to technology and feeling cut off from friends.

“The president (of San Juan College) was quick to recognize that we needed to talk to students, to see how their well-being is,” said Dr. Boomer Appleman, vice president for student services at the college.

Julia Dengel, a mental health counselor with San Juan College, conducts teleheath sessions with students from her home while the college remains closed during the COVID-19 pandemic.

The college has transitioned all counseling services to telehealth sessions, by phone or video. Since the pandemic and closures began, there has been an increase in students seeking services, but Appleman said it has not been a dramatic jump in numbers.

“It's a different age than it used to be, and students are more in-tune with needing good, strong mental health support, and they're more willing to access those,” he said. “We're very relieved and pleased that (students) access it.”

Farmington Municipal Schools has helped refer parents and students to a new app, NMConnect, available through the state's Behavioral Health Collaborative and New Mexico Crisis Access Line. The program was launched in response to COVID-19 and the growing emotional support needs around it. The phone app offers free 24-hour crisis and non-crisis support, including access to behavioral health professionals who will text or call.

“As the COVID-19 pandemic continues to force physical isolation, many people may experience challenging behavioral health symptoms, some perhaps for the first time,” said Bryce Pittenger with the Behavioral Health Collaborative.

Throughout the Four Corners, there is a concern with mental health professionals and school administrators that the increased mental health needs of their students will extend beyond the pandemic.

“We want to make sure they have the coping skills to walk along with them during this,” Appleman said.

lweber@durangoherald.com

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