This is the first in a series of articles addressing a largely hidden crisis: A decade of social-service cuts and rising poverty have left Minnesota schools ??which turn no child away ???struggling to serve a growing number of students whose severe mental-health issues and cognitive disabilities aren't being addressed anywhere else.
High school is an oasis for Justin, who is 14. He gets himself on the bus and comes every day, good or bad; he most looks forward to the classes where he can move around and do things. He?s particularly gifted at tasks that employ his hands. So far this year he has made a table and chairs in woodshop as well as several cups in art that he gave to his mother.
Justin (not his real name) also can be terrifying. He?s big for his age, six-foot-two. He gets off the bus most mornings swearing and mouthing off and keeps it up until he gets back on. School staff members never know which threats he?ll act on. At the start of the year, he put one in a headlock.
At most schools, this would have been the end of the road. If Justin didn?t end up in the juvenile justice system ? where an estimated 70 percent of kids have mental-health disorders ??he?d be expelled or suspended, or he'd drop out. When and wherever he reappeared, it would be as a grim statistic.
Justin attends a program operated by a west-metro school consortium, Intermediate District 287, for kids whose challenges are too much for conventional schools. Often they arrive with unidentified or unaddressed underlying mental-health or special-education needs.
Each of the two dozen-plus programs that operate in the district?s centers is tailored to a specific set of conditions. At any given time, some may enroll three dozen students, some just one or two. Identifying the exact one Justin attends would violate his privacy, but it?s a program that serves teens whose behavior is aggressive.
Community services cut as needs skyrocketed
Insurers have long been adept at shifting the care of children with mental-health issues onto public agencies. But over the last decade, cuts to human-services budgets have radically winnowed the availability of community services even as risk factors such as poverty and homelessness have skyrocketed.
Between 2008 and 2009, for example, Hennepin County reduced the number of children?s long-term residential mental-health treatment placements by almost 40 percent. The need didn?t go away; rather, it showed up in schools [PDF].
At the same time, demand for complex special-education services is rising. Over the last decade the number of kids diagnosed with autism spectrum disorders has nearly quadrupled to 11.5 percent. Yet a huge body of law designed to protect students? rights quite rightly prevents schools from turning away children with disabilities regardless of budgetary constraints.
Today, Minnesota schools are the ?payer of last resort? for children with severe cognitive or mental-health needs. Because state and federal funding doesn?t account for the cost shift, school districts are forced to tap their general education funds to make up the shortfall. In many districts, this means diverting $800-$900 per student.
Better positioned to help
Amid the bad news there?s a glimmer of silver lining: With realistic financing and some policy shifts, schools like the one Justin attends in some ways may be better positioned to help than the programs they are being forced to replace. And any downtick in dropout rates they achieve will boost the state?s economy.
After the episode with the headlock, police were called and District 287 staff met to reassess their approach. Since then, Justin has had access to services ranging from on-site mental-health care to job skills, and he works one-on-one with an educational assistant.
At six-foot-six, Richard Coffey is even bigger than Justin and possessed of a firm, low-key voice and a seemingly bottomless reservoir of calm. Still, Justin unnerved him. ?He just had a look in his eye,? Coffey recalls. ?He could look right through you.?
Coffey has learned that there are moments when Justin, whose home life is unbelievably stressful, is unreachable. He can?t be left alone with female staff, and in the halls it?s best to walk several steps behind him, where you can see him.
A focus on relationship building
When Justin is more peaceful, Coffey focuses on building a relationship with him. In the process he?s both come to understand what triggers the boy?s explosive behavior and ? he hopes ? given Justin a glimpse of a better kind of normal.
?Last week he was great, a breeze,? says Coffey, who has teens of his own at home. ?He said, ?I am here to learn today.? ?
On the worst days, the ones where Justin?s stream of insults involves Coffey?s wife or recently deceased father, Coffey reminds himself that the most fearful person in the room is Justin himself.
?He?s doing here what everyone else does to him,? he says. ?When I look in his eyes now, he doesn?t know what his future holds for him.?
MinnPost photo by Bill KelleyRichard Coffey on Intermediate District 287: "This is their safe place. This is the one place where their needs are being addressed."
This Justin has in common with his classmates. ?There are some of the seniors here who have opened up to me who are afraid,? says Coffey. ?They don?t see a place for themselves.
?This is their safe place. This is the one place where their needs are being addressed.?
***
Virtually the only thing the 600-plus students who attend Intermediate District 287?s on-site programs share is the unique and intense nature of their needs. Many struggle with mental illness, chemical dependency or cognitive disabilities that are both rare and profound.
Many have two or more conditions. More than 90 percent of students in its programs for emotional behavioral disorder, a special-ed diagnosis, have a current or previous mental-health diagnosis. Overall, it?s estimated 30 percent to 50 percent of special-ed students meet the criteria for a mental-health disorder.
Some need intensive support their home districts can?t provide. Some of the disabilities being addressed are unique, so District 287?s programs, which are open to kids from all over the state, may serve just a couple of students at a time. Because the goal is always to equip a student to return to a less-restrictive school, enrollment fluctuates from month to month.
The associated costs are staggering, but the alternatives even more so. In decades past, millions of these children nationwide were simply institutionalized. A series of federal laws, most recently the 1990 Individuals with Disabilities Education Act, protects their rights to a free and appropriate education.
Minnesota law allows school districts to form co-ops to collaborate or share resources. By creating an economy of scale, these intermediate districts enable members large and small to save money or everything from technology services to staff development, and to provide niche programming in the most cost-effective way.
12 Hennepin County districts
One of three intermediates of its kind, District 287 is made up of 12 suburban Hennepin County districts that draw on its shared services for everything from legal and technical assistance to gifted education. Special education accounts for 67 percent of its $82 million budget; like every other school district in the state, it has had to find efficiencies and cuts to make up for the shortfall in state reimbursement.
Its 11 sites serve kids aged birth to 21 from all over, including a number referred from Minneapolis Public Schools. Among them are the Hennepin County Home School and area residential treatment centers as well as a program for new mothers with on-site child care.
Many of the programs are clustered at a brand-new facility in New Hope, which will allow students to be better served at a lower cost. The state-of-the-art North Education Center is equipped with sophisticated security equipment, spaces tailored to the needs of students with sensory challenges, workforce-training spaces, a child-care facility and enclosed nooks within classrooms where students can go to calm themselves and regroup.
Eight of 287?s special-ed programs serve students with emotional or behavioral disorders, nine serve students whose ?low-incidence? neurobiological disabilities require customized programming, and seven serve young adults who are making the transition to living and working independently.
District 287 also operates 20 Area Learning Center (ALC) programs for students who need social, emotional and academic support and who may also have a special-ed diagnosis. While many are referred by counselors or others at schools that didn?t meet their needs, others enroll themselves. Their home districts may or may not provide transportation.?
Building a bridge
About 80 are enrolled in ALC Plus, a joint effort of the Hennepin County Human Services and Public Health Department, Juvenile Probation, District 287 and Minneapolis Public Schools to increase graduation rates. The idea is to build a bridge between the school and the services students need to stay there.
Nearly 4,000 Hennepin County students drop out of school each year. Human potential is lost, and the county spends about $400,000 a year on services for each cohort. As each group ages, their lost wages cost the state $1 billion a year.
ALC Plus is a 2-year-old effort to staunch the hemorrhaging. Students are referred by truancy workers, county social services or juvenile probation officers. An array of services including assessment, psychiatric care, chemical-dependency counseling and behavioral intervention are provided on-site, during an extended school day.
The approach has multiple advantages. Families often struggle to find mental-health services for children, or feel too stigmatized to consider them. Others are uninsured. And kids in families that find treatment on their own still miss more than half of their appointments.
Home visiting, monitoring
Not only do services literally come to ALC Plus students, case managers and ?system navigators? make home visits and monitor whether they are getting the right supports. State grants pay for some of the services, but for every dollar spent District 287 staff is able to leverage $2 in insurance reimbursement.?
There?s a great deal of interest in the approach. Minnesota is one of eight states currently using grants [PDF] from the federal Substance Abuse and Mental Health Services Administration (SAMHSA) and the John D. and Catherine T. MacArthur Foundation to create methods for steering youth with both mental-health and substance-abuse issues away from the juvenile justice system and toward more appropriate services. District 287 is part of the effort.
Hard data about this particular program is scant in part because the effort is new, but there is data [PDF] about the efficacy of locating mental-health services in schools. Since 2007, Minnesota districts that have used state grants to bring in the services have reached 8,400 students; about half of them have serious emotional disturbances.
More than half are receiving services for the first time. According to data compiled by Minneapolis Public Schools, as the amount of treatment goes up, suspensions are going down. Academic outcomes are up, too.
?The ?Bridge Model? is really working,? says 287 Superintendent Sandra Lewandowski. ?There?s a huge return on the investment.?
Life ring needed
Policy and funding need to catch up to reality, however. If educators and administrators are to expand on what?s working, they need the state to throw them a life ring so their best efforts aren?t overcome by the day-to-day crises.
With the Legislature beginning a new session and children?s mental-health issues the topic of tragic headlines, a number of groups, including District 287, have prepared presentations outlining measures that would help.
Atop the list: A long overdue reform to special-ed funding, the expansion of the successful 5-year-old state grant program that helps pay for school-based services, and the creation of psychiatric treatment facilities for the most challenged kids.
***
Consider this: One fourth of District 287?s 500 special-education staff members were injured during a recent seven-month period as the result of interactions with students. They don?t complain about it, though. Instead, they focus on student safely or they voice fears for what will happen when their kids are forced back out into a world that sees them not as disturbed but as disturbing.
Since fiscal year 2008, workers-comp premiums have increased 104 percent. Perpetually attempting to do more with less, administrators recently thought to save by reducing the police presence at one site from two officers to one. The police said no, they didn?t feel safe with a single officer there.
Teachers and aides feel safer at the district?s program in the County Home School, the long-term youth detention facility, than they do in some of its less restrictive facilities. There?s backup security and kids in the locked facility get regular meals and don?t have evening access to drugs and gangs.
Always some who are prone to violence
At any given time, there are a dozen students in district programs who are prone to violence. Monica (again, not her real name) is 14. She came to 287 through the corrections system, where she faces three felony charges. Both of her parents are incarcerated and two of her brothers killed by gang violence. She goes home at night to the custody of a 23-year-old sister.
She has moved a lot, and her school records are incomplete. A year-long stay in a residential treatment facility does not appear to have included any special-education services. She?s intelligent and probably suffers from a psychotic disorder.
Monica brought a knife to school and attempted to assault a classmate. She attacked the educational assistant who tried to intervene, the school resource officer who responded and four police officers. Deemed too violent for residential placement, she was sent back to school pending sentencing for the assault.
This year, on one of the first days another student had a meltdown that was violent enough that police were called. He assaulted the officer who responded, trashed the police car and banged his head against the window repeatedly. An ambulance took him to an emergency room, but he was back at school within 24 hours.
?There used to be a time when they received psychiatric stabilization,? says Charlene Myklebust, 287?s director of mental health, training and partnerships. ?There?s a lot of inadvertent cost-shifting. Services that have been removed elsewhere might have prevented problems with now have to deal with.?
The level of aggression is rising. Girls, who used to be more verbally abusive, are increasingly involved in violence. And ages are getting lower: The district serves 25 elementary pupils with emotional and behavioral disorders, including five kindergarteners.
***
Sammy White is a 287 paraprofessional who spent some time in an ALC himself when he was growing up. Like Coffey, he is a big believer in the value of personal relationships, both as an early warning system and as the best chance for change. The most valuable took in his arsenal is a morning greeting.
?I say, ?Got up on the right side of the bed?? or ?How was your weekend,? ?How was your evening?? ? he says. Students? replies suggest how the day should be approached. ?Sometimes I get the roll of the eye or maybe no response.?
When a student returns to school after a violent incident, White makes a point of greeting him or her first, and then saying they need to talk. His goal for the conversations is to let the students know that, willful or not, their behavior had an impact.
'Their challenge and their behavior is their normal'
?We have kids who come in here [for whom] their challenge and their behavior is their normal,? says White. ?Their behavior is the same wherever and whenever they are. Their choices in life are really limited.?
Last fall he found himself giving constant redirection to a young man who kept trying to follow a girl into a class that wasn?t his. The boy exploded, advanced on White and threatened him. White stepped back, walked off and explained the situation to the police liaison in the building. After they talked through his options, the boy chose to leave.
When he came back two days later and ready to talk, White sat him down. ?I pretty much explained how I felt, that I felt threatened,? he says. ?I want him to look at life through a different lens. I think he received it.?
Outsized as their efforts are, White and his colleagues often wish they could do more to position their students for long-term success. And they are painfully aware how poorly the world beyond their walls is prepared to take over when the kids leave.
In August, one of their success stories addressed a back-to-school gathering of 287 staff.
?I believe in me,? Jacary ??his real name; he's a junior at the north facility???told the educators, counselors and others. ?Do you believe in me? Do you believe that I can stand up here, fearless, and talk to over 400 of you?? The educators whooped and cheered that they did. ?
?Hey North Education Center, do you believe in me?? Jacary asked, to more cheering. ?That?s right, they do. Because here?s the deal: I can do anything, be anything, create anything, become anything, because you believe in me. And it rubs off on me. ...
?You better not give up on us ? no, you better not???because as you know, in some cases, you?re all we?ve got. You?re the ones who challenge us. But you?re also the ones who feed us, who wipe our tears, who hold our hands, hug us and love us when it feels like no one else does ? and when we need it the most.?
In the end, there were standing ovations all around.
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