School Mental Health Check in
Oregon School Leaders, Lawmakers, Advocates and Parents,
For the last several years, it has been my practice to update my leadership circles on the status of mental health service systems to equip educational leaders with the current status of youth mental health in Oregon. Working across the academic and behavioral health sectors, I know the power of education to make an impact in the lives of young people struggling with mental health concerns. As you read, you will find several articles and resources. This summary will provide context for the material as you read.
Mental Health America (MHA) State of Mental Health Report 2024 - MHA is one of the most potent data-driven advocates in national policy research into the mental health system nationwide. The link will allow you to download the report. Annually, MHA produces a “state of the states” report to help policymakers understand the most pressing concerns in the behavioral health system. Key points from the report are:
Oregon raised several ranks but continues to rank near the bottom of the nation (49 out of 51 states and territories) in our mental health system for youth. For nearly a decade, we have ranked poorly among state systems serving in serving the mental health of youth.
Oregon’s rating improved this year because of notable improvements in access to care across the state. Still, our numbers continue to remain among the poorest because we lead the nation in the prevalence of mental illness across depression, substance abuse, and suicide indicators.
While we have a state systemic infrastructure that eases the burdens for providers to provide and bill for services, we continue to see youth rates of “flourishing” or succeeding plummet. One key conclusion from the data is
While therapy services are available and compensated, they are not enough. We need a system that treats illness and promotes healthy, practical behavior. This should motivate us to work towards a more comprehensive approach to youth mental health.
Teacher Mindsets - The article Understanding Teachers' Attributions and Responses to Student Misbehavior (May 2024) explores how K-12 teachers' beliefs and the rationale provided about student misbehavior shape their responses. It reveals that when teachers attribute misbehavior to skill deficits rather than intent or trauma, they exhibit greater empathy, hopefulness, and self-efficacy, adopting supportive interventions rather than punitive measures. However, trauma-based explanations often lead to perceptions of behavioral stability, reducing hope and the likelihood of gathering additional information. For educational leaders, this underscores the importance of fostering a "skill, not will" mindset among staff and integrating training on neurocognitive impacts and positive behavioral strategies to enhance teacher efficacy and student outcomes. A key takeaway for leaders working with teachers around youth mental health is:
We need to emphasize that trauma causes skills deficits that are responsive to teaching, not simply relying on the idea that telling people that students have experienced trauma will make them more effective and compassionate.
School Medicaid Expansion Update - Last year, I wrote to you all about the impressive work of Senator Wyden to push for federal Medicaid expansion in school settings. This work has begun moving slowly through the state rulemaking process. I have worked with colleagues and allies on the School Medicaid Advisory Committee (SMAC) to advocate for improved rules and processes. The key highlights from this last year are as follows:
State surveys indicate that a small minority of the 197 school districts nationwide participate in the Medicaid billing process. Key reasons relate to inconsistent and often poor technical support, historical bias against billing, and lack of knowledge of the medical system by educational staff.
The Oregon Health Authority and its allies in the Community Mental Health Program Association have begun efforts to prevent some staff from participating in the Medicaid billing process. While the SMAC has advocated for improvement in rules at this time, OHA is working to prevent Qualified Mental Health professionals and Associates from participating in the school Medicaid billing process. This works against the efforts of programs like the Ballmer Institute to train mental health professionals in school settings.
All of us are moving towards the upcoming legislative session and Federal Administrative change with a great deal of work to do. Each of you is a key partner in our work to support the needs of Oregon’s youth, and I want to express my deep gratitude for your tireless efforts. Please feel free to share this information with your professional circles to help ensure that all our school leaders are equipped with the information they need to advocate for their students.
