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SALT LAKE CITY — Long before COVID-19, Utah schools reported that the need for mental health services was far outstripping the supply.
Then came the pandemic, which has contributed to an exponential increase in needs and referrals to community mental health agencies. Meanwhile, community and private mental health care providers have been dealing with an onslaught of demand for services by the adult population, whose care needs were exposed or worsened due to isolation forced by the pandemic.
State lawmakers have taken incremental steps the past few years that have resulted in greater access to care and better outcomes for many Utahns, but there is much to discover about mental illness and effective treatments and a need to expand the provider pool.
A massive new mental health facility is coming
Earlier this week, the Executive Appropriations Committee took a significant step to expand heath care access and support research leading to groundbreaking treatments by approving $90 million in funding for the Utah Translational Research Building at the University of Utah Huntsman Mental Health Institute.
The $90 million in state funds will be combined with $65 million in private giving to create a public-private partnership in support of the research and care facility. The funding was prioritized during a special session of the Utah Legislature in May as part of the $1.6 billion Utah accepted in COVID-19 relief funds.
Educators and researchers from universities and colleges across the state will use the facility to partner with the Huntsman Mental Health Institute on research, treatment and training initiatives.
"If we are going to tackle big problems like suicide, child mental health, and substance use, it will require bringing together teams of experts in basic science, translational science, law, technology, AI, and policy to solve these problems holistically," said Dr. Mark Rapaport, CEO of Huntsman Mental Health Institute.
University officials say the facility will catapult Utah to the forefront of mental health research and care as demand for care grows exponentially.
Kids' mental health: a growing problem
In a presentation to the Utah Legislature's Education Interim Committee this week, state education officials told lawmakers that Tooele County School District referred 61 students to mental health service providers in the 2019-2020 school year. The following year, the number of referrals increased to 307.
"That is an increase of 403% of students who the district determined needed those community referrals," said Ashley Lower, behavior specialist with the Utah State Board of Education's Safe and Healthy Schools team.
Marianne Oborn, Tooele County School District's director of counseling and social services, said the spike in referrals represents increased need for mental health services as well as expanded availability of services.
"Our staff and community awareness of mental health services supported by the district has made it more available and safe for our students to take advantage of mental health services," Oborn said.
The pandemic may be one factor contributing to students' increased need for services, but "we don't have qualitative data specifically for the impact of COVID on our students," she said.
"We do know from conversations students are having and watching student behaviors that COVID has impacted our students' mental health. We know that the consistent conversations about COVID and related COVID conversations in the news and on social media are impacting students' mental health," Oborn said.
Recent surveys of students and teachers indicate growing anxiety and hopelessness, she said.
The 2019 Student Health and Risk Prevention survey showed 10.7% of students felt unsafe going to school one day or more, compared to 7.3% in 2015.
Results from the SHARP survey, administered to students in grades 6, 8, 10, and 12 in most public schools in Utah every other year, also indicated growing numbers of students who felt sad or hopeless for two weeks or more during the past year. The percentage rose from 22.7%. in 2015 to 28.2% in 2019.
The SHARP survey helps educators and other government agencies track trends, plan programs and deploy resources.
Meanwhile, the 2021 Climate Survey administered to educators and special education educators showed that more than half of teachers felt overwhelmed, with 58% of special educators and 57% of general educators reporting they felt overwhelmed. Sixty percent of special educators reported feeling stressed, which was nearly the same among general educators at 59%.
In both groups, roughly 10% reported feeling depressed. Six percent of regular educators and 5% of special educators surveyed said they felt angry, according to the survey.
Lower said the survey showed the percentage of special educators who felt stressed or overwhelmed a majority of the time at work "was greater than the percentage that felt excited at work ... and gives us a little bit of a picture of our special education teachers and how they might be feeling at work."
A 'turning point' for help in schools
In recent years, the Utah Legislature has prioritized mental health resources and policies attempting to address significant needs for additional services for students.
Cade Douglas, superintendent of the Sevier School District, reflected on testifying to state lawmakers 3½ years ago after four students in the school district had died by suicide.
"It was a very trying time in our county. We had really seen an uptick in suicides. Our county, Sevier County, hadn't seen school-aged children die to suicide, and we had four at that time when I came to testify to this body, pleading for help, pleading for collaborative efforts and funding and program," Douglas said.
The passage of HB373, sponsored by Rep. Steve Eliason, R-Sandy, was a turning point, he said. The bill appropriated some $27 million in ongoing funding to the state school board for school support personnel and permits schools to contract with local mental health authorities for students who need clinical services.
If we are going to tackle big problems like suicide, child mental health, and substance use, it will require bringing together teams of experts in basic science, translational science, law, technology, AI, and policy to solve these problems holistically.
–Dr. Mark Rapaport, CEO of Huntsman Mental Health Institute
Sevier School District initially hired one mental health coordinator to serve the district's 12 schools. Later, with funding appropriated under the Teacher and Student Success Act and other funds, the school district hired six coordinators, who serve two schools each.
The coordinator/therapists work with students on resiliency, self-esteem, emotional safety and anxiety, among other issues. They work with entire classrooms, in small groups and on occasion, with individual students. They also help families with resources outside of the school.
Since the initial four deaths by suicide, two other students took their lives. Then, there were none for two years.
"We did have one in March, unfortunately, but the trends are looking much better. We are having some success," Douglas said.
Another statewide resource supported by state appropriations, the SafeUT app has also been helpful, Douglas said.
SafeUT confidentially connects students to crisis and suicide prevention resources and enables students to provide tips anonymously about perceived threats at schools, which are passed on to school contacts.
"It's very useful. It continues to improve, in my opinion, each year," Douglas said. At times, tips shared via the app can overwhelm principals and administrators.
"It's just a constant thing that they're sending them messages, 'You've got a student who's struggling with this or that.' We drop everything we're doing and we offer support to those students every time. So it's a very well-developed app and it's worth every cent in my opinion. It's very effective," he said.
In recent years, the University of Utah School of Medicine has been adding new psychiatric residency slots to help address Utah's mental health care needs, which was also approved by state lawmakers.