How one school district is looking to reconfigure mental health services for Minnesota’s most at-risk youth

Earlier this school year, Kate Hulse witnessed a rare partnership play out during one of her routine classroom visits at Intermediate District 287’s North Education Center in New Hope.

The classroom teacher had instructed her kindergarteners to practice writing some alphabet letters that they’d recently learned. But it quickly became apparent that one little boy had become too overwhelmed to continue doing his work — perhaps by the challenge of the task, or the break in routine created by having a visitor in the classroom, or a combination of factors.

He balled up his fists and began swearing under his breath, said Hulse, assistant director of mental health and crisis prevention for the district.

It’s the type of response that happens more often in an intermediate district like ISD 287, which serves students with some of the greatest social-emotional needs and learning disabilities. These students are referred by 11 member districts, which aren’t as well-equipped to serve these students on their own.

Before the situation with the boy escalated any further, the full-time classroom therapist tapped in, coaching the boy through some breathing exercises they’d practiced before, right at his desk. Once he’d calmed down, he was able to seamlessly go back to practicing his letters.

Lots of schools have on-site therapists or other licensed student support professionals tasked with addressing students’ mental health needs. Having a licensed therapist assigned to work exclusively with a single classroom teacher and their students, however, is basically unheard of — not just in Minnesota, but across the nation.

This new staffing arrangement is a key part of the Therapeutic Teaching Model that Intermediate District 287 has piloted in three elementary classrooms at its North Education Center. It’s supported by nearly $2 million in one-time grant funding that the district and its partner, the Amherst H. Wilder Foundation, received from the state.

In total, state lawmakers allocated $4.9 million to support the new School Innovation Grant Initiative that passed in 2017, allowing districts to experiment with new student mental health service models over the course of two years. The other fund recipients include the state’s three other intermediate districts and one service cooperative, the Southwest West Central Service Cooperative.

“We developed a model called the Therapeutic Teaching Model for our youngest students, K-3, that would blend services in the classroom,” said Sandra Lewandowski, superintendent of Intermediate District 287. “So, ideally, there’d be both a therapist — a  clinical person — and a teacher in the classroom at the stage in their lives where we may be able to change the trajectory for those kids.”

This particular model is designed to serve elementary students who have experienced some complex trauma, Lewandowski explained. It’s something that she and her colleagues in other intermediate districts have been sounding the alarm on, at the state Capitol, for years.

“Increasingly, we saw young people coming with untreated mental illness, complex and traumatic family situations. And we saw numerous barriers to these young people getting appropriate mental health services,” she said. “We struggle, educationally, with untreated mental health within our students’ school day. So the intermediates really started seeking out legislative help and partnership.”

Her district initially received legislative grant funding to deliver more targeted professional development to staff, who needed to better understand how trauma influences student behavior and how to keep both students and themselves safe in moments of crisis.

These efforts are aimed at decreasing some pretty common safety concerns — things like assaults on staff, ambulance and police calls, and suicide attempts. But there was still an unmet need to do something even more proactive.

Seeking to equip their youngest students with the self-regulation skills needed to safely participate in — and even enjoy — their school day, Lewandowski and her team partnered with clinical experts through the Wilder Foundation to design and pilot the Therapeutic Teaching Model.

So far, there are only 10 kids in the program, divided into one kindergarten classroom and two classrooms with a combination of first- and second-graders. But as student referrals continue to come in from partner districts throughout the year, they’ll continue to fill out the classroom rosters until they reach program capacity at 18 students.

Clinical staffing for the program, which is managed by Wilder, is pretty comprehensive. In addition to three classroom therapists, students in the program benefit from individual and family therapy sessions that take place in an on-site office with another therapist.

Additionally, students’ families are paired with a resource navigator — who also works out of the school building — to help connect them with things like stable food and housing.

Benita Amedee, a Wilder employee, supervises all of the clinical staff brought on board as part of the Therapeutic Teaching Model at the North Education Center. In her experience, the classroom therapist is the element that really sets this model apart from other wrap-around models that seek to link students and their families with the resources needed to be successful both inside and outside of school.

Since that therapist is embedded in the classroom, he or she is able to build an authentic relationship with students and to “really witness what happened with a clinical eye,” Amedee said. Rather than reacting to secondhand information, the therapist is able to intervene right away.

Because of the trauma that they’ve experienced in their lives, the elementary students that her therapists are working with are entering the classroom with a heightened system. “Any threat activates them,” Amadee explained, noting that this includes school work that they find difficult. “They need that co-regulation to be able to get to the point where they can get to the work.”

Program leaders have enlisted the help of a University of Minnesota researcher to help evaluate the program. They expect to see the number of behavior incidents among this particular student subset decrease and the students’ academic engagement increase. Perhaps most important, they hope to see students acquire the self-regulation skills needed to succeed in life beyond school.

“The time for mental health and education working in separate silos is past. We need to increase access. We need to blend our services. We need to work together,” Lewandowski said. “More deeply than that … legislators need to understand the profound impact of childhood trauma. It’s probably the biggest public health crisis we have in this country.”