Where can Minnesota students get free mental health care?

In 2000, few students in Minnesota public schools had access to mental health therapy in the school building. Today, over half of students do.

A new study published in the Journal of Human Resources determines how many lives these embedded therapists may have saved. The researchers estimated that suicide attempts decreased by 15 percent in 263 schools in Hennepin County that implemented school mental health.

Health officials want families to know that students have access to mental health services at school, whether they can pay or not. School mental health looks different from district to district and even from school to school. And high demand can lead to long waits. But state grants ensure that more than 1,000 Minnesota public schools provide therapy in their buildings.

Farah Hussain, a mental health therapist, says her team at Minneapolis South High School is trying to make sure students get equal access to therapy. We asked Hussain for more details on exactly how students and families can access the services; her answers are below.

Earlier assessments of school mental health have been promising, but Minnesota researchers believe this new study is one of the first to use rigorous statistical methods.

The results are “incredibly encouraging,” said lead study author Ezra Golberstein, who studies mental health economics and mental health care policy as an associate professor at the University of Minnesota School of Public Health.

“There are countless examples of promising programs that, when rigorously evaluated, don’t seem to do as much as we’d hoped,” Golberstein said. “In this case, we have very significant results, particularly for suicidality and increased rates of mental health service use.”

The researchers made their calculations using data from Medicaid and the Minnesota Student Survey, which includes self-reports of suicidality. The researchers were able to examine this data during the period when Hennepin County started school mental health programs.

“We realized that we could see what the effects were when schools implemented this model,” Golberstein said.

Still, the results were more of a relief than a surprise.

Mark Sander has worked with Hennepin County and Minneapolis Public Schools since the mental health program began in 2005. (In Hennepin County, therapists typically share space with a school medical clinic, but the location of therapists’ offices varies by school, district, and county .)

Sander and other program coordinators had already estimated that about half of students seeking therapy at school were receiving mental health treatment for the first time. And of those, about 40 percent were severely emotionally disturbed, Sander said.

“These were children who were potentially at risk for out-of-home placement in the next year,” Sander said: children could be referred to foster care or hospital care. “It wasn’t just the worry”—i.e. people who may be unnecessarily anxious. “They were students who couldn’t get into community care.”

Black and brown youth benefit the most from school-based mental health care

The new study confirms that black and brown youth show the greatest increase in the use of school mental health services. And the researchers found some evidence that increased access to therapy was associated with fewer suspensions and involvement in juvenile justice.

“We work hard to prioritize families that have historically been marginalized,” said Farah Hussain of South High School. “We’re trying to reach those students and families who normally don’t have access to these services. We work with school counselors and social workers; they pit families who have additional resources against families who do not have access to services.”

Often, this is due to socioeconomic status or cultural stigma, Farah said.

Despite some positive findings in the study, increased access to mental health care did not show benefits in every area of ​​education. For example, children with access to mental health at school do not appear to do better on test scores or attend school more often.

But Sander hopes the study will help more cities, counties and schools get funding for services — especially since these new school services often can’t keep up with demand.

“There’s a lot of need in all the schools,” Farah said. Minneapolis Public Schools has two therapists in each of its school clinics, instead of one. But children often have to be on a waiting list before they can get treatment, Farah said.

Minneapolis South High School is home to a small clinic that provides a variety of essential services, including mental health. credit: Aaron Nesheim | Sahan Journal

How school mental health works

Students can see therapists for anything from serious mental health conditions (such as anxiety, depression, self-harm, suicidal ideation and trauma) to less urgent problems (such as poor concentration in school, conflict with peers or life transitions), Farah said. Therapists work in collaboration with school counselors and social workers. Teachers are often the first to identify a student who would benefit from therapy.

Do you want to know more? We asked common questions students and families might have about Farah at South High School. Her answers below have been slightly edited

The programs operate in a similar manner at all public schools in Hennepin County. If you are outside of Hennepin County, see if your school offers services here. School principals, social workers, or counselors should be available to answer any school-related questions.

FAQ for students

Question: I can’t get out of bed. When can I come and talk to a therapist? Do I need an appointment?

Headlight: You can log in and ask about mental health services. It’s called self-referral. The front desk assistant will see if we are available right away. We will then explain our services, review our mental health informed consent form, and discuss next steps.

Or you can meet with your school counselor if you already have a relationship with that person. They will then assess and refer you to us if necessary.

I’m a high school student stressed out about college. who to talk to

If you are not already seeing a therapist at school, you may want to contact your school counselor. School counselors do a lot of academic planning and college planning, so when a question like this comes up, you’ll want to talk to that counselor.

Should I tell my parents that I want to see a therapist at school?

As of this year, there is a minor’s mental health consent form. So if you’re 16 or over, you can consent to your own mental health treatment. If you’re really uncomfortable with your parents knowing—if there’s a significant cultural stigma around therapy or you wouldn’t be safe at home if your parents knew—you can agree to your own treatment and we don’t need to talk to your parents. [Editor’s note: If you’re under 16, parents need to consent to treatment.]

The student is the main customer, but often young people want their parents to know. And we can do family therapy if students and parents are open to it.

If you are in serious danger of harming yourself or someone else, or if you have been or have been abused (verbally, emotionally, physically, or sexually) in the past three years, we are legally and ethically obligated to break confidentiality.

I don’t have health insurance. How much will a meeting cost?

Our services are free, but if your family has private insurance and is able to pay something, we will charge for insurance. If it’s a high wage that you can’t pay, we pay it – we don’t put that burden on families. And the lack of insurance is not an obstacle to seek our services.

How long will I have to wait for an appointment? What if I have to see someone today?

If we are not full, we follow up within 1-2 weeks. If we are full, we communicate with the support team and it becomes the responsibility of the school’s social workers and counselors to connect you with community services.

FAQ for parents

I’m worried about my student. Can I make an appointment for them?

Parents can direct their children. This is absolutely an option.

If my student talks to you, can you tell me about it?

We don’t share details of what we’re talking about unless we have safety concerns.

We like to involve parents as much as possible and necessary, but we don’t share details of everything we talk about in therapy. To respect the privacy of our students so they can trust us, we do not call parents or disclose details of what happened in therapy.

We will not share things about a student’s identity or whether or not they are in a relationship without their consent.

But we often encourage our students to share things with their parents.

How long can my student see you? Should they possibly be transferred somewhere else?

We work all year round – we are not on winter break, but on spring break. Even when school ends in mid-June, we continue to accept students as needed: either at school if the building is open; or telehealth; or at home; or in a park near their home. Students can be on our cases for as long as they see fit.

Seniors can see us until the end of August after their senior year. And if they still want to do therapy, we connect them with someone in the community or their college.

How many classes will my student miss?

We schedule appointments so they don’t always have to miss the same class, although the teachers are very supportive and they are excused from class. We also offer meetings before and after school.

What if I don’t speak English?

I speak Somali so I can explain the process in Somali. We also have a Spanish speaking relative that I have worked with.

And schools can use the language line to communicate with parents who don’t speak the same language as school staff.