Facing a rise in student mental health care needs, the Palo Alto Unified School District is planning to hire its own mental health staff, rather than continue to contract out the vast majority of its program.
The school district currently contracts with outside agencies for about 95% of its mental health services, Genavae Pierre-Dixon, the district's mental health specialist, told the board during its meeting on Tuesday. The shift to providing in-house services will take place over time and is in its early stages, but board members signaled strong support for the plan.
"We really need a reenvisioning of what healthy schools look like and feel like," board member Jesse Ladomirak told district staff. "After reading this plan and listening to you all, I actually felt some optimism that we are taking steps toward that reenvisioning."
The district intends to begin by hiring its own staff to work at elementary and middle schools, while continuing to use contractors at the high school level for the time being. The change is expected to cost roughly an additional $1.2 million next school year.
The school board didn't take a formal vote on the plan. The costs will instead be included in the budget assumptions that come back to the board, Superintendent Don Austin said.
By the fall, Palo Alto Unified expects to hire 10 associate-level clinicians, plus several health techs for its elementary schools.
At the middle school level, the district is looking to bring on one clinician for each of its three campuses to staff the wellness center five days per week.
At the high school level, staff intend to gather student input before nailing down a more detailed plan of what will come next.
Palo Alto Unified currently has a $620,391 annual contract with Counseling and Support Services for Youth (CASSY) to provide a part-time or single full-time mental health provider at each of its elementary schools. At middle and high school levels, Palo Alto Unified has a $711,925 contract with CASSY, which provides one therapist for each middle school and three clinicians at each high school, when fully staffed. According to Austin, CASSY hasn't been able to find enough people to staff at these levels this school year.
Next school year, CASSY's contract will be reduced so that its staff are only serving certain special education students and high schoolers, Austin told this news organization.
Beyond CASSY, Palo Alto Unified also has a $98,627 contract with Asian Americans for Community Involvement (AACI) to provide clinical services in Mandarin and parent workshops and an $80,580 contract with Stanford Child Psychiatry Fellows to provide one-time consultations on high-need individual cases. Those contracts will likely have some changes for next school year, but the cost will stay roughly the same, Austin said.
Spike in mental health needs during a staffing crunch
Students were already reporting high levels of stress and anxiety before the pandemic, according to a staff report, with COVID-19 and the resulting school closures only serving to exacerbate those issues.
On top of the increased needs, the district's contractors have been struggling to find enough qualified people to fill the expected number of positions. This comes amid broader national staffing issues, particularly in the mental health field.
"Unfortunately, there have been many gaps in staffing from our contracted agencies this year," the staff report said. "Even when fully staffed at each level, there were still not enough qualified clinicians to truly meet the needs of all our students."
District administrators believe that by hiring people directly, they will be able to get more comprehensive coverage and offer more access to services for students.
"That's the most important piece of this entire puzzle — that we make sure that at every one of our sites we have qualified staff who can meet the needs of our students," Assistant Superintendent of Equity and Student Affairs Yolanda Conaway said.
Board member Jennifer DiBrienza said she supported the plan, but asked administrators how confident they were that they'd actually be able to hire enough people. Austin expressed confidence that the district would succeed and said the plan is to begin recruiting immediately.
Beyond providing individual counselors for students with the highest needs, the district also wants to expand broader support for the entire student body. The idea is to have a tiered system, ranging from one-on-one treatment to universal screening and prevention programs for all students.
"An integrated, in-house approach to providing mental health services will build a community of caring and trusted adults for our students and a supportive school climate for staff," said Dawn Yoshinaga, the district's recently hired director of mental health.
Four people called into Tuesday's meeting to address the board on the mental health plan. Three were supportive, while one said that the district's plan is still insufficient and requires more funding.