After Littleton: What?

Richard Louv
April 22, 1999

Once again, the shots ring out, and once again pundits and politicians will call for attention to children's mental health. Maybe this time, we'll do something about it.

Our lack of commitment to mental and emotional health services in the schools—school counseling staffs, school nurses and psychologists, and other support staff—is shameful. Nationally, only one school psychologist is available to every 3,000 students. In most high schools, the student-to-counselor ratio is abysmal, and in many elementary schools, non-existent.

"As in most of the country, we're almost prohibited from doing real counseling because we're buried in paper work, helping kids plan for college," one all-too-typical high school counselor tells me. "The district is making us into piece workers: How many tests did you give today? One girl told me that whenever she came to see me, she felt that she was bothering me because I was always testing and had so much paper work to do. Sometimes I even felt guilty for taking the time to talk to her." Later, this girl committed suicide on the way to school.

Teachers, ill-prepared by schools of schools of education, need better training in mental health issues, according Charlotte Ross, former director of the Youth Suicide National Center in Washington, D.C. In 1975, after a cluster of suicides occurred in San Mateo, Ross was asked to find out what could have been done to prevent it.

"We found that teachers were often afraid to get involved with children who were suicidal, afraid of making it worse, afraid of criticism from their peers," says Ross. "When we looked at the homework of children who had killed themselves, we often found clues—even suicide threats—that teachers had graded for grammar, and without comment." So she developed a public school curriculum in suicide prevention, which focused on teacher education and peer support, now used across the United States and in Israel. "But the use of it is spotty," she says.

In the era of managed care, the health care system may be even less attendant to the mental health of children and teens. Over the next few years, the federal government will invest $24 billion to expand health care coverage to millions of children whose families do not now have health insurance. The states are currently writing their proposals for how they're going to use this money. But under the federal plan for children's health insurance, mental health is not considered one of the primary elements to be covered in the basic benefit package. Rather than a basic benefit, children's mental health is considered an "additional" benefit, and therefore treated as a second-class health problem.

"Substance abuse care is not even considered an 'additional' benefit. The states don't have to cover it. And prevention isn't even on the horizon," says Ron Manderscheid, chief of the Survey and Analysis Branch for the U.S. Center for Mental Health Services.

However, progress is being made in some areas—at least bureaucratically.

Mental health advocates and government agencies are working to create a new mental health safety net for kids. The goal: coordinate efforts of schools, justice systems, social services, and health and dental care providers, into a safety net capable of catching children—or keeping them from falling in the first place. San Diego County, for instance, is making some important strides through a program called Project Heartbeat. With an annual budget of $58 million, the project consolidates county services, will initially focus on youths served by the departments of mental health, social services and juvenile probation, as well as those eligible for special education services.

One thing is clear: government policy should not focus exclusively on school safety, but on children's mental health—especially the mental health of boys.

Without waiting for federal or state governments, libraries, recreational programs, kind and sensitive neighbors, extended family, small business owners—every institution and individual that comes in contact with children can play a role in supporting troubled children and their parents.

For example, in Coronado, California, the Kiwanis Club pays for the part-time salary of the only counselor to work Coronado's three elementary schools. "Think what these kids could accomplish if their emotional health was dealt with in school a couple hours a day," says the group's president. "Seems to me that mental health has something to do with academic achievement."

And at Van Asselt elementary school in Seattle, one mother says she volunteers in the child's classroom, and finds herself acting as a surrogate parent to troubled children.

"More than anything else, I've been overwhelmed by the emotional needs of so many of these children," she says. "One little girl I'm working with is unwilling to learn anything right now. She just wants me to hold her, to be hugged, and to lay her head on my lap. I find myself-more than teaching these children—I find myself loving them."

Unfortunately, the nation's focus on children's mental health fades rises with each school shooting or cluster of teen suicides, and then falls until there's another incident. Another Littleton.


Richard Louv is Senior Editor of Connect for Kids, a columnist for The San Diego Union-Tribune, and the author of several books on children and community, including "Childhoods Future" (Anchor) and "The Web of Life: Weaving the Values That Sustain Us"(Conari Press).