Schools asking parents about their child's mental health history
Palm Beach Post - 8/11/2018
Aug. 11--Tucked at the bottom of Palm Beach County's student registration form, on the page that begins with who is permitted to pick up your child from school and just under the box to check if a student has life-threatening allergies, is a new question: Has the student ever been referred for mental health services?
Yes? No? Not known?
The question comes in the wake of the Parkland school shootings. It is a requirement of the Marjory Stoneman Douglas Act -- the same law that now compels districts to park a police officer on every campus.
Unlike the officer on every campus rule, this directive to "note referrals to mental health services upon initial registration" has raised concerns, criticisms and more questions from school administrators and mental health advocates.
To begin with, there's the matter of how to answer the question.
* What constitutes being "referred to mental health services"?
* But also, then what? Must a parent disclose more? How much more?
* Where does that information go? Who sees it? Will a box checked yes, or any accompanying details follow a student when he or she applies to college or pursues a career in the military or law enforcement?
* Will an affirmative answer connect a student and family with needed services or will it flag a child in a way that makes him or her a target when things go wrong?
The answers for many of these questions isn't particularly long, says Alisa LaPolt, executive director of the National Alliance on Mental Illness Florida. "We just don't know. We're in new territory."
While state law demands the question be asked, the state's Department of Education has left it up to the 67 countywide districts to figure out how to ask it and what to do with the answers.
Per state law, Palm Beach County's registration form has long asked whether a student has been charged with a crime or expelled from school. Last week, the district unveiled its modified form to also ask about mental health.
Thousands of parents and students are expected to fill out the form in the next few weeks, as new student enrollment typically builds from the week before school starts through October. Parents of students already registered will also see the question as they're asked to update their students' information in the coming weeks.
What happens if it's 'yes'
Palm Beach County is among several that kept the question short and chose not to ask for further details on the registration form, Deputy Superintendent Keith Oswald said.
A "yes" answer takes the parent away from the front office staff for a private conversation with someone designated by the principal, "most likely a school counselor," Oswald said.
"They would then have a private conversation to gather more information that they would log and keep that confidential," Oswald said.
He said the goal of the conversation is to determine whether the student or family needs support at the school, but would start with something like, "Are you able to share more information? Is it intensive? So then the school staff would say, 'We want to be able to support your child. Given that you've checked yes, can you tell me more?'"
Oswald went on to say: "We'll provide training. There's a protocol we're going to provide staff that we'll follow. Obviously, there's no exact script. We want to be respectful of the parent and the privacy."
Privacy is paramount in the concerns that come up when a school district starts asking about a student's mental health -- the question stands at the crossroads of federal medical privacy laws and student privacy ones, said LaPolt.
Most people are somewhat familiar with HIPPA, the Health Insurance Portability and Accountability Act, intended to keep someone's medical records private. But is a student registration form a medical record or a school one?
Student privacy law, the Family Educational Rights and Privacy Act or FERPA to be precise, offers parents and students certain protections regarding those records, including transcripts, disciplinary records and the like.
In general, FERPA says student records can't be released without a parent or student permission, LaPolt notes. But the law carries several exceptions that allows schools to share records with law enforcement and other school officials, to name just two.
"That's a concern I've hear from a couple of parents," LaPolt said. "My advice to parents is to ask those questions to the school district and to the school." Also, she suggests asking how they retain the records and who has access to them. In Palm Beach County the answer for now is only principals and school counselors, Oswald said.
The concerns go back to something NAMI has been fighting nationally -- stigmatizing people who seek help for mental health issues.
"That stigma is there and it's real," said LaPolt, who was one of Gov. Rick Scott's appointees in the room where the bill was being hammered out in the wake of a clearly disturbed young man who killed 17 people at Marjory Stoneman Douglas High on Feb. 14.
"That was the challenging when crafting the law -- the sense that who was seeking mental health services was a danger," LaPolt said. "There are many, many reasons why people commit crimes like Nikolas Cruz did. It could be childhood trauma, that's a risk factor. Another is alcohol or drug addiction. Another is being a young white male or having a history of violence."
Are all killers mentally ill?
Painting all children who seek mental health services with that brush -- "That's not fair and that's not an accurate picture, but that's what we observed in the conversations around this law and this legislation," LaPolt said.
NAMI leaders nationally have described this challenge of untangling gun violence from mental illness for years.
NAMI points to research that shows only 4 percent of violence in the United States -- not just gun violence, but any variety -- can be tied to someone with schizophrenia, bipolar disorder or depression. A bigger problem for those with mental illness is self-harm, they report.
For those reasons, the organization is keen to make the public aware of these distinctions, lest people shy away from seeking the help they need for fear of being labeled.
Advocates including LaPolt and educators are hoping instead that the question on the registration form serves to knit the schools into the fabric of community resources that can help students and families.
The legislation directs school districts to devise plans to direct students and families to services when schools spot students who may need that additional help.
At Santaluces High School in suburban Boynton Beach, the guidance office saw 50 or 60 new registrations last week. So far, the additional line of inquiry has not prompted any parent questions or concerns, Principal Tameka Robinson said Friday.
"Everyone has been answering the question," Robinson said. But so far, no one has checked "yes" prompting a next-level discussion with the school psychologist she has designated to speak to parents should the need arise.
About 195,000 students from kindergarten through grade 12 will attend district schools this year. The law requires students note any mental health service referrals "upon initial registration for a school within a school district." Only a couple thousand will register for the first time in Palm Beach County in any given year.
But the registration form those new students fill out is the same one schools send home with every student within the first weeks of school, administrators report. It's part of the district's annual attempt to make sure all of the information is up to date, Oswald said. Which means the question eventually will be put to all of its students.
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