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'Like nothing we have experienced': Panhandle kids on verge of mental health crisis

Miami Herald - 6/13/2019

Jun. 13--TALLAHASSEE -- For some children, all it took was the rain.

When thunderstorms passed through the Panhandle this winter, the sound was enough to distress some students just returning to school, reminding them of Hurricane Michael's raging path last October that left much of the state's northwest in ruin.

They would run to their teachers in tears, fearing the storm might return, recalled Sharon Michalik, the communications director for the school district in Bay County.

"They were asking if the water will still work, will their parents be able to pick them up and where will they be able to go when their home blows away," she said. "The weather toll itself was creating and bringing back the trauma."

As another hurricane season begins, the devastation and the slow pace of recovery are instilling a sense of despair among many of the region's residents who are still struggling to find housing or fulfill basic needs. Many are living in tents or campers outside ruined homes while they wait for contractors or for state or federal assistance.

The strain is starting to show among many of the Panhandle's children, as school officials in Bay County are fearing that a full-blown mental health crisis may be taking root.

Hundreds of students have been evaluated for symptoms of mental distress and referred for further care as officials have started more closely tracking students' mental health needs. According to a survey done through the school district in the spring, more than a third of the district's roughly 30,000 students and staff likely have clinical symptoms of depression, anxiety or PTSD.

The school district has also reported a handful of suicides of students' relatives since classes resumed, and more than a hundred students have been involuntarily examined under the Baker Act just through the school system, some as young as 6.

Fewer mental health providers

But already strained mental health services in the Panhandle haven't kept up with the load as providers, like many others in Bay County, have left. Those remaining have struggled with the influx of new cases and patients, and the school district still has not received any federal or state funding specifically for mental health needs related to Michael's impact.

As students and their families have struggled, their distress has emerged in painful ways. In one extreme case, three girls made a suicide pact, brought razor blades to school, then tried to cut their wrists open in front of classmates, according to a district report. In another, a kindergartener said his parents had talked about killing themselves in their home, and that he wanted to take his life, too.

"The current mental health crisis in Bay County is like nothing we have experienced before," officials wrote in a document summarizing the mental health needs in the school district late last month. "We have the real potential of falling into a full blown humanitarian crisis should another adverse event occur."

Increases in mental health needs after a natural disaster are widely documented. But it can often take several months -- as people begin to adjust to the "new normal" of disaster recovery -- for issues like depression, anxiety and PTSD to start to emerge.

"As time goes along, a lot of people are at the point where they're starting to feel hopeless," said Deborah Mobley, a local mental health professional who oversees one of the disaster counseling programs operating in the region. "How can we remain here without housing? How can we remain here without a job, or a job that pays enough to afford a home here in Bay County?"

Struggling school district

Bay County's schools were hit hard, too. Closed for nearly two months, nearly all campuses were damaged in some way. When most of the schools reopened -- four were permanently shuttered -- the district found more than 4,000 students never came back.

Teachers and staff have struggled to help students since classes resumed, said Ken Chisholm, the mental health team coordinator for Bay District Schools. Nearly 5,000 more were and still are homeless.

"We're seeing an increase in anxiety and depression-related problems," from absences from school to acting out, he said. "The issues are not anything more than you would expect to have happened after a Category 5 devastates the area."

Staff have been relying on an on-call mobile response team, funded by mental health dollars given to schools after last year's Parkland shooting, to evaluate more than 150 students who are experiencing mental distress, as well as a disaster counseling program aided by FEMA and state dollars canvassing throughout hurricane-affected counties.

But a shrinking pool of mental health providers has struggled to keep up with the increasing need for help, even just among children.

There are so few beds available in the region that some of the 125 students who have been Baker Acted since the storm have had to be sent as far away as Bradenton to be evaluated on a timely basis. Nearly a thousand Bay County students have been referred for more mental health services, but the district still does not have information on whether about 320 of those students, as of June 11, have continued receiving them. The shortage in staff and providers has meant some are still waiting for care, while others' records have been backlogged by the dearth of staffers who are able to keep track of cases.

That's to say nothing of the day-to-day problems faced by students whose families are still struggling. Some no longer have reliable transportation to seek help or keep appointments. Others have had issues with money or insurance to cover that care.

The widening housing crisis has pushed many clinicians and mental health professionals who used to live in the area to leave, sapping resources and staffing. Some local providers have reported losing about 30% to 40% of their staff since the storm, and many have struggled "just to maintain the services they're required to provide for people," Chisholm said.

Life Management, one of the major mental health providers in the area, has lost at least a fifth of its workforce after Michael, said Mobley, and recruitment has been challenging given the lack of affordable housing. About 70 percent of all housing in Panama City was damaged and destroyed, and rents in the area have soared up to fourfold. "All of the places are having trouble finding qualified staff. If you just look at our website and count the positions, it's overwhelming."

Requests for more aid

Bay school officials have lobbied lawmakers at the state and federal levels for months, but say they have still received no financial assistance that will help them fill their hurricane-related mental health needs. They need new clinicians to hire, support for case management services and additional tools and resources for the services they do provide.

The district estimates that it needs $30 million to put a licensed clinician and a support team on each school campus -- though it's unclear when or if they'll directly get such funding.

And with students now on summer break, some fear that their mental distress will only worsen as they detach from the regular routine and supervision they've had for months. The district is still providing food through some schools during the summer months, and local groups are arranging for summer camps, but many of the places children might gather -- the mall, movie theaters, parks -- are gone or scarred by hurricane damage.

"School was the one place that was consistent and safe. They knew they could go there every day, they knew someone would say hello to them every day, they knew they could get breakfast and lunch," said Cheri Wroblewski, a student services administrator with the county. "This is the time period right now where crisis is about to set in.

"During the school year, as teachers and educators, we have a good pulse on how our kids are -- we can watch patterns and behaviors and we can interject and see them all the time. My fear is over the summer they won't have that positive or aware person who has that pulse on their well being."

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