The Centers for Disease Control and Prevention reported in August that overall suicide rates in the United States increased by 2.6 percent from 2021 to 2022 — reaching an all-time high of 49,449 people — but decreased in youth ages 10-24 years old by 8.4 percent. While that news is encouraging, Johns Hopkins University researchers found gun suicide rates are rising and, for the first time, that the gun suicide rate among Black teenagers surpassed the rate among white teens. September is National Suicide Prevention Month and a good reminder to review what supports and resources local educational agencies are providing to their students.

Schools can play an integral role in suicide prevention, and can equip students with the coping skills, support and resources that stay with them even after graduation. The Orange County Department of Education — which leads the statewide implementation of California’s Multi-Tiered System of Support framework — has partnered with the Orange County Health Care Agency, Children’s Hospital of Orange County (CHOC), Western Youth Services and CalOptima Health to develop a plan to increase services and support for student mental health in all of Orange County’s 28 school districts.

This funding is available through the statewide initiative Student Behavioral Health Incentive Program (SBHIP), and CalOptima Health, the county’s only managed care provider, was granted $25.5 million to fund the partnership. Of that $25.5 million, the school districts will receive up to $10 million for various initiatives, including hiring additional behavioral health clinical staff, such as social workers, school counselors and school psychologists; enhancing training and development; and implementing electronic health record and billing systems.

Specific interventions that will be implemented are:

• Behavior health screenings and referrals — Enhance age and developmentally appropriate behavioral health screenings for adverse childhood experiences and other conditions, to be performed on or near school campuses, and build out referral processes in schools.
• Building stronger partnerships to increase access to Medi-Cal services — Build stronger partnerships between schools, managed care providers and county behavioral health plans so students have greater access to Medi-Cal-covered services.
• Technical assistance support for contracts — Ensure managed care providers execute contracts with county behavioral health departments and/or schools to provide preventive, early intervention and behavioral health services.
• IT Enhancements for Behavioral Health Services — Implement information technology and systems for cross-system management, policy evaluation, referral, coordination, data exchange and/or billing of health services between the school, managed care provider and county behavioral health department.

Up to $11 million will be allocated to interventions provided by Hazel Health, Children’s Hospital of Orange County and Western Youth Services that will be implemented in schools.

Hazel Health will implement a behavioral health telehealth platform that all Orange County students, regardless of insurance coverage, can access to receive behavioral health telehealth counseling services. CHOC will implement a variety of activities, including 10 new WellSpaces, which are sites at schools that offer quiet respite for students in need. In addition, CHOC will add staff to link schools and the hospital for in-person or telehealth mental health services. CHOC will also provide mental health services for students who are deaf or hard-of-hearing and an autism care program for students between the ages of 12 and 17. Finally, Western Youth Services will develop a behavioral health curriculum and train selected school staff on screening and early intervention strategies for behavioral health issues.

Jami Parsons, OCDE director of Learning Supports, cited data from the California Department of Health Care Services (DHCS), that found the repercussions of neglecting child and adolescent mental health issues can extend into adulthood. Studies have indicated that about half of all mental health conditions begin by the age of 14, yet many cases go unnoticed or untreated. Over the past decade, there has been a rise in hospitalizations and suicide rates among young people, leading to concerns of a youth mental health crisis in the U.S. Moreover, the unprecedented impacts of COVID-19, including stay-at-home orders, have exacerbated stress and anxiety among children and adolescents.

“We know that schools play a vital role in offering preventive and early intervention behavioral health services, given that students spend a significant amount of time in school,” Parsons said. “The DHCS notes that swift identification and treatment through school-affiliated behavioral health services can reduce emergency room visits, crises, inpatient stays and costly special education or out-of-home placements. Establishing collaborative partnerships across systems to improve access to behavioral health services within schools is essential for enhancing outcomes.”

SBHIP is a program that was created by Assembly Bill 133, signed in 2021, with the goal of removing barriers to accessing behavioral health services for students covered under Medi-Cal. The goal is achieved by implementing focused measures that enhance the availability of preventive, early intervention and behavioral health services. These services are offered by behavioral health providers affiliated with schools, specifically catering to TK-12 public school students.

OCDE also offers a host of suicide prevention resources on its website: bit.ly/44betx3.